Physician assistant misconceptions

There are plenty of misconceptions about physician assistants.

The newness of their field naturally leads to a number of misconceptions about physician assistants.  If you’ve never met a PA or been treated by one, you’re left to guess what it is that PA’s do, and sometimes these guesses (though understandable), are just plain wrong.  Hoping to dispel some of these, I’ve made up a list of the more commonly held misconceptions about physician assistants.  Hopefully it will be helpful both for those who are starting to research the field and for those who already know a few things about it.  If you have others, please let me know.

Misconceptions About Physician Assistants

  1. “Physician Assistants are assistants to doctors.”  With the poorly chosen name that our field has lived with for nearly 50 years, this one is easy to understand.  It turns out though, that PA’s are only truly assistants to doctors in the area of surgery, by being the lead assistants in surgery, even before other surgeons.  It’s important to note, however, that surgical PA’s do plenty of work on their own, including rounding on patients before and after surgery, doing bedside surgical procedures in the hospital such as inserting chest tubes and central lines, and seeing patients in the office.  As for non-surgical PA’s, the vast majority work nearly independently, and consult with their supervising doctor when they feel they need to.
  2. “Physician Assistants don’t prescribe.”  False.  State regulations vary, but for the most part, PA’s prescribe medications as any doctor does.  In some states the term is “furnish,” or “dispense” (when medications are given directly to the patient by the provider, as with samples), but these are minor distinctions.  You should know, however that when a PA writes a prescription, he/she does so as an agent of the supervising physician, and in most states the physician’s name must appear on the prescription form too.
  3. “Physician Assistants don’t prescribe narcotics.”  Taking #2 a step further, PA’s can prescribe controlled (scheduled) medications, such as opiates like Percocet, morphine, and Fentanyl.  In most states the PA must obtain a separate DEA registration to do so.  Some choose to practice without it, which means that they can’t prescribe these types of drugs, but the vast majority of PA’s, for the sake of convenience, do choose to get their own DEA registration number.
  4. Physician Assistants work under the doctor’s license.  Actually, PA’s are certified nationally (by passing a national exam, the PANCE), and licensed by the state in which they practice.  What’s the difference?  A license is a credential that allows one to practice (effectively) permanently, so long as one pays the professional fees and does regular continuing education.  PA certification is a more temporary credential that must be renewed by retestingPhysician assistant certifications must now be renewed every 10 years.  This means that every ten years, a PA must pass a recertification exam (the Physician Assistant National Recertifying Examination, or PANRE) that proves he/she is still proficient.  There are also certification exams for different PA specialties.  This is all in addition to paying annual professional fees and performing continuing medical education (CME’s).  In California, for example, PA’s must do 100 hours of CME’s every two years.  Though it’s a hassle to keep having to prove you know your work, the recertification process is a good thing.  It lends credibility to the field as a whole – PA’s must keep their knowledge up, or they can’t practice.
  5. Physician assistants don’t specialize.  Cue the buzzer – false again.  PAs specialize in pretty much every area of medicine.  About 36% of PA’s work in primary care, with the other 64% working in surgical, ER, and subspecialty areas, such as dermatology or rheumatology.
  6. “Physician assistants don’t order or interpret labs or imaging studies.”  In truth, PA’s order and interpret labs and imaging studies (x-ray/CT/MRI etc.) just as any physician does.
  7. Physician assistants provide inferior care compared to physicians.  This is very hard to measure experimentally, but the research does show that PAs aren’t sued for malpractice any more often than physicians, and the judgments from lawsuits against PAs aren’t any larger than those against physicians.  In terms of patient outcomes, the research shows us consistently that PA’s, NP’s, and MD’s are all about equal.
  8. Physician assistant isn’t a satisfying job.  Actually, the vast majority of PA’s say that they are very satisfied in most areas of their work, such as their pay, feeling that they matter, and liking what they do.  The one area where they consistently show somewhat lower satisfaction is their workload, much like physicians.  The satisfaction scores are higher for PA’s in the area of workload than for doctors, however.
  9. Physician‘s Assistant.  It’s physician assistant – no apostrophe-s!
  10. Physician Assistants don’t get sued for malpractice.  In any malpractice lawsuit, the plaintiff usually sues everyone who was involved with the patient’s allegedly improper care.  This is no less true for physician assistants.  On rare occasions, physicians can prove that they provided adequate supervision, despite the PA’s negligence, and therefore escape the malpractice judgment.  But most often, is a PA is named in a lawsuit, the PA and the MD either win or lose the lawsuit together.
  11. Physician assistants all wish they could be doctors.  Sorry, but it just aint so.  Of course, there are some who would prefer to become physicians.  But the vast majority chose to be PA’s because that’s what they preferred – because it can offer more life balance, provide more time with patients, is in keeping with debt-free living, or a hundred other reasons.  Don’t believe me?  Go talk to a few PA’s, and you will.

There are plenty more misconceptions about physician assistants.  Can you think of one we’ve missed?  Leave a comment to let us know!