“What’s in a name? That which we call a rose
By any other name would smell as sweet.”
Romeo and Juliet (II, ii, 1-2)
Should the physician assistant title become physician associate?
Take the poll, then read the article to learn about the effort to make it happen, along with the pros and cons…
Shakespeare’s star-crossed lover struggled with titles just as the PA profession does. Unfortunately, Juliet lost that struggle in the end.
But would the PA profession have better luck? The jury is still out, but more PAs than ever working to do away with their dreaded title of assistant in favor of the less less subservient-sounding physician associate. (If you haven’t already, please check out my recent piece on the other PA name fiasco – physician’s assistant vs. physician assistant). But I digress…
I got an email several days ago from Matt Andersen, PA-C, one of the organizers of the new Physician Associate National Name Change Campaign, asking me to bring this topic up with our readers. It’s a topic I have long mulled over, and long avoided. It’s just as relevant to pre-PAs and PA students as it is to certified PAs and the lay public, but I’ve avoided it until now because I’m just not sure how I feel about it. Matt’s nudge pushed me other the edge, and I decided that rather than keeping my “check engine” light covered with duct tape, I should pull over take a look under the hood, so to speak.
Where the Physician Associate Idea Came From
There are many, including Mr. Andersen, who claim that physician associate was the term for PAs from the start, but from my research, this is not the case. The first PA program instituted at Duke University by Dr. Eugene A. Stead Jr. in 1966 was originally called a Physician Assistant program. Not until the early 1970’s was it known as a physician associate program. More important here, however, is that physicians soon demanded that the program change back to “assistants.” Either way, the title “physician associate” was not snatched at random by PAs who didn’t like being called assistants–at least not recently.
Mr. Andersen’s group argues that after nearly 50 years of the PA profession’s growth, the “assistant” word no longer fits, and here, he and I agree. Unfortunately, though it doesn’t burn my ears as much as “assistant,” the word “associate” means even less to me, so I have a hard time getting behind it.
No matter what your stance, if you want to become a PA, you should learn about this issue. You might be asked about it at a PA program interview, or while shadowing a doc.
Here’s a primer:
Best Arguments For Physician Associate
- Assistant” does not describe what PAs do. Most of the time, PAs–though supervised–work independently, and consult with a physician as they see fit.
- The public has trouble understanding the distinction between “physician assistant” and “medical assistant,” (a big distinction).
- Calling a medical clinician with a graduate-level education an “assistant” is demeaning. It does no justice to their advanced training.
- Other occupations use “associate” for professionals of lower authority, such as with associate deans, associate pastors, associate professors, etc.
There are other arguments, which I encourage you to read on the Campaign’s website, but in my opinion, these are the strongest.
Best Arguments Against Physician Associate
- Calling a PA a physician associate does not describe their functions, skills, or training any better than calling them physician assistant, and possibly worse. “Associate” means little more than “someone affiliated with,” or someone “connected with” someone else. We should not rename the profession with an even less specific term.
- These days, everyone is an “associate.” If you ask for help at Walmart, you will get it from a Walmart “Associate.” If you buy a used car, you are helped by a “sales associate.” “Associate” implies an effort to elevate one’s job status by using a euphemism (i.e. “sanitation associate” for garbage man). We should not hold ourselves out as something we are not. Doing so make the public more suspicious, not less.
- It has taken long for the public to understand the role of a PA. It’s unwise to change the name now that the message is starting to sink in.
- There are other terms which might better serve the purpose without galling physicians, insulting PAs, or confusing the public. Examples: mid-level-clinician, mid-level provider, and physician extender (which does describe what PAs do).
Why Physician Associate will be an uphill battle
Probably the biggest barrier to the acceptance of the term physician associate is physicians. They are represented by the American Medical Association (AMA), a political juggernaut that defends its turf with the congressional lobbying money that comes from living at the top of the food chain. For example, since 1990, the AMA has successfully prevented 12 states from allowing Ph.D. psychologists from earning the privilege to prescribe (psychiatric) medications.
The current name change campaign aims to float “physician associate” as only a “cosmetic” change, meaning that it does not change the PA scope of practice. It remains to be seen if this tactic will work.
So keep your eye on this one. As with Juliet, there’s far more than a name at stake here.