What Kinds of Things Can A Physician Assistant Really Do?

Are you considering applying to physician assistant schools but are unsure about just what you’ll be able to do as a PA? It’s understandable – the profession is young, and even though it’s growing rapidly, you may not have even been treated by a PA before. So what types of activities do the different kinds of PAs do? Here’s a partial list:

The More Common Physician Assistant Specialties

• Primary Care. Primary care refers to working as the first contact for those who need help with health related problems and preventive care. PAs in primary care do physical exams, see patients who are sick with everyday illnesses (viruses, diabetes, high blood pressure, rashes, etc.), and provide ongoing care. They order tests, make diagnoses, and prescribe medications, and usually work in a doctor’s office or a health clinic. Primary care is the most common work area for PAs, particularly since its demand is high, and the supply of primary care physicians is high.
• Surgery. PAs are the first assistants in surgery, even before other surgeons. Surgical PAs usually perform some surgical procedures on their own (putting in chest tubes, central lines, doing lumbar punctures, etc), and help cut, clamp, retract and close with a surgeon/anesthesiologist/nursing team.
• Emergency. PAs in the emergency room are used to see patients who are generally more stable, who need help with uncomplicated ailments, and perform procedures like suturing and wound care, treating colds and other infections, sprains/strains, medication refills, rashes, etc.) Depending on the hospital, PAs may also do more advanced procedures, like putting in breathing tubes, surgical drainage tubes, starting central IV lines, and treating major emergencies as part of a doctor/nurse/PA team.
• Orthopedics. Aside from assisting a doctor with surgeries on broken hips and other bones as above, orthopedic PAs help reduce dislocated bones, make and remove casts, and perform live imaging procedures like fluoroscopy.
• Psychiatry. Mental health work involves interviewing patients who are in mental distress, are suicidal, depressed, or suffering from dementia. Prescribing medications and giving “depot” shots of long-term medications to patients with major mental illnesses.  They also order relevant labs (lithium levels, blood tests, urine toxicology screens, and the like).
• Hospital care (Inpatient Medicine). PAs in the hospital may work as “hospitalists,” which means they are responsible for evaluating and treating patients who have been admitted to the hospital (inpatients). These patients are generally quite ill and require close monitoring and extensive care.

For all of these specialties, physician assistants answer to a licensed physician who is generally accessible on the premises. The doctor need not be in the room actually watching what a PA does, but they must be available for consultation if the PA requests it. If a particular patient has a complex or challenging problem, the physician may choose to get involved, check in with the PA, or even take the patient off the PA’s hands.  Much of this depends on the PAs level of comfort with each case and experienced.  If seeing patients on your own makes you nervous, you should know that an important part of PA education is learning when to get the supervising physician involved, because if you become a PA, that decision is usually your call.

There are many other specialties that use PAs, and the demand in all of these depends on the needs of the medical facility and the community in which it resides. As an estimate, PAs can do about 80% of the work a physician does.