Physician Assistant – A Scope of Practice

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If you are trying to decide if working as a physician assistant is the right career for you, it is helpful to understand a PA’s scope of practice. Although the American Academy of Physician Assistants developed guidelines and regulations for PA’s, they also allow individual states to regulate a physician assistant’s practice. It is also important to understand the PA profession is always evolving, and their scope of practice may change in the future. Below are answers to some common questions involving physician assistants.

Can PA’s practice independently?

Physician assistants cannot run their own practice. They have to work under the supervision of a physician. Many states allow physicians to determine exactly what constitutes supervision.  Supervision may involve co-signing orders. In other cases, doctors have developed written protocols, which dictate procedures to follow.

What type of procedures can PA’s perform?

According to the American Academy of Physician Assistants, 35 states allow the practising physician supervising the PA to determine scope of practice. The theory is the doctor working with the physician assistant knows their skill level and can decide what the PA can do and not do.

The type of procedures a physician assistant can do also varies by the type of practice they work in. For example, PA’s who work with a pulmonologist may perform intubations, which involves inserting a breathing tube in a patient’s airway. Physician assistants working in the emergency room may perform emergency procedures, such as inserting chest tubes.

Do doctors have to be onsite with a PA?

The majority of states allow a physician assistant to work without a doctor on site. The PA still works under the direction and supervision of a doctor, but the physician may be off site. For instance, a PA who works in an urgent care clinic may not have a doctor onsite, but may have access to a doctor if needed.

Are physician assistants allowed to do surgery?

If the doctor the PA is working with determined a physician assistant can perform certain surgical procedures, the PA is allowed.to. In general, physician assistants may take on more of an assistant role during surgery. In general, surgeons will perform complex procedures. PA’a will perform preoperative care and care for the patient after the procedure while they are recovering.

Do PA’s have to go through a residency similar to a doctor?

There are PA residencies, which are optional after completing a physician assistant program. A residency can provide a PA with additional training in the specialty they plan to pursue. While a PA residency can be beneficial it is not required.

Is additional training required if a PA changes specialties?

A physician assistant is not required to go for additional training if they want to work in a different specialty. For example, a PA who works in the emergency room is not required to obtain additional training if they want to work in family practice.

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