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The Physician Assistant

The Physician Assistant profession has been in existence for thirty years but only in the last decade has the role come to the attention of the general public. The increased presence and autonomy of the Physician Assistant stems from the decreasing profitability from seeing patients. All Physician Assistants must have a supervising physician and an agreement that states what the PA may do under the Physician's supervision. In theory, this sounds like a plausible, effective and safe modality for increasing access to health care while controlling costs. There are several cracks in the foundation so to speak. First, PA education has become a profitable business in and of itself. While the establishment of a medical school requires meticulous care to plan, implement, fund and approve, the rollout of PA schools happens literally overnight with little or no regulatory oversight. The PA profession will argue that the ARC and NCCPA oversee this but in fact, the people who run these "regulatory" bodies are not medical professionals and the two organizations are not state or federal agencies. The state medical boards oversees medical education of doctors but superfluous organizations created by PAs and staffed with administrators (ie head of one group is former telephone company employee) are merely "rubber stamps." The real problem shows up when you look beyond the brochure on these PA schools.In a Medical School where doctors are trained, the faculty hold MD's or PhD's. In a PA school where PAs are trained, they faculty hold Bachelors or Associates degrees. If they have a Masters, it was done by mail order from a company in Nebraska. So, the classroom training of PAs is horrific. The bigger problem is the explosion of new PA schools and the increase in class sizes. College presidents know that PA tuition is 30,000 a year. Starting a new program of 100 students can bring in 3 million dollars annually. Hire a few part-time faculty who work ten hours a week and you have a nice profit center. However, the second year of PA school is "clinical." Because these new schools (and expanding schools) have no relationships with medical centers, the students cannot find suitable clinical sites for training. As such, they are often spending substantial portions of the "clinical year" sitting in their homes studying from books or going to sites that do not meet the requirements for certification. The schools are not properly regulated so the PA students are improperly trained and the schools are making enormous amounts of money. The only people who are hurt by this are patients. I am sure that this person who is identified with Kettering College of the Medical Arts (a vocational technical school in Dayton Oh) is a symptom of a widespread systemic problem with the growing utilization of Physician Assistants.


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