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13.05.2019 Feature Article

The Physician Assistant Position; A Rew revolution

With physicians’ shortage looming ominously on the horizon, healthcare systems across the globe are awaiting a surge of eager young doctors to enter the field. Much to the dismay of these systems, it does not appear that there will be a collective sigh of relief in the coming years. Fortunately there still remains a promising position to fill the gaps and potentially overcome the growing inundation of patients, shortage of general practice physicians, and ever growing underserved rural populations: The Position of Physician Assistant (PA).

BACKGROUND
A physician assistant(PA) has been described as a licensed health professional who is trained using the medical model in order to perform an extensive range of both diagnostic and therapeutic services under the supervision of physicians. Accordingly, the PAs field of study focuses primarily on general medicine in primary care and hospital settings, enabling PAs to work across a broad spectrum of clinical positions. Similar in function to a nurse practitioner, PAs differ with respect to their level of specialization. The PA profession was created to expand the primary care workforce and address the shift of more physicians to specialty care Conversely, should a PA choose to enter the realm of specialty medicine, the skills they acquired through PA school serve as a foundation for extensive on-the job training to bridge the gap between the knowledge and skills required for general practice and those tailored to a more concentrated specialty practice. It is the expansive knowledge akin to the PA position that allows for such flexibility within a variety of healthcare settings.

PRACTICE CHARACTERISTICS
The role of PAs in the practice of medicine includes diagnosing, obtaining medical histories, performing physical examinations, ordering and interpreting diagnostic studies, providing therapeutic procedures, prescribing medications, and educating and counseling patients. clinical positions. PAs see a mean number of 70 patients per week, with some seeing over 100 patients per week in Ghana. PAs now have prescriptive privileges in all states, and approximately 98% report that they prescribe medications for patients with acute and chronic illness. On average, PAs work 40 hours weekly.

ROLE OF PA IN PRIMARY HEALTH CARE
Provision of effective primary health care is an important strategy in addressing the critical challenges of any health care system refers to first contact and ongoing care and is where most health problems are treated. Primary care physicians form the backbone of primary care provision; however, recent initiatives are promoting greater team-based care to address the challenge the nation experiences in finding physicians, as well as to respond to the growing complexity of care needs across the health care spectrum.

Physician assistants are medically educated clinicians who practice within a formalized relationship with physicians. Although educated and qualified as medical generalists, PAs receive additional education and experience on the job and can work in various practice settings. Unlike nurse practitioners, PAs are not independent practitioners; rather, they work under the license of supervising physicians, through a formal practice contract.

Physician assistants can substitute for a physician or complement the physician role (by taking over existing services or offering new ones) unlike those of their physician counterparts; however, PA’s practice patterns are relatively flexible. In fact, nearly one-half of PAs reported that they worked in a primary care specialty at some point during their career. PAs tend to practice in a variety of specialty areas over the course of their career; International research has demonstrated that PAs perform comparably to physicians on measures of quality and patient satisfaction, make positive contributions to productivity, and, in settings where they have been evaluated, provide cost benefits owing to their ability to substitute for physician services at lower cost.

FUTURE PA CONTRIBUTIONS TO THE WORKFORCE
PAs currently account for an appreciable percentage of the country’s primary care workforce. Allowed to work within their full scope of practice within a Physician-led inter-professional team. PAs fill an important role in the provision of primary care and specialty services.

PA’s education is shorter, which means they can enter practice more quickly with lower educational debt. Also, most programs have a generalist focus, which enables PAs to be more nimble, allowing them to move between primary care and specialty careers to meet evolving workforce demands. The capacity to respond quickly to new health care delivery systems is likely to become even more important as the need and demand for health care increases because of the aging population and expanding insurance coverage.

Given the projections related to the development of new PA programs, as well as increasing capacity of some existing programs, PAs are expected to continue to grow in number and be a major force in meeting the nation’s health care needs.

However, growth may be limited because of faculty shortages and decreasing availability of clinical training sites. It is important to note that these problems are not unique to the PA profession. Faculty shortages are well documented in the nursing profession and clinical training site shortages are emerging as a significant issue across the health professions, prompting a recent trend at some schools to provide payment for clinical training experiences and thereby creating a competitive environment across schools and programs.

THE FUTURE OF THE PA POSITION
Physician Assistants across the country have been received positively by patients who, in many cases, request PAs over doctors. Our education system continues to foster young programs with expansion to under-represented areas serving as a leading objective. The development of the PA role continues to propel forward and the PA workforce is expected to increase by 30% before the year 2020 as education programs move to establish gold standards of care in the field.

One thing in particular to look for in the coming years is the option or addition of specialized certification within the PA program, more so in the Ghana, where it is believed will provide a competitive advantage within the PA workforce and ensure higher standards of practice.

With the PA position constantly adapting to the ebb and flow of various healthcare, it will be interesting to see how the position evolves in the coming years. Presently, the PA position is indeed a convincing solution to healthcare issues in Ghana and many countries who have adopted the position

By Emmanuel Tetteh Siadey,
Physician Assistant Student,
Level 200,
University of Cape Coast.

Emmanuel Tetteh Siadey,
Emmanuel Tetteh Siadey,, © 2019

This author has authored 1 publications on Modern Ghana. Author column: EmmanuelTettehSiadey,

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