Addressing Misconceptions about the Physician Associate/Assistant Profession
Main Article Content
Abstract
The Physician Associate/Assistant profession has recently experienced attacks seeking to malign the extensive positive contributions made to patients and healthcare systems for over 50 years. The myopic view of some of these critics that only a physician is qualified to lead healthcare teams is not based on evidence in many cases but misconceptions about the training and experience of physician associates/assistants. In fact, when comparing a physician associate/assistant and a physician with the same number of hours of clinical experience, patient outcomes are similar. The purpose of this paper is to systematically analyze the statements being propagated and provide scientific data that categorically refutes these statements. Addressed are issues of education, clinical training, medical malpractice liability concerns, changing provider numbers, and expanding scopes of practice to meet healthcare needs worldwide.
Keywords:
Physician Associate Profession, Physician Assistant Profession, Misconceptions in Healthcare, Clinical Training, Healthcare Team Leadership, Patient Outcomes, Medical Malpractice Liability, Scope of Practice, Healthcare Needs, Comparative Clinical Experience
Article Details
How to Cite
KILGORE, James R. et al.
Addressing Misconceptions about the Physician Associate/Assistant Profession.
Medical Research Archives, [S.l.], v. 12, n. 6, june 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5545>. Date accessed: 02 july 2024.
doi: https://doi.org/10.18103/mra.v12i6.5545.
Section
Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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7. Who is able to apply for PANCE? Accessed April 11, 2024. https://www.nccpa.net/become-certified/#pance-faqs
8. Certificates of Added Qualifications (CAQs). Accessed April 11, 2024. https://www.nccpa.net/specialty-certificates/#specialty-faqs
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13. Data Analysis Tool. The NPDB – Data Analysis Tool. Date Unknown. Accessed October 25, 2022. https://www.npdb.hrsa.gov/analysistool/
14. DePalma SM, DePalma M, Kolhoff S, Smith NE. Medical Malpractice Payment Reports of Physician Assistants/Associates Related to State Practice Laws and Regulations. J Med Regul. 2023; 109(4), pp.27-37.
15. The National Academies of Sciences, Engineering, and Medicine. Implementing high-quality primary care: Rebuilding the foundation of health care. The National Academies Press; 2021.
16. Adams EK, Markowitz S. Improving efficiency in the health-care system: Removing anticompetitive barriers for advanced practice registered nurses and physician assistants. The Hamilton Project; Published June 2018. Accessed December 12, 2023. https://www.hamiltonproject.org/assets/files/AdamsandMarkowitz_20180611.pdf
17. US Department of Health and Human Services, US Department of Treasury, US Department of Labor. Reforming America’s healthcare system through choice and competition. Published 2018. Accessed December 12, 2023. https://www.hhs.gov/sites/default/files/Reforming-Americas-Healthcare-System-Through-Choice-and-Competition.pdf
18. Altarum. Provider scope of practice: expanding non-physician providers’ responsibilities can benefit consumers. Published November 2017. Accessed December 13, 2023. https://www.healthcarevaluehub.org/application/files/6715/9130/2949/Hub-Altarum_RB_21_-_Provider_Scope_of_Practice_Update.pdf
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20. Medicare Payment Advisory Commission. Report to the Congress: Medicare and the health care delivery system. Published June 2019. Accessed December 12, 2023. https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/jun19_medpac_reporttocongress_sec.pdf
21. Mafi JN, Chen A, Guo R, et al. US emergency care patterns among nurse practitioners and physician assistants compared with physicians: a cross-sectional analysis. BMJ Open. 2022;12(4): e055138. 2022 Apr 20. doi: https://doi.org/10.1136/bmjopen-2021-055138
22. Morgan PA, Smith VA, Berkowitz TSZ, et al. Impact of physicians, nurse practitioners, and physician assistants on utilization and costs for complex patients. Health Aff (Millwood). 2019 June;38(6):1028-1036. doi: https://doi.org/10.1377/hlthaff.2019.00014
23. Johnson D, Ouenes O, Letson D, et al. A direct comparison of the clinical practice patterns of advanced practice providers and doctors. Am J Med. 2019 Nov;132(11): e778-e785. doi:https://doi.org/10.1016/j.amjmed.2019.05.004
24. Valentin VL, Najmabadi S, Everett C. Cross-sectional analysis of US scope of practice laws and employed physician assistants. BMJ Open. 2021; e043972. doi: https://doi.org/10.1136/bmjopen-2020-043972
25. Timmons EJ. The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care. Health Policy. 2017 Feb;121(2):1 89-196. doi: https://doi.org/10.1016/j.healthpol.2016.12.002
26. McMichael BJ. Supply-side health policy: The impact of scope-of-practice on mortality. J Public Econ. June 2023;222. doi: https://doi.org/10.1016/j.jpubeco.2023.104901
27. Brock DM, Nicholson JG, Hooker RS. Physician assistant and nurse practitioner malpractice trends. Med Care Res Rev. 2017 Oct;74(5):613-624. doi:https://doi.org/10.1177/1077558716659022
28. Wang F, Krishnan SK. Medical malpractice claims within cardiology from 2006 to 2015. Am J Card. 2019 Jan;123(1):164-168. doi: https://doi.org/10.1016/j.amjcard.2018.09.008
29. Hooker RS, Moloney-Johns A, MacFarland M. Patient satisfaction with physician assistant/associate care: An international scoping review. Hum Resour Health. 2019; 17(104): 1-11. doi: https://doi.org/10.1186/s12960-019-0428-7
30. Dill MJ, Pankow S, Erikson C, Shipman S. Survey shows consumers open to a greater role for physician assistants and nurse practitioners. Health Aff (Millwood). 2013 June;32(6):1135-1142. doi:https://doi.org/10.1377/hlthaff.2012.1150
31. The Harris Poll. The patient experience: Perspectives on today’s healthcare. Published 2023. Accessed December 12, 2023. https://www.aapa.org/download/113513/?tm stv=1684243672
32. Robeznieks A. Inside the AMA’s wide-ranging fight against scope creep. American Medical Association. Published June 13, 2022. Accessed May 2, 2004. https://www.ama-assn.org/amaone/ama-recovery-plan-america-s-physicians-fighting-scope-creep?utm_effort=DAPSRH&utm_effort=DAPSRH&gclid=CjwKCAjw88yxBhBWEiwA7cm6pXXyt_1TTK4aGcYBlF4qhdPVB77RYSrDcd9ftpvRcA96YKaEcXRL_hoC-moQAvD_BwE
33. Crowell A, Kraus EJ, Thompson TE. Debate continues around scope of practice expansion for APPs. The National Law Review. Published December 1, 2022. Accessed December 12, 2023. XII (335). https://www.natlawreview.com/article/debate-continues-around-scope-practice-expansion-apps
34. AMA unveils Recovery Plan for America’s Physicians. AMA website. June 10, 2022. Accessed May 2, 2024. https://www.ama-assn.org/press-center/press-releases/ama-unveils-recovery-plan-america-s-physicians
35. Standards of Accreditation for Schools of Medicine. Accreditation Commission on Colleges of Medicine website. Published 2024. Accessed May 2, 2024. https://accredmed.org/standards/
36. AAPA Common Questions. What is included in the PA School Curriculum? AAPA website. https://www.aapa.org/about/what-is-a-pa/
37. Kilgore, James R. DMSc, PhD, PA-C, DFAAPA. Working together to address the healthcare provider shortage. JAAPA 36(8):p 9-10, August 2023. | DOI: 10.1097/01.JAA.00 00944628.63922.0c
38. Hooker, Roderick S, Christian RL. “The changing employment of physicians, NPs, and PAs.” JAAPA. 2023; 36: 32 - 37.
39. American Association of Nurse Practitioners. NP fact sheet. Accessed June 2, 2023. www.aanp.org/about/all-about-nps/np-fact-sheet.
40. American Association of Colleges of Nursing. 2021-2022 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing Graduate Nursing. Washington, DC. Accessed April 14, 2024 https://www.aacnnursing.org/news-data/all-news/data-spotlight-a-closer-look-at-enrollment-and-graduation-trends
41. US Bureau of Labor Statistics. Occupational employment and wage statistics. USBLS website. Accessed April 14, 2023. www.bls.gov/oes/tables.htm.
42. Wiesen K. 27 States Where Nurse Practitioners Can Practice Independently – 2023. NursingProcess.org website. Accessed April 15, 2024. https://www.nursingprocess.org/states-where-nurse-practitioners-can-practice-independently.html
43. Gustafson K. Nurse Practitioner (NP) Practice Authority By State & Scope of Practice. NPSchools.com website. Accessed April 15, 2024. https://www.npschools.com/blog/practice-authority#:~:text=Nurse%20practitioners%20who%20have%20completed%206%2C240%20hours%20of,may%20apply%20for%20a%20Full%20Independent%20Practice%20Credential
44. AMA Advocacy Center. State Law Physician Assistant Scope Practice. American Medical Association website. 2018. Accessed April 15, 2023. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/arc-public/state-law-physician-assistant-scope-practice.pdf
45. DeCapua M, Smolko B, et al. In What States Can Physician Assistants Practice Independently? Barton Associates. June 8, 2023. https://www.bartonassociates.com/blog/physician-assistant-pa-independent-practice/ accessed April 15, 2024.
46. McChee M. 2023 State by State Scope of Practice: Physician Assistant. Healthcare Hiring Hub. 2022. Accessed April 15, 2024. https://hire.vivian.com/blog/2022-state-by-state-scope-of-practice-physician-assistant
47. Jividen S. Full Practice Authority for Nurse Practitioners by State. Nurse.org website. March 22, 2024. Accessed May 5, 2024. https://nurse.org/education/np-full-practice-authority/
48. Tine Hansen-Turton et al. Nurse Practitioners in Primary Care. 2020; 82 TEMP. L. REV. 1235, 1245. accessed May 5, 2024. URL: http://www.temple.edu/tlawrev/
49. Andrea Reino. New Mexico: An Expansion of Scope of Practice Model, 23. Ann Health Law, 2013; ADVANCE DIRECTIVE. 2013; 185, 196.
50. Waxman S, Dechene J. Expanding the Scope of Practice for Nurse Practitioners and Physician Assistants to Enhance Healthcare, 33 Annals Health L. 2024; 101.
51. US Bureau of Labor Statistics. Occupational employment and wage statistics. Accessed April 25, 2023. www.bls.gov/oes/tables.htm
52. US Bureau of Labor Statistics. Occupational Outlook Handbook. Physicians and surgeons. Accessed April 25, 2023. www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm
53. US Bureau of Labor Statistics. Occupational Outlook Handbook. Fastest growing occupations. Accessed April 25, 2023. www.bls.gov/ooh/fastest-growing.htm
54. Anderson GF, Hussey P, Petrosyan V. It's still the prices, stupid: why the US spends so much on health care, and a tribute to Uwe Reinhardt. Health Aff (Millwood). 2019;38 (1):87–95.
55. Hedden L, Barer ML, McGrail K, et al. In British Columbia, the supply of primary care physicians grew, but their rate of clinical activity declined. Health Aff (Millwood). 2017;36(11):1904–1911.
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