Spotlight: What I Do As a Physician Assistant
In addition to doctors and nurses, there is a wide range of professionals who provide medical care to people on a daily basis. For example, a physician assistant usually has more time than a rushing physician to spend time with patients and provide care.
On the surface, this is an easily misunderstood role – becoming a physician assistant requires more education than a nurse, and you’ve likely seen or been treated with a PA and probably just assumed it was a physician. To find out what it means to be a paramedic, we spoke with three-year-old physician assistant Jordan Hall.
First of all, tell us a little about your current position and how long you have been in it.
My name is Jordan Hall. I am a Physician Assistant (PA) in Atlanta, Georgia. A PA is a federal and local licensed medical professional to practice medicine. My areas of practice include examining patients, ordering and interpreting tests, performing procedures, and diagnosing and treating pathology under the supervision of a hiring or sponsoring physician. I have been working for a little over three years. Before that, I went to school for about seven years, preparing for this career.
What prompted you to choose your career path?
Like many of my colleagues, I was drawn to medicine because of my closeness to science. I have always been interested in biology, chemistry and physics, so it was natural that I gravitated towards a profession based on these subjects. I didn’t know the profession until I attended the Physiology College Job Fair at the end of my undergraduate degree. Before the job fair, I was about to go to medical school, but what I learned at the fair piqued my interest. I contacted several of the doctors I followed, each of whom hired paramedics to see if I could come and see them at the clinic.
After my observations, I carefully researched the career. I was attracted by the wide range of opportunities after graduation, as well as the opportunity to devote more time to each patient and not to have a rushed schedule. In addition, I learned that I can do whatever I want in medicine as a PA: I can see and treat patients autonomously, prescribe medications within my practice, and participate in surgeries with my treating physician. After considering the costs and benefits, I decided it was the right choice for me and felt that it matched the quality of life I wanted.
How did you get a job? What kind of education and experience did you need?
Nearly all PA programs are 2-3 year graduate programs that require a bachelor’s degree for admission. Typically, admissions are based on the overall GPA undergraduate, GPA in basic sciences, and GRE / MCAT scores. There are pre-classes that are considered compulsory in every educational institution. These classes usually include organic chemistry, microbiology, genetics, and anatomy / physiology. Most applicants have a life sciences degree that meets the above requirements. Admission to the PA program is competitive, and admissions committees often require applicants to have a certain number of “hours of clinical practice.” Hours of clinical experience are earned by observing or working with healthcare providers in a professional setting. Clinically experienced candidates have a clearer understanding of the profession. Clinical experience requirements can vary from program to program from 200 to 5000 hours.
Do you need any licenses or certificates?
Upon completion of your professional degree from an accredited university, you must pass a national licensing exam: the National Physician Assistant Certification Exam (colloquially known as PANCE). Passing this exam is required to practice medicine as a PA. In addition, you must be certified in the state in which you practice through your local medical commission. Until recently, CBOs required national “recertification” every six years; however, recently this period has been increased to 10 years, so it meets the requirements of doctors. We also have to complete 200 hours of continuing medical education every two years.
What distinguishes a paramedic from a nurse or doctor? (I probably mistakenly assumed you were a nurse.)
Nurses are more limited in the decisions they can make without a doctor. Nurses are not allowed to diagnose and treat patients, order tests, or prescribe medications. In short, the nurse is not allowed to make any decisions about the patient without the permission of the doctor. A better comparison would be to a nurse practitioner who can also do the same. We have more training than a nurse and less than a doctor.
What are you doing besides what most people see? What do you actually spend most of your time on?
Nowadays, documentation is becoming the mainstream of medicine. Federal review commissions and private insurance companies have gone to great lengths to improve not only the completeness of the documentation, but also its quality. Documenting and dictation takes about thirty percent of my time. I spend about forty-five percent of my time in person with patients in a clinical or surgical setting, and the remaining twenty-five percent on medical research such as X-rays and laboratory results.
PAs can spend more time with the patient in the clinic than with the doctor, which I am always happy about, and to be honest, this is the aspect of the work that I enjoy the most. I like to educate my patients by discussing the more subtle aspects of the pathologies found. I believe this gives the patient a deeper understanding of their health. Doctors often do not have time for this kind of personal attention and patient education due to their busy schedules, which is why PAs take pride in this aspect of the work.
What misconceptions do people often have about your job?
The profession is still relatively young, and misunderstandings arise among people both inside and outside medicine. One misconception is that PA is still in school or studying to be a doctor. If I come across this delusion, I will not be offended. I reply by explaining that I have already spent a lot of time in school to become a PA and that I am a fully licensed healthcare professional who has received all the necessary training. I want my patients to feel comfortable knowing they are being looked after by a well-trained professional.
A second, more disturbing misconception is that a person becomes a PA due to the inability to go to medical school. This delusion usually manifests itself in the form of an overheard mocking remark. Unjustified and unconfirmed remark. The PA school is incredibly competitive due to its challenging academic and clinical workload. The enrollment rate is around three percent at most educational institutions (according to Yale , Duke and the GRU ) due to the small class size. Many of my classmates and I were accepted into medical school, but chose to continue at PA school instead. The misconception seems to be more common among older patients. My younger patients tend to have a better understanding of my profession, which I suspect is related to the increase in PA practitioners over the past decade.
What’s your average uptime?
The PA schedule depends on their individual situation and the needs of the practitioner and the attending physician. The schedule can be very flexible if needed. My typical work week is forty to forty-five hours.
What personal tips and shortcuts have made your job easier?
When I was a student redesigning pediatric cardiology, one of the students told me to “study as if you were a freshman for the rest of your life.” What I love most about medicine and science in general is that it is an ever-evolving environment. I continue to delve into research and lecture for professional and personal interest. I hope this profession attracts curious and motivated people, because this is what modern medicine needs. We live in an era of increasing availability of information, and providers must strive to keep up. But it’s so much fun for me! Strengthening the boundaries of the health sciences is how we, as a species, fight disease and benefit humanity.
What are you doing differently from your colleagues or colleagues in the same profession? What are they doing instead?
I am more tech savvy than some of my peers. I use technology all the time for educational and professional purposes. There are great applications for everything from drug interactions to illustrations that I show patients to explain pathology in detail. I am very interested in computer science and feel that the fusion of modern technology and medicine will bring amazing results in the healthcare sector. We have already made astonishing advances in laboratory methods, and I am thrilled to see results when the clinical side is undergoing a similar revolution.
What’s the worst part of a job and how do you deal with it?
I work in the field of orthopedics, so I have the misfortune to see some insidious metastatic disease and then I must reveal the diagnosis. This allows me to quickly see my personal problems and remind me how fragile our health can be. I’m not sure if this part of the job is for everyone. It is extremely difficult when I have to inform a patient that she has cancer when she came to me for back pain. I do my best to treat all patients as my friends. I do this because I hope that if someone I love was in such a situation, they would be treated with compassion and consideration for their illness. I try to follow the proverbial golden rule: treat others the way you would like them to treat me.
What is the most enjoyable part of the job?
Making a positive impact on someone’s life is the most rewarding part of the job. I hope that even the most cynical and haggard person in health care initially came into the profession to help others. Of course, these are not all happy times. I have stressful days, but a patient who truly appreciates your concern quickly clears up unpleasant memories.
What advice can you give to people who need to use your services?
I am sincerely pleased when a patient asks me a question about his health, because it shows that he is interested in participating. I would advise all patients to ask a few questions, ranging from clarifying the diagnosis or prognosis to preventive strategies. Don’t be alarmed. Medicine is very complex and it can be helpful to break it down into more understandable language.
Anyway; Please understand that while we are happy to answer a few questions, we also expect to see patients on a very tight schedule. I would recommend asking no more than two questions per issue. If you need more information, just ask about making another appointment for further discussion.
Also, avoid the following phrase at all costs: “I saw this from Dr. Oz and wanted your opinion …”
How much money can you expect at your job?
The salary range most commonly cited for PA from open sources is $ 95,000 to $ 150,000 per year. This number represents the national average. Wages will tend to be higher in large cities, however I suspect this is because I work in a narrow specialty in a large city, and there is a known discrepancy between narrow specialties and a wider career. In less populated areas and in family medicine, salaries will be lower. Experience and productivity also play a large role in wages, with wages increasing as experience and productivity increase.
How are you “progressing” in your field?
I believe that experience and clinical skill set are two ways of promoting PA. Understandably, as your skill set grows and you can take on more challenging tasks, you will be valued more and compensated accordingly. By clinical skillset, I mean procedures that you are competent to perform in addition to your ability to cope with complex medical situations. Plus, as your workload increases and you see more patients, you take the burden off your PCP, which is likely to be rewarded. Also, taking on administrative roles is a path that could be taken if they hadn’t been interested in formal practice for a long time.
What do your patients underestimate / overestimate?
I think patients overestimate the idea of a quick fix. So many people want immediate and permanent relief from pathologies that have taken years to develop, and that just won’t happen. We live in a society where delayed gratification has become obsolete, and unfortunately in medicine, you need to drop this myopic thinking. If I had a magic wand that instantly improved the condition of each of my patients, I would use it without hesitation, but we must do our best using what medicine has given us. If there was a scientist or physician who found a “cure” for arthritis, he or he would receive the Nobel Prize in Physiology. It would be a startling discovery that would change the course of medicine. It wouldn’t be something you could read about in a magazine advertisement or someone else’s blog. As my hero Neil de Grasse Tyson says, “there is no alternative physics,” and medicine is no exception. The treatment is either effective through a rigorous scientific process, or it is cheating. Despite what you might think, there are not many gray areas.
What advice would you give to those who want to become your profession?
I would say go for it! There are still many barriers to medicine, and it still has a “members only” façade for those who have not yet been indoctrinated. Don’t let a tricky set of required science courses or a tough MCAT exam get in the way of your desire. We need passionate and curious people to help care for our growing and aging populations. Whether you want to be RN, PA, NP, or MD, at the end of the day, the letters after your name will only be letters. Strive to be a competent, intelligent and responsive service provider and always keep in mind those who help you along the way.