September 27, 2004
A: FROM MENTOR LESLIE WAITE IN CA
Hi Renee!
I work at a Medical Center, so I asked around about your question. It
turns out this is a much more complicated question than it appears!
Here is what I found out:

The duties of a physician's assistant (PA) are similar to that of a
nurse practitioner (NP). That is, they see patients, do basic workups
and diagnoses, and can sometimes work quite independently to provide
basic medical services to patients. While officially PA's and NP's
are under the supervision of a physician, they frequently work quite
independently, and a physician need not be actually present when they
see patients.

In both cases (PA and NP), if a patient has needs beyond basic care,
or diagnosis of more straightforward problems (such as say, a bladder
infection), then both PA's and NP's consult with or refer a patient
to a physician for further care.

Where things get complicated is that the duties and responsibilities
of PA's and NP's vary from specialty to specialty, and according to
each state's regulations. So a PA working as a primary care person in
a rural area where there are fewer physicians may have much more
autonomy and responsibility than one that works in a hospital
emergency room.

In some states, PA's and NP's can prescribe drugs (although it's not
called prescribing it's called providing or furnishing or something
like that). In California, they are even allowed to provide the more
serious drugs (like morphine for example). Different states have
different regulations concerning who can prescribe drugs, and which
type of drugs they can prescribe.

There are also some more subtle differences in what PA's and NP's do
versus what physicians do. If a patient needs long-term care or
surgery, a PA or NP will track everything that happens to that
patient throughout their care. They will communicate with all of the
patient's various doctors and other health care providers and make
sure that everyone is on the same page, including the patient. This
is something that used to be done by a patients general practitioner
(GP), but sometimes people don't have GPs or sometimes GPs aren't
given the time to do this level of care anymore. This type of
tracking and coordinating person is called a "hospitalist", and there
is a movement (started here at UCSF!) to make sure that all patients
have one so that medical mistakes and other problems are fewer and
patients get better care.

Finally a note about PA's versus NP's: the focus of training of a PA
is slightly different than that for an NP: PA's are trained more like
physicians, in what is called the disease model: here the focus is on
identifying and treating disease. NP's are trained more like nurses
(in fact, are nurses with additional training), where the focus is
more on health maintenance. They are more likely to focus on
lifestyle and nutrition changes. Both PA's and NP's are quite
capable, and one is not better than the other, it is just a matter of
what direction you approach the problem from, and how you think of it.

You can find out more about PA's and NP's at these sites:
PA's: http://www.skaggs.net/ChooseAPhysician/PA.htm
NP's: http://www.skaggs.net/ChooseAPhysician/NP.htm
or
http://www.dvc.edu/career/Career%20Sheets/nurse_practitioner.htm

Good luck!
Leslie
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A: FROM MENTOR KRISTIN TAGHON IN IL
Hi, Renee,

I found a great website by searching in www.google.com, using the words,
"physicians assistant duties". The following website was one of the links
returned.

http://www.bls.gov/oco/ocos081.htm

Check it out as it talks about Nature of the Work | Working Conditions |
Employment | Training, Other Qualifications, and Advancement | Job Outlook
| Earnings | Related Occupations | Sources of Additional Information

The intro says :

Significant Points

The typical physician assistant program lasts about 2 years and requires at
least 2 years of college and some healthcare experience for admission.
Most applicants to physician assistant programs hold a bachelor’s or
master’s degree.
Job opportunities should be good, particularly in rural and inner city
clinics.
Earnings are high.

It sounds like the main difference is what the state that you lives in has
laws on. ie - can a PA prescribe medications. 47 states and D.C. allow
it. Also, the PA needs to report back to a physician for every patient
worked on.

Kristin