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Physician Associate

 

Any physician assistant or student who has been practicing for a short time has had the experience of, “I don’t want to see the assistant” from an ornery patient. During a busy clinic day, taking a few minutes to explain to the patient that we are not assistants, but rather collaborating providers, can seem like a tall task. As a result, many clinicians have asked the question about a physician assistant name change and it makes us wonder, what should PA stand for? Many options have been put forth, but the debate has rested with physician assistant vs. physician associate.

During my career as a PA, I have probably heard it all. Any type of derogatory or innocently phrased question that isn’t meant to hurt, but does. “When is the doctor coming in?”, “when are you going to be done with your schooling?” or “Can you even prescribe medication?” There are many questions that one might field during a routine day in the clinic, all of which stem from a complete and utter misunderstanding of what we do as clinicians.

Responding to these remarks

If you have been practicing medicine for some time, you probably have an off the cuff response that quickly quells the patient’s concern. My usual response is to challenge the patient, asking them a simple question: if you walked into this room, not knowing anything about my background, training or education, how would you know whether I am a PA, NP, or MD? The answer is, you wouldn’t! This usually stumps the patient and then by the end of the visit, I have used my patient care skills, compassion, empathy and diagnostic skills to blow the patient out of the water, all while not getting upset about their misunderstanding of our profession.

The term “Assistant”

At the same time, I do try to take a step back many times, for I really can not blame the patient. When I started researching career options years ago, my initial reaction was, this seems confusing. The term assistant has been our Achilles’ heel since the inception of our profession, because it is a tremendous misnomer. In my practice, our entire office of PAs, NPs and MDs, work collaboratively and we are all on equal levels. Behind the scenes, it would be difficult for patients to see this, because they assume the almighty doctor makes all the calls and authorizes our prescriptions with an iron staff, like Moses parting the Red Sea.

Our name is a misnomer

As a result, our profession has been in somewhat of a limbo. If patients are not able to understand what our role is, but are continuing to seek care and prefer care from us, then what do we do as a profession? On one hand, there are still many geriatric patients who do not understand our role and transfer care because they “prefer an MD”, but at the same time I have countless patients who would delay their own care in order to see me as their provider as opposed to seeing one of the other providers in our office based on the rapport we have built over time.

Proposals for Name Changes

There have been many proposals for a name change over the years, many of which have made sense and some of which have not. As a result of this, there has been confusion among students and clinicians as to where our profession should move in the future. As time goes by, more and more patients are very familiar with who we are as clinicians and what we do, so the question begs, is it already too late for a name change?

 

The Physician Associate

As we have discussed above, one of the more popular options that has been put forth is that of the physician associate. In some particular cases, places have already adopted this on their own. The AAPA has been slow to make recommendations on this and to give advice for the future. The most known proponent of the physician associate is that of the Yale School of Medicine, who has actually adapted and adjusted the name of their program, not to include physician assistant but to move forward with physician associate. Occasionally, when I am looking for a provider’s information to make a referral, I will see a specialty office list their providers as physician associates, which always seems to give me pause to think more about the future of our profession.

What should be done moving forward?

The answer is not obvious and difficult to comprehend. Each provider, student and practitioner may have a different take depending on experience and preference. For me, I think that the answer is layered and difficult to wade through. On the one hand, the moments where a patient asks about the profession or transfers care because they “don’t want to see the assistant”, well those are very challenging. At the same time, I worry about yet another name change or another name introduced into the many terms and professions already listed in the realm of the profession of medicine.

Moving forward, what we can do as physician assistants is to impress our patients with our skills and compassion. At the end of the day, the letters after your name or the title you possess matter far less than the impact your compassion and caring nature has on your patients.

 

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