Written By: Jennifer Schlette MSN, RN
So, you know you want to pursue a career in the medical field, but you do not really know what path to choose. Have you ever thought about becoming a physician assistant? By 2029 this field is projected to grow 31%. That is pretty fast. It all sounds great, but there is still that lingering question, what does a physician assistant do? Well, I’m going to answer that for you. Let’s take a look at what your responsibilities and duties will be as a physician assistant.RECOMMENDED ONLINE HEALTHCARE SCHOOLS
The scope of practice of a Physician Assistant will depend on multiple factors. These factors include your education, experience, state laws of where you practice, your workplace’s policies, and your patient's needs. When it comes to your state’s laws governing your practice, your privileges can be different from state to state . The state will determine your co-signature requirements by a physician, your prescriptive authority, and how many PAs a physician can supervise or collaborate with, and what that arrangement will look like. In some states, the medical board will regulate your practice, and in other states, you will have your own PA regulatory board. In 47 states in the United States, the supervising or collaborating physician will determine your practice scope with consideration to the state’s laws.
The duties and responsibilities of the PA will change based upon which specialty you choose to pursue. Let’s take a further look into what will be expected of you based on the specialty you work in. The following are the most common specialties for Physician Assistants.
If you are interested in pursuing a career in anesthesia as a physician assistant, you will be performing thorough health histories of patients, performing physical examinations, initiating appropriate labs, radiology tests, or other special tests required for evaluation to develop a working diagnosis and treatment plan. You will be providing information to patients regarding anesthesia and pain management as well as answering any questions that they may have. As a physician assistant in anesthesia, some other responsibilities would be to educate patients on the peri-operative process, treatments, drug and treatment side effects, and hazards that could occur.
The duties of a physician assistant in cardiology will vary depending on the type of setting you may choose to work in. Regardless of the setting, the PA in cardiology can order and interpret tests, prescribe medications, diagnose an illness, assist in surgery, perform certain procedures, and manage treatment plans for their patients. If you choose to work in the inpatient or hospital setting, some of your most common responsibilities will be participating in rounds, performing consultations, completing the admission history and physical and preparing the discharge summaries. In the outpatient setting, your most typical responsibilities will include follow-up care on your patients, initiating and adjusting medications, new patient consults, and any education the patient may need.
you choose that you want to work in the world of dermatology, you will find yourself working in collaboration with a Dermatologist. In the world of dermatology, the physician assistant's responsibilities are just not looking at rashes all day. You will be part of a team and have the authority to diagnose and treat patients who have a wide array of skin, hair, and nail conditions. Some of these conditions that the patient is seeking care for may need a medical approach to remedy. Other conditions that the PA in dermatology may manage will require surgical intervention. You will also come across clients who are seeking cosmetic intervention for their condition. You would be treating these types of conditions in collaboration with your supervising physician.
Physician assistants have been playing a very important role within the emergency department since the 1960s. The typical physician assistant duties in the emergency department can range from triaging a patient, performing procedures to performing lifesaving measures. If the emergency department seems like the right fit for you as a PA, your daily responsibilities will include taking detailed histories, ordering therapeutic diagnostics, and prescribing medications, to name a few. Some of the procedures you may find yourself performing are laceration repair, casting and splinting, and thoracentesis. Of course, there are many other duties and responsibilities that you will have ownership of, but these are to give you an example.
If you decide that you want to pursue a career in ENT/otolaryngology as a PA, you will have the authority to diagnose and treat patients with a full range of conditions. These conditions and sometimes, injuries will be of the ear, nose, or throat. Through your history and exam, you will be able to diagnose, order diagnostics, and interpret them. You will have the authority to prescribe a treatment course for your patients. Some examples of procedures that you may be performing is mastoid cavity cleaning, cautery if needed in that nasal cavity, foreign body removals from anywhere in the ear, nose or throat, anterior nasal packing, excision or biopsy of and visible lesions, fiberoptic laryngoscopy, and nasal endoscopy and post-op debridement of procedural sites. You may also find yourself assisting the physician with procedures or certain diagnostics that are more complex. You will complete education and follow up with your patients. If a patient requires a referral to a different discipline, you will also assist the patient by making said referral.
The major duties of a physician assistant in the family medicine practice will be to provide care to both the adult and pediatric population. If you choose to work in family medicine, you will be responsible for your patients' day-to-day care. When a particular case warrants a more advanced perspective, it is the responsibility of the PA to seek guidance from their supervising physician. When you work in family medicine, you will find yourself performing assessments, diagnostics, and writing prescriptions. If a patient needs any minor surgical procedures, it would be in the practice scope for the family PA to perform such a procedure after consulting the supervising physician. Those patients who have comorbidities and who need management of their chronic illness will also be seeking your expertise. Other duties will include educating your patients about their illness or injury and how to manage these conditions.
What does a physician assistant do in general practice? Becoming a Physician assistant in general practice will lead you to attend to the non- severe problems of the patients while referring them to specialized care units or an internal physician if necessary. You will be determining the patients needed level of care alongside a physician to make the proper referral. You as the PA must perform a complete history and assessment to determine which course of action will be needed. For minor problems the patient is seeking care for, you will be treating based on your knowledge base and judgment.
As a Physician Assistant in Internal medicine, you will be working with adults ranging from healthy individuals to those individuals who have a complex medical history. You will also be accepting referrals from those in general practice since you have the knowledge base to care for the more complex patients. If you choose this type of career environment, you will find yourself providing care to your patients over the course of an extended period. You will be providing care to your patients in either an office setting or a hospital setting. Aside from obtaining the health history and physical on your patients, you will also be working with patients who possess one or many diagnoses, and you will work to manage and coordinate their care. In the inpatient setting, you will be able to perform certain bedside procedures, emergent and non-emergent, conduct bedside ultrasound interpretation, x-ray interpretation, and perform and interpret EKGs, to name a few.
Like all specialties that a physician assistant can work in, you are part of a team. That is no different for Neurology. You will be conducting the history and a very specialized assessment of the neurological system. Your findings will help you decide which specialized diagnostics will be indicated if any for your patient; upon completion of any diagnostics you ordered, you will also need to interpret those findings based on your knowledge and skills. The neurology physician assistant's responsibilities will vary greatly depending on the setting they are working in. As a PA in neurology, you will be assisting a neurologist and neurosurgeon in non-invasive and invasive procedures.
If you decide that you may want to explore the world of becoming a PA in obstetrics and gynecology , you may find yourself caring for a broad range of patients in both the inpatient and the clinic setting. The responsibilities of a physician assistant in OB/GYN in the clinic setting will include performing annual pelvic and breast exams, providing family planning services, and providing pre and post-natal care. You may also find yourself addressing infertility issues and gynecological conditions. In the inpatient setting, you will be performing diagnostics such as ultrasounds and fetal monitor strip interpretation. Some examples of procedures you could perform as a PA are colposcopies, cryotherapy, and internal monitor placement. When a patient is in need of a more advanced procedure, such as radical hysterectomy, you as the PA will be assisting the gynecological surgeon.
The responsibilities of a physician assistant in the discipline of radiology may have you working in MRI, CT, or interventional radiology. If you are a PA working in interventional radiology (IR), you will perform minor IR procedures. You would be assisting the Interventional Radiologist on the more invasive and complicated cases. You would be able to order radiographic protocols and interpret findings in CT and MRI. As a physician assistant in radiology, you can also administer medications via all routes, and administer fluids, blood, and blood products as needed. You will also find yourself writing progress and procedure notes and documenting the history and physical exams you obtained on your patient. You will also find yourself participating in radiology rounds and working as a team to help patients.
The physician assistant’s duties in pediatrics will be age-specific. When you provide care to those in pediatrics, you will be caring for those who are newborns to those who are young adults. Under the supervision of a physician, you will perform well and sick child visits in the outpatient setting. Well, visits will include the annual physical exams, screenings, and immunizations. During the sick visits you will assess, diagnose, and treat children seeking care for an illness or injury. Ordering additional diagnostic tests such as x-rays and prescribing treatment modalities such as physical therapy and writing prescriptions for medications will fall within your scope. Physician assistants in pediatrics could also find themselves working in the in-patient setting. Your duties and responsibilities in the in-patient setting may find you caring for children with simple, straightforward issues, or you may find yourself working with a specialty such as cardiology or caring for critically ill children.
A physician assistant who chooses the field of surgery will be an essential part of the team who will work in the peri-operative, intra-operative, recovery, unit-based, and outpatient areas. You will be providing diagnostic, therapeutic, surgical, and preventative care alongside a physician. In the office setting, the PA's role will be determined by the supervising physician but may include ordering post-operative labs and diagnostics as well as completing the post-operative assessment. In the hospital setting, a PA may serve as the 1st assistant in surgery. Post-operatively the PA can write orders, including therapeutics and medications. You will also complete the discharge process, such as writing summaries, prescriptions, and ensuring that the patient and their family fully understand the post-operative recovery, instructions, and follow up appointments.
Majority of the physician assistants work in Offices of Physicians (54%), General Medical & Surgical Hospitals (26%), Outpatient Care Centers (8%), and Colleges & Universities (4%). Let us take a deeper look at what a physician assistant does in each one of these work settings.
Offices of Physicians: What a physician assistant does in an office setting will be primarily dictated by what type of office you work in. It can be a general practice office or a specialty office. One thing that will remain constant is that you will first and foremost take the history, physical exam, and then devise a plan. You will be able to refer patients to other specialties if indicated or refer them for any type of diagnostic test. If you already work in a specialty area office, you may perform specialized exams or tests according to your specialty. For example, if you work in a neurology office, you may be performing a cranial nerve assessment. In contrast, if you work in the pediatric office setting, you may be administering vaccines and performing the lead test.
General Medical & Surgical Hospitals: If you choose to work in general medicine, keep in mind you will be working with a patient with minor, non-complex complaints. You could be performing physicals for work, or you may find yourself caring for a patient who has a minor injury and needs stitches. In a surgical hospital, your role will greatly differ from that of the role in general medicine. In a surgical hospital, you will be treating the surgical patient. Treating the surgical patient may include a pre-surgical assessment and education session. You may be working side by side with a surgeon helping them perform surgical procedures. Post-operatively your focus will be recovery and discharging the patient with all information pertinent to their recovery.
Outpatient Care Centers: In the outpatient setting, you, as the physician assistant, will be working in many different environments. Some outpatient settings could include women’s health where you will be performing annual exams or you could work in an addiction rehabilitation facility. The market where you can choose to work in the outpatient setting is truly vast. If a specialty physician is willing to supervise, then the PA could work in any discipline.
Colleges & Universities: There always has to be the next generation of physician assistants trained. For those who are interested and enjoy educating people, maybe working in a college or university is right for you. As faculty working in this environment, you will be providing aspiring physician assistants with didactic and clinical education. You will ensure that those striving to become a PA meet the competencies to complete this degree. If a PA chooses to go on for more specialized education, such as cardiology, you could provide them with the knowledge base to become a PA in cardiology.
The typical work hours for the Physician assistant will differ depending on where you choose to work. If you are working in the outpatient or specialty services, you will typically find yourself working Monday thru Friday 8-hour days. Taking calls on the weekends will be at the discretion of the supervising physician. In the in-patient setting, 8-hour days are possible but so are 12-hour days. The days you work in the hospital may include weekends, nights, and holidays.
So, what does a physician assistant do? Well as you can see, they are a vital part of the health care team. A physician assistant is so versatile that they can work in so many different specialties and settings. The physician assistant’s duties and responsibilities will be regulated and outlined by the state and the physician that is overseeing them. I know I just threw a lot of information at you but, now you have the information and tools to make an informed decision about your career path and if becoming a physician assistant is right for you.
To become a Physician assistant, most degree programs will require that you have at least two years of college concentrating in basic and behavioral sciences before being eligible to apply to PA school. Many programs will also require that you have some clinical healthcare experience. Some of the prerequisites that must be successfully completed are chemistry, anatomy, physiology, general biology, and microbiology. Once you have entered a PA program , you will typically take 26 months to complete it. Your coursework will include a didactic component as well as clinical rotations.
If you are interested in becoming a physician assistant, one major factor affecting the cost of education is if you live in the same state or a different state of the school you choose. In-state residents tend to get a price break on their education. In-state residents' median cost to attend a PA program is around $43,000 for a public program and topping out at around $76,000 for a private PA program. If you live out of state, you can expect to be paying around $77,000.
Regardless of which discipline you are thinking about going into after you complete PA school, it will be quite difficult to work during this time. PA school is a full-time rigorous program that will demand your full attention.
Once you have successfully graduated from a program, you will be eligible to sit for the Physician Assistant National Certifying Exam . If you successfully pass this exam and you maintain your certification by completing 100 hours of continuing education credits every 2 years and successfully pass your recertifying exam every 10 years, then you earn the title of being certified. All states will require that before you can practice, you become licensed. To become licensed, you must first graduate from an accredited program and pass your certification exam.
A physician assistant's job may be stressful depending on your patient and what setting you work in. As with all jobs, there may be moments of stress and moments of calm. It is how you deal with stress is what really counts. Suppose you do not do well with stress and do not like pressure; working in critical care is probably not a good idea. If you like calm, then maybe working in general medicine is more suitable for you. This does not mean that a PA working in general medicine won't have a stressful day. We all sometimes do.
Although there is an overlap between a physician and a physician assistant , there is still a vast majority of differences. First and foremost, the physician is responsible for overseeing the work of the PA. In general practice and primary care, you will not see the difference as much as you would in dealing in practice with those with more complex medical conditions. In education, the PA will attend a PA program after college, whereas a physician will need to go to medical school after college and then a residency program. The major difference in the physician and the PA will be in the level of autonomy. Remember, a physician does not need to be supervised, whereas the PA needs to be supervised by the physician.
When discussing the differences between a PA and NP , you first need to look at the type of education they have. An NP attends a Nursing school which is based on the values of a patient-centered model where they focus on disease prevention and health promotion. A PA attends a medical school or a medical center where they focus more on a disease-centered model. The disease-centered model focuses on the biology and pathology of a patient. NPs tend to specialize in an area where a PA is more of a general education. Both career choices can assess, diagnose, and treat their patients. One huge difference between the NP and PA is their authority to practice independently. An NP may have full practice authority and may not need a physician's supervision, depending on the state they choose to work in. A PA always needs to have some form of physician supervision.
Well, the short answer is No. All physician assistants do not make the same salary. Your salary will primarily depend on which specialty you choose. For example, a cardiothoracic PA will make somewhere around $125,000 a year. An emergency medicine PA can expect to bring home somewhere around $115,000 a year. Here you can see the top paid PA specialties .
Jennifer Schlette MSN, RN Jennifer Schlette is a registered nurse in pediatric critical care in New York City. She is the former Director of Undergraduate Nursing at a college located in New York. After obtaining her BSN from the College of Mount Saint Vincent, she went on to complete her MSN.