1. The Physician Assistant Profession
Randy D. Danielsen, MPAS, PA-C
Associate Professor & Chair
Department of Physician Assistant Studies
2. The Concept of Assistants to
Physicians
The Russian Feldsher 17th and 18th Century
Introduced in the military by Peter the
Great
Retired from military into rural communities
By 1913 there were 30,000
By 1976 90% of feldshers were female, and
25% of Russian physicians were previously
feldshers
3. The Concept of Assistants to
Physicians
1930 - US. Federal Prison System trained
former military corpsman on the job to
extend services of correctional physicians.
1961 - Charles Hudson, MD proposes training
assistants for the primary care physician at an
American Medical Association conference.
They were somewhat less than receptive!
But 30 years ago is a long time.
4. Thirty Years Ago (In Perspective)
Medical education was based on the
following paradigm:
start with a sound liberal arts
background (4 years) and then,
learn the basic sciences in-depth,
then normal structure and function and
finally pathophysiology with clinical
correlation.
5. Thirty Years Ago (In Perspective)
Military corpsman were learning many
medical skills without a liberal arts
background or a formal basic science
knowledge; yet applied those skills
during the Vietnam War very
effectively.
Many skills could be taught without a
significant basic science background.
6. The Beginning, Thirty Years
Ago Circa 1960 - 1965 Duke University
Eugene A. Stead, Jr., MD
originally suggested
extending capabilities of
nurses at Duke Hospital
This was opposed by the
National League of Nursing
Duke Hospital was
experiencing a shortage of
Nurses
Duke Department of Plastic
Surgery used fireman and
ex-corpsman to staff the
burn unit.
7. Thirty Years Ago (In Perspective)
Stead and E. Harvey Estes, MD create a
24 month curriculum combining basic
science and clinical medicine at Duke
University.
This is the first time in American History
that someone other than physicians
officially share the knowledge base of
medicine!
8. Thirty Years Ago, or so...
1963-Four ex-Navy corpsman start the Duke
PA Program.
Henry Silver, MD and Loretta Ford, RN (Univ.
of Colorado) start a Pediatric Nurse
Practitioner Program (that becomes the Child
Health Associate Program).
Richard Smith, MD starts the MEDEX program
in the State of Washington
9. PAs and NPs
What is the difference?
Medical versus Nursing model
Dependence versus Independence
10. General PA Program
Information
1999 - 120 accredited PA Programs
35,782 graduates
55% programs offer Baccalaureate
degree or degree option
40% programs offer Masters Degrees
05% programs offer Certificate or
Associate degree
11. PA Program Applicants - 1996 AAPA Survey (n=2,269)
Mean Age 30, Mean GPA = 3.41
100%
80%
60%
40%
20%
0%
Males Females Never in Bachelors Need
Military Degree Financial
Aid
12. PA Graduate Statistics - 1997
AAPA Census (n=15,206)
Surgery
Primary Care
Clinical Practice
Male
Female
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
14. PAs will play a prominent role in:
• Rural Health Care
PA / Physician teams will put the “doctor” back
into rural doctoring
The challenge is to resolve the maldistribution of
health care providers in rural areas!
ASHS will prove to be a leader in this area.
• Surgical Specialties
PAs will become 1st assistants in many operations
15. PAs will play a prominent role in:
• Hospital Inpatient Services
PAs will continue to become house staff officers
The cut back on licensing international medical
graduates has created many spots for PAs.
• Correctional Health Services
• Managed Care Organizations
