The P.A. Will See You Now

In an aging population, a shortage of doctors has created new demand for care providers like physician assistants and nurse practitioners - nurses with advanced training who can also examine and treat patients, make diagnoses and write prescriptions.

From 2001 to this year, the number of nurse practitioners in the United States has grown to 125,000 from 82,000, according to the American Academy of Nurse Practitioners, and the number of P.A.'s to 68,000 from 43,000, says the American Academy of Physician Assistants. According to the US Department of Labor, "Employment is expected to grow much faster than the average as health care establishments increasingly use physician assistants to contain costs. Job opportunities for PAs should be good, particularly in rural and inner city clinics, as these settings typically have difficulty attracting physicians. Employment of physician assistants is expected to grow 27 percent from 2006 to 2016, much faster than the average for all occupations. Projected rapid job growth reflects the expansion of health care industries and an emphasis on cost containment, which results in increasing use of PAs by health care establishments."

To patients, the two roles can seem very similar. Salaries can be similar, too. The average total income for physician assistants in full-time clinical practice is about $86,000, according to the P.A. academy.

But there are important differences. Physician assistants must practice under a physician's supervision. Nurse practitioners are licensed as independent health care providers, without mandated physician supervision, although some states require them to have a supervising or collaborating physician to whom they can turn for advice. Some nurse practitioners have private practices.

Another important difference is that P.A.'s are generalists, while nurse practitioners train in a specialty like family medicine or women's health. As a result, P.A.'s can switch fields more easily.

Linda Gale, 51, of Fairfield, Conn., worked as a physician assistant in orthopedics for 18 months after graduating from the physician associate program at Yale in 2005. In 2007, she switched to a urology office, where she sees patients and assists doctors in the operating room, suturing incisions and operating the tiny camera used in laparoscopic surgery.

P.A.'s are licensed by state boards of medicine. Like doctors, they initially take classroom lecture classes emphasizing science and diseases, then continue with clinical rotations. Ninety percent of P.A. schools offer master's programs. After finishing a program, candidates must pass a national certifying exam. The programs have an average total cost of $46,000, the P.A. association says.

For additional information in Minnesota contact:

Minnesota Board of Medical Practice, 2829 University Avenue SE, Suite 500, Minneapolis, MN 55414-3246, (612) 617-2130, www.bmp.state.mn.us

See also: http://stats.bls.gov/oco/ocos081.htm

Source: NY Times, 8/10/8