Just tick off some of the tenets of the new health-care reform, and you’ll understand why physician assistants (PAs) can play a pivotal role: patient-centered, collaborative and compliant. These linchpins of reform align with the relationship-based brand of care that PAs deliver, working alongside the physicians who supervise them.

Today, there are almost 80,000 working PAs in the U.S. and 155 colleges and universities that offer the accredited graduate training for the profession, an almost four-fold increase since the early 1990s, according to the American Academy of Physician Assistants (AAPA). The AAPA projects that by 2025, there will be 110,000 PAs working in the U.S.

That’s good news for patients. According to a 2008 study from Duke University Medical Center, this rapid increase in the number of PAs entering the workforce is adding efficiency to our health-care system. Essentially PAs increase the availability of physician services and replace or augment care that would otherwise be provided by physicians.

Industry-wise, “with an aging population and more chronic disease, the medical profession needs all the help it can get,” says Dr. J. Lloyd Michener, professor and chairman of the department of community and family medicine at Duke. “PAs are a critical member of the health team. They provide a different set of eyes, hands and perspectives.”

Better Patient Access More Promptly

“PAs open up visits that wouldn’t have existed if the doctor was at the hospital treating another patient or completely booked,” says Cindy Lord, clinical associate professor and director of physician assistant education at Quinnipiac University and a practicing PA. “This means that I can see the 80 year old who is having trouble breathing and provide an earlier diagnosis.”

Diagnosing is just one of the functions PAs perform. They also conduct physical exams, treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery and write prescriptions.

Alexander Powers, assistant professor of surgical sciences-neurosurgery, is a pediatric neurosurgeon at Brenner Children’s Hospital. Powers has been working with the same PA for two years, and says the dynamic definitely allows him to see more people and provide more access and efficiency to his patients. The PA makes clinical decisions on his own and handles routine cases.

PA assistance also gives Powers time to address more complex issues. “If I have to see a youngster who’s been referred to me with a serious diagnosis like a brain tumor, I’ll want to spend an hour with that patient and family. That will bring my day to a grinding halt--and my schedule backed up for months.”

The PA makes it possible for Powers to “see” 40 patients per day. Without one, that number would drop to 10 or 15.

All-Around Rewarding Model 

Case discussions between the doc and PA tend to occur at the end of each day, but not immediately following an appointment. This autonomy contributes significantly to the career satisfaction of the majority of PAs, according to Lord, and to the success of the PA model.

Concentration on wellness and prevention is also central to the PA model, and experts underscore its correlation with the relationship-building prevalent in the profession. “Studies have shown that PAs tend to be relationship-centered,” says Michener. Their role and the kind of people they are makes inclines them to take more time with patients and talk to patients in a way they understand.

Serving the Underserved

PAs also work well running community health centers that function as satellites to larger practices. These larger practices provide medical care to geographically dispersed populations who are in need of health care, but not large enough to support an independent physician practice.

The PA profession grew out of a need to provide care in underserved areas: places in which a lot of uninsured people lived. “Lots of physicians were hovering in large urban and suburban areas,” says Lord. “Then, too, the country doc flavor was going away and physicians were shifting toward specialization.”

An important future goal of the AAPA and the PAEA is to increase the diversity of the profession in its makeup, and the way this diversity will assist the profession in providing care, says Kevin Lohenry, PAEA’s president. In evolving the education process for the future, stakeholders must consider education beyond the classroom and work to provide clinical opportunities within underserved communities. Like physicians, PAs are self-directed learners whose education is ongoing beyond graduation.