History of the Physicians Assistant

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  • History of the Physicians Assistant

    1. 1. The Physician Assistant Profession Randy D. Danielsen, MPAS, PA-C Associate Professor & Chair Department of Physician Assistant Studies
    2. 2. The Concept of Assistants toPhysicians 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. 3. The Concept of Assistants toPhysicians 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. 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. 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. 6. The Beginning, Thirty YearsAgo 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. 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. 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. 9. PAs and NPsWhat is the difference?  Medical versus Nursing model  Dependence versus Independence
    10. 10. General PA ProgramInformation 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. 11. PA Program Applicants - 1996 AAPA Survey (n=2,269) Mean Age 30, Mean GPA = 3.41100%80%60%40%20% 0% Males Females Never in Bachelors Need Military Degree Financial Aid
    12. 12. PA Graduate Statistics - 1997 AAPA Census (n=15,206) Surgery Primary CareClinical Practice Male Female 0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
    13. 13. The Future: Danielsen’s Predictions
    14. 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. 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
    16. 16. The End

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