PAs Now and Then

[Guest TerryF]

What was the original intent of the first PAs that came out of Duke, if I have my history correct?

 

How far has the PA concept and practice evolved since their beginning?

 

TerryF

[andersenpa]

What was the original intent of the first PAs that came out of Duke, if I have my history correct?

 

How far has the PA concept and practice evolved since their beginning?

 

TerryF

 

I was recently doing some research on theassitant/associate name issue and looked back into the records from the early days.

 

All the documentation clearly talks about the stuff we already know- capitalizing on the practical knowledge of corpsman/military medicine, who lacked "theoretical knowledge". The training programs were VASTLY different, but by the time the early 70s rolled around the AAPA had coalesced from it's splintered origins and the AMA had signed on. At that point the training was more standardized, accreditation was established, as was the certification process.

 

It seems clear to me that PAs have FAR outgrown the original model, which was intended to truly act like an "extender"- enable physician practices to become more efficient (this was a time when physician labor was tapped to the limit and they were extremely overworked). it should be noted that early on there were already PAs establishing remote rural practices in underserved areas, so there were autonomous PAs as well.

 

Our training is better now in that there is a strong standard in terms of what is offered in the education. We lack standard postgrad training, and since OJT is part of the deal, the final PA product (a functional, efficient clinician) has NO standard. Specialty certification is trying to fix this but who knows how it will play out. Any PAs calling for independence face THIS is the main barrier.

 

the other main difference is the switch to specialties. There were early programs like Yale that intended to train specialty PAs but the demographic shift has been signfiicant, and that is probably due in large part to $$$.

 

We have evolved for the better, and practice laws are improving but we still are stuck in a rut which is imposed by the regressive minds of the BOMs and, forgive me, but nursing as well. If we could get practice parity with NPs we would be in a much better place.