Introduction to the Physician Assistant Profession Study Guide
The organization solely responsible for creation, administration, scoring and reporting of physician assistant national certification examinations (PANCE and PANRE)
NCCPA (National Commission on Certification of Physician Assistants )
In ________, the physician assistant student characteristic of _____________ "peaked" and has been dropping off ever since, to the current day. Applicants have less healthcare experience than applicants of the 60's-80's.
1992, healthcare experience
In the year __________, the __________ established registration category for "__________ practitioners" to prescribe controlled substances
1993, DEA, midlevel
Prepaid group practices that provide capitated care for groups of patients are known as what? (Capitated = pays clinician or group a set amount $ for each enrolled person assigned to them, per period of time, whether or not that person seeks care)
HMO (Health Maintenance Organization)
The federal definition of "rural" for a county located in the U.S. is?
Less than 100,000 people
One of the early predecessors of the Physician Assistant profession was military "loblolly boys" of the U.S. Navy. Loblolly boys assisted ships doctors with sick sailors.
Loblolly boys
In terms of ______________, Student section of the AAPA (SAAAPA) says "it is much more important to cooperate and help each other succeed"?
Competition & grades
Majority of PA programs in United States are based in?
Universities without medical schools
This program designed by Dr. Henry Sliver for PA training in pediatrics was the first PA program (1975) to offer a Masters degree
University of Colorado (Denver) PA Program
The post-graduate program at the _______ is in the specialty of ________.
University of Kentucky, Neonatology
What of urban PAs tends to be less than rural PAs?
range of clinical activities as the more rural the PA practice, the wider the range of activities
Most recently, most physician assistant graduates choose _____________ over primary care
surgical specialties
The greatest growth in employment in the last 10 years has been in the
surgical specialties
The growth of physician assistants was assisted in ______, when PA providers became covered for reimbursement of services under ________
1986, Medicare Part B
In an HMO setting, typical physician assistant productivity is comparable to a physician's productivity seeing how many patients?
16-25 PPD/patients per day
CAQ (Certificate of Added Qualification) testing is available in the following:
• Cardiovascular and Thoracic Surgery • Emergency Medicine • Hospital Medicine • Nephrology • Orthopaedic Surgery • Pediatrics • Psychiatry
Characteristic of the physician assistant profession now:
• More than 100,000 practitioners • Mean age ~40 years old • Mostly female • Predominate population of PA's in NE U.S. • Minorities ~14%
Who is responsible for ensuring public & patient safety?
State medical boards
Physician Assistant Impairment is mostly (according to case records) due to?
chemical dependence (alcohol, illegal drugs, prescription medications)
A physician assistant who works with a physician, ____________ being provided by that physician, is practicing in the mode of ____________?
enhancing services, "complementary"
State medical boards are responsible for?
ensuring public & patient safety
Factors influencing _________ of physicians toward physician assistants are most likely to be influenced by whether PAs are viewed as ___________
future attitudes, colleagues or competitors
In 2004, the Accreditation Commission on Graduate Medical Education (ACGME) for physicians set ____________________. This enhanced the number physician assistants hired by hospitals 2005-2015
limitations on physician resident work hours
0-10% of graduate physician assistants have gone on to?
medical school (either MD or DO)
A predominance of ________________ work in urban areas.
occupational medicine physician assistants, it is less likely to find occupational medicine in rural areas of the U.S.
PA Profession Timeline: Period following 1990
"Maturation and Establishment"
Currently the largest % of practicing physician assistants are of what U.S. federal government designated category?
"Black, non-Hispanic" minority group
PA Profession Timeline: Currently (2017) in a period of
"Global Expansion"
Post graduate PA training that is a practically oriented, didactic curriculum combined with intensive clinical rotations and educational experience in a hospital setting is called the?
"Internship Model"
PA Profession Timeline: 1981 - 1990
"Recognition and incorporation"
There have recently been many Florida changes in the "law" regarding physician assistant practice. The final step in the legislative process that makes a bill become a state law in Florida is?
"Signing by the Governor"
Most Physician Assistants practice in
"Single/multi-specialty physician group practice" employer settings
What was the average salary of certified Physician Assistants?
$98,387
At the ________ Census of practicing physician assistants, the largest represented group (40%) had a __________. Transition to the masters degree had occurred over the past 9-10 years.
2008, bachelors degree
Based on studies from director reports, post graduate physician assistant "residents" or "interns" average how many hours of hours of activity/work per week and are technically not restricted under current MD/DO resident hour restrictions?
76-100
What is the percentage of patients that are willing to be seen by a PA if the primary doctor isn't available and would be willing to see the PA again if necessary?
76-90% of patients
How many graduates of physician assistant programs are eligible to sit for the national certifying "entry level" PANCE examination each year
8,000-10,000
What percentage of programs award Master's degrees currently?
80% of programs
A majority of programs offer the terminal degree for the profession which is?
A Masters degree
When a patient sues a clinician, they make a "claim" against that provider. What is a claim?
Assertion that one is entitled to, or perceived or actual right to receive, money or property
This program formed in 1988 to further specialty education of PAs and assist in the development of postgraduate educational programs and curriculum
Association of Postgraduate Physician Assistant Programs (APPAP)
In early 2000, this country successfully piloted a project to move former military Physician Assistants into general and ED practice
Canada
In 1961 which president of the National Board of Medical Examiners (NBME), called for training of "mid-level providers" in Journal of American Medical Association
Charles Hudson
The process of validating background and assessing qualifications of healthcare professionals is known as?
Credentialing, hospital "credential" providers and then grant "privileges" to practice.
New York has pioneered much of the effort of PAs signing what type of document?
Death certificates, some PAs in rural counties serve as coroner and may sign death certificates.
What are the highest paying specialties?
Dermatology, Emergency Medicine, Critical care, Surgery
What degree is the next step in the educational development of Physician Assistants?
Doctorate degrees, NPs have already begun this route.
_______________ of PA postgraduate programs have ______________ so their benefit to the system is not completely understood.
Economic and social benefits, not been studied
A factor that signifies the growth of the physician assistant profession and its professional relationships according to our text authors is?
Expansion of the Physician Assistant based literature
T/F Neurology is included in the new NCCPA specialty certification testing for physician assistants
False, it is NOT
These clown activists of the early and mid 1600's are considered to be a precursor of Physician Assistants in the U.S.?
Feldshers
Who is the current president of the Florida Academy of Physician Assistants (FAPA)?
George Rego
Which rural areas have the greatest percentage of physician assistants working in "primary care"?
Health Professional Shortage Areas (HPSAs)
__________________ has grown in the past 10 years for physician assistants and currently employ ~31-45% of all practicing PAs
Hospital employment
Where do we find the highest Physician/PA substitution ratio [determined by level of delegation and comparative productivity of physicians and PAs for the delegated services]
In the Military
What group of graduates comprise 0- 30% percentage of all practicing physicians in the U.S. today?
International medical graduates or IMGs (aka foreign medical graduates, FMG's
Who is a Physician Assistant profession expert from George Washington University, and one of the three main authors of the text for this course?
James Cawley
Which was the First HMO to employ a physician assistant in 1970?
Kaiser Permanente
Who is the current president-elect of the Florida Academy of Physician Assistants (FAPA)
Kate Callaway
What is the main reason for PA grads choosing specialties in the past 5 years?
Market forces (salary, benefits, demand)
Founded the Frontier Nursing Service and was the predecessor of the Nurse midwife profession
Mary Breckinridge
The first physician assistant post-graduate program was at?
Montifiore Hospital, New York in surgery. Post grads at Montifiore acted as interns/residents on surgical services
The Organization solely responsible for the creation, administration, scoring and reporting of the physician assistant national certification examinations (PANCE and PANRE)
NCCPA (this was a repeat, might show up twice)
A legal doctrine that occurs when an employer (physician or hospital/clinic in medicine) fails to reasonably monitor and control an employee's actions (a Physician Assistant or NP etc.) is known as?
Negligent supervision
Question about referrals "to" specialists by physician assistants
Not all specialist providers welcome referrals from physician assistants
Competition from who is considered a challenge to the growth and sustainability of the physician assistant role in the U.S. particularly in the areas of which field?
Nurse Practitioners, primary care
Which is one of the lowest paid "specialties", which is in line with salaries for primary care?
OB/GYN
What type of insurance covers a malpractice event provided there was insurance coverage at the time of the alleged event, regardless if the coverage is in force at the time the claim is filed?
Occurrence type - liability insurance
A function in hospital setting, that instructs hospital to perform functions on behalf of patient (meds, services, labs, nursing services, etc.) is?
Order writing
A reasonable conclusion about the PA profession given the perspective of the textbook authors is that?
PAs will be drivers of improved care and standards of care in the future
This organization administers Centralized Application Service for PA Applicants (CASPA), creates and administers End of Rotations Examinations and supports PA programs and faculty.
PAEA (Physician Assistant Education Association)
__________ is a primary care specialty that is more likely to be team-based, alert to the idiosyncrasies of ____________, and aware of variations from normal (as in growth and development) in terms of testing and responses
Pediatrics, dysmorphology
The right of a physician or surgeon to use an "extra pair of hands" under conditions not constituting a medical emergency was a core right tested in which legal case?
People v. [neurosurgery physician assistant] Whittaker in 1966
What is considered to be a barrier to physician assistant practice?
Physician dependence [dependence on physicians by rules, regulations and laws]
These programs began in 1971, and now number ~75 programs with ~ 300 possible spots for post graduate PAs (far fewer than the number PA program graduates each year)
Post graduate PA programs
The provision of integrated, accessible health care services by clinicians who are accountable for meeting most personal health care needs, developing sustained partnerships with patients, and practicing in the context of family and community is known as?
Primary Care
What constitutes primary care?
Primary care is: Family medicine Pediatrics General (adult) Internal Medicine OB/Gyn (Women's Health)
In the early 2000's this study concluded that PAs are highly regarded as substitutes for nurses or doctors
Scotland's Physician Assistant pilot project
Physician Assistants: Policy and Practice 3rd Edition by Roderick S. Hooker PhD, James F. Cawley MPH PA-C, David P. Asprey PhD PA-C.
Textbook information
This doctrine simply states - "Physician is considered liable for the negligent acts of other employees"
The "Captain of the ship" doctrine
The purpose of which commission is to establish the standards for U.S. PA education?
The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)
Which branch of the military has an Emergency Medicine doctorate program for physician assistants?
The Army
National data repository of all state board actions or malpractice actions against licensed health care professionals is called?
The National practitioner data bank
Ultimately, who is responsible and liable for the acts of a physician assistant in the clinical setting?
The PA him/herself, is responsible
What is true of the the U.S. federal government including the military, U.S. Public Health Service and other federal agencies?
They are the single largest employer of physician assistants in the United States
First 4 students of Cohort #1 of the Duke Physician Assistant program class were ex-medical corpsmen from the Navy. How many graduated?
Three of them graduated the program in 1967.
What is the purpose of the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)?
To establish the standards for U.S. PA education
The __________ began training physician assistants in _________ and now has approximately ______ practicing PAs (and growing)
United Kingdom, 2004, 250
What is the mission of the American Academy of Physician Assistants (AAPA)?
To speak on behalf of PAs and support their professional development
T/F Physician Assistants, midwives, nurse practitioners all began about the same time in medical profession history.
True
T/F Employment opportunities have led many PAs into different, more complex roles in the past several years?
True, Physician Assistants are being placed in alternative, non-clinical roles
True or False: Physician Assistant unions are mostly non-existent in the U.S.?
True, the majority of PAs are not in unions
was a physician assistant "predecessor" and worked for Dr. Alfred Blalock (cardiac surgery, Vanderbilt University) who pioneered the surgical treatment for Tetralogy of Fallot
Vivien Thomas
It is estimated that by the end of 2017, there will be how many clinically active PAs in the U.S.?
Well over 100,000
American Medical Association (AMA) established the first accreditation mechanism for Physician Assistant programs in 1969. Now operated by?
a separate organization, the ARC-PA (Accreditation Review Commission on Education for the Physician Assistant)
NCCPA ensures that PAs meet ____________________ necessary for safe and effective clinical practice with the administration of which exams?
a standard level of knowledge and have skills, PANCE and PANRE exams
Where did the Feldshers originally begin?
in the German military
0-20% of physician assistant graduates are currently engaged in?
non-clinical roles (don't see patients) in administration, entrepreneurial activity, pharma sales/support and others.
Systems like HMOs (Health Maintenance Organizations), are ideal settings for examining the cost benefits of Physician Assistants due to?
the basic organization of these organizations, known as "vertically integrated" systems
Trained military medical teams (combat medics, Navy corpsmen, etc.) returning from war in SE Asia (Vietnam, Cambodia, Laos) contributed to what?
the emergence of the physician assistant profession in the 1960's
One of the key "needs" verbalizing support to the development of the Physician Assistant profession was?
the need to reverse the misdistribution of clinicians (mostly physicians at the time)
American Academy of Physician Assistants position on _______ is that "Caps on noneconomic damages appropriate if they are part of a comprehensive medical liability insurance reform"
tort reform
What are drivers of future demand for health care providers (including Physician Assistants)?
• Population growth • Population aging • High public expectations • Increased resources of baby boom generation • Rapid rise of lifestyle risk factors
