Oct 6, 2017

Interview Transcript

Interviewer: What role will physician assistants play in the evolution of healthcare? We'll talk about that next on The Scope.

Announcer: Health tips, medical news, research and more, for a happier healthier life, from University of University of Utah Health Sciences. This is The Scope.

Interviewer: The physician assistant profession is 50 years old this year. And today we're going to talk a little bit about the history, and also how they're going to be playing a greater role in healthcare in the future. Odds are if you're not using a physician assistant now, in the future, you very well may be. Jennifer Coombs is an Associate Professor of physician assistant studies at University of Utah and is also a physician assistant herself. In order to better understand where the profession will be going, tell me how physician assistants came to be because I think it's a fascinating story that grew out of a need.

Jennifer: Correct. Well, we like to say that the origin of our profession was the Vietnam War. There were returning military corps men and a physician at Duke University had the idea to train relatively rapidly providers that can work relatively independently but in collaboration with physicians.

What happened at Duke University was Dr. Stead, who was the founder of our profession, he found that he had a need to have someone in the office that can really help him, deeply help him, prescribe medications, see patients, come to him if there were any issues. And this is the stroke of genius that he had this idea, that he had when he saw how well trained these Vietnam veterans were and they came with so much experience.

Then, he had this idea to start training people. And it quickly moved from being Vietnam veterans and corps men to all sorts of other people who had amazing experience. We had, quickly, nurses. Nurses would go to nurse practitioner school. Nurses could also go to physician assistant school. We had respiratory therapists. We had physical therapists. We had paramedics, all sorts of experiences and backgrounds.

Interviewer: People already in the healthcare industry in one way, shape, or form.

Jennifer: Correct. And then they would be trained, and then they could go back and work with physicians and do everything, really, that their supervising physician did.

Interviewer: Right. So the physician was able then to see more patients because they had somebody that could prescribe or do a lot of the things that other staff of the hospital or doctor's office couldn't?

Jennifer: Right. Physicians then could see sicker patients, could see the more complex patients. And then everyone could be seen because, really, no one can do it all. I mean, this whole idea that physicians are going to be the managers of everything is absurd. And they need help.

Interviewer: What was the need that they needed to fulfill by creating this new role in health?

Jennifer: It is interesting because it continues to this day and I think the role is access and quality care. And that is provided on teams. We know that teams provide the best care. And teams aren't really a new idea. But PAs have really taken off, and they've bridged a gap that was needed. So if you have a child that has a fever in the middle of the night, you go to a quick clinic or an InstaCare, you might see a physician assistant, and that person is going to get you treated. It's going to get you excellent quality care and get you out of the door. And that just has been our thing, and we've done it well, and we just keep having more and more demand for our services.

Interviewer: Yeah. So the bottom line is to treat a lot of the things you or I might go to the doctor's office for, you don't need all the education that a doctor has. So how much training does a physician assistant have?

Jennifer: We are a two-year program, and you get a master's degree. Of course, people come with a tremendous amount of experience. People are usually a little older when they go to physician assistant school. And they come with an undergraduate degree. And then they go through the two-year program.

Interviewer: So the history kind of, maybe, sets us up for what the future is going to look like. We have a profession of medical professionals that don't need as much training, that can handle a lot of things that a regular physician could, that allow the physician then to focus on those more complicated cases as you said. So going forward, how will a physician assistant play a role in healthcare? How is healthcare evolving? How is it changing, that it's going to require good physician assistants?

Jennifer: I think one thing that is important in healthcare today is providing very, very quality safe care at a good value. And we talk about value a lot at the University of Utah. Physician assistants can provide very high-quality care. And we provide that service at a good value for the institution, a good value for the community. Physician assistants isn't as expensive to train as physicians. And so I think that's one thing that has been our bailiwick is quality care at a good value.

Interviewer: And correct me if I'm wrong, but I understand in healthcare there is going to become a shortage of primary care physicians. And we hear a lot in healthcare about how in the future, your primary care physician is going to be your kind of point of contact for care, but there is going to be fewer of them, which causes a problem because we've got a generation . . . a big population of people that are going to need more and more care. How are physician assistants going to fill the role?

Jennifer: Physician assistants are really well trained for primary care. They can take care of a variety of problems, but you're going to see PAs in all aspects of medicine. There are shortages of care in every specialty of care. And if you have a child that has epilepsy, it might be a physician assistant you can be seen over at Primary's initially, get in the door, then you might be referred. You might see a physician assistant over at the University of Utah Health Care, in neurology. And so they're everywhere. They're everywhere. They're in hospitalists, they're in surgery. They really just coming in and providing that care that's needed and opening up that access.

Interviewer: And in the future, as we move more to team-based care, what will the physician assistant role be in that team-based care?

Jennifer: Often, the physician assistant is a little bit of leader on that team so the physician may not come in the room. The physician might be only called in to help out if needed. I know that in rural areas, we have physician assistants that do everything and that are the leader of the teams. You're going to see PAs everywhere on every team.

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