Jun 20, 2014

TRANSCRIPT

Interviewer: What can a physician's assistant, or "P.A." do for you? We'll talk about that next, on The Scope.

Announcer: Medical news and research from University of Utah: physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: All right, you have called the doctor's office because you want to get an appointment, and the person at the other end of the phone says, "Well, the doctor isn't going to be able to see you, but we can have a physician's assistant see you," do you hesitate and think, "oh man, am I sacrificing some quality care?" It's a common question. Jennifer Coombs, who has been a P.A. for 21 years will hopefully be able to answer that and some other questions about physician's assistants. Thanks for stopping by.

Jennifer Coombs: Hi.

Interviewer: Did I make you bristle a little bit there?

Jennifer Coombs: No, I think there's a great question, and I want to talk about how P.A.s are utilized in a clinic and how patients have really come to accept physician's assistants now. We're an integral part of the healthcare system, and I think it's going to be all hands on deck here in the future with us. We have big, big healthcare needs that are going to need some very trained professionals that are going to be able to help people out there.

Interviewer: So help me understand, what exactly is a physician's assistant? I think most people get what a doctor is, but what is a P.A.?

Jennifer Coombs: A physician's assistant is a medical professional, we're nationally certified, we're licensed to practice in the state of Utah, we can prescribe medications, we can see patients for really, a lot of the issues that you're going to call and need to be seen for, you can have a P.A. see you. And most patients are really happy with the care that P.A.s are giving, and you can get in, you can get out, and get your needs taken care of.

Interviewer: So what's the educational difference between a physician's assistant and an actual doctor?

Jennifer Coombs: P.A.s are trained in the medical model, work very closely with their supervising physician, they have a great deal of autonomy, and we're trained in, it actually came out of a fast track medical model post world war II where they thought about training physicians in a little faster way. That is a didactic year and a clinical year. It's about three academic years, 2,000 clinical hours. It's a very rigorous program.

Interviewer: So, in a lot of cases, if I have the option of seeing a physician that has say 10 years of experience and a P.A. that has 10 years of experience for kind of a common issue, would the P.A. actually maybe even be better able to handle that because they've seen more of it?

Jennifer Coombs: Absolutely, P.A.s are very well trained and qualified to see patients for quite certainly simple issues, but also complex issues. You're going to see P.A.s in urology, you're going to see P.A.s in the nursing home, you're going to see P.A.s in family practice clinics.

Interviewer: Wow, so even in specialty care there are physician's assistants.

Jennifer Coombs: Absolutely, they're doing procedures, they're doing absolutely everything that a supervising physician can do.

Interviewer: So then what is the difference?

Jennifer Coombs: Well you know, I think just like any physician, if you have a need that that provider can't help you with, they're going to refer you. And they're going to refer you to the right person.

Interviewer: Mm-hmm.

Jennifer Coombs: So I think that we're all out there trying to get the patient the proper care that they need. I'm certainly going to see a patient, and if they have a need to see a urologist, I'm going to refer them to that urologist because that's something that I can't necessarily do. So I think P.A.s can coordinate care and they can provide care, and they're doing it all, again, with the supervising physician as someone that they can talk to, bounce ideas off of. The supervising physician often bounces ideas for their patients off the P.A.

Interviewer: Sure. I'm going to ask you kind of about a stereotypical question that I believe a lot of people have. So as a P.A., why did you decide to stop there and not go on to medical school?

Jennifer Coombs: You know, that is a question that almost every P.A. gets asked. You get asked that in the interview to P.A. school, you get asked that in the clinic, and a lot of people say, "well, aren't you going to be a doctor some day?" They just assume that. And you know, the thing is it's just a great profession. So many P.A.s, you ask them, "would you want to be a doctor?" or you know, "are you considering being a doctor?" They're so happy doing what they're doing, you could provide so much care. If you had to do it over again, you'd be a P.A..

Interviewer: All over again, huh?

Jennifer Coombs: And I guess what happens is, patients come in, they see you, you talk to them, they're very pleased with the visit, and usually it never comes up again.

Interviewer: Gotcha, gotcha. So in your mind, what makes being a P.A. so much better than being a physician?

Jennifer Coombs: Well, I'm not a physician, so I don't know how it would be to be honest.

Interviewer: But you see what their lives are like.

Jennifer Coombs: I think P.A.s are in a sweet spot of medicine, which is that, I can always say, "well you know, let's get some help with this," and you know, you might end up grabbing your supervising physician, bringing him in the room to see the patient with you. You just feel like you're right in the middle of a really effective team, and I think that makes for a very satisfied patient, and a very satisfied provider.

Interviewer: And it seems to me that with healthcare, it's kind of going towards a direction of more team based care if I understand correctly.

Jennifer Coombs: Absolutely, and the thing is, in this country we're going to have a lot of people who have health insurance, hopefully, and we also have an aging population, and that means that we're going to have to see people. And we need to provide access to care. That's a big part of what's going to have to happen. And so the physician can't do it all, they're going to need help. And I think that one of the things that's really been great is that P.A.s have been able to come in and fill needs in lots of different spaces, in specialty care, in primary care, and I think it's a concept that has worked well for close to 50 years now, and the reason is because of the team.

Interviewer: So as a consumer of healthcare, if somebody says, "the doctor can't see you, but we can get you in to see a P.A.," I shouldn't worry about that at all.

Jennifer Coombs: I don't think you should worry about it at all, I love seeing my P.A., and I like taking my kids to see a P.A., I think that we provide very good care.

Interviewer: Anything that I left out? Any final thoughts or anything that you would like to add?

Jennifer Coombs: So the bottom line is that research has shown that patients accept and enjoy seeing a P.A. just as much as they like seeing their regular physician, especially if there is a time trade off.

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