A physician assistant (P.A.) is a licensed health professional who practices medicine under the supervision of a physician. A physician assistant provides a broad range of health care services that are traditionally performed by a doctor. As part of the physician/P.A. team, a physician assistant exercises considerable autonomy in diagnosing and treating illnesses. What a physician assistant does varies with training, experience, and state laws. In general, P.A.'s can provide approximately 80 to 90 percent of the services typically provided by a physician. They perform physical exams, diagnose illnesses, develop and carry out treatment plans, order and interpret lab tests, perform minor surgery, provide preventive health care counseling, and write prescriptions. A P.A. can do whatever is delegated to him/her by the supervising physician and allowed by law. The scope of the P.A.'s practice corresponds to the supervising physician's practice.

Across much of the United States, there is a much greater demand for dermatologic care than there are dermatologists to provide this care. It is not uncommon for patients to call in to schedule and appointment, only to wait 3 to 6 months to be seen. The primary advantage to having P.As within a practice is providing much quicker access to care.

Physician assistants are trained in the medical model. In many schools they attend the same classes as medical students. One of the main differences between P.A. education and physician education is not the core content of the curriculum but the amount of time spent in school. The length of a P.A. program is about two-thirds that of medical school. After graduation, the PA continues to learn while treating patients by continuing self-study and appropriate interaction with the supervising physician. Doctors are independent practitioners; P.A.'s practice medicine under the supervision of a physician.

In the mid-1960s, physicians and educators recognized a shortage and an uneven distribution of primary care physicians. To expand the delivery of quality medical care, Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of P.A.'s in 1965. He selected Navy corpsmen who had received considerable medical training during their military service and during the war in Vietnam but who had no comparable civilian employment. He based the curriculum of the P.A. program in part on his knowledge of the fast-track training of doctors during World War II.

Physician assistants are found in all areas of medicine. Today, approximately 50 percent of all physician assistants practice what is known as primary care medicine, that is, family medicine, internal medicine, and pediatrics. About 23 percent are in surgery or the surgical subspecialties. Physician assistants receive a broad education in primary care medicine. Their education is ongoing after graduation through continuing medical education programs that are required and through continual interaction with physicians and other health care providers.

Most P.A. education programs require applicants to have previous health care experience and some college education. The typical applicant already has a bachelor's degree and more than four years of health care experience. Nurses, EMTs, and paramedics often apply to P.A. programs. P.A. programs look for students who have a desire to study and work hard. On average, an accredited P.A. program lasts 25 months. P.A. programs are accredited by an independent organization sponsored in part by the American Medical Association. All PA programs must meet the same standard curriculum essentials. P.A. students typically study anatomy and physiology, pharmacology, microbiology, internal medicine, pediatrics, emergency medicine, obstetrics and gynecology, geriatrics, surgery, and psychology. These classes are taught as both lectures and lab sessions. P.A. students also spend at least one year in clinical rotations. During this period, they treat patients in each of the major disciplines of medicine and perform additional course work on campus. A P.A.'s education doesn't stop after graduation. P.A.'s are required to take ongoing continuing medical education classes and to be retested on their clinical skills on a regular basis.

Physician assistant-certified. It means that the person who holds the title has met the defined course of study and has undergone testing by the National Commission on Certification of Physician Assistants (NCCPA). The NCCPA is an independent organization, and the commissioners represent a number of different medical professions. It is not a part of the P.A. professional organization, the American Academy of Physician Assistants (AAPA). To maintain the C after P.A., a physician assistant must log 100 hours of continuing medical education every two years and take the recertification exam every six years.

P.A. training is demanding in its own right. This route to a medical career is neither a short cut, nor an easy way out. P.A.'s are not people who didn't get into or who flunked out of medical school. They decided to become a P.A. for a number of personal reasons. They enjoy what they are doing and get great satisfaction from providing quality, affordable, and accessible health care.