Computers are playing an ever-increasing role in health care. Computer-based medical records can improve data access, retrieval, output, decision support, and quality assurance. The author discusses computer innovation in medical record-keeping, laboratory data reporting, and drug delivery.
Like other health professionals, PAs must deal with the issue of impairment. An impaired practitioner is one who is unable to practice medicine with reasonable skill and safety because of physical or mental illness, including age-related impairment, loss of motor skills, and substance abuse. Because PAs practice under the supervision of licensed MDs, they face unique problems when their supervisor is impaired. The AAPA's Code of Ethics and Strategic Plan both stress the responsibilities of individual PAs and PA organizations to address impairment issues. The suggested model for self-regulation is the disciplinary/grievance model, which allows the profession to meet its ethical and legal responsibilities regarding quality, competent health care while providing a compassionate, caring program for impaired PAs/supervisors.
Halting the spread of AIDS and HIV infection has become the top priority for clinicians and public health officials. The majority of HIV infection transmission occurs as a result of specific behaviors. A thorough discussion of the individual history is necessary to learn about a patient's lifestyle and formulate an HIV risk assessment. This article examines the two principal behaviors responsible for HIV transmission--injection drug use and high-risk sexual activity--and discusses in detail how to conduct risk-assessment interviews.
While PAs may be familiar with their hospitals' medical staffs and may even be members or affiliate members of a medical staff themselves, substantial benefits can be gained from a greater understanding of the scope of medical staff operations and the potential involvement of PAs. A medical staff is more than a group of practitioners who have been granted clinical privileges in a given institution; it is also a legal entity that formulates policy directly affecting the clinical practice, compensation, and job security of providers within its purview, including PAs. For these reasons, PAs need to keep informed of medical staff decisions and should seek representation in some capacity on the medical staffs of the hospitals in which they practice.
Immunization remains the most cost-effective tool in preventive medicine. Many adults should receive seven immunizations: influenza, pneumococcal, measles, rubella, and hepatitis B vaccines and tetanus and diphtheria toxoids. This article will focus on the use of immunizations in adults to prevent tetanus, diphtheria, influenza, and pneumococcal disease and on some of the barriers and solutions to adequate immunization. Physician assistants can play a crucial role in preventing infectious diseases by organizing effective screening programs and routinely administering appropriate vaccines to their patients.
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