Physician assistant (American Academy of Physician Assistants)最新文献

Occupational medicine encompasses the delivery of physical, mental, and emotional health care in the workplace. Involvement of PAs in occupational medicine escalated in 1978, as industry responded to cost-containment pressures; PAs performed annual employee physical examinations, exercise stress testing, occupational health education, and treatment of work-related injuries. Work settings initially focused on underserved areas; today they include plant sites, private industrial-medicine clinics, and corporate medical administration. Utilization continues to expand. The American Academy of Physician Assistants in Occupational Medicine--founded in 1981--develops continuing medical education programs and educates industry and the public about PAs in occupational medicine. The future of PA utilization in occupational medicine lies in cost containment.

Medical technology has given clinicians the means to sustain life past the time when such actions are prudent or wise. The existence of such technology does not always mandate its use. The decision to withhold or withdraw treatment must be based on diagnosis, prognosis, and the patient's wishes. Given the relationship between PAs, physicians, and patients, PAs are in a unique position to assist in the decision-making process. Continuation of care is an important consideration even when a specific therapy is withheld or withdrawn.

Growth and opportunity are the catchwords for the PA profession into the 1990s. Numerous changes can be expected, along with stimulating new challenges. Concern about the survival of the profession has waned. Current focus is on expansion of the profession to meet demands of America's changing health care delivery system. A distinguished panel of PA leaders discusses such issues as diversity within the profession, growth of hospital-based PAs, HMOs, public policy, PA education, the growing job market, and expanding roles of PAs.

Skill at patient education is crucial to the battle against the spread of human immunodeficiency virus (HIV). The fight is not confined to one segment of society or to a few geographic areas. Counseling patients at risk about HIV-antibody (HIV-Ab) testing requires a full understanding of the available tests; a psychosocial profile of the patient; candid, nonjudgmental exchanges between patient and clinician; and an ability to deal with significant emotional stress. All PAs should use their talents at patient education to help contain HIV infection.

Last June, the American Medical Association proposed creating the registered care technologist to ease the nursing shortage. There are similarities to the creation of physician assistants 25 years ago. Given the present PA shortage, the PA profession should note how medicine is solving the nursing crisis and take steps to increase enrollment in PA programs, lest a new provider be created to supplement PA roles.

Physician assistants' involvement in administration focused on educational programs early in the profession's history. Recently, PAs have begun to work as administrators in hospitals and other settings. Preparation for management positions varies from on-the-job training to graduate degrees in business administration and public health. Clinical experience as a PA increases marketability in health care administration. Physician assistants who work as clinicians and administrators may find it difficult to balance responsibilities. In this forum, four PAs who helped pioneer this role explain how they became administrators and answer questions raised by other PAs interested in this growing job opportunity.

During the 16th Annual Physician Assistant Conference in Los Angeles, 415 PAs responded to the following survey that measured opinions on direction of the profession, prescribing habits, and potential employment settings. Physician Assistant is pleased to share the results.

Marketing is a conscious plan to influence the behavior of others. Physician assistants can use marketing techniques to promote themselves and their profession as well as to help build a practice and improve patient services. Basic components of a marketing strategy include analysis, planning, implementation, and monitoring. Marketing tools easily accessible to PAs are the telephone (call to check on compliance); a photocopy machine (patient handouts and practice newsletters); and the mail (postcard to remind of follow-up visit).

Communication is a two-way process in which meaning is shared. To be effective, clinicians must assess appearance, environment, field of experience, language skills, tone of voice, listening abilities, cultural differences, and body language. Conscious awareness and continual evaluation of all elements of the communication process can significantly improve diagnostic skills and patient compliance, as well as strengthen the bond between patient and provider.

The PA profession has experienced a decline in the applicant pool and the actual number of PA students in training programs. This comes at a time when demand for PAs has increased dramatically. Basic questions facing the profession regarding this critical issue include: What is the current situation facing the most PA programs? Who are the individuals seeking to become PAs? What are the vi able options for the future? How can individual PAs impact the applicant pool, attracting and retaining qualified students? PA leadership must address these questions immediately. All Pas must take an active role in recruiting more students.