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

Coronary artery bypass grafting and other cardiac procedures are proving their efficacy, and the demand for surgical correction of coronary artery disease will increase in the future. Physician assistants will benefit from this development because cutbacks in surgical residencies, reductions in the number of available foreign medical graduates, and imposition of budget constraints have motivated cardiothoracic surgeons to recruit surgery team members from the PA profession.

The chairperson of the AAPA ad hoc committee on recertification and the AAPA's executive vice president candidly debate the present recertification process and discuss options under consideration with members of the Physician Assistant editorial board and other leaders in the profession.

Ethical dilemmas in medical decision-making over the past ten years have assumed an unprecedented magnitude of importance. All members of the health care team--including physician assistants--have been drawn into the debate. This development has placed an obligation on PAs to develop skills of ethical analysis in order to make informed contributions. Ethical theory can furnish the basis for formulating a schema that can be used to solve ethical problems.

During the past ten years of PA education, new methods of instruction have been introduced and tested, and curricula have been expanded. Clinical experience is being provided in a widening range of medical settings. Greater emphasis has been placed on standardization and accreditation of instruction. Most PA programs are now sponsored by four-year colleges, with instruction leading to a bachelor's degree.

Eight months after physician assistants in Wisconsin were given the authority to write prescriptions, a survey of pharmacists in that state indicated that PAs were utilizing the privilege. The survey further concluded that the technical quality of prescriptions written by PAs was appropriate, that pharmacists have confidence in prescription writing by PAs, and that other professionals in health care and the public need to be informed about PA prescribing authority.

Technologic advances, such as organ donation and the ability to sustain life when no hope for recovery exists, mandate a need to document each patient's value system during routine visits while the patient in fully competent. Clinicians who maintain patient value histories are better prepared to help families make crucial decisions during times when life-sustaining technologies are required. At a workshop sponsored by the Association of Physician Assistant Programs (APAP) in Cincinnati, ten health care professionals reviewed a program developed by the authors to help clinicians conduct ethical investigations into a patient's value system as part of routine history-taking, thus expanding the concept of informed consent.

Medicare part B reimbursement for PA services is six months old. The present legislation represents only a partial victory for PAs, since coverage is restricted to surgical assisting, hospitals, skilled nursing facilities, and intermediate care facilities. All PAs should understand the full implications of Medicare reimbursement so that they can help patients secure payment. As a member of the American Academy of Physician Assistants' Legislative and Governmental Affairs Committee, the author suggests that the new coverage is at least partially successful despite predictable implementation problems. It is especially important for state chapters to contact local carriers, and for PAs to continue lobbying for full coverage.