Physician assistants step in to fill health care gaps

The College of Health Sciences has a long-held reputation for preparing exceptional and dependable health care professionals in the physician assistant (PA) field. Now, research is proving exactly how important physician assistants are across the medical landscape, and this impact extends particularly to Kentucky patients. 

“PAs are found in almost every field—from dermatology to adolescent medicine to psychiatry,” said Somu Chatterjee, MD, MPH, assistant professor and senior clinical coordinator for the physician assistant studies (PAS) program. “As far as setting is concerned, they are employed majorly in office-based practices, but they also form a very important work force for the hospitals and urgent care facilities. PAs are also employed in public health practices like the US public health services.”

Chatterjee published an article in December ascertaining the perception of PAs in health care practices and the benefits they can provide. The research asks physicians in KY to rate PA skills related to six competency domains (medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning, and improvement and systems-based practice).

“A physician’s career is demanding, and most are short on time because of their workload between balancing paperwork and patient care. It becomes important to prioritize the amount of time that can be spent with patients depending on their health status,” Chatterjee said. “This is one of the many areas where a PA can step in to fill the gap. PAs can help patients get answers to their questions, counsel, or perform follow up examinations, etc.”

This gap is especially felt in rural Kentucky, where adequate healthcare is short in supply and often at the end of a long drive. “According to Health Resources and Services Administration Database, as of March 2019, there are 148 primary care, 108 dental, and 88 mental health healthcare facilities in federally designated healthcare provider shortage areas in Kentucky where there is an acute need but not enough healthcare providers,” Chatterjee said.

“PAs bring with them a wealth of clinical experience, even if they are just a new graduate. This is due in large part to the twelve clerkships in areas of specialty and primary care that each PA student must successfully complete similar to a medical student,” he continued. “This training allows a PA to initiate workups necessary for common disease processes that would otherwise require a referral to an urban tertiary center.”

Additionally, because the UK’s PAS program places great emphasis on recruiting from and giving back to Kentucky’s rural communities, students graduate the program with a similar passion and commitment to the underserved.

In these rural healthcare practices, PAs can serve as a point of first contact for evaluations, cutting down the wait times in offices and hospitals. Since PAs spend more time one-on-one with the patient, they can focus more on education with patients and their caregivers.

“Rural medicine is often characterized as being more intimate,” Chatterjee said. “You take care of entire families and you shop at the same places as your patients. UK PA graduates do very well in this environment because the program consciously recruits from rural communities.”

Students are taught to consider social determinants such as a patient’s home environment, nutritional status, and insurance coverage as well as the importance of cultural diversity. “We try to recruit diverse students of different social and economic backgrounds so they can learn from each other, become compassionate caregivers, and take that experience out into the field where they’ll interact with the patients,” Chatterjee said.

PAs are not only helpful in rural settings; larger healthcare providers can benefit from the employment of PAs as well.

“PAs make a very efficient and beneficial addition to health care teams,” he added. “Their training is rigorous and follows the medical model. Anecdotally, we say the PA education focuses on 75 percent of the medical curriculum in 50 percent of the time. So, by content, it’s similar to medical school education, which provides a good breadth and a sufficient depth to share designated responsibilities in a physician-PA team.”

“The large and urban healthcare marketplace is built on volume and specialty care,” Chatterjee continued. “Hundreds of patients may have complicated surgical procedures or teams of specialists may attend to a trauma victim. PAs have been proven to be an efficient addition to this 365/24/7 pace of large healthcare institutions, filling positions in emergency rooms, surgery centers, and hospitals. PAs are the critical hubs that allow for effective communication and healthcare delivery between physicians, nursing, patients, families, and administrators.”