Few things in the medical field are static, but some positions, departments, and topics are more dynamic than others. Most commonly known as physician assistants, PAs are members of a particularly vibrant career in the field of medicine that sees them interacting with patients on several levels. From designing and conducting clinical trials in search of the next best innovation in patient care and treatment to conducting original studies and interacting with public health initiatives, PAs play an important role in research and health education. This article will explore the role of PAs in the US healthcare system and how they are tied to the future of public health.
What are PAs?
Before we dive into exactly what PAs do to help revolutionize health education and medical research, let’s talk about the history of the profession. Some careers in healthcare, such as working as a doctor, have been around for centuries. Others are a bit newer to the scene. The PA profession was first developed rather recently in the 1960s. The goal when creating the career was to improve the quality and availability of healthcare in the United States, specifically within the field of interventional pain management. Luckily for patients across the country, that milestone has been effectively reached.
Today’s PAs are not restricted to work in the interventional pain management field, either. A growing body of research indicates that PAs help lower costs and fill in care gaps while improving patient outcomes in secondary care. They have also proven invaluable in general surgery, where their work has led to an increase in unplanned early discharges as well as lowering unplanned late discharges for patients receiving a wide variety of procedures. Finally, PAs are closely related to staff job satisfaction, too, and their presence often creates more balanced offices and other care environments to the benefit of patients and providers alike.
If you think that the work described above is similar to the work carried out by nurse practitioners (NPs), you aren’t wrong. Both professionals share a similar set of responsibilities and required skills. When it comes to the role of a nurse practitioner versus physician assistant in practice, nurse practitioners are often more autonomous and provide a more comprehensive scope of care, although this largely depends on the state in question. If you’re interested in learning more about what nurse practitioners do in the healthcare system, consider consulting with established educators for more detailed information. Wilkes University, for example, details the difference between the two professions and even offers its own Post-Master’s Nurse Practitioner program for aspiring professionals.
With all of that said you can consider PAs to be important team members for balanced care teams all throughout the healthcare system in the United States, too. Let’s take a look at five more specific roles they play in health education and research.
Bridging the gap in research
One of the primary areas where PAs impact public health via research and education is medical research. You might not think about the PA role when considering critical medical research, but PAs are actually well-positioned to conduct research (as well as trials, described in more detail below). This is due in large part to their close interaction with patients.
Because PAs work closely with patients and are responsible for caring for all manner of health conditions, they are often among the first professionals to identify areas in the medical field that require additional investigation. If they realize that their patients are in need of more efficient care in a specific area of cancer care, for example, PAs are often able to leverage their observations to collaborate with physicians and additional researchers to design effective clinical trials and conduct their own unique research into the areas they have identified. This allows them to directly improve the care their patients receive.
Conducting clinical studies
There is a misconception that PAs cannot serve as “principal investigators” in clinical trials and research. In actuality, PAs are well-suited to serving as both lead and sub-investigators in research spanning the industry, allowing doctors to focus on caring for patients as the shortage of physicians in the United States continues to grow. According to a recent report and literature review released in 2023, PAs are some of the healthcare professionals best suited to this critical role, second only to physicians.
As principal investigators, PAs are responsible for managing their research teams as well as ensuring that the research conducted is carried out properly and accurately to ensure the results are valid. This includes conducting research on their own, such as analyzing blood biomarkers or consenting patients, as well as determining what tasks to delegate and who on their research teams are suited to certain tasks. Potential delegees must have the training, experience, education and state licensure (when required) to carry out the assigned tasks, and PAs must do their own research into laws and regulations to ensure that their team members are qualified for the tasks.
In addition to managing their research teams, PAs serving as principal investigators are held responsible for any discrepancies in recordkeeping, breach of protocol, or other infractions made by their subordinates. You can consider them as holding “complete responsibility” for the trials. Additional responsibilities of PAs serving as lead investigators include:
- Ensuring IRB approval
- Tracking drugs and distributing them properly (as specified in the protocol they develop)
- Reporting the progress and safety of the trials, along with any financial obligations to the study sponsors
- Informing subjects about the drug products
- Training staff
- Compiling and keeping regulatory binders updated
- Regularly checking data for validity
This list is not exhaustive, but it is fairly comprehensive, especially when paired with the additional responsibilities outlined elsewhere in this section. PAs working in clinical research are incredibly important and are held accountable for any potential issues that come up over the course of the study.
Educating future healthcare professionals
Another important role PAs hold is that of an educator. PA educators are responsible for working with aspiring medical students to help ensure they have the skills they need to treat patients properly and safely, as well as to carry out any of the additional responsibilities associated with working as a PA. There are many benefits to working as a PA educator, too, including a more flexible lifestyle when compared with non-educating PAs, especially when working as full-time professors or trainers in the industry. With that said, it is not a gateway to retirement unless the PA in question has substantial experience with teaching and is prepared for the rigorous requirements they must meet while teaching.
PA educators can work in any of a few different environments. Two of the most common are universities and clinics. In clinics, they work with students who have already completed a large portion of their education and work with them to further develop the foundational skills required to successfully and safely work with patients. In universities, they are often responsible for laying the foundation for advanced learning in the field. This path for PAs often requires a significant amount of time interacting with students and other professionals, so it is important that PAs interested in this route are comfortable with consistent interactions with a variety of other people.
As educators responsible for educating future healthcare professionals, PAs have the opportunity to shape the future of the healthcare system in the US. They must remain up to date about needs in the field and be prepared to address any emerging educational deficiencies in the field by adapting their curriculum accordingly. Note that PA educators are typically required by their employers to have at least two or three years of clinical experience, so working as a general provider at the beginning of their career is often the best option.
Promoting evidence-based practice
Another area where PAs influence research and education is evidence-based practice (EBP). EBP is the act of using the current best evidence in the care process. It is important in both education as well as practical care, and it essentially means that the PA in question bases their treatment methods on proven evidence wherever possible, utilizing the best available clinical evidence. Treating a patient with diabetes, for example, should consist of treatment options developed specifically for diabetic patients – treatments that have been extensively researched to ensure safety and efficacy. In situations where not much research exists, PAs must base their treatment decisions on evidence as much as possible. Perhaps there isn’t much research into patients with diabetes and broken legs, for example, but there is plenty of evidence about patients with both health conditions independently of each other. The PA’s job is to base their treatment on the methods developed for each of the health concerns.
The EBP process consists of a few important steps. Some of the most important of those steps include:
- Assessing the patient
- Using observations to ask searchable clinical questions
- Acquiring evidence by researching respected sources
- Appraising the evidence they discover for validity, applicability, and timeliness
- Applying the information gleaned from the evidence examined
- Evaluating their performance with the patient, as well as their ability to answer clinical questions
PAs must be well-versed in the steps above and make regular use of them to ensure that they are providing the best, most effective, and safest care to their patients as possible.
Advocating for public health initiatives
The last role PAs play in education and research in their field that we will discuss in this article is advocating for public health initiatives. As healthcare professionals with a wealth of knowledge and firsthand experience in their communities, PAs are perfectly poised to not only recognize the need for public health initiatives but also to work to meet them as they practice. A professional who notes that their communities seem to have many young people coming in with obesity, for example, might champion a public health initiative of educating children about the importance of healthy diet and exercise.
Just as physicians and other healthcare professionals are responsible for educating their patients and their staff about the importance of the initiatives relevant to their communities, PAs must be prepared to explore the ways in which the proposed initiative will impact their communities. Whether they develop an initiative themselves or adopt a federal public health initiative, in other words, PAs must be certain that the work they carry out is beneficial to the people they serve. Not every initiative is relevant to every community, and sometimes, they don’t have a positive impact on patients at all. PAs are responsible for understanding the gaps in care and educational opportunities common in the populations they treat and for working to remedy both issues.
PAs play an important role in safe and effective care. Through their direct interactions with patients in a variety of different settings, they are able to streamline the care process and use their experience to help educate not only patients but also future care providers. If you’re interested in learning more, keep the information above in mind and dig into the field a bit more in your own time.