The Status of EBP in the PA Profession

The physician assistant (PA) profession has been described as “one of the greatest innovations of the last half of the 20th century.”1(p1) The profession has been established for less than fifty years, but it has managed to develop and expand vastly within those years consisting of more than 105,000 certified physician assistants and more than 170 accredited physician assistant programs. Simply stated, a physician assistant is defined as a certified medical professional responsible for providing medical care and treatment under the supervision of a physician. In order to completely understand the role and importance of physician assistants in the medical field, the history of the profession must be acknowledged.

According to Warren et al. (2016), numerous barriers exist for implementation of evidence-based practice (EBP) within hospitals. In a study conducted evaluating the strengths and opportunities for implementing EBP in hospitals, lack of autonomy, lack of leadership support, and lack of inclusion in clinical practice decisions, were noted as the top barriers to the implementation of EBP (Warren, et al., 2016). The study revealed that while the majority of respondents’ beliefs

Physician assistant’s scope of practice is defined by the level of education, experience, state laws, facility policies and the supervising physician’s delegations. PAs work as a team with the supervising physician and they support the physician’s scope of practice. Since the physician assistants are also educated in the medical model, PAs also practice with physicians in every specialty and setting.

While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.

The biggest challenge that Physician Assistances face is when a patient questions their competency or their ability to care for them. PA’s are one of the youngest allied health fields and some people are unaware of the role of a physician assistant. The best way to reassure the patient that they are being properly taken care of is to educate the patient on the topic of Physician Assistant. The first Physician Assistant program started in 1960 in the military, to help with the growing need for primary care doctors (Mittman). Physician Assistance must first obtain a four year degree with a competitive GPA of 3.6 or

Every year, an estimate of 5.9 million people dies from disease (World Health Organization, 2016). Some of these diseases are caused by bacteria, parasites, virus, trauma, mutations, and environment. Although these diseases can cause death and injury, in many cases, they can be treated by a specialist called a physician. A physician is a person who is qualified to practice medicine. Often, these medical specialists need help in treating large numbers of patients in need of care. In the 1960s, the physician assistant (PA) profession was created.in 1965, there was a noticeable shortage of physicians. Eugene A. Stead Jr., MD, of the Duke University Medical Center assembled the first class to take on the role as physician assistants. These men received medical training in fast track manner to what a physician might learn (Academic Academy of Physician Assistants Organization, 2014).The duties of a physician assistant are similar to what a physician may carry out but differ in some ways. Today, the physician assistant profession is a growing field, but more difficult to achieve. Recently, there has been an increase in the amount of school time and pre requisites to be accepted into a physician assistant graduate program. Specialization of a particular field is even more difficult to achieve. In addition, work environments can be often challenging. However, high salaries and benefits of working in the medical field give reward to the employee.

The rate of enrollment to medical schools in the United States has decreased from previous years, therefore there will be less licensed physicians within the health care field, as the older physicians age out. The growing elderly population in the United States, in need of medical care, is another reason for the increase in need for medical assistants. One last factor is the greater accessibility to health insurance for all. This is driving more people into the health care system, therefore spawning a need for more non-medical professionals, such as medical assistants who can assist on the administrative end to get the patients information into the system for care and

A Physician Assistant (PA) is defined as a mid-level medical practitioner who works under the supervision of a licensed doctor (an MD) or osteopathic physician (MedicineNet). Although a Physician Assistant need not be physically supervised at all times while performing his or her duties, some form of communication and contact between or with a physician or doctor is mandated. If employed by the federal government, one has the necessary credentials needed to practice and perform services, such as ordering/interpreting lab tests, testing physical examinations, prescribing medicines, and counseling patients (ASAPA). Over the years, it has been stereotyped that more women than men are involved in this department, healthcare is too expensive, and

Physician Assistants are clinicians practicing in a physician extender role. They are found in almost every medical and surgical area in the U.S. and are appearing in both primary and specialist care settings in Canada. They perform similar tasks to their physician supervisors, including examination, diagnosis, diagnostic testing, treatment, referrals and prescribing. Research shows PAs to be capable of giving care, comparable to that of physicians for similar services.

Research and best-practices are an integral part of evidence-based management(EBM) and allow an organization to successfully implement EBM into their facilities. HSHS-EWD is a group of four hospitals that work with several clinics and healthcare providers to promote the health and well-being of many local communities. Connie Dorn, manager of central scheduling and prior authorization, is located within the revenue department and oversees registration and scheduling of the four different hospitals. During her 10-year tenure with the hospital systems she has seen many changes occur that have been beneficial to the hospitals, patients, and staff. Management meets on a continuous business to discuss areas that need improvement in order to stay on top of the latest advancements in the medical community. Connie currently sits on many boards, teams, and groups within the hospital system and is very experienced in the utilization of research and best-practices in regards to EBM. She recently utilized these skills while seating on a team that was trying to find a solution to denial of claims and poor customer satisfaction due to lack of authorization being in place. During the research phase it was discovered that the authorization team was obtaining authorization, however, physician offices were ordering the test incorrectly causing the radiologist to update the orders. Her team eventually found a solution that is in the process of being rolled out system wide called ACR-Select.

Physician assistant were not to popular begin with unlike today. Many physicians opposed to the ideas of having physician assistant in presence as a territory invasion. Physician assistants were brought up as stole stealer, lesser doctor. Although some physicians saw the benefits of having extra hands to help around, but majority viewed it as someone taking their jobs and duty. However, a few years later, this view began to revise. Physicians began to notice the benefits of having physician assistants around. Physician assistant assisted generate surplus revenue for doctor expenses. In addition, PAs also aid doctors with stress as doctors have less patients to see for themselves and able to do other stuffs. These are just some of the historical fact of how Pas became into

Physician Assistants are also known as a PA’s; they practice medicine under the direction of physicians and surgeons. They formally trained to examine patients, diagnose injures and illness, and provide treatment. Physician Assistants also evaluate and treat patients under the supervision of doctors and surgeons. A Physician Assistants is a graduate of an accredited Physician Assistant educational program who is nationally certified and state- licensed to practice medicine with the supervision of a physician. Core tasks of a Physician Assistant are they take medical histories and examine patients. They Interpret lab test and make diagnoses, Treat minor injuries with stitches, splints, casts, and prescribes certain medications, The

Evidenced-based health care management is constrained by multiple factors. The pressure of rapid change and the financial pressures provide much of the incentives for health care managers not to use evidence-based decision practices. Many managers believe the health care rapid cycle change does not allow time for study and analytical review before decision making (McAlearney & Kovner, 2013, p9). Many manages believe it is more efficient to make a decision and change it if it does not work. In addition, many senior leaders and decision-makers are skeptical of the economic value of predictive models (Guszcza & Lucker, 2012). The is also a belief that the stakes are too high and the evidence is to subtle and complex to turn over to relay on an

EBP calls for the integration of the latest evidence and clinical expertise to provide optimal health care (Cronenwett et al., 2007). An understanding of EBP allows the doctorate of nursing practice (DNP) leader to summarize current evidence regarding diabetes care, redesign clinic processes and create interventions that improve patient outcomes. According to Powers et al. (2015), DSME is a cost effective EBP tool proven to reduce hospital admissions and readmissions, along with reducing the estimated lifetime healthcare costs associated with the illness. EBP provides the context for organizations to use methods proven in literature to improve patient outcomes. The literature describes several strategies to increase participation in SME including, technology based user friendly interventions (Kline et al., 2016), peer led, family-focused, culturally competent community-based programs (Philis-TSimikas & Gallo, 2014), and education programs with limited demands on cognitive

Most were older than ten years old and the authors did not use any references dated within the last five years. The authors did not effectively critique the research used in the literature review. The review of the literature has an almost biased tone as it mostly discusses that nurses would like to implement EBP into their practice but they have many barriers to overcome. Although specific citations were made concerning relevant information, the authors often used terms like “some” and “many” in reference to findings. In these instances a substantial citation could have been more effective in depicting the scope of the problem. Within the literature review, the authors did not discuss the strengths or weakness of the research they used nor did they offer recommendations for future areas of study.