Role of physician assistants in modern healthcare


Due to changes in the pattern of care and staffing dynamics in modern healthcare, specialist nurses or physicians assistants are slowly being introduced to share the responsibilities of junior doctors. This article highlights the key aspects of the skills, qualifications and the role of a physician assistant.

Introduction

A few years ago, one would see junior doctors or house surgeons running around endlessly with the consultants or specialists and carrying out all the requests related to the medical or surgical care of a patient. But now, there has been sweeping changes in which, the private sector has become a vital component of healthcare delivery in India. A consultant in medicine or surgical specialty cannot do all the work that is related to patient care. Some of this has to be delegated to a junior member at the level of a house surgeon. One cannot always find house surgeon at all hospital and junior doctors wouldn't remain in a junior position for a long time.

In such circumstances, a Physician Assistant is very useful. The job of physician assistant, the education and its training, is a relatively emerging field in India wherein trained nurses or graduates don the role of a specialist nurse to assist a specific specialty team or consultant and do part of the work of a junior doctor with suitable training. Here the nurse becomes an assistant cum secretary to the doctor but the important difference is that he/she has with clinical care related duties and little administrative duties. This concept is established in Western Healthcare systems and has started off in India, especially the corporate hospitals.

Job Description

Generally, the responsibilities would include participating in day to day care of patients. Being part of the clinical team, the person would participate in facilitating or in parts administering care to patients as appropriate. Going on the ward rounds to see in-patients, documenting the treatment plan as formulated by the doctors, be in the OPD with the consultant, typing notes, collecting reports, assisting or doing dressings, surgeries, administering Injections, antibiotics, checking vital signs and progress, drafting summaries, being a point of contact for patients and referring doctors for the team under which he or she works. On the surgical side, these assistants are trained to assist the surgeons in pre-operative workup, at the actual surgery and in the post-operative period.

There are many departments in which one can become an assistant and be involved in patient care. This includes a Physician Assistant in Surgical Specialties ( general surgery, oncosurgery, OBG, gastrointestinal surgery, orthopedics, urology). Similarly, they can find a place in non-surgical specialties also like Physician Assistant Medicine and allied specialties ( Anesthesia, Cardiology, Pain management team, Respiratory medicine etc).

After spending time in the job, the assistants can further enhance their skills by going for short courses like wound management courses, stoma care courses, surgical assistant course, counseling courses etc.

Desired qualities of a physician assistant

In the simplest of terms, the assistant should have all the basic skills that are required from a nurse working in the wards or operation theater or in the outpatient department. The candidate should have a passion for becoming more than a nurse and be part of a clinical team of doctors who care for patients under a single specialty. They need to follow the basic principles of patient care, assessment, maintaining confidentiality, administering medications, carrying out the typing and other paperwork and talk to patients and their families in a manner that instills confidence and trust.

Apart from the knowledge gained in the general nursing course, a physician assistant should gain additional theoretical and practical knowledge related to the specialty they are working in. They need a good command of English and local languages, computer skills related to data entry, using custom-made healthcare programs for data capture. Having basic counseling skills and additional knowledge of performing tests ( like pulmonary function tests, uroflowmetry) would be desirable.

Essential Qualifications

Any nurse with basic nursing qualification and good experience in a specific specialty (obstetrics, surgery) can work towards becoming a specialist nurse. Specialist nurses have a bigger role to play in the care of a patient right form admission to discharge and further follow-up. The patient numbers would be less and it would be following the doctor or the teams' group of patients rather than working in a particular hospital ward or wing.

There are training centers established by well-reputed hospitals that offer training to eligible students on how to become a Physician Assistant. These are around 6 months – 2 years. There is a formal body, the Indian Association of Physician Assistants, that one can have an affiliation with for further enhancing the skills and career.

  1. Corporate Medical Assistant course, after 12th exams, a six-month program that would be the minimum experience to start of as a physician assistant (this is offered by Apollo Hospitals).
  2. Physician assistant Diploma Course, after B.Sc nursing(1 year) or after general nursing and midwifery (2 years).
  3. PG Diploma in Physician Assistant, a two-year course for B.Sc science graduates.
  4. Bachelor's in Physician Assistant, a 4-year course after 12th exams is also offered by some hospital training academies (Narayana Health,www.naryanahealth.org).
  5. One year Physician assistant program (https://www.sakraworldhospital.com/physician_assistant/).


Applying for the job of Physician Assistant

With the qualification as stated above and or experience of working in a good hospital with good references from medical consultants and surgeons, one can start applying for the jobs that are available at various private hospitals via the online job portals or approaching the hospitals directly. A good CV and a cover letter that focuses on clinical experience as a nurse in a specific department (obstetrics, surgery, medicine) from a good hospital, a few hands-on courses attended, basic life support training would all help in starting a good career as a physician assistant.

If you are new to applying for a job, you can find information on how to draft a job letter and prepare a CV. Here is a simple example for letter Format for job application.

Summary

Current trends in modern health care have thrown open the doors for deserving candidates to be part of a medical team treating patients. This enables the individual to learn more about a particular specialty and interact more with patients of a specific specialty rather than looking after patients in the wards like a traditional nurse.


Comments

Author: K Mohan08 May 2018 Member Level: Platinum   Points : 1

Yes the role of physical assistant in modern healthcare is demanding and that should be in order. Why I am insisting the word order because, a assistant to a physician is also equally responsible for ongoing activities either at the operation theater, out patient department or even in wards. The Physician assistant must have utmost patience in dealing with critical case patients as they have too many doubts which the doctors wont reveal and they seek help or information from the assistants. In that case some information which was to be concealed and not be revealed to patient should not be told by the assistant and thus this job is very challenging and one should not have lose talk about the disease or danger to the patient.

Author: Natarajan16 May 2018 Member Level: Diamond   Points : 4

Thanks Mohan Sir, The physician assistant is 'not equally responsible', that is the whole point. His/her responsibility is related to paperwork, keeping track of progress of basic day to day events, assist and do simple things. He or she will 'not' be dealing with critical care. They have to support the consultant or the specialist at a level that is in between a regular staff nurse and a junior doctor.
Yes, they will have to maintain confidentiality, never comment or blindly disclosed results and progress of the patient unless the situation dictates and there are sufficiently experienced to pass on such crucial messages until the doctors can speak to families.



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