Physician assistants are fast becoming in high demand
Rising patient caseloads seen driving trend
By Davis Bushnell, Globe Correspondent, 6/20/04
It's a hot field and one that won't be shipping jobs offshore anytime soon.
Physician assistants are forecast to be one of the fastest growing health-related occupations in the nation, one whose growth is fueled by a variety of economic and social trends.
Demand for physician assistants will continue to rise as healthcare institutions and physicians use the assistants' skills to deal with rising patient caseloads driven in part by an aging population that needs more medical care, specialists say.
''Physician assistants have a definite role to play in today's complex healthcare world, where doctors often can't provide all the care,'' said Dr. Richard Marshall, chief medical officer of Harvard Vanguard Medical Associates. Its 14 Greater Boston offices collectively record 1.5 million patient visits a year.
The number of US physician assistant jobs is projected to increase from 63,000 in 2002 to 94,000 in 2012, or a 49 percent gain, according to the US Bureau of Labor Statistics.
Only jobs for medical assistants and network systems and data communications analysts are growing faster, the bureau notes.
More than 30 years ago, the first physician assistants were mostly former military medical corpsmen who had served in Vietnam. Now, women outnumber men in the field, 59 to 41 percent, according to a 2003 survey of the American Academy of Physician Assistants.
These men and women, who must have a bachelor's degree and must be certified and registered in their respective states, work under doctors' supervision, performing a variety of medical and surgical procedures from conducting physical examinations to suturing wounds.
In 2003, the median US salary of a physician assistant who worked at least 32 hours a week for a primary employer was $72,457, according to the American Academy of Physician Assistants.
Boston's status as a medical hub spells opportunity for those in the field.
Locally, Harvard Vanguard, Brigham and Women's Hospital, Massachusetts General Hospital, Beth Israel Deaconess Medical Center, Boston Medical Center, and Tufts New England Medical Center employ more than 200 physician assistants among them.
Dr. Jack Ansell, vice chairman of the department of medicine at Boston Medical, said his department has a dozen physician assistants, and he's looking to hire another.
''There is a growing demand in medicine and other departments for physician assistants to help with patient care,'' Ansell said, partly because of restrictions on the number of hours a week residents may work. Residents are limited to 80 hours a week by federal rules.
The field ''has become more and more important'' to the workings in healthcare because of the stresses caseloads have put on the healthcare delivery system, said Dr. Deeb Salem, chief of the department of medicine at Tufts New England.
In Massachusetts, 1,321 people are registered by the Board of Registration of Physician Assistants, said Jean Pontikas, director for the division of health professions licensure at the Department of Public Health.
Although the words ''registered" and "licensed'' are often used interchangeably for physician assistants, a section of the Massachusetts general laws clearly states, Pontikas noted, that physician assistants are registered and issued certificates of registration.
And physician assistants are being registered in increasing numbers. In 1999-2000, for example, 91 people were registered, compared with 175 people in 2003-2004, said Barbara Webster, chairwoman of the physician assistants' registration board.
According to the American Academy of Physician Assistants, an estimated 50,121 physician assistants were in clinical practice in the United States at the beginning of this year. The field's credentialing organization, the National Commission on Certification of Physician Assistants, said that about 5,000 people are being certified annually.
Although there is an impressive number of physician assistants entering the field each year, there is a limit on how many students colleges and universities may admit to physician assistant programs, program directors said.
Major physician assistant programs in Massachusetts are being offered by Northeastern University and the Massachusetts College of Pharmacy and Health Sciences, both in Boston, and Springfield College.
Northeastern and Mass. College have master's degree programs, while Springfield has a bachelor's program.
''Medicine requires intricate teaching skills that are not easy to come by,'' said Jennifer Hixon, physician assistant program director at Springfield College. ''Also, we want to make sure that there's one-on-one time,'' she said, referring to student-teacher ratios.
The downside, she said, ''is that we have to turn down many applicants every year.''
There are now 134 accredited physician assistant programs across the country, up from 54 in 1991, according to the Accreditation Review Commission on Education for the Physician Assistant, which is responsible for accrediting all programs nationally.
The Northeastern program was one of the first in New England when it began in 1970, said director Suzanne Greenberg. More than half of its graduates have gone into internal medicine and family practice departments, the rest in surgery and other specialties, Greenberg said.
Physician assistant Ina Cushman, 50, of Weymouth, has been with Harvard Vanguard since 1988 and works out of the Braintree office.
Most of her time is spent on general surgery matters, the rest on orthopedics, said Cushman, a past president of the American Academy of Physician Assistants.
Her duties, she said, range from draining abscesses and suturing cuts to helping to draw up treatment plans for breast cancer patients.
''What I like most is the absolutely wide variety of things I do to help patients,'' said Cushman, who was motivated to go into the field by a physician assistant who cared for her years ago.
Cushman has worked for 16 years with Dr. Brent Shoji, a general surgeon at Harvard Vanguard and a doctor at Brigham and Women's and Faulkner hospitals.
Shoji said Cushman and the other physician assistants ''are exceptional clinicians who follow through with patient care. They provide needed continuity for our practices.''
The two largest physician assistant specialties at Harvard Vanguard are internal medicine and surgical, said Marshall, the chief medical officer.
Harvard Vanguard has more than 50 physician assistants on staff, who are paid between $50,000 and $85,000 a year, he said.
Last week there were four job openings for physician assistants.
John de Jesus, 28, of West Roxbury, is rotating through various specialties at Tufts New England as a senior physician assistant student at the Mass. College of Pharmacy. From 1995 to 2001, he was a medic and laboratory technician in the Army.
''The PAs I met in the military encouraged me to get into the field after I was discharged, and so here I am,'' de Jesus said last week, after taking time out from working in the medical center's emergency rooms.
De Jesus said he's undecided about which specialty he'll pursue full time when he receives his master's degree next May.
Michele Elms, 29, of Boston, has been a physician assistant for three years and works in the emergency room at Harvard Vanguard's Kenmore Square office. She also heads the 400-member Massachusetts chapter of the American Academy of Physician Assistants.
''I do about everything a doctor does while consulting with my supervising doctors,'' said Elms.
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