Physician Assistants: filling a need in patient care

Years ago, in a remote village in Mexico, as a volunteer in a medical clinic, Kaye Kvam decided to become a physician assistant (PA). A relatively new field—just 10 years since the first class of PAs had graduated—Kvam thought it sounded promising as a career, but others warned her the profession wouldn’t last. Thirty years later, Kvam—and the profession—are still going strong.

According to the American Academy of Physician Assistants (AAPA), there are approximately 74,000 physician assistants in the United States—twice as many as just 10 years ago—providing nearly 260 million patient visits and increasing access in underserved areas. These numbers are expected to increase.

“We are very lucky to have our PAs, and as we anticipate the challenges of health care reform, I expect we will find even more ways to work with this great group to provide high quality, affordable care,” said Chief Medical Executive Michael Soman, MD.

Kaye Kvam’s career as a PA has taken her from a rural clinic in California to an emergency medicine residency in Los Angeles County, where she stayed as clinical director for 6 years. She has been at Group Health since 1989, and is currently practicing family medicine at Kent Medical Center. “I like the philosophy of medicine here at Group Health,” said Kvam, who was a nominee for Group Health Permanente’s 2007 Steve Turnipseed award for outstanding non-physician clinician. “And I like the fact that PAs are looked at as colleagues. We’re a team.”

Cristina Ryser, a PA specializing in sleep apnea at the Capitol Hill Sleep Clinic, feels that she “can make an impact as an advocate for patients, helping them make their health care decisions.” The Sleep Clinic trained Ryser—the first PA to be employed in that specialty—in 2003. Now, more than 100 PAs in a dozen specialties play a part on the team at Group Health.

Studies show that PAs save as much as 20 percent of the costs of medical care, can perform at least 80 percent of the functions in an ambulatory care practice. Patient experience surveys indicate satisfaction with PAs is equal to that of other providers.

Physician assistants are educated in intensive accredited medical programs; the average curriculum runs approximately 26 months. After graduation PAs are required to take ongoing CME classes and be retested on their clinical skills on a regular basis. A number of postgraduate PA programs have also been established to provide practicing PAs with advanced education in medical specialties. Because PA training is based in primary care and includes rotations through the major specialties, they will be especially invaluable with the looming shortage of primary care physicians our nation faces.

“Besides helping us take great care of our patients, PAs have personally taught me a great deal about casting and splinting, minor procedures, and the care of a number of musculoskeletal problems,” said Dr. Soman. “I couldn’t imagine Group Health without them.”