This Week is National Physician Assistant Week.

Whether it’s a routine check up or emergency care, patients want to be treated by a skilled and caring medical staff.  These days, in addition to physicians and other healthcare providers, Certified Physician Assistants (PAs) are often key members of strong medical teams. That’s certainly true at Adirondack Health, where Dr. Anthony Dowidowicz, medical director of emergency services, and Certified Physician Assistant Roy “Skip” Parker work as part of a team that seamlessly treats patients at the health system’s emergency departments in Saranac Lake and Lake Placid.  These two emergency departments are visited by 14,000 local residents, vacationers and sports enthusiasts who downhill or cross-country ski, hike in the Adirondack Park, or train at the U.S. Olympic facilities.

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Physician Assistant Roy “Skip” Parker and Dr. Anthony Dowidowicz, medical director of emergency services for Adirondack Health, consult on a patient case recently. Skip has devoted nearly four decades to his career as a Physician Assistant.

Dr. Dowidowicz and the chief medical officer oversee a staff of 12 PAs in the Emergency Department.  “I am proud to say this is a PA-driven program,” he says.  “We encourage PAs to perform autonomously, and our data demonstrates they deliver great outcomes and consistent, high quality care.” In addition to the Emergency Department, Adirondack Health relies on Physician Assistants in its primary care centers and inpatient care areas. The demand for emergency services is declining slightly in our area, in large part due to the implementation of the Patient Centered Medical Home.  The goals of the medical home demonstration project are to emphasize prevention and better manage chronic conditions, which will ultimately improve quality of care, help patients avoid visits to the emergency room and contain costs.   This healthcare delivery model tightly couples patients with their primary care provider, enabling patients to get in touch with a physician 24 hours a day.   If an urgent health need cannot wait until normal business hours, patients can contact a member of the Adirondack Health Medical Staff by calling the “after-hours call line” at (518) 897-2744. 

 “This is just one example of the Adirondack Health board and leadership making decisions that will ensure this health system remains a vital part of the community through challenging times,” says Dr. Dowidowicz.   “PAs will continue to be in high demand in these new healthcare delivery models.  Studies show they have high patient satisfactions scores and are cost effective.” Dr. Dowidowicz points out that Adirondack Health for the most part has a well trained, heavily credentialed PA staff.  Certified Physician Assistants are highly educated medical providers who graduate from accredited, masters-degree level PA programs, pass a rigorous national certification exam, and maintain certification through ongoing education and recertification exams.  They are also licensed by state medical boards.

 Certified PAs practice medicine with the supervision of a physician. They routinely obtain medical histories; examine, diagnose and treat patients; order and interpret diagnostic tests; and develop and implement treatment plans.  They can perform minor surgery and assist in major surgery, instruct and counsel patients, order or carry out therapy and prescribe medications. 

According to self-reported data collected by the National Commission on Certification of Physician Assistants (NCCPA), each week certified PAs work 3.8 million hours enabling them to increase healthcare access by seeing 7 million patients. Over 9,500 of the nation’s approximately 92,000 certified PAs practice in New York State.

PAs Practice in Primary Care and Specialties

Parker has seen great change in the profession over the course of his career.  “There is a mutual respect between PAs and physicians, and I am included as a member of the credentialing committee. 

“PAs at this medical center even teach new physicians procedures, like spinal taps, that we have done frequently,” he adds. “So it is obviously important to keep skills sharp.”

Parker was one of the first PAs in New York to earn the Certificate of Added Qualification (CAQ) in Emergency Medicine from the NCCPA.   The CAQ credential recognizes experience, education and qualifications in emergency medicine, and requires recipients to pass a national exam in the specialty.

Dr. Dowidowicz points out that Adirondack Medical Center has now set the CAQ “as a standard for PAs in emergency medicine as a measure to prove their high-level of competence.”

Parker, who will retire soon, has enjoyed his career as a PA. “This is a great place to work, and I sense tremendous respect from my peers and physicians,” he says. “This is a small community, and people are appreciative. There is a wonderful connection with patients when they say ‘thank you.’ It is very rewarding.” 

Why PAs are in Demand

The number of individuals with medical insurance is quickly multiplying, making changes inevitable in how we consume healthcare in the U.S.  

The reasons include:

•          Provisions in the Affordable Care Act that will make private or federally-subsidized insurance available to 36 million individuals, starting in 2014

•          Aging baby boomers who are being added to the Medicare rolls at a rate of almost 11,000 seniors every day

•          A shortage of 66,000 primary care physicians by 2020, begging the question: who will care for all these new patients as they enter the healthcare system?

 This new environment calls for a team-based approach to delivering coordinated healthcare, and the physician-PA team concept is working and growing in every state, specialty and medical setting. 

Certified PAs must pass rigorous standards to earn the PA-C designation after their name. 

 This designation validates their clinical knowledge and cognitive skills because it is only granted after they have graduated from an accredited PA program and passed the Physician Assistant National Certifying Exam, administered by the NCCPA.

 To maintain NCCPA certification and retain the right to use the PA-C designation, PAs must complete continuing medical education credits every two years and successfully pass a recertification exam every six to 10 years.

 For those PAs who commit to a medical specialty, the CAQ credential is available in seven specialties: Cardiovascular and Thoracic Surgery, Emergency Medicine, Hospital Medicine, Orthopedic Surgery, Nephrology, Pediatrics and Psychiatry.  CAQs are not needed for certification or state licensure; however they are recognition of a PAs additional ability to perform specialty-focused patient care.

 Since it is a matter of public record, anyone can check to see if a PA’s certification is current just by entering the name and state on the NCCPA web site, www.nccpa.net.