The Untold Truths About Physician Assistants

Posted on: July 15th, 2024 by Our Team

Reviewed by  Rick Noodleman, MD & contributions made by Jason Cheema, PA-C; Karen Chen, PA-C; Miriam Eshoiee, PA-C; Sandra Diaz O’Donnell, PA-C; Kevin Lee, PA-C; Jack Sharkey, MMS, PA-C; and Yelena Wapen, PA-C

Physician Assistants (PAs) are qualified practitioners who treat, diagnose and care for patients. It is a misnomer that PAs are assistants to physicians when, in reality, PAs go through rigorous course work and are “licensed and certified to practice medicine, and [their] scope is determined by state regulations and [their] collaborating physician’s supervision,” said Miriam Eshoiee, PA-C. Each PA possesses a distinct background, contributing something unique to their practice. Despite their different journeys, PAs share commonalities, which enables them to address dermatological concerns effectively.

PA Education

To earn the designation of PA or PA-C, one must complete the proper education and pass a national certification exam. First, a bachelor’s degree is required, followed by a master’s degree through an accredited PA program. Each PA program is 2.5 – 3 years on average, consisting of “in-depth study of the human body, pharmacology, and rotations in various specialties to get real-world experience,” said PA Eshoiee. Sometimes, PAs  “complete several thousand hours in patient care experience before applying and pursuing [their] masters [degree],” said Jason Cheema, PA-C, to be able to provide the best care possible to their patients.

Like doctors, PAs can pursue fellowships or residency programs for more in-depth training. The Society of Dermatology PAs (SDPA) has a diplomate fellowship program to educate PAs further, allowing them to “become particularly proficient in dermatology,” said Yelena Wapen, PA-C. “That level of specialized training or experience would allow the PA to excel in [it].” The dermatology residency program will give PAs an even better understanding of the dermatology field. The program can be up to one year “of a mixture of didactic learning along with hands-on training,” said Kevin Lee, PA-C, giving PAs more exposure to real-world scenarios in clinical settings.

What PAs Can Do

PAs operate at an advanced level in the medical field and are responsible for evaluating and managing patients’ healthcare needs. PAs are licensed and qualified to be able to do the following:

1. Conducting thorough patient history and physical examinations
2. Making diagnoses using information from step 1 and, if needed, lab tests or biopsies
3. Creating treatment plans, often involving medication prescriptions
4. Organizing follow-up appointments to monitor diagnosis accuracy and treatment effectiveness

PA Wapen explained that a properly educated, trained and experienced PA is expected to provide the highest quality of care, which is standard at CSI. Therefore, PAs are qualified medical professionals to do a wide range of treatments and procedures including, but not limited to, skin checks, various biopsies, acne care, phototherapy, eczema treatments, excisions, injections, biologic management, acne surgery, cryotherapy, Botox®, fillers and laser treatments. “There are no limits [except for a few exceptions] in what a PA can do, as long as the supervising physician feels comfortable with [their] knowledge and skills,” said Sandra Diaz O’Donnell, PA-C. PAs also help “fill in the gap or need when a physician’s schedule does not have room,” said PA Lee, to see patients.

PAs cannot perform Mohs surgery. A board-certified Mohs Surgeon must do this.

Collaboration Between PAs & Physicians

PAs collaborate with various healthcare professionals, such as their supervising physician, a patient’s PCP, or a referring physician. “As a PA, I have a supervising physician that I can always go to for questions and difficult cases,” said Karen Chen, PA-C, highlighting the supportive relationship between PAs and their supervising physicians.

A supervising physician is more of a colleague and mentor for the PA. PA Wapen further emphasizes this partnership,  stating that the supervising physician is a colleague and mentor, guiding PAs in managing cases within their scope of practice and progressing the PA’s clinical skills in their designated specialty. This collaborative approach ensures patients receive the most comprehensive care while consulting or referring to other physicians for cases beyond a PA’s expertise.

Beyond their supervising physician, PAs can also collaborate with patients’ PCPs or other referring physicians to coordinate care and determine the best course of action. This collaborative practice model enables PAs to “excel in patient communication, education and building long-term relationships,” said Jack Sharkey, MMS, PA-C.

How PAs Stay Current In The Medical Field

Doctors and PAs both participate in continuing medical education to stay current in the medical field and pass recertification exams. Maintaining board certification for PAs involves earning 100 CME credits over five two-year cycles and passing an exam every ten years to ensure ongoing clinical competency. “Reading articles and attending dinners to [stay] informed [about] new drugs [and treatment processes] is always important,” said PA O’Donnell. CMEs can also be obtained by attending courses, talks, conferences, and lunch and learns. ”This enhances [a PA’s] diagnostic abilities, surgical skills, and ability to manage the most complex cases,” said PA Sharkey.

PAs possess extensive medical knowledge and can specialize in dermatology, enabling them to treat dermatology patients effectively. Recognized as essential members of the healthcare team, PAs “extend the reach of physicians, increasing access to care,” said PA Sharkey. “We are vital in managing chronic conditions, providing preventative services, and ensuring overall patient well-being.” Their autonomy and proficiency in patient care challenge the traditional “assistant label,” said PA Cheema, and there is a movement to change the title to physician associates to represent their role in patient care better.

Book with a PA today. California Skin Institute offers a range of dermatologists and advanced practitioners to provide comprehensive dermatologic care to our patients.