Q&A With a Local PA

About a Physician Assistant

Physician Assistants (PAs) are state licensed and nationally certified members of the health care workforce. The growth of health care demand nationwide, especially in Nevada, has created a need for PAs in a wide array of clinical settings. PAs practice medicine in collaboration with physicians and a variety of environments including primary care, hospital, and specialty practice. A PA is trained to:

• Perform physical exams
• Order and interpret tests
• Make diagnoses and treat patients
• Prescribe medications
• Assist in surgery
• Make rounds in hospitals and nursing homes
• Counsel patients and develop treatment plans

PAs train in the medical (disease-centered) model and work in collaboration with physicians. A PA exercises considerable autonomy in diagnosing and treating patients, but local practice and state law determine the scope of a PA's practice. Having entered the program with substantial health care experience, PAs spend less time in training and join the workforce immediately upon completing their educational and national certifying requirements.

Interview With a Local PA

Terri Elliott is a Physician Assistant in Reno, Nevada and has been practicing since 1997. She graduated from the University of Wisconsin, Madison and has lived in Reno since 2005. In the past, she has worked in Cardiac Surgery and even traveled abroad to the Netherlands teaching endoscopic vein harvesting for open-heart surgery. Surgery is her true passion and she says that's what she loves about being a PA is that she can change her specialty at any moment. "You are not locked into a specialty as a PA, you're only locked in by your own reservations of wanting to put in the effort to become an expert in a new specialty. A surgeon can never just go from one specialty to another, but I can just make the change easily." Currently, Terri works for Renown Health and the School of Medicine had a moment to chat with her about her job and her experience as a PA.

Who is the PA Program For?I think it’s geared towards a person who wants to give back to their community, from a medical perspective. Much like a doctor or nurse, it takes a whole team and you’re not excluded as a PA being a part of the team. Most people who have approached me with an interest as a PA have families and are already involved in health care at some level. For example, a scrub tech I know in his mid-thirties, has a wife, two children – he is the kind of student this program is for. He understands the field, he understands medicine and knows what’s involved. He already has the baseline skills but wants to advance his career.What are misconceptions about a PA?Often, the title Physician Assistant implies that you are an assistant. You are a lot more than an assistant. PA’s provide medical care, just as an M.D. or N.P. within a particular scope of practice. You can even be providing that medical care from a clinic that’s out in a small suburb of Nevada, and only have an M.D. available via phone – and you’re the PA that’s available. The title doesn’t give you that credit. Patients that have been cared for by a PA, they love us. Our training is very broad and patient-focused, and we have excellent physical exam skills, which often leads to the choice of care that that patient needs.What is it about the PA career that attracted you, rather than an M.D.?That’s an easy one. I was 35, a single mom, had a pre-med focus in my schooling and I was a year out from graduating. I had never heard of a PA. I looked into nursing, physical therapy, and med-school. I had a really good GPA. I could have gone anywhere. Every nurse I talked to said they wished they had gone to PA school or NP school – so I started looking into it. After researching it, that seemed a better choice for my family and me. I never had a desire to do the med-school route. There are different personalities, where you need to be the boss, the Dr., and that’s what you want in life. My comfort level was being a team player, having colleagues that I could always pass things by, passing off something I wasn’t comfortable with to the doctor. It’s a perfect fit for me.How many hours a week do you work?80 hours a week.Do you have to be on-call?Not in my current job. In cardiac surgery I was on call one day out of three. It was rewarding but exhausting. In that position, I took all the phone calls from all the nurses, in every hospital in the town.What’s the difference between a PA and an NP?In clinic practice, absolutely nothing is different. However, their training is completely different. I think you need all different arms of a medical team to care for patients.Does the supervising doctor shadow you or see your patients afterward?I never see the supervising doctors. In cardiac surgery, I saw the surgeons every day, but they were never shadowing me. If I were worried about someone, I would ask them to come to check on the patient. And you can never operate without a surgeon. At my current job, I have four M.D. partners and one NP partner. We provide post-acute care to four rehab facilities in town. We cover about 400 patients a day. The doctors and I talk via text or phone call, and we just take care of patients. I cover a facility by myself, but my supervising physician is available to me. He comes once a week to do new admissions or to follow-up on patients that I’m concerned about. I am their partner, not their assistant.Do you ever have issues with patients not willing to see you?Never.Was it hard getting a job right after you graduated?It was an easy transition. In Madison, WI it’s saturated with providers, so even there, it was easy. I got a phone call from an orthopaedic surgeon that heard I had good hands and asked me if I wanted a job.What advice do you have for a prospective student considering an education/career as a PA?The pre-requirements to get into the program are important. When you take biochemistry, you should really be learning it, and not just be there to get a grade. When you get into PA school, you have to have a pretty solid foundation. They are going to throw a lot at you in a very short period of time. But it's a wonderful career. It's great to help people, in general. You help them psychologically and emotionally. It's more than providing an antibiotic to a patient. You're their home base. It's the kind of career that gives back to you at every moment.