What is your primary care provider’s title? Are they a medical doctor (MD), doctor of osteopathy (DO), nurse practitioner (ARNP), or perhaps a physician associate (PA)? That last title may be slightly different from what you are familiar with. The physician associate used to be called a physician assistant, at least in some circles. A name change in May of this year has rankled physicians and advocacy groups around the country. So, what’s in a name?
Physician assistants were first recognized as a mid-level provider in 1967. Since that initial group of four PAs, the practice has grown to 150,000 PAs around the country. As mid-level providers they have a fair amount of autonomy. PAs perform many of the same tasks as doctors, including prescribing medication, ordering imaging and tests, and examining patients. Some PAs do operate in a role more closely characterized as an assistant in part of a larger care team, such as in a surgical team. Most states require a measure of supervision of the PAs by physicians.
Mark Twain once wrote: “[t]he difference between almost the right word and the right word is really a large matter – it is the difference between the lightning bug and the lightning.” This comment is often quoted or paraphrased in legal briefings and court opinions. It also highlights the meaning of words in the proper context. So, in an effort to better describe their role, the American Academy of Physician Associates changed its name this May to from American Academy of Physician Assistants. This change has been met with ire from some physician’s groups, who express concern about public misunderstanding about a PA’s role in health care.
Advocates for a broad acceptance of the change from “assistant” to “associate” note the greater autonomy their practice allows for. Some of the physicians’ groups have argued that it is inappropriate because this is part of the pursuit of fully independent practice, or, more cynically, to “obfuscate their credentials.”
Whatever happens in the long run, PAs, be they “associates” or “assistants” will likely continue to play a growing role in healthcare in the coming decades.
