1 week Ago By Cindy Krischer Goodman
Janice Cohen, of Boynton Beach, refused to wait another four weeks to get an appointment with her primary care doctor. When offered a visit with a physician’s assistant, she reluctantly agreed. The experience, she says, proved to be a good one.
“She took much more time with me than a doctor ever would,” Cohen said. More often, a medical appointment now involves interaction with a physician assistant, particularly in Florida, where a doctor shortage has led to long wait times. Also known as physician associates, they see patients in primary care practices and urgent care centers and work for specialists, including cardiologists and pediatricians.
They help fill a gap in Florida caused by retiring doctors and a smaller pipeline of medical students available to cater to the state’s aging population. (In fact, the demand for physician assistants is expected to increase 28% by 2032, according to the U.S.
Bureau of Labor Statistics . Florida’s 16 master degree-level accredited educational programs are working to meet the need.) Those in the profession acknowledge that patients often don’t understand their role, even as they seek to push new laws in Florida that remove the requirement for physicians to supervise them in primary care after a set number of years of practice.
“If we do become more independent, it would require marketing,” said Marilyn Suri, the southern region’s director for the Florida Academy of Physician Assistants. “Part of the issue we have now is patients don’t know who we are and how capable we are. We have to educate the public a lot more.
” A 2024 Harris Poll of 2,519 adults age 18 and older found many didn’t always understand the role of a physician assistant — but those who do believe PAs play an important role in meeting people’s healthcare needs. Nearly 80% of adults polled rated the medical care they had received from their PA in the previous 12 months as good or excellent, and nearly two-thirds said they would trust a PA to be their primary healthcare provider. Suri said the Florida Academy of Physician Assistants plans to lobby the Florida Legislature during the next session to allow PAs to independently practice primary care in Florida without a doctor’s supervision.
Suri works as a physician assistant in pulmonary critical care at Jackson Health North and said typically physician assistant education is focused on primary care. “We take a board exam that encompasses primary care knowledge,” she said. “I can’t say I did the same amount of schooling as a neurologist, but I did enough to practice on my own in primary care.
” The academy sees this change in the law as significant for improving healthcare access, allowing PAs to fill the need in some areas of the state where the physician shortage has left gaps in care. However, medical organizations in the state are likely to oppose the change. The Florida Medical Association has said it opposes expanding the scope of physician assistants’ activities beyond the current law.
Dr. Jason Goldman, immediate past president of the Florida Medical Association, said PAs are a necessary part of the healthcare team but lack the depth of education and training that physicians receive. “They are there to help physicians in their duties.
They do not have the training, skills or ability to practice independently,” said Goldman, who also is president-elect of the American College of Physicians. “It would be bad for patient care. They don’t know what they don’t know.
” Ray Berry, CEO at Health Business Solutions in Broward County, said health systems are struggling to hire doctors, and PAs help fill the need, but they are not equal to physicians. Berry said he would rather see more efforts to train and keep medical residents in Florida rather than rely on physician assistants to fill the need. “They are a stopgap for routine things,” Berry said.
“But M.D.s go through a lot of education, so for anything complex I would want an M.
D.” The profession has been around since 1967 and is one of the fastest-growing in the United States. Physician assistants see patients of all ages in nearly all specialty and primary care areas, diagnosing and treating common illnesses.
Below are a few things to know about physician assistants. Physician assistants can perform many routine tasks of a primary care doctor, such as taking medical histories, examining patients, diagnosing illnesses, prescribing medications, ordering tests, performing procedures, assisting in surgery, and making rounds at hospitals and nursing homes. In Florida, they do this under the supervision of a licensed physician.
The supervising physician doesn’t need to be in the room when the physician assistant provides care but must be available for consultation. State law now says a physician can supervise up to 10 PAs at a time Since 2021, the Florida Legislature has given physician assistants the ability to do more, including order Medicaid home healthcare after an examination, prescribe a two-week supply of psychotropic drugs to minors, supervise medical assistants, and bill and receive payments from insurers. Some Floridians admit to being reluctant to see a PA, concerned about the differing level of knowledge.
Edward Cripe, of Fort Lauderdale, said he has seen a physician assistant in his cardiologist’s office and found her helpful. However, he added: “I would prefer to have an M.D.
as my primary care doctor.” “I saw a physician’s assistant at a primary care office to the total exclusion of the actual doctor,” said Judy Ellis, 83, of St. Petersburg, who wrote to the South Florida Sun Sentinel about her experience with healthcare.
“At my age, it’s important for the doctor to listen to my heart to see if I’m starting to grow something in the cardiology department that’s going to require specialized attention ...
And you wonder if the PA has the training and the knowledge to recognize a situation like that.” So, what is the difference in education? PAs don’t go to medical school like doctors and they don’t do residency or fellowship programs. Instead, they complete a 27-month master’s degree program that focuses on practical patient-care skills.
Then, they get hands-on training by working under a doctor’s supervision. Like primary care doctors, they refer patients to specialists when warranted. So, overall, doctors receive more education and do more hands-on training in their specialty.
A doctor usually gets 11 years of education following high school, while a PA gets six to seven. In Florida, PAs must do 2,000 hours of clinical rotations, while a specialty-trained physician does 9,000 to 10,000 hours of clinical training before being licensed, according to the Florida Board of Medicine. In Florida, PAs take a board certification exam administered by the National Commission on Certification of Physician Assistants (NCCPA).
Those who pass then need a license from the Florida Board of Medicine, which is the same entity that licenses the state’s doctors. To maintain certification, a PA must complete 100 hours of continuing medical education (CME) credits every two years and take a recertification exam every 10 years. Doctors enter their specialty with a deeper understanding of complex medical issues than do PAs, who undergo a shorter, focused training program.
However, Suri said that after 12 years of experience, her knowledge of the specialty in which she works — pulmonary critical care and sleep medicine — is extensive. She said she has learned on the job by working hands-on, side by side with physicians. “I am still practicing under the supervision of a doctor, but I am extremely confident and I train residents.
That speaks volumes in itself,” she said. “I work as a team with physicians.” More than 125,000 PAs were practicing last year in the United States; their median annual pay was $115,390.
By comparison, the median annual pay for a family physician in 2020 was $207,380, according to the Bureau of Labor Statistics. Physician assistants practice in a wide range of specialties and work settings, which likely is why a 2023 Harris Poll found more than two-thirds of U.S.
adults (68%) have seen a PA, and of those, nearly six in 10 (58%) have seen the same PA more than once. In Florida, PAs work in hospitals, nursing homes, medical offices, outpatient clinics, urgent care facilities and surgery wards — interacting with orthopedists, obstetricians, pediatricians, dermatologists , and other specialized medicine professionals . Diana Cherkiss, director of the PA program at Nova Southeastern University in Davie, said students in NSU’s PA programs do a rotation through specialized areas of medicine, can take electives in any specialty they wish to pursue, then undergo training under supervision.
“The same three years an MD is doing residency, PAs are doing training with a supervising physician. It’s almost exactly the same,” said Cherkiss, who is a PA at Memorial Hospital Miramar. She said PAs know the limitations of their knowledge and refer patients to specialists if needed: “They work collaboratively on any type of complicated case.
” South Florida Sun Sentinel health reporter Cindy Goodman can be reached at [email protected]..
