Talk:Physician assistant/Archive 2

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Archive 1 Archive 2 Archive 3

History

These edits over comments regarding Taiwan also deleted edits showing that the PA profession has changed radically from original goals by Dr. Eugene Stead. The PA profession was started by Dr. Stead with the intention of training experienced nurses and "street" and military medics to fill the gap in rural and urban medically under-served areas. However, most PAs schools now demand little or no previous medical experience, focusing instead on high GPA. As a result, fewer than 9 percent of PAs are practicing in rural areas. This is fact, and failure to include this information violates Wikipedia's neutral point of view policy by removing information that provides clarity, balance and objectivity.News4a2 (talk) 04:12, 16 November 2008 (UTC)

And can you provide the name of a reliable source that asserts that fewer than 9% of PAs practice in rural areas? Wouldn't that also vary from country to country? And mightn't a comparison to the number of people living in rural areas, and the number of physicians living in rural areas, also be appropriate? WhatamIdoing (talk) 23:36, 16 November 2008 (UTC)
If you even read the entire Wiki entry and perused down to "Employment," you will see the same statistic that you question. You suggest not editing to say U.S. but deleting entirely only from the history section? The grand and lofty goals of Dr. Stead have been corrupted. Facts prove it. PA's were supposed to fill the medically under-served gap ... and do not. They were supposed to have extensive experience in patient care before being considered for didactic and are not. Skill, not GPA, was the prime criterium. It's doubtful the earliest Vietnam veteran medics would ever be accepted into _any_ program today, much less the one at Duke.News4a2 (talk) 10:29, 17 November 2008 (UTC)
Wikipedia reports what is Verifiable, not what is True™. We must have a reliable source. How do we know that 9% is the right number? What if the correct number is 8%? We must have a source. The fact that you and I happen to believe it is completely unimportant. WhatamIdoing (talk) 19:42, 18 November 2008 (UTC)
AGAIN, you're commenting without even fully reading the entry. The source is there and verified. I again refer you to the original article, under the "Employment" section. It's _been_ a part of this Wiki entry, the results of a 2007 AAPA survey (most recent) -- 9% -- not me, the AAPA. I can only say your edits are Orwellian in nature. Its placement in the history section is important to illustrate that the original intent behind the formation of PAs has been corrupted and PAs and PA schools generally have failed to fulfill Dr. Stead's wishes.68.11.139.174 (talk) 11:57, 19 November 2008 (UTC)
The reference must be at that sentence, not elsewhere in the article. And the ref needs to directly state this particular fact, which, if you're relying on Table 3.13, it does not. Table 3.13 in that survey divides PAs according to whether they're in a metropolitan or non-metropolitan area, and it puts 15.0% of PAs in non-metro areas. If you exclude suburbs and exurbs (small towns adjacent to large cities), then the number is 6.3%. If you want to set up a standard that the surveyors rejected (defining rural as <20,000, even if that city of 19,999 shares a border with New York City), then the numbers add up to 8.2%, not 9%. WhatamIdoing (talk) 20:05, 19 November 2008 (UTC)
I placed the reference at that sentence. And as far as your disagreement goes with the "9%" I suggest you take that up with the AAPA. Your argument is akin to the number of angels dancing on the head of a pin. "If you can't fool them with facts, baffle them with BS." Any sensible person can add it up. Moreover, if you're that adamant against using the official data of the AAPA, why haven't you questioned the addition of the information when it was first added in the Employment section? Your failure to do so there but adamance to do so here indicates you have a hidden agenda in your editing.News4a2 (talk) 22:07, 19 November 2008 (UTC)
Have you actually pulled out your calculator and added up the numbers? When I add 4.4% + 2.4% + 3.7% + 2.9% + 0.6% + 1.0%, I get 15.0%, not "about 9%". Similarly, when I add up the Wikipedia-editor-selected sections of this column, which are 3.7% + 2.9% + 0.6% + 1.0%, I get 8.2%, which might be "about 8%," if you're determined to round to a single digit, but really can't be represented as "about 9%".
I don't object to the inclusion of accurate information (are you aware that I've repeatedly restored its inappropriate deletion?). Do you have an objection to removing basic arithmetic errors from the article? WhatamIdoing (talk) 03:40, 20 November 2008 (UTC)
Well, so now it's not a citation, it's the number! Okay. I'm still trying to figure out why you're taking your stand on the history section when apparently this so-called math error has been existent on the entry for how long? You've failed to answer that question several times, which is surprising because you apparently like to argue for the sake of the argument. And while I submit those numbers are subject to interpretation defined by the government's definition of medically under-served areas, the deletions in the history section comprised the entire paragraph entry and not just a math correction here OR in the employment section. It was a wholesale deletion not an edit of math errors. 6 or 10, it still says that the _vast_ majority of practicing PAs went to the city and left the medically under-served, under-served despite Dr. Stead's dream and promise to provide care for those most vulnerable and in need. You pick the number ... but apply it consistently.News4a2 (talk) 05:52, 20 November 2008 (UTC)
The history section must have a citation added to it.
Both sections must have the correct number.
I have personally not deleted this information from this article ever.
Are we clear on these points? WhatamIdoing (talk) 20:47, 20 November 2008 (UTC)
If you didn't delete it, then WHY, pray tell, are you even chiming in here? When the lock gets pulled off, put in whatever edits you want on the numberS and state your reasons. My grief is with the person who kept deleting the 'graf in its entirety. Are we clear on that point?News4a2 (talk) 21:04, 20 November 2008 (UTC)
The person that kept repeatedly deleting this paragraph was User:Nomad2u001, who has been temporarily blocked for his efforts. Are you familiar with the "History" tab?
The reason that I care about this is because the sentence as written (that is, including the error and not including a proper citation) is out of compliance with Wikipedia's core policy. WhatamIdoing (talk) 23:18, 20 November 2008 (UTC)
(grammatically, that would be "the person WHO" sted that unless you can verify they're a "that" sted "who") If you will go to the history page you will see the cite as it was placed on my last insert/undo. "http://www.aapa.org/research/07census-content.html#3.13" This is the same format that was used in the "Employment" section. If I erred, then the error was never corrected in the "Employment" section in the first place and I repeated it thinking that was the style. Regarding the numbers, perhaps a range would be best.News4a2 (talk) 09:28, 21 November 2008 (UTC)
Actually, using that for all restrictive clauses, including those that describe humans, is perfectly correct. It's simply more formal than the most common American English usage.
Actually, it's grammatically incorrect. The "that" in your sentence refers to "The person," and persons are "who" not that.68.11.139.174 (talk) 08:17, 23 November 2008 (UTC)
What range of numbers do you propose? And why did you exclude so many non-metro areas? WhatamIdoing (talk) 23:24, 22 November 2008 (UTC)
6.3 (excluding rural/non-metro suburbs adjacent to metro areas) to 15 (including same). If it's non-metro, greater than 2,500, and adjacent to a metro area, it's a suburb or exurb.68.11.139.174 (talk) 08:17, 23 November 2008 (UTC)

(undent) Actually, you misunderstand the grammar issue. People can correctly be referred to as either that or who. The choice of that is less common in modern American English, but its declining popularity doesn't make the older use wrong. See, for example, Matthew 7: "Not every one that said to me, Lord, Lord, shall enter into the kingdom of heaven; but he that does the will of my Father," or Othello's famous line, "Then must you speak/Of one that lov'd not wisely but too well" (emphasis added, obviously). Furthermore, it's the only way to indicate that a speaker intends a clause referring to a human to be restrictive instead of non-restrictive (descriptive); who serves both functions.

Back on the actual topic: Why not just say 15% serve in counties that are not considered metropolitan areas? That's the distinction that all the government agencies consider to be most important.

Additionally, are you aware that only 17% of the US population lives in these counties (as of the 2000 census)? That suggests that just about the correct number of PAs are working in nonmetro areas. There's currently little need for "extra" PAs in geographically rural areas; inner city Los Angeles is vastly more underserved from a medical perspective than, say, tiny Poweshiek County, which is considered code 7 (Nonmetro county with urban population of 2,500-19,999, not adjacent to a metro area), but which also has many medical clinics and a relatively large, "full-service" hospital, not to mention several major medical centers (e.g., University of Iowa Health Care) within less than an hour's drive. WhatamIdoing (talk) 19:15, 24 November 2008 (UTC)

I'm sorry, how many angels did you say were dancing on the head of the pin? An hour's drive is 70 miles you can't travel if you don't have a car. Your thinking is self-centered in _your_ world ... step out of it. I've worked this areas, not Scarsdale of course, but real by-golly rural areas 20 miles+ from a definitive care hospital. If the people don't have transportation, they don't have health care and _all_ their health needs become emergencies. And that, madam, is why it's necessary. I'm sorry to have to say this, but you obviously have too much time on your hands and really like to argue. I don't have that time, but this is very, very, very important information and I won't continue to trivialize it by getting muddy in the sty with you. When the lock comes off, I'll edit it and put it the numbers as I see fit. If you don't like it, delete it. I'll undo it. And before long, it'll be locked again, the paragraph won't be included and PAs and PA schools will continue to migrate toward boutique medicine, without penalty or the reprobation from society due them, and crap on the dreams of Dr. Stead and society's most vulnerable.68.11.139.174 (talk) 03:24, 25 November 2008 (UTC)
I don't see that what you are saying is helpful. You seem to have only edited this article.[1] Do you have any sourced information you can provide that will improve the article? —Mattisse (Talk) 03:47, 25 November 2008 (UTC)
I provided balance to a section containing unbalanced information. One can't just cite the lofty goals of Dr. Stead without also citing that that aims were not achieved, the promise unfulfilled.News4a2 (talk) 22:19, 25 November 2008 (UTC)
Not exactly. You provided your personal point of view, without any support for your assertion that Dr Stead had a particular desire to see PAs in rural areas (as opposed to any geographic area that happens to be underserved). WhatamIdoing (talk) 05:13, 26 November 2008 (UTC)
Not POV but established fact. Once again, you're either failing the read the information already included in the Wiki, to wit: "The PA profession came into existence in the mid-1960s due to the shortage and uneven geographic distribution of primary care physicians in the United States," or trying to argue the minutia like some kind of usenet troll. It was started because of uneven distribution and there still exists uneven distribution. The information I included, already accepted in the employment section, illustrates that. Regarding this particular section, I'm not adding information to the Wiki that wasn't already there, just adding it to a section to provide balance to an unbalanced statement.News4a2 (talk) 09:55, 27 November 2008 (UTC)
I read the actual source listed in that paragraph, and it makes no mention at all of rural areas. Do you have a source that specifically declares that PAs are supposed to be in rural areas? WhatamIdoing (talk) 20:32, 27 November 2008 (UTC)
Try this [2]link.68.11.139.174 (talk) 21:43, 29 November 2008 (UTC)
That's much better, but it spends just as much time talking about underserved populations, suggesting that their inability to access a physician is more important than their geographic location. 03:21, 2 December 2008 (UTC)
I've read your edit of the employment section and it is nothing but obtuse and confusing to anyone who reads it. Angels on the head of a pin. As I've said before, you relish debating the minutia. I doubt Dr. Stead saw Hollywood as "underserved" if there were not enough plastic surgeons to tighten the sagging wrinkles but you want to expand the definition to include this minutia. You are trying to confuse the true reasoning behind the formation of the PA profession, and for reasons I cannot fathom.News4a2 (talk) 10:54, 14 December 2008 (UTC)
Nomad2u001, I consider your wholesale deletions without discussion and without explanation vandalism. WhatamIdoing, you don't _own_ the page. I suggest you compromise on some of your disagreements or we're going to going in circles on this until it's locked again.News4a2 (talk) 07:13, 19 December 2008 (UTC)

(undent) As I have said previously, if you have a problem with the sourcing of the information or the way the information is presented, you should have piped up long before now.News4a2 (talk) 10:54, 14 December 2008 (UTC)

That a mistake was made a year ago is never an excuse for perpetuating it now.

I'm just pointing out that you seem enthusiastic debating the minutia here but never had a problem with the information as placed in the employment section and it makes one curious is all.68.11.139.174 (talk) 21:43, 29 November 2008 (UTC)

Please do not stick your comments in the middle of someone else's; it leaves other readers confused about who said what/when. I've moved your comment here so we can carry on two separate conversations, since that seems to be your goal.
This article has been on my watchlist (along with about 900 other pages) for about six months, to keep an eye out for vandalism and edit warring. I've never actually bothered to read the entire article at once: it's not necessary to know what every sentence says to figure out whether replacing the entire page with I LOVE CHEEEEZZEEBURGERS!!!! is vandalism.
As for your implied accusation of a conflict of interest, I'm not a licensed healthcare professional of any sort (it's been years since I had even as much as a CPR certification), and I don't care one way or the other about PAs as a profession. I'm perfectly indifferent (unlike you) and therefore a neutral party.
What I do care about is whether Wikipedia is publishing outright errors or making assertions that aren't backed up by proper sources. I addressed the lack of proper sourcing and the errors as soon as I was aware of them. Do you have any problem with that motivation? Or were you just expecting me to correct problems before noticing them? WhatamIdoing (talk) 03:21, 2 December 2008 (UTC)

News4A2-- You keep mentioning that Dr. Stead meant for the profession to serve "rural areas," when in reality he meant for PA's to provide care to the under served. Rural and under served are not necessarily synonymous. Many urban areas are very under served; thus, were included in his vision for PA's also. 66.36.223.162 (talk) 16:22, 9 February 2009 (UTC) —Preceding unsigned comment added by 66.36.223.162 (talk) 16:07, 9 February 2009 (UTC)

It is stated that Dr. Stead began the program in 1965 with military medics who had extensive experience in the Vietnam War. U.S. combat soldiers were first sent to Vietnam in 1965. My question is: how could they have had much combat experience? Even if they served in Vietnam as medical personnel for the military advisers who were there before 1965, their experience would not have been related to combat injuries for the most part. Just wondering. [User:Utah44|Utah44]] (talk) 01:57, 22 August 2010 (UTC)

Edit request from Mgerchufsky, 27 October 2010

{{edit semi-protected}} Please change *ADVANCE for Physician Assistants journal to *ADVANCE for NPs & PAs journal because the name of the publication and its URL have changed to reflect its having been combined with ADVANCE for Nurse Practitioners. Following new URL provided will verify. Plus, I am editor of the publication; i.e., I am the source.

Mgerchufsky (talk) 18:54, 27 October 2010 (UTC)

Done Thanks, Stickee (talk) 21:56, 27 October 2010 (UTC)

US perspective

Although the article is still centered on the profession in the US, I have moved some sections so the flow is better, i.e. all information pertaining to the US grouped together and clearly labelled as such. I have also updated/added some links for more worldwide perspective on related professions.Guptan99 (talk) 17:03, 15 March 2011 (UTC)

I

I think this page should include a section on how nurses dislike physician assistants because they require less training yet are assumed to have higher qualities of medical care. (Clamster5 00:54, 8 July 2006 (UTC))

Actually, PAs are trained differently that nurses; PAs are trained in medicine, nurses in nursing. I know that sounds like I'm stating the obvious, but there is a significant difference. Also, most nurses have an RN (2 years) while PAs have a BA/BS + PA school (6 years), and have a much greater education in medical science and medicine. Gtadoc 02:39, 18 June 2007 (UTC) note: I'm not a PA.

Clamster5 you're welcome to write a bit about the conflicits between PAs and other health care professionals. Nephron  T|C 23:00, 14 July 2006 (UTC)

Nurses almost always have a nursing degree (4 years) where I am. The two year RN training was phased out a long time ago. — Preceding unsigned comment added by 128.189.226.132 (talk) 20:06, 18 October 2011 (UTC)

Major Overhaul Needed

This article is in need of some serious editing. There are some minor grammatical errors as well as some major structural problems. For instance, most of the first paragraph of the "Education and Certification" section is flat out confusing. Instead of explaining the accreditation of PA education and the credentialing process (ie that it is competency based, standardized, and ultimately determined by the AMA) the author mentions that "some PA programs are starting to offer a clinical doctorate degree." This is a gross distortion of the facts, and it reeks of bias and inappropriate boosterism, especially since the AAPA explicitly came out against the clinical doctorate for PA's. Only the US Army has a program that offers such a degree, and it exists only for the purpose of allowing PA's to advance in rank within the military.

Also, I plan on removing all incidences of the term "physician assistant/associate," as well as the subsection on the "Name Change", which is incidental to describing what Physician Assistants do. If anything, it may deserve a mention in a footnote. This is an encyclopedia, not a forum to advocate for your particular stance on a intra-professional political squabble. The name of the profession is Physician Assistant, not Physician Associate. Please stick to the facts.

Considering that this Wikipedia page is the second page that comes up on a Google search for "Physician Assistant," I am very concerned that this is a resource many people worldwide will consult to learn more about the profession. This is my first time editing a Wiki, and reading this article has inspired me to be bold and bring this article in compliance Wikipedia's Manual of Style.

--NorthCoastPA (talk) 01:02, 11 December 2011 (UTC)

Deleted International Section

I saw no compelling reason to keep this section. The information was too vague and outdated to justify it's own section. There has been criticism that this wiki is too US-centric, but that is because the profession was started in the US and has no exact equivalent in other countries. Similar professions in other countries can discussed in their respective wikis (ie "Clinical Officer" or "Feldsher"). — Preceding unsigned comment added by NorthCoastPA (talk • contribs) 17:05, 19 December 2011 (UTC)

Maybe what we need is a "non-physician provider" navbox which can link these various articles? Jclemens (talk) 17:24, 19 December 2011 (UTC)
That's a great idea. I'm new to editing so I don't know how to add a navbox. NorthCoastPA (talk) 16:27, 20 December 2011 (UTC)

Physician's "Associates" ??

PA stands for "assistant" and assistant only. Associate implies equals, though PAs are midlevel providers along with nurse practioners and nurse midwives. PHysicians are top level providers. The word "Associate" should be removed from the opening paragraph. It is totally made up. —Preceding unsigned comment added by 68.50.28.153 (talk • contribs) 00:22, 23 November 2006 (UTC)

This is simply not the case. Some PA programs in the USA are refered to as Physician Associates. [3] [4][5] just a few for example. In recent discussion groups in the PA world, the term Associate is being debated because it better reflect the relationship of the PA with the Physician. PAs do not pretend to be (nor want to be) physicians. However in todays world of medicine the role they play is more of an associate than the term assistant implies. Hences the debate. —Preceding unsigned comment added by 132.183.65.204 (talk • contribs) 09:15, 23 November 2006 (UTC)

I would tend to disagree. I graduated with a Bachelor of Science Degree as a Physician Associate, and subsequently received a second degree as a Master of Physician Assistant Studies--Family Medicine. Do I consider myself to be an equal of a physician, absolutely not. In 1971, what is now the American Academy of Physician Assistants was the American Association of Physician Associates (http://www.pahx.org/period03.html). Roadster 15:18, 27 November 2006 (UTC)

The certification uniformly appears to be called physician assistant. I looked at the three references provided; the first (Yale) states "... and advance the physician assistant profession."[6] and the third states "... is to educate physician assistants...", if one looks a bit further. The second reference is a page about a training program for medical students (i.e. physicians-in-training)-- "[Rural Physician Associate Program] is open to third year medical students enrolled in the University of Minnesota Medical School at the Twin Cities or Duluth campuses." -- and in a sense justifies the criticism by User:68.50.28.153. To me, it looks like a few physician assistant programs are trying to push the envelope a bit and make their program sound like they are training people that are equals to physicians.
In any case, I encourage both of you (User:68.50.28.153 & User:132.183.65.204) to register (see WP:REGISTER). Nephron  T|C 22:07, 26 November 2006 (UTC)
I have removed the reference to "Physician Associates" -- based on this reference (Physician Assistant History Center): "In the 1980's, the American Academy of Physician Assistants (AAPA) recommended that graduates of AMA accredited programs refer to themselves as physician assistants and that legislation enacted by states use this terminology to reduce confusion. Physician Assistant is the current term used to describe the profession." Nephron  T|C 22:23, 26 November 2006 (UTC)


The movement for "physician associate" is less than eight percent of the entire Physician Assistant population. Often times proponents of this give a sense of entitlement to change the name of over 75,000 PAs country wide. They have no clear, identifiable reason for the name change as it does not affect the profession as a whole. It will only confuse patients and other healthcare professionals, while providing a slim few providers the essential ego boost that they are not just an "assistant". Then again, when you go to a store and purchase something you're seeing a "Sales Associate" so realistically you are taking this moniker which is an even lower standard in other business industries and you are applying it to the medical field for no reason whatsoever. It does not affect patient care, nor reimbursements. It only affects the satisfaction that some have, or lack, to try to get themselves to sleep well at night. — Preceding unsigned comment added by 96.238.60.20 (talk) 17:24, 6 February 2012 (UTC)

Training

A two-year associate degree from an accredited physician assistant program is the minimum qualification to sit the licensing exams and practice medicine.[citation needed] It is not necessary to have a masters degree like this article suggests.[citation needed] In which case previous experience in a healthcare field would be necessary. — Preceding unsigned comment added by Ronns (talk • contribs) 13:57, 29 January 2012 (UTC)

The AAPA has officially endorsed the MS degree as the entry level and terminal degree for the profession.[citation needed] Nearly every PA program transitioned to master's programs decades ago and the few non-MS programs are in the process of transitioning.[citation needed] — Preceding unsigned comment added by NorthCoastPA (talk • contribs) 15:48, 29 September 2012 (UTC)

Wow, no way, physician assistants still trying to portray themselves as Medical Doctors.

The very first sentence is misleading considering someone with a clear agenda removed the second part of the original sentence. From reference one, "Physician assistants are healthcare professionals who are authorized by the state to practice medicine as part of a team with physicians."

http://www.aapa.org/the_pa_profession.aspx

The key part of the sentence is "as part of a team with PHYSICIANS."

"PHYSICIANS"

The sentence in the beginning is ignorant and deliberate misinformation. Sure, in a sense they practice medicine, by carrying out menial tasks under the supervisions and direction of ATTENDING PHYSICIANS - DOCTORS OF MEDICINE.

68.50.119.13 (talk) 01:42, 17 May 2013 (UTC)

This article needs work

I am disputing the first reference - http://www.aapa.org/the_pa_profession.aspx

The information is vague. For example, the list of tasks a PA COULD carry out should not be written as their actual duties. PA's in Nationalized Health Care systems might do some of those tasks, but it should be noted. It is misleading to imply PA's carry out all of the listed possible tasks world wide.

68.50.119.13 (talk) 01:51, 17 May 2013 (UTC)

Third sentence.

"Physician assistants are concerned with preventing and treating human illness and injury by providing a broad range of health care services that are traditionally performed by a physician."

The third citation, of which this sentence uses, does not say what is quoted. It actually reads "Physician assistants, also known as PAs, practice medicine under the direction of physicians and surgeons. They are formally trained to examine patients, diagnose injuries and illnesses, and provide treatment."

Again, the critical part of the first sentence is "under the direction of physicians and surgeons." I am changing it. 68.50.119.13 (talk) 02:00, 17 May 2013 (UTC)

American Medical Association Guidelines

Why aren't the AMA Guidelines included in this article? Those guidelines clearly state (item 4 below) that the PA is responsible to the patient's physician in all settings. Since that is the requirement of the AMA, I would think it is quintessentially relevant to this wikipedia article. Anyone who comes here for info about PA's should be aware that this is the position of the AMA, especially since this document is on the website of the American Association of Physician Associates. http://www.aapa.org/uploadedFiles/content/The_PA_Profession/Federal_and_State_Affairs/Resource_Items/AMAGuidelines.pdf

Passed by the AMA House of Delegates, June 1995

1. The physician is responsible for managing the health care of patients in all practice settings. 2. Health care services delivered by physicians and Physician Assistants must be within the scope of each practitioner’s authorized practice as defined by state law. 3. The physician is ultimately responsible for coordinating and managing the care of patients and, with the appropriate input of the Physician Assistant, ensuring the quality of health care provided to patients. 4. The physician is responsible for the supervision of the Physician Assistant in all settings. ...

Also, the NIH website of medical literature states: "All state laws require PAs to have a supervising doctor." See: http://www.nlm.nih.gov/medlineplus/ency/article/001935.htm It seems that this requirement is structural to the program and is hugely important to people (patients) who come to wikipedia for info about the program.

Thanks for your consideration. N0w8st8s (talk) 18:07, 29 September 2013 (UTC)n0w8st8s

United Kingdom - Re-certification

Re-certification "All qualified PAs are required to re-certify every 5–6 years through a 2 hour MCQ exam, testing knowledge on all aspects of medicine, regardless of t Re-certification will move to ever 10 years in the US starting in 2015. The test is called the PANRE (PA National Recertification Exam). The content of the PANCE / PANRE Blueprint (comprehensive content) covers all organ systems with emphasis going to Cardiac, Pulmonary, and Musculo Skeletal." This section seems to combine references to the UK and US PA's Re-certification process and needs to be fixed.Joedumlao (talk) 14:52, 30 December 2014 (UTC)

"Supervision"? Time to retire it.

Per [7], AAPA no longer refers to physicians working with PAs as "supervising physicians", but rather "collaborating physicians", as more accurately reflecting the broader current scope of PA practice. Certain laws will still use the older terminology, and direct supervision is certainly one form of collaboration, but it's time to adopt appropriately modern language in the article to reflect how practice has evolved. Jclemens (talk) 22:26, 20 July 2016 (UTC)

Whether described as collaboration or supervision, this isn't just about the about scope of practise. Simplifying the description of the arrangements as collaborating is not more accurate, for example see a recent article in the Huffington Post. In the UK Physicians associates do not (yet) have a statutory register and are not legally able to prescribe or order radiological investigations. AAPA is one organisation that promotes the interests of its members. After a vote at one of their meetings, AAPA recently quietly went about replacing the terminology on its webpages from Physician Assistant to PA. I think Wikipedia shouldn't simply mimic AAPA's approach to descriptions. In terms of the responsibility for actions it seems there is legally a clear element of supervision, even though some PAs will accomplish many tasks without direct supervision. Drchriswilliams (talk) 06:11, 21 July 2016 (UTC)
There are also issues with using the generalised description that a professional group "practices medicine" when referring to a group that includes people that don't hold a primary medical qualification and aren't on a statutory register. Drchriswilliams (talk) 06:56, 21 July 2016 (UTC)
I'm wondering if this is a US vs. UK issue. In the US, physicians are increasingly abandoning low value specialties such as family medicine, and PAs (and nurse practitioners, but this article is not about then) are filling the gaps. Often times, a non-physician medical provider is going to be the only medical provider at all available in rural locations... Hence the AAPA modifying its stance to favor the more inclusive term. But that isn't going to be applicable to the UK. Do we need to segregate the article more, so as to accurately describe each nation's setting? Jclemens (talk) 07:19, 21 July 2016 (UTC)
There are some differences between how things are organised in the US an UK. But supervision is required in both. Medline Plus says that "All state laws require PAs to have a supervising doctor." This is immediately apparent in guidance issued from California to New York. Even the latest legal changes in Virginia clearly indicate that supervision is required. Drchriswilliams (talk) 21:15, 21 July 2016 (UTC)
Sorry, but those are primary sources. Wikipedia does not quote laws verbatim without reliable secondary sources interpreting them. More importantly, the legal terms are not particularly useful to understand how the profession operates. News outlets cover this evolution: Forbes, Forbes again, Politico, and Clinical Advisor, the oldest of which is 16 months old. To be sure, there's a place for discussing "supervision" in the appropriately more detailed body of the article, but the lead is not the place for archaisms. Jclemens (talk) 05:03, 22 July 2016 (UTC)
Thanks for these secondary sources, which are also better than the AAPA website material. I have spent some time trying to update the sources for this article. I appreciate there is some change in legislation and culture occurring in the US. The secondary sources do pick up on PAs being given more autonomy, but they don't report complete autonomy. As mentioned before, arrangements where there is an element of supervision can still be present, even when there is increased scope of practice. Jansen's article in Forbes in July 2016 notes that Physician assistants are escalating their lobbying efforts. It describes legislative change in the supervisory arrangements in New Jersey, but the supervision element is still there. The Politico article talks about a "collaborative culture", but the legal requirement for supervision still exists. The Clinical Supervisor article (reporting on an AAPA meeting) is clear that many state legislatures still use this terminology. Drchriswilliams (talk) 06:36, 22 July 2016 (UTC)
The issue isn't the legal language, but the lead description. Sure, from a purely legal standpoint, every physician assistant is 'supervised' by an MD or DO. Yet, in many cases, PAs own practices and employ MDs to supervise them; in many others, PAs do not routinely work at the same site as their nominal supervisors; but most common of all is that PAs simply take care of patients without needing any regular, day-to-day interaction from those nominal supervisors. Any of those arrangements would not be understood by most people as a supervisory relationship: my own states' paperwork notes that PAs and supervising physicians are "both professionally and personally equally responsible for any act performed by the PA as it relates to the practice of medicine" [8]. I'm trying to think of another instance where using the bare legal language would provide an average reader as much disinformation as it does in this case, which is why I cannot see the utility of including such language in the lead, without the necessarily verbose explanation of what it means. Jclemens (talk) 07:08, 22 July 2016 (UTC)

Scope of practice: lack of citations, NPOV

Section Scope of practice has unsupported assertions and uses technical terms, i.e. "mid-level" without a link to their meaning.

Previously described as mid-level practitioners[citation--------], along with nurse practitioners, the term mid-level has been fiercely rebuked by practicing PAs[citation----------] 'who continue to provide the highest level of quality medical care, not intermediate level, in comparison to care provided by physicians'.

The bolded part of the sentence belongs in an article or section about controversies, and not in the main body of Scope. In what way is using superlatives consistent with an NPOV? MichelleInSanMarcos (talk) 12:13, 28 August 2017 (UTC)

Mid-level practitioner now points to the wikipedia article on that subject, where there are references that support and refute its use. This turns out to depend on the health system of each country. MichelleInSanMarcos (talk) 12:34, 28 August 2017 (UTC)

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Informal - Military PA versus Civilian and More

What proportion of PA - for the USA earned the title certification through the military and kept after leaving service/ active duty retirement. MY impression - could be wrong - Military PA typically have never had any typical college education - but the PA specific training is equally intensive as college classes. Military PA typically served with a front line unit as a medic / corpsman - and superior performance there is what earned them the opportunity for the PA training. — Preceding unsigned comment added by Wfoj3 (talk • contribs) 15:24, 21 January 2019 (UTC)

PA Communications Guide by American Academy of PAs (AAPA)

July 2016

A Guide for Writing and Talking About PAs

As the PA profession evolves, so does the language used to talk about it. The explosive growth of the profession, coupled with the continued modernization of PA laws, is rapidly changing the way PAs practice and the language we use to describe what they do. This is a reference guide for how to communicate about the profession in a way that reflects the realities of modern PA practice. If you have any questions, please contact Janette Rodrigues, Editorial Director, (571.319.4382, jrodrigues@aapa.org).

The PA Abbreviation Use “PA” as the title of the profession in all copies, not “physician assistant.” We do not use “physician assistant” any longer to refer to the profession as the name does not adequately depict the medical services PAs provide to patients every day. If you must spell it out to aid in external audience awareness, only use “physician assistant” once in parentheses after the first PA reference, i.e., PA (physician assistant). Use PA for all subsequent references.

The PA Honorific To promote uniformity of address in clinical and other settings, use PA as the honorific before the person’s name, i.e., PA Pam Smith or PA Smith. Encourage the adoption of PA [surname] as the recommended address for PAs among staff and external audiences, unless a more suitable formal address is appropriate, such as military rank or academic role.

Who are PAs? PAs are nationally certified and state licensed to practice medicine and prescribe medication in every medical and surgical specialty and setting and in all 50 states, the District of Columbia and all U.S. territories, with the exception of Puerto Rico. PAs are educated at the graduate level, with most PAs receiving a master’s degree or higher. In order to maintain national certification, PAs are required to complete 100 hours of continuing medical education every two years and to recertify as medical generalists every 10 years.

What do PAs do? • PAs practice medicine. • PAs practice in every medical and surgical specialty and setting. • PAs manage the full scope of patient care, often handling patients with multiple comorbidities. • PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, assist in surgery, coordinate care, counsel on preventive healthcare, prescribe medications and more.

How do PAs work? PAs’ scope of practice is determined by their education and experience. Scope of practice is also subject to state laws and facility policy. In optimal settings, PAs practice at the top of their education, training and experience, and the scope is determined at the practice level. • PAs practice medicine in teams with physicians and other healthcare professionals.

Why are PAs unique? • PAs increase access to healthcare. • PAs provide quality care and have been shown to positively impact patient outcomes. • PAs are educated, to seamlessly work in a team-based model of care. • PAs are educated as medical generalists and recertify as medical generalists. • PAs are one of the most versatile healthcare providers; during the course of their career, most PAs will have worked in two to three specialties. • PAs manage patient care coordination and provide clinical preventive services. • Four out of five PAs report high job satisfaction.

Phrases to Avoid • Inaccurate Terminology: “PAs are mid-level providers, physician extenders, non-physician providers, advanced practice providers or advanced practice clinicians.” • These terms are often misunderstood by consumers and do not accurately portray or describe how PAs practice medicine to other providers or patients. Nor do they reflect their license or legal title. If PAs need to be referenced as part of a larger group, use “healthcare provider”, “healthcare practitioner,” or “clinician” but the preferred reference would include simply the title name of each profession (e.g., “PAs and NPs”).

• Inaccurate Terminology: “PAs work on physician-led teams.” or “PAs are supervised by a physician.” It is no longer the case that physicians have to be at the helm of the care team. Today’s PAs collaborate with physicians. Supervision should only be referenced when required by legal and regulatory documentation. For example, patient-centered medical homes allow for various health professionals to function as leaders of care teams, including PAs. In practice, a PA’s scope typically grows over time with clinical experience. It is common for a PA to serve as the lead on care coordination teams and see patients in all settings without a physician present. In fact, in many rural and underserved areas, a PA may be the only provider, with PA-physician collaboration occurring via telecommunication. — Preceding unsigned comment added by 207.244.167.176 (talk) 23:09, 1 September 2016 (UTC)

Thank you for sharing the marketing materials for a US-based organization. The English Wikipedia serves the entire world, and does not follow the marketing advice of any organization. WhatamIdoing (talk) 18:34, 22 May 2019 (UTC)

Related fields

It would be appropriate for this article to spend more time explaining the similarities to and differences from similar professionals. For example, I see that Clinical officers are mentioned, and probably Nurse practitioners and Registered nurses should be, too. That will help readers understand what PAs do (and how that differs from their misconceptions). WhatamIdoing (talk) 18:37, 22 May 2019 (UTC)

vandalism

Hi guys, as several of you will be aware, we've had for months what seems like a single editor abusing multiple accounts and IPs, and reinstanting the same changes again and again and again. (-> Actually you're wrong. I only edited this page on 2 occasions. Calling all of the edits from 1 side of the discussion as if it's from a "single editor" is false, so don't assume things)

In the latest installment, he/she is resorting to naively copying and pasting edit summaries (I hadn't seen anything like this before) in an effort to make his/her edits look legitimate (see [9] and then [10] - it's almost comical).

Several of us have tried speaking with him/her, to no avail. What do you guys think would be a good way to deal with the situation with this editor going forward? Dr. Vogel (talk) 11:28, 5 June 2021 (UTC)

Not even surprised, unfortunately. American lobbying efforts are still taking place. Now the AAPA wants to change their name to "physician associate" in order to further blur the lines between physicians and their midlevel profession. Just a matter of taking advantage of the general public as most have no clue in who's hands they are receiving care... In the US, many physicians (with an MD or DO and residency training) are "associates" to senior physicians when starting in a new practice. As for the article, I reverted the changes, restoring to an earlier version, warned the user, and requested (again) page protection. Hopefully this helps. Cheers, Spyder212 (talk) 12:19, 5 June 2021 (UTC)
The AAPA has changed the name of the profession; it is now at odds with the various practice laws in the United States and its territories. This has inspired partisans on either side (assuming, for the sake of argument, that there only two...) to attempt to inappropriately mold the article. Calling it vandalism is unhelpful, I would say. POV pushing using socks and edit warring would be a more apt description. Jclemens (talk) 18:26, 5 June 2021 (UTC)
If a profession wants to changes their name for marketing purposes, it might belong in an article, but it doesn't mean wikipedia should be part of the promotional effort. https://en.wikipedia.org/wiki/Wikipedia:What_Wikipedia_is_not#Wikipedia_is_not_a_soapbox_or_means_of_promotion I would say that the name change is openly an advocacy play. It is the stated purpose, as part of the organization's efforts of expanding the scope of practice and relevancy of the profession. It might be notable enough to put that they are attempting to change their name in this context, but changing the name throughout the article and stating that they are now called by a different name just because the association wants them to be is basically falling for a promotional tactic. GavinJEdit (talk) 20:52, 8 June 2021 (UTC)
Agreed. It can and should be covered in the article when it's covered in independent reliable sources. Jclemens (talk) 00:15, 9 June 2021 (UTC)

"Not to be confused with a physician"

Hi Jclemens and DrVogel. I do think it's relevant to include "not to be confused with a physician" in the lead. As I said in my edit summary, you perhaps might find this obvious, but 1 in 4 people don't: https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/premium/arc/tia-survey_0.pdf. ‑‑Volteer1 (talk) 05:48, 7 October 2021 (UTC)

That's nice that you think that, but you'll need a better cite than that. You're doing multiple things wrong here:
1) Not providing an inline citation per WP:BURDEN.
2) Reading a conclusion out of the source you did find, per WP:SYNTH
3) Trying to put the insinuation in Wikipedia's voice. Per WP:BIASEDSOURCES you would need to phrase it as "The American Medical Association is concerned..." The AMA is a reliable primary source for what a physician is or is not, at least within America, in most cases. The AMA is not an authoritative source on what a physician assistant (or associate) is or is not.
You've taken the side of two editors, who have self-declared to be physicians on their user pages, attempting to edit an article in a manner that nonsensically inserts a tautology: "assistant X is not X", and even if a reliable source outright said 25% of America indeed couldn't understand that, it would still not be justification for inserting it uniquely in this article's lead in a way no other equivalent profession article includes. Jclemens (talk) 06:42, 7 October 2021 (UTC)
The actual claim in the article is that a physician assistant is not a physician. Are you disputing that? We don't need citations for material that is already repeated in the body (see WP:LEADCITE). I mentioned this source here just here to make clear why I thought it was helpful for readers to distinguish the two – for instance, you wouldn't need a citation added to a {{Distinguish}} hat note, but a source at a talk page may be helpful if there's an editorial dispute over whether such a confusion exists. The editors you disagreed with do appear to be physicians, as you appear to be a physician assistant (I am neither, to be clear), but that is not necessarily an issue if it doesn't lead to tendentious editing or engaging in advocacy.
Regarding the sourcing for whether such a confusion exists, confusion surrounding what a physician assistant is seems to be well documented: see e.g here in the section titled "PA perceived to be a doctor". I'm not interested in this discussion with what the AMA is concerned with, the source I provided was a presentation of the results of a phone survey conducted by the Global Strategy Group. I don't think there's any reason to believe the AMA would fabricate the results of GSG's survey (at least not without GSG kicking up a stink), so I don't believe there's any reason to distrust these numbers. I just referenced it here to show that there is such a confusion among some members of the public, and distinguishing concepts there is confusion surrounding is generally a helpful service to readers. ‑‑Volteer1 (talk) 07:16, 7 October 2021 (UTC)
For the sake of argument, would it be OK for me to go to Physician and include "Not to be confused with a Naturopathic physician" in the lead? Of course not; the terms are distinct in their very essence. The comparison is irrelevant, tautological, and even if someone somewhere once published an article that said people thought that naturopaths graduated from medical school, it still would be WP:UNDUE.
The numbers aren't untrustworthy, they're irrelevant, in that using them to support the lead placement of the disputed clause is synthesis--one or more editors coming to conclusions based on sources yet not included explicitly in those sources, rather than reporting what the sources themselves say.
The clarification between physician assistant and assistant physician actually makes sense: One completed a rigorous course of instruction and passed their boards, while the other completed med school but failed to match. It is reasonable to think that the public might be confused that "X assistant" and "Assistant X" could be equivalent.
Furthermore, your WP:LEADCITE argument works against inclusion. There is no text, cited or not, anywhere in the article as of now, that deals with possible confusion of PAs and physicians, although the Canada section does note possible confusion with nurse practitioners. Jclemens (talk) 07:35, 7 October 2021 (UTC)
It would be strange to add that to physician because almost no one sees the term "physician" and thinks they are a kind of naturopath/fake doctor/whatever, whereas a substantial proportion of the public sees "physician assistant" and thinks they are a type of physician, or are at least unsure if they are or not. There isn't really any substantial amount of confusion over what a physician is that we'd need to distinguish with other articles, but "assistant physician" is an unfamiliar term that tends to lead to confusion and misunderstandings. Edit: actually, there's a hatnote about physicist, which I guess does make sense.
We do not need to have a sourced sentence in the text that establishes that there is significant confusion among people for us to distinguish different concepts/articles. If that was the case, almost all of the transclusions of {{Distinguish}} or mentions of "not to be confused with" would be policy violations, which is obviously not true. The only conclusion we're putting in the actual text of the article is that physician assistants aren't physicians, and nor are they assistant physicians – which we're all in agreement over. (To be clear, I do think there's adequate sourcing for us to explicitly include something about the degree of confusion with other professions if we wanted to.) ‑‑Volteer1 (talk) 12:07, 7 October 2021 (UTC)
Those last 2 paragraphs by Volteer1 echo my thoughts exactly.
I also wanted to say, could we perhaps just say "physician assistants are not to be confused with physicians" ? Because the word physicians includes all physicians, regardless of whether they're assistants or not. Dr. Vogel (talk) 17:55, 7 October 2021 (UTC) Of course, that's the actual title of this section. Sorry, too tired. Dr. Vogel (talk) 18:11, 7 October 2021 (UTC)
The lead placement instead of {{distinguish}} is something that had also occurred to me in the interim while I was away and thinking over the dispute. Let's move the text from the lead to the top of the page, and see what looks best there. Jclemens (talk) 06:06, 8 October 2021 (UTC)

Extra discussion on physician assistants as mid-level providers

There has been yet another discussion on this subject on my talk page. Wanted to keep this on the record for future reference if needed. Goal of keeping an international perspective for this article despite American lobbying efforts. See my talk page for details. Please remember to stay WP:CIVIL if you decide to comment. This conversation has lead to way too much administrative action so far, in my opinion. Spyder212 (talk) 16:11, 31 March 2021 (UTC)

You are actively edit-warring and engaged in disruptive editing. You are required to immediately cease. I am only here to build knowledge and share it freely for all, worldwide. (talk) 20:26, 4 April 2021 (UTC)
Please explain. You like putting all these threads up and vandalizing my talk page, but there isn't any content nor any foundation on your accusations. Thank you for bringing it to the noticeboard. That's where I was heading as well. Cheers. Spyder212 (talk) 20:43, 4 April 2021 (UTC)
The improvement tags that have recently been added are appropriate. The mid-level terminology isn't embraced by the organisations representing PAs, but is used in an international context and referenced. Drchriswilliams (talk) 20:56, 4 April 2021 (UTC)

Even when discussing as an "international perspective" as Spyder mentions "Mid-Level" is an inaccurate and derogatory term. Spyder has a and obvious conflict of interest and political agenda in continuing to pursue and engage is such professional derogatory speech. Nothing about the healthcare delivered by a PA is middle level. Stop the propaganda push Spyder your comments are not constructive or helpful to patients receiving appropriate access to care worldwide. — Preceding unsigned comment added by 107.0.137.98 (talk • contribs)

Hi 107.0.137.98, could you please explain how exactly "mid-level" is derogatory? Dr. Vogel (talk) 21:58, 7 April 2021 (UTC)

Here is one source to help explain if you truly do not understand how it is derogatory. https://www.aanp.org/advocacy/advocacy-resource/position-statements/use-of-terms-such-as-mid-level-provider-and-physician-extender — Preceding unsigned comment added by 162.218.232.51 (talk) 22:48, 18 October 2021 (UTC) Updating a tile / name change to that of the accepted title by the governing organization is no bias but rather a reflection of change in the profession. Similar to how updating Physicians no longer tasting patient urine samples is no longer correct as we have UAs now. This isn't going with lobbyist interests it's the current state of the profession. Please allow changes to both the new agreed upon physician associate name and Advanced Health Practitioner (no longer using the outdated and derogatory 'midlevel provider'). — Preceding unsigned comment added by 64.54.94.223 (talk) 15:49, 22 October 2021 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 20 September 2021 and 11 December 2021. Further details are available on the course page. Student editor(s): Kwhite94.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 06:37, 17 January 2022 (UTC)

Physician assistant in India

In West Bengal (India) there is a degree course on Physician assistant named B.Sc.Physician Assistant .

For admission, need to vaild rank on the entrance examination 42.105.1.137 (talk) 14:02, 6 February 2022 (UTC)

Semi-protected edit request on 28 August 2021

The American Academy of PAs (AAPA) House of Delegates (HOD) passed a resolution to affirm Physician Associate as the official title of the PA profession. Outside US, particularly in the UK, PAs are Physician Associate. 2A01:4B00:8042:D000:806F:70BB:147D:6C95 (talk) 11:12, 28 August 2021 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. ScottishFinnishRadish (talk) 11:16, 28 August 2021 (UTC)
https://www.fparcp.co.uk/examinations/overview/
https://www.rcsi.com/dublin/postgraduate/taught-courses/physician-associate-studies/why-rcsi-dublin
The English Wikipedia serves the entire world, not just the US the title tothis page should read "Physician Assistant or Associate". Yogiali (talk) 22:40, 12 March 2022 (UTC)
Also throughout the article there are instances where the term "physician assistant" is used where the subject also applies to physician associates. Replacing "physician assistant" with "PA" would allow the reader to include both terms. Yogiali (talk) 22:51, 12 March 2022 (UTC)
 Not done: The page's protection level has changed since this request was placed. You should now be able to edit the page yourself. If you still seem to be unable to, please reopen the request with further details. No need to resurrect this old edit request. The page is no longer protected. RudolfRed (talk) 00:27, 13 March 2022 (UTC)
https://www.aapa.org/title-change/ 162.218.232.51 (talk) 05:23, 6 October 2022 (UTC)

PA

Physician Assistant should be the name; not Associate. 173.166.24.93 (talk) 17:28, 27 July 2022 (UTC)

Physician associate is the UK name. Physician associate is also the AAPA's name for the profession in the United States, while most US laws reference physician assistant. Jclemens (talk) 18:34, 27 July 2022 (UTC)
https://www.aapa.org/title-change/ 162.218.232.51 (talk) 05:25, 6 October 2022 (UTC)
The profession has voted to change the name, it is done, this is not up to debate any more.
https://www.aapa.org/title-change/ 162.218.232.51 (talk) 05:26, 6 October 2022 (UTC)
So, 1) That's just for the US, and 2) Each US state has its own laws naming the profession, so no, it's not "done," but again--the UK it's been Physician Associate since the inception of the profession in that country. This article covers the profession worldwide, under whatever title is currently in vogue, as demonstrated in reliable sources. Jclemens (talk) 06:48, 6 October 2022 (UTC)

Getting rid of low-quality statements

I would encourage everyone who dislikes the recent edits I've made to help by only reinserting material where a specific citation, accurately interpreted, supports the proposed text. This is basic WP:BURDEN, and the state of this article has been a mishmash of different nationalities' takes on one profession that doesn't have the exact same scope of practice, or even the same name, in any two countries in which it is instantiated, as far as I can tell. Jclemens (talk) 03:29, 6 November 2022 (UTC)

I think you've made it a lot better. It's still a bit of a mess, but much less so. Dr. Vogel (talk) 15:49, 6 November 2022 (UTC)

So, what SHOULD the lead actually say about Physician Assistant/Associate/Whatever? Here's a first set of thoughts.

  1. It's a profession (or collection of similar professions) that emerged in the late 20th century.
  2. This profession performs some, but not all, functions traditionally associated with a physician.
  3. The education and training requirements in any specific jurisdiction will be less than that of physicians in that jurisdiction
  4. The profession conducts work overlapping with physicians, but in partnership, collaboration, or supervisory relationship. The level of this teamwork varies by setting and specialty.
Am I leaving anything out? Obviously, each should be substantiated in general, and then major international instantiations of this profession (US/Canada, UK, etc.) have its own specific descriptors of title, training, legal framework, etc. with sources to that particular national instantiation. Jclemens (talk) 22:20, 6 November 2022 (UTC)
Hi, I don't think you're leaving anything out. The current lead mentions certification, which may or may not need to be mentioned there. Also the first paragraph of the current lead talks about something specific to the US ("in most states...") but at that point countries haven't been introducted into the narrative yet. It is however a more general thing, it's not just a requirement in (some of) the US. Dr. Vogel (talk) 00:02, 8 November 2022 (UTC)

protection

Just to let you guys know, I've requested protection to help with the situation that several of us have been dealing with. If you disagree, please by all means do say. Dr. Vogel (talk) 16:32, 20 December 2022 (UTC)

My apologies for not looking in and helping clean up the mess; I've been too behind in my charting to edit Wikipedia much this week. I agree that semi-protection should help with this. I AGF that people who have a partial understanding of the worldwide nature of the profession are trying to do their best here... but it's not helpful. Jclemens (talk) 19:53, 21 December 2022 (UTC)

US focus

Why is this so US centric? Can we edit it to be international from the start? Tannim101 (talk) 21:48, 20 December 2022 (UTC)

Hi @Tannim101, I agree that would be useful. Another thing to consider is whether "physician assistant" is the most appropriate title (as opposed to "associate"). Dr. Vogel (talk) 02:10, 21 December 2022 (UTC)
JAAPA has been running articles on the PA profession worldwide. They just did one last month on Israeli PAs, who are limited to ER work but don't even get mentioned in our current article. This month's is on PAs in Myanmar, (Brown, Gina R. MPAS, PA-C; Blue, Zu Zae Nar PA. PAs in Myanmar: Courage and humanitarianism required. JAAPA 35(12):p 58-60, December 2022. | DOI: 10.1097/01.JAA.0000892748.12231.e1) and I confess I haven't read it yet. Their collection on the international progression of the PA profession is here, and I would be happy to help supply articles as needed to anyone who has the time to update a specific country's entry in this page. Jclemens (talk) 20:02, 21 December 2022 (UTC)
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