As you have read the various sections and chapters in this book, the authors and editors hope you have learned about the history of the profession; how the profession developed throughout the years; what physician assistants (PAs) “really do” on a day to day basis; and the numerous roles, including direct and indirect medical positions, in which PAs are currently engaged. We also hope you have begun to think about the role you might be interested in or suited for, especially in these current times of innovative health care model development, access and delivery model changes, technological advances, and ever-changing reimbursement requirements. To paraphrase the author of Chapter 1 , as many older and retired PAs continue to say, with great enthusiasm: “I had no idea where the PA career would take me or the many options and opportunities that would come along. Who knew?” That statement is as meaningful then as it is now!
We also hope that you will continue to use this book long after you have graduated and secured a job. Many of the chapters you used during your training can be very useful after you are in the workforce, especially if you want to change specialties. The chapters on other medical and surgical specialties can offer some insight as to what may be required, but keep in mind that every practice will vary with job description, protocol, and modes of practice. As you will see later in this chapter, the future of the profession is in your hands. The chapter on leadership will give you a means to become an effective and forward thinking leader. Continue to use this book as a resource and guide as you embark on the journey that is the PA profession.
So what will the future of the PA profession be? This question is best answered by revisiting why the PA profession was conceived and the developments that have occurred over the past 50 years of the profession: to facilitate access to health care for the United States by extending the physicians’ medical practice through the use of passionate people trained in the medical model by physicians. This has been admirably accomplished, and as you have experienced through your education, new and innovative teaching models have been developed that broaden the topics being taught while continuing to adhere to the medical model of health care education. You will also note that although physicians still lecture to classes, the majority of PA program faculty are now PAs. Program chairs used to be physicians, and now the majority are PAs. More exciting is the appointment of PAs to associate dean and dean’s positions in universities and colleges. There are many more examples of the expanding roles and opportunities for PAs such as congressmen and-women; military leaders in all branches, including the White House, Federal Bureau of Investigations, and Central Intelligence Agency; hospital administrators; National Institutes of Health and Centers for Disease Control and Prevention researchers; and most exciting, PA consultants, teachers, and clinicians for developing PA programs in Canada and overseas! By way of these examples, the answer to the initial question depends on the willingness of you and other graduates to be innovative, involved, and adventuresome!
How can you affect the future of the profession? First and foremost, be the best health care provider and patient advocate you can. Be ethical, sympathetic, understanding, and nonjudgmental in your dealings with patients, staff, community, and the profession. Be an active member of the interprofessional community, and above all, be a lifelong learner. Stay up-to-date with medical treatment and diagnostic innovations that will evolve during your professional tenure. Stay appraised of your state’s requirements, the state’s PA and medical professional societies, national PA organizations, medical specialty organizations, and the national health care changes that are inevitable. Our profession has exemplified the aforementioned traits and has moved us forward along the path of growth and professional recognition. You can help influence the future of the profession by saying “yes” to committee membership and many other leadership opportunities as mentioned in Chapter 1 .
What is the future of the PA profession? The first word that comes from the “crystal ball” and current news reports is growth —demand in the usual medical and surgical disciplines as well as growth in new areas of medicine such as interventional radiology, oncology, pathology, genetics, and forensics, to name a few. Other growth areas are in contract services with the government, both overt and covert. An exciting area of growth is that of international clinical and educational positions. The second and third words that come from both the future and the past are innovation and willingness —innovation to see the possibilities for the profession and willingness to pursue the avenues to accomplish those potentials. With these words, innovation and willingness , as operative stimuli for the current and new PAs come the technological advances that are inevitable in the practice of medicine. In the beginning of the profession, there were no computed tomography or magnetic resonance imaging scanning technologies. Now we have the ability to expand these scanning technologies with three-dimensional (3D) image compilation, arteriography, and the use of positron emission computed tomography scanning to view disease processes, including tumor identification and spread. We are now able to view these scanning reports and images online or via a disk. 3D printing technologies are allowing medicine to literally print anatomic structures and eventually working organs. The electronic medical record is now a requirement that has helped practices, hospital and diagnostic laboratories, and radiologic services to be in touch with each other, albeit with some glitches. As this modality continues to develop, it will benefit continuity of care. The PA profession is in a position to not only use the technology to its fullest but also to be innovators in developing better and more user-friendly interfaces. With that being said, technology is marvelous, timely, informative, and helpful. It is also mystical, borders on sorcery, and is clearly impersonal. Do not let bauds, bytes, check boxes, computers, programs, or apps supplant the touch of humanity. Communicate with your eyes, your hands, and your hearts. Communicate with your personality and not with a computer or tablet!
There will be many more future changes in the medical field, including new diagnostic modalities, novel physical examination instrumentation, and innovative therapeutic medications and interventions. Embrace them and become responsible practitioners, keeping in mind that not every advance in medicine can or should be used or will fit every patient. Be lifelong learners for your patients’ sake.
The future of the profession is in your hands! Be steadfast (no pun intended) advocates of the profession, and be responsible medical practitioners by remembering the following Key Points, many of which echo this book’s first chapter.