Physician assistants providing more health care in Iowa

In clinics, doctor's offices, nursing homes and hospital emergency rooms, physician assistants are playing a greater role in health care.

Supervised by doctors, physician assistants are trained to provide diagnostic, therapeutic and preventive health care services. They take medical histories, examine and treat patients, order and interpret laboratory tests and X-rays and make diagnoses.

Emily Appleton, a physician assistant with St. Luke's Physicians & Clinics Mount Vernon Family Practice, said she has a degree of autonomy that allows her to handle many of her patients' diagnoses and treatment.

“I always submit my notes to a doctor for them to sign off, and I can always ask them a question,” Appleton said. “I've been a physician assistant for 12 years, and I really enjoy what I do.”

Dr. Dustin Arnold, chief medical information officer at St. Luke's, said physician assistants fill a critical role.

“They are extremely important because we continue to experience a shortage of primary care physicians,” Arnold said. “They are more than capable of handling many situations involving the basics of medical care, particularly in rural communities. We have no reservations releasing someone from the hospital to their care when a patient returns to their community.”

Physicians assistants often are the principal care provider in rural clinics where a doctor is present only one or two days each week. They treat minor injuries, counsel patients, order therapy and prescribe certain medications.

“With the profession achieving some sort of a critical mass, I think the public is becoming more aware of physician assistants and the role they play in health care,” said David Asprey, an assistant dean with the Carver College of Medicine at the University of Iowa.

Almost 83,500 physician assistants are practicing in the United States, representing a 100 percent increase in the past 10 years, according to the American Academy of Physician Assistants. The U.S. Bureau of Labor Statistics is projecting that number will increase by 38 percent by 2018, as an aging population requires more services and health care cost-containment becomes a priority.

A report issued in November by the UI Healthier Workforce Center for Excellence found three out of four Iowans surveyed by phone would be willing to see nurse practitioners and physician assistants, instead of doctors, to reduce costs.

(A nurse practitioner is an advanced practice registered nurse with either a master's or a doctoral degree and is licensed or certified through the state nursing board rather than the medical board.)

Iowa has nearly 1,000 practicing physician assistants. Women outnumber men about 2-to-1 nationally.

Asprey, who supervises the UI physician assistant program, said the profession originated in the early 1960s when doctors felt they were overwhelmed and unevenly distributed. The first program was started by Duke University's School of Medicine in 1965. The University of Iowa admitted its first class in 1972, he said.

Asprey said the UI program differs from most others in that students take their courses alongside those in the medical degree program.

Physician assistants graduate from the UI with a master of science degree. While not required to complete a residency, many do in subspecialties such as pediatric cardiology and emergency room medicine.

Chelsea Peoples, a native of Woodward, spent a year working in the emergency room at St. Luke's Hospital before enrolling in the UI physician assistant program. Peoples, 24, was initially a pre-med student but switched to pre-physician assistant.

“It was really a magic fit,” Peoples said. “I felt that this was really my dream job because it would allow me to really help people.”