Working alongside physicians, Bill Mahaffy has harvested arteries and treated patients in cardiac-care units, but he's not a physician; he's a physician assistant (PA), an occupation that is expected to be one of the fastest-growing over the coming years.
PAs, who work under the supervision of doctors, are highly trained, licensed healthcare professionals who treat and diagnose patients, perform various medical procedures and act as a liaison with nurses, lab techs and others on the healthcare team. In 48 states and the District of Columbia, PAs can even prescribe medication.
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With greater demand for healthcare services, Mahaffy says PAs are "taking care of about 80 percent of what the doctors used to," freeing doctors to focus on more complicated cases.
For those willing to undergo the rigorous required medical training, the PA profession offers excellent prospects and a variety of opportunities for specialization.
Mahaffy, a certified physician assistant (PA-C) at Evangelical Community Hospital in Columbia, Pennsylvania, became a PA about 10 years ago after 25 years as a paramedic. "I had colleagues who were PAs, and it seemed like a logical progression," he explains. "It was the best career choice I ever made." It's a promising one as well. According to the US Bureau of Labor Statistics, the occupation will be the third fastest-growing professional job in the nation through 2012, when the number of PAs is expected to increase to 94,000, up 49 percent from 2002. The median annual salary is about $65,000, with the top 10 percent earning more than $90,000.
While salaries are high, aspiring PAs must be willing to tackle one of the more extensive health education programs outside of traditional medical school. Most physician assistant programs require applicants to have previous healthcare experience and some college education. The typical applicant holds a bachelor's degree and has worked in healthcare for four years, according to the American Academy of Physician Assistants. PA training usually takes about two years full-time. In addition, graduates must pass a national certifying exam to obtain their state licenses. Continuing education is also required.
Like Mahaffy, many PAs segue naturally into the occupation from other healthcare fields. Mahaffy has seen former nurses, exercise physiologists, fitness trainers and even two mortuary technicians become PAs.
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The Adrenaline Rush
PAs can be generalists or specialize in areas such as cardiology, pediatrics, psychiatry or trauma.
Mahaffy, who is president of the American Association of Surgical Physician Assistants, is a surgical PA specializing in cardiothoracic procedures. He's harvested arteries for cardiac surgeons, put in dialysis catheters and inserted feeding tubes. Today, as a hospitalist (another specialty), he works anywhere outside the OR where surgical expertise is needed. For example, one of his duties in the cardiac-care unit is providing chest drainage to patients with congestive heart failure.
Mahaffy works five days on, five days off, starting at 5:30 a.m. or 6 a.m. for what are supposed to be 10 or 12-hour shifts, but he stays as long as he's needed. His specialty can be "a young man's game," he admits. "You can live on adrenaline and caffeine."
In a Family Way
Charlene Morris, MPAS, PA-C, offers another look at a PA's life. A former lab tech, Morris has been a family-practice PA for 24 years. While she has been employed at major medical centers, she now works alongside a family-practice physician at the B.F. Taylor Medical Arts Family Medicine Clinic in the small town of Burkesville, Kentucky.
She describes the relationship with the doctor she supports as "very complementary" and says she loves the versatility of family medicine. "I'll handle everything from colds and rashes, to sports injuries, to people with diabetes," says Morris, who is president of the Association of Family Practice Physician Assistants.
Earlier this year, she widened her work's scope by dividing her time between the clinic and the Cumberland County (Kentucky) ER. "I've had to go back and expand my suturing skills, and we have to be up on advanced cardiac life support," she says.
Morris and Mahaffy emphasize the flexibility in their careers and agree that they could move into other areas, from neonatal to aerospace medicine. "PAs can work in any and all settings with their physician colleagues," Mahaffy says.
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