The Debate Over Renaming the Physician Assistant: Is 'Associate' Accurate Enough?

The topic of whether to rename the position of Physician Assistant (PA) to Physician Associate has been a subject of debate in professional circles. I had the opportunity to participate in this discussion during the AAPA House of Delegates. In a nutshell, the term 'Associate' provides a more accurate representation of the role PAs play in healthcare, but the potential costs associated with changing the title could delay efforts to further improve PA practice.

Currently, we largely refer to ourselves as PAs rather than making the change. This arrangement allows us to devote resources to other essential initiatives. While some PAs may have future career aspirations, such as attending medical school or pursuing business opportunities, most are employed in environments where professional titles and career progression may not follow a strict corporate hierarchy. Therefore, the desire to change the title seems to be outweighed by practical considerations.

Navigating the Hospital of Delegates: A Unique Perspective

I recently worked on establishing a new chain of Urgent Care Centers in Brooklyn, a setting where I frequently interact with various medical professionals. This experience provides an interesting vantage point on this topic. Typically, the term 'associate' is used in a corporate context to indicate a path to higher positions, often culminating in partnership in law or financial firms. Many PAs I know fit this trajectory, but it's important to note that these opportunities are often more aligned with aspirations rather than being readily available in healthcare settings.

While there are some private medical practices that may use the term 'associate physician' to allow individuals to build equity in the organization, this usage is not widespread. Nonetheless, the prefix is not entirely foreign to the medical field.

Patient Expectations and Professional Standards

It's crucial for patients to understand that they are interacting with highly trained and experienced professionals. Medical Assistants (MA) play a significant role in supporting healthcare providers. They manage vital signs, review medical histories, administer injections, and perform various tasks that require a high degree of skill and discipline. Patients typically expect a level of care from medical professionals, and using a title that implies equivalence to a physician might undervalue the unique skills and expertise that PAs bring to the table.

The Reality Check: Evaluating Patients Dr. Google

One of the key challenges in using the title 'Physician' is that PAs do not possess the extensive education and training that physicians do. A physician has the ability to understand and evaluate a complete differential diagnosis, a complex process that involves considering all possible diagnoses for a given set of symptoms. As someone pointed out, PAs, despite their expertise, may not have the same level of knowledge to perform this critical task. The reality is that many of us might not even look for a full differential diagnosis in most patients, leading to a limitation in the care we can provide.

In contrast, Dr. Google, with its vast array of information and tools, often offers a better first-line evaluation for patients. Providers like PAs need to be cautious with the assumptions they make and the level of care they deliver based on limited information. Using a title that implies a similar level of authority to a physician could potentially lead to misunderstandings or underestimating the complexity of a patient's condition.

Alternative Titles and Future Considerations

Given the existing challenges, an alternative title might be considered that emphasizes the specific expertise of PAs. One suggestion would be to create a new title such as 'Certified Medical Provider' (CMP), which could focus on the distinct aspects of the role while maintaining a clear distinction from physicians. This approach would likely enhance patient understanding and respect, highlighting the valuable role PAs play in healthcare without causing confusion or misrepresentation.

In conclusion, while the debate over renaming the term 'physician assistant' may not be a pressing issue, it does raise important questions about professional titles, patient understanding, and the unique role of PAs in the healthcare system.