Letter to the editor
LAUREL COUNTY, Ky. —
To the editor:
Thank you for the informative article (Aug. 26) on use of mid-level healthcare providers in our area. Both nurse practitioners and physician assistants are trained to provide preventive and basic care in a primary care setting. PAs are trained following the physician model, a team approach relationship with physicians. NPs are trained using the nursing model, a collaborative relationship with physicians.
Both professions require hours of classroom and clinical training. Upon completion, both professionals must complete a certification exam and maintain a license with annual continuing education requirements. In addition, PAs must take a recertification exam every six years. Once certified, PAs apply for state licensure. This process varies by state. As the chairman of the PA Advisory Council to the Kentucky Board of Medical Licensure, I participate in reviewing all applications in Kentucky. Once reviewed, applications are forwarded to the KBML for its approval. If the PA is applying to practice in a specialty area, a supplemental application outlining their responsibilities and additional training is required. Original legislation allowed PAs to perform any duties within the scope of practice of their supervising physician. The physician was responsible for monitoring the PA to ensure appropriate practices. An effort to ensure patient safety resulted in this additional supplemental application being required.
PAs have a long history of working in cooperation with physicians. In the mid 1960s, to fill an identified physician shortage, a physician at Duke University selected a Navy corpsman who had returned from Vietnam and trained them using a fast-track training as used for doctors during World War II. Duke graduated its first PA class in 1967. Today, more than 79,000 PA graduates continue to provide care, many in areas where health care shortages have been identified. PAs have shown increased interest in specialty areas. Physician specialists have identified the advantages of PAs in providing care. These physicians recognize the PA will require additional training on the job to provide any specialized services. …
PAs are permitted to write prescriptions for any non-scheduled medications. Most medications required for providing preventive and basic care are included here. PAs are not permitted to prescribe scheduled medications, like narcotics.
Our training may not as extensive as the physicians, however, we work in cooperation with physicians to provide care, not replace them. We are very well trained to provide these services. … We have come to the southeastern Kentucky area to provide health care for our family, neighbors and friends, but we still have a long way to go. Any PA would be happy to discuss their training and experience. We are very proud of the important void we fill in the healthcare needs of southeastern Kentucky.