The state medical board has come down on several local doctors in the last year: Nadjmabadi, Jellinek, Cosgrove, Fritch, Mosser, Loos.

Now a physician assistant is being added to the list.

The state medical board is seeking to revoke or suspend John Harvey Cates' medical license after he accidentally punctured a patient's lung with a needle.

His supervising physician, Dr. Raymond Herbert Helston, has been placed on six years of probation in lieu of having his license revoked for the same incident.

(Read "Medical board goes after doctor for lung puncture" in today's Californian.)

This incident made me wonder about physician assistants, how they are trained and what they can and can't do. At my current physician's office, I've only been seen by PAs, which hasn't been a problem considering the care has been excellent. I couldn't even pick my physician out of a line-up if my life depended on it.

Here's the Q and A about PAs from the Physician Assistant Committee's Web site. The committee is under the umbrella of the state medical board.

Also, you can look-up the status of a PA's license and if he/she has been publicly disciplined in the past on the site.

Q. What is a physician assistant?
A. A physician assistant, or PA, is a licensed and highly skilled health care professional, trained to provide patient evaluation, education, and health care services. A PA works with a physician to provide medical care and guidance needed by a patient.

Q. What are the training requirements to become a PA?
A. A PA must attend a specialized medical training program associated with a medical school that includes classroom studies and clinical experience. An academic degree and/or certificate is awarded upon graduation. Many PAs have two or four-year academic degrees before entering a PA training program. Prior health care experience is required by most PA training programs.

Q. Is a PA licensed by the State of California?
A. Yes. To practice in California, each PA must pass a rigorous national examination before being licensed by the Physician Assistant Committee, which is part of the California Department of Consumer Affairs' Medical Board of California.

Q. What additional duties does the Physician Assistant Committee perform?
A. The Physician Assistant Committee is responsible for consumer protection, making recommendations about the scope of practice of PAs, and providing information about PAs to the health care community and others.

Q. What types of services are provided by a PA?
A. A PA performs many diagnostic, preventative, and health maintenance services. These services include, but are not limited to, the following list.

• Taking health histories
• Performing physical examinations
• Ordering X-rays and laboratory tests
• Performing routine diagnostic tests
• Establishing diagnoses
• Treating and managing patient health problems
• Administering immunizations and injections
• Instructing and counseling patients
• Providing continuing care to patients in the home, hospital, or extended care facility
• Providing referrals within the health care system
• Performing minor surgery
• Providing preventative health care services
• Acting as first or second assistants during surgery
• Responding to life-threatening emergencies

Q. How does a PA work with their supervising physicians?
A. Each PA must be supervised by a physician. The physician supervises the PA either when both are at the same location or by telephone. The supervising physician must always be available to the PA should the need arise. The supervising physician is responsible for following each patient's progress.

Q. Is there any difference in fees charged by a PA and a physician for the same service?
A. In many medical offices the charges are the same regardless of which health care provider is seen. As a general rule, the PA spends a great deal of time with patients. A PA emphasizes primary care and patient education, which may reduce the number of return visits.

Q. Is a PA covered by malpractice insurance?
A. Yes. Generally the PA works under the insurance policy of the employing physician or health facility. PAs may also carry their own malpractice insurance.

Q. Do most insurance policies cover care provided by a PA?
A. Yes, most do. Some carriers bill for the PA directly, while others bill through the supervising physician. All reimbursements for Medi-Cal usually are made through the supervising physician or the employing institution. Medi-Care reimburses for services provided by the PA in hospitals and skilled nursing facilities, in addition to primary care services.

For more information about physician assistants, a specific physician assistant, licensing requirements, or to file a complaint, contact:
Physician Assistant Committee
1424 Howe Avenue, Suite 35
Sacramento, CA 95825-3237
(800) 555-8038
(916) 263-2323
E-Mail: pacommittee@mbc.ca.gov


Have you been treated by PAs? What did you think about the care?