Physician assistants are an important component of the geriatrics care team, providing an essential link between geriatric patients, physicians, and other medical providers.
According to an article published in Clinical Geriatrics, physician assistants are “well positioned to contribute care for our elderly population.” The article also stated that physician assistants as geriatric medical providers “can offer comprehensive geriatric assessment with a focus on the functional status, cognitive status, and special needs of the patient.”
Because adults over the age of 65 remain the fastest growing population in the United States, and because people continue to live longer, requiring care for both chronic and acute illnesses, the need for physician assistants in geriatrics remains strong.
According to the Eldercare Workforce Alliance, the current healthcare workforce is not large enough to meet the needs of the nation’s baby boomer generation. Further, the scarcity of workers specializing in the care of older adults is even more pronounced. According to current projections, 3.5 million additional healthcare providers and direct-care workers must enter the workforce by 2030 to handle the demands of a massive elderly population.
The Role of the Physician Assistant in Geriatric Medicine
Physician assistants treat geriatric patients in long-term care facilities, nursing homes, physician offices, and outpatient clients, among others.
Their role is consistent: to provide medical care to seniors under the supervision of a physician. And their value is clear: According to a study published by the American Academy of Physician Assistants (AAPA), when a long-term care facility added a physician assistant to the medical team, the amount and quality of care residents received increased. A similar study published by the AAPA found that after introducing physician assistants to a nursing home, annual hospital admissions fell by 38 percent.
A study published by the American Geriatrics Society in 2004 mirrored these studies, showing that physician assistants in nursing homes reduced “potentially preventable hospitalizations.”
The role of physician assistants in geriatrics is multifaceted, regardless of the setting in which they practice. These medical professionals coordinate treatment of their older patients, which often includes managing treatment in their home, in a facility, in a hospital, and in a family practice setting. PAs often serve as primary on-call physicians, where they visit their patients outside of the medical practice, performing initial consults and follow-up care.
Their expertise in conditions and diseases affecting seniors allows them to deliver a high level of care to their patients. Some of the conditions and diseases more prevalent to the senior population include:
- Cardiovascular disease
- Congestive heart failure
- High blood pressure
- High cholesterol
- Heart attack
- Cognitive diseases
- Alzheimer’s disease
- Joint and bone diseases
- Rheumatoid arthritis
- Neurological diseases
- Parkinson’s disease
- Sight/hearing conditions
- Age-related macular degeneration
- Age-related hearing loss
- Anxiety and mood disorders
Physician assistants in geriatrics focus on patient relationships, which includes coordinating treatment with other healthcare providers and keeping lines of communication open with family members. For example, in addition to providing care for their geriatric patients, PAs often work with families to establish end-of-life directives or arrange placement in a nursing home or assisted living facility.
Physician assistants in geriatrics are ideal providers of maintenance care, as they are able to spend more time with individual patients than supervising physicians. This extra attention is particularly important for the elderly, who often require additional time for counseling and follow-up care.
The job scope of physician assistants ultimately depends on the setting in which they work. For example, in nursing homes, this may include:
- Performing acute and regular care visits
- Assessing new patients to guide their care
- Admitting patients
- Providing ongoing case management
- Meeting with families to answer questions and ease concerns
While in retirement communities, their job duties may include:
- Overseeing the-site clinic
- Providing follow-up care based on the direction of primary care providers
- Providing acute care treatment
How to Become a PA Specialized in Geriatrics: Education and Training Requirements
All physician assistants must successfully complete a physician assistant graduate degree program accredited by the Accreditation Review Commission on Education for the Physician Assistant.
Accredited graduate degree programs include classroom instruction, lab instruction, and clinical rotations. Most programs are about 26 months in duration and include at least 2,000 hours of clinical rotations. All PA programs must include clinical experiences in geriatrics, in topics unique to the elderly, such as end-of-life care.
After graduating from a physician assistant graduate program, candidates must pass the Physician Assistant National Certifying Examination (PANCE), administered by the National Commission on Certification of Physician Assistants, and then apply for state licensure.
For many new graduates, a post-graduate residency in geriatric medicine is the ideal way to begin earning valuable experience in gerontology. A post-graduate residency exposes new graduates to both basic and advanced geriatric concepts and techniques. These residencies provide graduates with experience in a number of settings, such as clinics, hospitals, nursing homes, and hospice care, just to name a few.
Although the National Commission on Certification of Physician Assistants (NCCPA) does not offer a specialty certificate of added qualifications (CAQ) in geriatrics or gerontology, physician assistants specializing in geriatrics may choose to pursue a CAQ based on the setting in which they work, such as:
- Psychiatry CAQ
- Orthopaedic surgery CAQ
- Nephrology CAQ
- Hospital medicine CAQ
- Emergency medicine CAQ
- Cardiovascular and thoracic surgery CAQ
To qualify for a CAQ, physician assistants must possess a PA-C designation and a valid, unrestricted licensed to practice as a physician assistant in at least one U.S. jurisdiction. They must also possess at least two years of experience and specific training and experience in the specialty field for which they are seeking certification, and they must pass a specialty examination.
Resources for Physician Assistants in Geriatric Medicine
Participation in professional associations allows physician assistants in geriatrics to stay up-to-date on issues affecting their profession, while networking with other professionals in the field:
- American Geriatrics Society
- The Gerontological Society of America
- Association of Family Practice Physician Assistants
- American Association of Surgical Physician Assistants
- Society of Emergency Medicine Physician Assistants
- Association of Physician Assistants in Cardiovascular Surgery
- Urological Association of Physician Assistants
- Association of Physician Assistants in Cardiology
- Association of Physician Assistants in Psychiatry
- Physician Assistants in Orthopaedic Surgery