Specialization training programs for physician assistants: Symbolic violence in the medical field?

摘要

The physician assistant (PA) profession is well established in the United States healthcare system dating back to the late 1960s. The initial premise of this unique practitioner was a dependent adjunct to the physician taught in the medical model. Inherent to the profession from the onset is the team approach to patient care allowing for the physician to broaden their availability to patients, provide and maintain continuity of quality medical care, and reduce medical cost by way of improved practice performance and physician productivity. Although the world of medicine consists of non-physician practitioners working together for the common purpose of quality care, e.g., nurse practitioners and advanced practice nurses, the PA is the only mid-level medical practitioner with the clinical knowledge and skills anchored by the medical and dyadic relationship with physicians.State medical boards govern PA practice in the United States and, although each state has individualized practice acts, there is a common thread allowing the physician/PA team leeway in the interpretation and action upon specific delegated responsibilities and procedures (American Academy of Physician Assistants [AAPA], 2011). Ultimately, the physician is responsible and accountable for the actions of the PA lending to a relationship built on robust communication and trust.