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Physician Assistants, PAS, are mid – level practitioners. We study in a special post-graduate program associated with a medical school for two to three years. PAs have been in the medical field for decades. The first graduates were former medics, who returned from Vietnam loving the practice of medicine but with limited time or money to acquire an MD. There was a great need for primary care providers, formerly known as general practitioners.
We have differing privileges from state to state. In California, where I practiced (I am now retired), we can examine patients and diagnose, prescribe and treat many illnesses. Because I worked closely with Dr. Koffman for many years, I have been involved in the care of several chronic lymphocytic leukemia or CLL patients. Often my role was to reassure my patients that not all of their problems are caused by their cancer. Lymph nodes in the neck can swell up due to a simple cold and shrink back to normal. But we also know that we need to be more aggressive in treating infections that might be more trivial in someone with normal immunity.
We must work under the supervision of a medical doctor with whom we can consult by phone or in person. Legally, that physician must sign 5% of our notes, but he or she also serves as teacher and another brain to solves the mysteries and advise a diagnostic and/or therapeutic track.
If you had a visit with me as a family medicine PA, I could take care of your sore throat, Pap smear, or a sports injury. I am excellent at ensuring that you are getting the right screening tests and immunizations, in other words the preventive care that is so important when you have a cancer of the immune system, such as CLL. We know that secondary cancers and infections are a problem for CLL patients so we try to do what we can to lower your risk.
I can help advise you about your best diet and a healthy lifestyle and the proper exercise and even address your most intimate concerns. You could talk with me about anything that is happening with your health.
If you have CLL, we would urge you to consult a hematologist/oncologist with a strong interest in CLL. My role might be to interpret and explain some of the medical treatments that you are considering. I also can help calm your fears. I think that is how I would be most helpful – to listen to your feelings and confusions. And sometimes, to pass on to your MD what he needs to explain to you. Physician Assistants are often especially good at speaking in “plain language”. I know that when I was in PA school, I needed to translate some of the mechanisms of disease and treatment – to understand and learn, for myself.
My experience with the many other PAs that I know is that we are good listeners. We are perceptive and often have more time to be with our patients than physicians. Maybe you just need to unload your fears and feelings. I hope we are receptive to that; I know I would be. Sometimes you just need to talk– and especially to someone who understands a little of the medicine. Maybe you need to express your darkest and deepest thoughts to someone who does not have a personal stake. (Like a relative and friend might).
Use us. We can be a sounding board and help you plan what you need to do.
Kent was a professional actress for twenty years. After having her first child, she felt that she wanted to contribute to humanity in a more rewarding way.
She went back to school and, after a slow accumulation of the appropriate prerequisites, got her physician assistant certificate from USC Medical School in 1994.Ultimately, she worked in Family Practice with Dr. Brian Koffman and stayed in that group for more than eighteen years. She retired in Nov. 2015 and is now happily spending time with her little grandchildren.
Originally published in The CLL Tribune Q1 2016.