Juliet: "What's in a name? That which we call a rose by any other name would smell as sweet."
Okay, show of hands.
Who would prefer we change the name of our profession?
Should it be Physician Assistant or Physician Associate? Or, something different altogether?
Patients are already confused by what we do. Wouldn't a name change just confuse them even more?
Part of this patient confusion comes from the term assistant. It assumes (rightfully so) that we are indeed "assisting" someone; in this case a doctor.
The term itself would lead one to believe that at some point during their office visit they should have time with the actual physician for whom the PA is assisting.
As a family practice Physician Assistant in a rural setting, I usually work alongside other PAs and Nurse Practitioners. Nowadays rarely is there a doctor to be found on site. And that is OK; there is always someone available by phone if necessary.
In other words, I rarely "assist."
But, this, in my opinion, is just semantics. I am proud of what I do as a Physician Assistant and the high quality of service I bring to my patients.
When my patients ask me when I am going to become a doctor, I just smile and explain the millions of reasons why I love my job, why I became a PA and why even if given a free "upgrade" to MD I would never even consider it.
The term associate is not absent of ambiguity.
Just look at one of the definitions assigned by Wikipedia:
Associate, a person who is in league with the Mafia but is not treated as a full member, e.g. a corrupt official.
Not that there isn't a bit of a "cool" factor that comes with being likened to the mafia.
I think the big complaint about the term "assistant" is that it comes with a feeling of subservience. In a law firm, an associate is a low-level lawyer. The problem with this is that PAs are not low-level doctors they are something entirely different.
Maybe the main problem is the term Physician
A physician is at the highest level of the medical field. And therefore, the term should be reserved for just that.
For a comparison take a look at variations of the term Nurse:
- Nurse Practitioner
- Certified Nurses Assistant
- Licensed Vocational Nurse
- Nurse Midwife
- Nurse Anesthesiologist
This professional deviation from the term "nurse" is far removed from the original intention.
Here are some other common medical professions:
- Emergency Medical Technician
- Medical Assistant
- Respiratory therapist
- Scrub Tech
- Physical Therapist
- Occupational Therapist
- Dental Hygienist
- Social Worker
Here you see many different qualifiers such as: "Therapist," "Worker," "Tech," "Technician" and once again "Assistant."
Outside of the medical field are other types of professions that exist alongside another "main" occupation; Paralegal comes to mind.
One could make the case then for the term Para-medical instead of Physician Assistant, but this is just too confusing. Especially given the closely related term paramedic.
A New Profession:
In all honesty, the physician assistant of 2018 is a lot different from the PA of 1977.
Part of what has happened is that we are coming to terms with the fact that to be an excellent diagnostician in primary care one does not need to attend medical school and complete a residency.
There is a minimum effective dose for primary care, and that is probably the education of a Physician Assistant.
Of course, while working alongside a physician in a surgical role the term assistant is always appropriate.
So maybe what we need then is an entirely new professional designation.
It is not the "Assistant" or "Associate" designation we should be concerned about but the term "Physician"!
Otherwise we will always be playing the same game, creating the same patient confusion and constantly struggling to find our own identity.
But, if you want my personal opinion the term "assistant" and "physician" are forever two star-crossed lovers... In the words of William Shakespeare:
A Rose By Any Other Name Would Smell As Sweet!