History Of Physicians Assistant

(this paper is very precise with several pages explaining the books that I read and even the list of pages of every piece that I had cited. I recieved a A for this paper and it is 15 pages long


History of the Physicians Assistant Occupation
Jayme K. Hansen
13 December 1999
Course: LC 393
Professor: Ettinger, Laura












The year is 1959, and Mr. Scott has had a migraine headache for the past few weeks and so he drives to the local Potsdam Hospital. The poignant antiseptic smell fills his nostrils as he steps unto the polished hospital floor but what catches his eye is the large number of people waiting in the lounge. Mr. Scott patiently stands behind the long line of people to sign the needed forms to be seen by the physician. An hour and a half passes, and it is finally his turn to see the receptionist. He looks at the woman behind the counter in the bright white uniform and asks, “Is it always like this?” The woman replies in a weary but irritated tone “It was not this hectic until Dr. Johnson and Dr. Smith left to specialize in Syracuse.” As Mr. Jones fills out the questionnaire about his insurance, he mutters to him self, “Boy, they need to do something about this. They should hire more doctors or something." The medical community did do something to off set the projected decline of physicians. About thirty years ago, a new health care profession was integrated into the medical field to assist physicians to prescreen and handle the routine patient loads. At first, Physician Assistants (PA’s) met some opposition, but later they were accepted as a need and an asset to society. The following history of the physician assistant will show how a crisis caused the development of this profession, and the conditions which created the profession and how the struggles of the PA profession during the 1960’s through the 1970’s ended with the maturity phase of the 1980’s and 1990’s.
A crisis caused the development of the PA profession. This problem was the widely held belief that there was a shortage of medically trained personnel , which originated from the 1959 Report of the Surgeon General’s Consultant Group of Medical Education. This report gave three main reasons why an expansion of health care was needed in the United States:
1. There was fear of rapid population growth projections with disproportionate increases of the young and elderly. These two populations statistically and historically utilize more health care than the average populace.
2. There was an increased per capita use of health care facilities. This was spurred by numerous factors. The first was improved living standards that brought higher life expectancy and lower infant mortality. An increase in health care facilities and transportation systems, both private and public, increased the number of patients to the hospitals. The public educated themselves; thus they knew the signs and symptoms of when they needed to seek medical help. This knowledge spawned more frequent visits. Finally, the wider use of medical insurance (private, as well as Medicare and Medicaid) gave greater numbers of patient’s access to healthcare.
3. There were large numbers of general practitioners that shifted into research, specialization, industry, and other fields. One report concluded:
Although the physician rate per 100,000 had remained fairly constant for the 30 years proceeding the report and was 141 per 100,000 in 1959, the percentage of physicians serving as primary care physicians, even including the new specialties of internal medicine and pediatrics, had decreased. Primary care physicians furthermore decreased in absolute numbers, making the ratio per 100,000 physicians much smaller.

Ettinger’s lecture on historical trends of physician placement further supported the belief that general practitioners shifted into specialization. She stated that hospitals developed and pushed training programs for specialization during World War II, and hospitals made it easier for specialists to see more patients with the aide of pre-screeners who in turn made specialists more productive and profitable than general practitioners. Because of these incentives, many general practitioners became specialized. In the 1960s, their utilization sharply declined. It was predicted they would become extinct.
To summarize points one through three, this government report was inaccurate in its projections. The population growth was over estimated and what really occurred was