Physician Assistants Valued for Patient Care and Research Support at NCI
In this highly competitive world, those whose work contributes to success are far too often unsung and anonymous. The medical and research community is no exception. But from October 6–12, one key element of the health care team hopes to shine the light on their many contributions. At NIH and across the country, the vital role that physician assistants (P.A.s) play in patient care and education is being celebrated during National Physician Assistant Week.
P.A.s have been providing patient care at NIH since 1990 in a wide range of medical disciplines and for a variety of diseases, including cancer, HIV/AIDS, other infectious diseases, and autoimmune diseases. But how P.A.s fit into the wider cancer care continuum is something most people aren’t as familiar with as, say, the roles of doctors and registered nurses.
“The P.A.’s role in cancer research is evolving,” noted Dr. Ramaprasad Srinivasan, staff clinician and principal investigator in NCI’s Urologic Oncology Branch (UOB). “I view the P.A. role largely as one of clinical support. They spend the majority of their time focusing on patient care.
“However,” he added, “there are going to be certain branches at NCI and certain P.A.s who want greater involvement in research. Fortunately, NIH is a place where that is possible.”
The P.A. profession started in the mid-1960s at Duke University in response to a growing shortage of primary care physicians. Today, more than 78,000 P.A.s practice in the United States in a variety of health care settings, according to the American Academy of Physician Assistants. P.A.s are able to diagnose and treat patients, prescribe medications, and perform a variety of clinical procedures under the supervision of a physician.
Increasingly, the contribution that P.A.s can make to clinical research is also being recognized.
“The nice thing about being a P.A. is that you can switch from one medical specialty field to another, because you have a background in general internal medicine, which suits a P.A. for a broad variety of patient care needs,” explained Julia Friend, a P.A. who works with Dr. Srinivasan in the UOB.
She previously worked for the National Institute of Allergy and Infectious Diseases but said she was drawn to the UOB, and particularly to Dr. Srinivasan’s work, because of what she heard about his research with novel therapies for familial kidney cancers.
“I thought that the combination of clinical trials for kidney cancer in an outpatient setting was interesting,” she said. “The job involved a lot of general internal medicine, a lot of genetics, and a lot of patient teaching and patient care.”
Dr. Srinivasan says that regular contact with patients is what makes Friend such a valuable member of his research team. In this role, she is able to approach him with interesting research questions related to her patient care in the course of the study, such as a finding of high parathyroid hormone blood levels among kidney cancer patients receiving an experimental therapy. “That is the type of research question that needs to be tracked down; questions that require a fair amount of clinical knowledge to try to understand exactly what is happening,” he said.
P.A.s can also help manage clinical research protocols, including screening patients for study participation. That is a job that P.A. Kerry Ryan, of NCI’s Medical Oncology Branch, has performed. “I’ve been involved in a clinical trial where my role was to screen all of the patients, both inpatients and outpatients; record their histories; perform physicals; and provide their medical care while they were at the NIH Clinical Center,” she said.
Although Friend relishes her contributions to cancer research, “Patient care comes first for a P.A.,” she said. “I’m at UOB because patients come in, and they have other medical problems besides their cancer. I help to manage and coordinate care for many of their other medical problems. Perhaps more importantly, I help manage the side effects caused by chemotherapy. It’s part of taking care of the whole person.”
Learn more about the role P.A.s play in health care and the research community from the American Academy of Physician Assistants.