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The P.A. Prescription

The first class of physician assistants may be just what the doctor ordered

February 2003

by Amanda Gallagher

We have a tight economy.
We have workers who are grateful for good jobs.
And we have Betty Ramos -
a Health Science Center graduate who gave up a promising career as a registered nurse to take a gamble.

Diagnosis: Positive

"We diagnose the patient as well as prescribe patient care," said Betty Ramos, a physician assistant at the Kellum Medical Clinic in San Antonio. Ramos is one of the first graduates
of the Health Science Centerís new P.A. program. "I liked the idea of being in the first class. It was a little more challenging," she said. "It allowed us to take an active role in our learning process."

  Betty Ramos
Betty Ramos
In April 2000, Ramos accepted a position in a brand-new physician assistant studies program - a part of the School of Allied Health Sciences. At the time, the program had one faculty member and had not yet received accreditation. But Ramos didnít see it as a risk. Instead, she saw it as a good investment.

"I wasnít concerned the program wasnít initially accredited," Ramos said. "I thought the faculty and staff were very well qualified and I knew accreditation wouldnít be a problem."

Ramos was right. The Health Science Center proudly graduated its first class of physician assistants (P.A.s) this past December. The program is fully accredited, boasts five core faculty members and 15 new alumni, including Ramos. Five more will graduate from the first class this spring.

Students are enthusiastic and committed to the program, which says volumes, said J. Dennis Blessing, Ph.D., associate professor and chairman of physician assistant studies. The Health Science Center recruited Dr. Blessing in May of 2000 to launch the new department. He is now well on the way to creating one of the best P.A. programs in the country. "We have real support and enthusiasm for the program from the Health Science Center," Dr. Blessing said. "All we need is time."

Actually, the program couldnít have come at a better time. The federal government declared much of South Texas as "medically underserved," meaning there arenít enough doctors to treat patients. Thousands of people travel hundreds of miles to cities like San Antonio for medical care.

But San Antonio also faces a struggle. Beginning July 1, medical residents can only clock 80 hours a week - leaving hospitals scrambling for staff. The Health Science Centerís physician assistant program may be the strongest prescription for a potentially painful health care crunch.

"P.A.s are trained in the medical model. State laws and patient preferences may play a role in what each P.A. can do," Dr. Blessing said. "But we are now seeing P.A.s supplementing residents and house staff as the number of resident hours decreases. In rural areas, where there are not as many physicians, P.A.s actually serve as the primary health care provider."

Physician assistants conduct clinical exams, diagnose and treat illnesses, order and interpret medical tests and counsel patients on preventative health care. They work with the supervision of a doctor.

While the majority of P.A.s practice in primary health care (about 50 percent, according to the American Academy of Physician Assistants), they can train or learn to specialize in anything from cardiology to cancer.

"We completed 15 months of clinical rotations in rural areas like Eagle Pass, Carrizo Springs and inner-city clinics," Ramos said. "We also rotated through surgery, pediatrics, ob-gyn - the full array of specialties."

Ramos graduated with a baccalaureate degree in physician assistant studies - but the Health Science Center program has already evolved. The incoming class will be required to complete 90 hours of general coursework at a university elsewhere, followed by three years in the physician assistant studies program. Students will earn a masterís degree. Most wonít have any trouble finding a job.

The U.S. Department of Labor now lists the profession as one of the top 10 jobs in the country. The starting pay is excellent, averaging about $50,000 annually, and according to Dr. Blessing, the field retains 90 percent of its trained professionals.

"I think our role is growing, especially considering the number of people in our population who donít take the best care of themselves. Patient education is a major emphasis for us. We are known for being very thorough," Ramos said. She began working at the Kellum Medical Clinic in San Antonio almost immediately after graduating and said there are plenty of other good positions available.

"Because of todayís health care needs, there is a demand for this profession," Dr. Blessing said. "Now general practice is finding new niches in medicine and weíre filling some of those niches. P.A.s are part of a team of doctors and nurses. Health care is a team effort and we need P.A.s on that team."

Now that the Health Science Center has successfully graduated its first class, Dr. Blessing said heíd like to expand the program. "I would like to see this program offer other masterís degrees for physician assistants. Iíd like to see a masterís in education and residencies in specialties and Iíd like for us to conduct our own research. All of this takes time," Dr. Blessing said. "But we have the opportunities and the support."

And the demand. More than 200 students applied for the 20 spots available in the next P.A. class. So while the odds of getting in are greater, you can be assured the program is destined for success.


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