Frequently Asked Questions  

Q: What is a Physician Assistant?

A: The Physician Assistant (PA) is a skilled medical provider who is trained and qualified to provide health care in a variety of health care settings as well as medical and surgical specialty under the supervision of a licensed physician. The PA is permitted to practice medicine under the supervision of a physician and consult the supervising physician as necessary. As in the case of the supervising physician, PA's also consult specialty physicians. Also, PA’s may practice with delegated autonomy in sites apart from the supervising physician, with consultation readily available via: telephone, radio, or teleconferencing. They have enabling legislation allowing practice in every state, the District of Columbia, and other territories. Some 44 states allow prescriptive authority, and PA's may prescribe controlled substances in 38 states.

Q: Where can Physician Assistants work?

A: Physician Assistants are utilized in various areas of health care. Initially the profession was instituted and trained to fill the need for Primary Care providers in underserved areas. Since then, however, need for physician extender capabilities, such as afforded by PAs, has been in virtually every major and minor area of medicine. After Primary Care, surgery is one of the largest areas of utilization of PAs.  General and vascular surgery, cardiac and thoracic, urology, orthopedic, ophthalmology, ENT, transplant teams and other surgical areas have long utilized the skills of the well trained PA. Medicine subspecialties also use PAs such as nephrology, internal medicine, cardiology, and rheumatology also utilize PAs in many practice settings with enabling legislation in all 50 states and Washington DC. The VA was one of the first employers of PAs, is the largest federal employer of PAs and is the largest single employer of PAs in the US.        top

Q: What is a PA allowed to do?

A: Physician Assistants are allowed to examine, diagnose and treat patients within the scope of their designated practice setting. They must have a Scope of Practice defining these duties, and it must be signed by both the PA and the Physician with whom the PA is working. The scope may not include duties that the supervising physician would not be able to perform, nor duties that the PA was not trained to do. The Joint Commission on Accreditation of Healthcare Organizations [JCAHO] allow hospital medical staff to permit PA’s membership on the hospital staff provided they are credentialed with appropriate Bylaw wording, and have enabling state law. Otherwise, they must have an approved scope of practice. PA’s can have their care reimbursed by Medicare [at 85% MD levels] and by third party payers.

Q. Are PAs required to have Preceptors listed in PCMM?

A: No. PAs work under a set of regulations that allow them, at the medical center's discretion, to carry a Primary Care Provider status and workload without a Preceptor being identified in PCMM. The PA still must have a Physician identified as the person from whom he receives guidance and this, in some states, is identified as a preceptor. It is not the same definition of preceptor that PCMM uses, however. PCMM rules are required only for resident physicians, not PAs. It is the same relationship that a Nurse Practitioner has with a physician in the same setting, only they refer to this as a collaborative relationship.       top

Q. Are PAs required to use up all their Annual Leave allowing only 240 hours to go over  to the next year?

A: No. PAs are covered under Title 38 USC and as such have different rules. Actually we are a hybrid of both Title 5 and Title 38, but for AL accrual the Title 38 regulations are followed. If you have Acrobat  Reader you can link to this document via the Internet or the VA Intranet giving you the full text of the regulation. But, in short, we can accrue up to 685 hours before we start to lose as a full time PA, or 240 hours if part time (though there are conversion factors if you converted to part time from full time). (MP-5, Part II, Chapter 7, then see page 11 of the document.)       top

A. You can connect directly our Practice Updates page on this website.       top

A. Instructions for Accessing HR Link$ from your computer:
Open Internet Explorer or Netscape Browser
Log on to www.hrlinkaac.va.gov and click on Self Service
Enter your SSN and PIN number (if you don't have one, request from local HR)
   IMPORTANT: Log in with your MOUSE, or you'll get a beep and not connect.
On Menu, select: Pay & Leave Activities, then Direct Deposit... select savings allotment on the second allotment and enter routing # 051000017 (Bank of America, Alexandria, VA) and select checking account type, account # 4113124617; and 3 or 3.00 in amount (be careful to use the decimal if 3.00 entered!), then hit the Submit button.
When you see "Confirmation" in RED at the top of the screen, then Print the screen so you have a hard copy confirmation of your transaction. You may then select another HR transaction or exit. That's all there is to it. [Once you are signed on as a member through payroll deduction don't forget to send a member form with SS # to AJ in our home office letting him know that you are on payroll deduction!]        top

A. A survey of VA PAs was conducted in 1997 and published in the Veterans Health Systems Journal in March 1999 (VHSJ, 1999;4:45-53.) At that time, of the 777 respondents (68.7% response rate), 216 or 27% stated they were at the GS-13. This was not published in the article. It is very hard to get data from each facility so any survey you might do on this list would probably not be accepted as scientific.       top

A. There is not a question pertaining to the type of clinician who does the AIMS test (nor the GAF). The only question is, 'was it done?'. If ANY PA's are getting grief that their facility is being 'dinged' on the performance measures because they did either of these tests - have your Quality Manager send me an email with patient name. Will have the score changed and have EPRP clarify with the abstractor. As a matter of fact if any of you are getting any grief over ANY of the performance measures (because you are a PA - not because you're not doing them) let me know. I assure you, there is no bias from the performance measures stand point against PA's. -Bonny Collins, Office of Quality and Performance (10Q) 202-273-8987; fax 202-273-9030       top

A. I have received several questions regarding the new CME logging process with NCCPA that will start in the 2002 logging cycle. Beginning with the 2002-2004 CME logging cycle, the now separate CME logging and re-registration processes will be combined into a simpler certification maintenance process with a single fee. Full details including the timeline for implementation can be found on the NCCPA Web site at: http://www.nccpa.net/