The Role of the Physician Assistant in Our Practice
Among other "firsts", DVDG was the first to introduce dermatology physician assistants to the state of Delaware. A PA is a graduate of an accredited PA educational program who is nationally certified and state-licensed to practice medicine under the supervision of a physician.
Dr. Saruk is proud of the PAs he chooses to work with and train and has complete confidence in them. The licensed, certified physician assistant in a practice allows more patients to benefit from the knowlege of the supervising physician, by acting as his surrogate, and providing a gateway to the dermatologist whenever there is need.
We have never liked the word "assistant"* in the profession's name and prefer to think of our PA's as, what they really are, physician extenders, or physician associates. The PA educational program is modeled on the medical school curriculum and is intense and rigorous. The average length of a PA education program is 27 months and includes more than 2,000 hours of clinical rotations. Specialty dermatology training follows completion of the program and national certification.
Dr. Saruk personally trains** his physician asistants ( or does a clinical assessment of their skill level for very experienced derm PAs) and defines their scope of practice before he will agree to supervise them. Primary dermatology training with Dr. Saruk lasts from three to nine months depending on the prior experience of the PA and Dr. Saruk's assessment of their readiness. He needs to be assured that they not only know what they need to know, but are equally aware of what they do not know -- and therefore, recognize when it is time to call upon him. Physician-PA practice can be described as delegated autonomy. Physicians delegate duties to PAs, and within that range of duties, PAs use autonomous decision-making for patient care. This team model is an efficient way to provide high-quality medical care.
Our PAs work independently within our office much like a staff dermatologist seeing a wide range of medical, surgical and cosmetic patients, but always under Dr. Saruk's supervision. Moreover, training never ends. It is career-long. PAs get additional training through their daily supervision by Dr. Saruk; their required CME hours; attendance at AAD, SDPA and other dermatologic organization-sponsored conferences; and special-interest courses.
* From the "You say potato, I say potaahtoh" file. You will note that Lisa Van Horn graduated from a "Physician Associate" program at Yale University. So, it seems that Yale didn't like the word "assistant" in the name of the profession any better than we do. As a result, we have adopted the term for ourselves. Whether called, "Physician Assistant" or "Physician Associate", the difference is purely semantic.
** It is worth mentioning here that Dr. Saruk is a skilled and experienced medical educator. He is a Professor and an honored member of the clinical associated faculty of the University of Pennsylvania's Department of Dermatology -- the acknowleged top-rated dermatology training program in the country -- and has been training future dermatologists for over twenty-five years.