Patients seeking medical care today are having more frequent exposure to non-physician providers, such as physician assistants and nurse practitioners. Both of these groups of health care practitioners are professionals licensed to practice medicine under the supervision of a physician.
They can perform a wide variety of medical duties, from basic routine medical care to highly technical procedures. They may also work as surgical assistants to a surgeon. Their patients can range from newborns to the very elderly. They can be found in virtually every medical and surgical specialty.
In rural areas that are short of physicians, they often work independently, conferring with a supervising physician as necessary and as required by law. Their responsibilities are determined by their experience, their working relationship with the supervising physician and state laws.
The first physician assistant program began in 1965 at Duke University Medical Center in North Carolina. Many of the first students in this program were Navy corpsmen who had received considerable training and on-the-job experience in the Vietnam War but had no options to use their talents upon return home to the U.S.
The nurse practitioner program began at the University of Colorado, also in 1965. Unlike physician assistants, nurse practitioners first receive their registered nurse degree and then go through further training to practice medicine under a physician’s supervision.
Both nurse practitioners and physician assistants can:
**Take medical histories and perform physical exams.
**Prescribe medication and order medical tests.
**Diagnose and treat illnesses.
**Counsel patients and promote wellness.
**Perform minor surgical procedures independently.
**Assist in surgery.
Their practice may also include administrative services, education and research.
Both groups have to pass a national certification exam, be continually reexamined after a number of years and also complete a prescribed number of continuing medical-education hours to maintain their licenses.
Physician assistants and nurse practitioners can be found serving a wide variety of medical needs in settings from remote rural areas to major urban centers. They work in physicians’ offices, hospitals, clinics, the armed forces and government agencies.
I have worked with nurse practitioners and physician assistants for the major part of my career, dating back to the mid-1970s. They have been a tremendous asset to my practice, as well as to the many physicians who call upon their talents and skills.
Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or e-mail him at va**********@sb*******.net. Information in this column is not intended to replace advice from your own health care professional. For any medical concern, consult your own doctor.

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