I read with interest Ms. Ashley Imlay’s article about proposed legislation to allow physician assistants to work independent of physician supervision (“Inside Utah fight to expand the scope of physician assistants amid health care shortage,” Jan. 17). Ms. Imlay writes that a physician assistant “can diagnose and treat illnesses, prescribe medication, conduct physical exams and perform many of the other tasks of general practice physicians.”
However, she does not compare the amount of difference of education and training between a primary care physician and that of physician assistant. She indicates that a physician assistant degree is earned after two years of classwork with a third year of 2,000 hours of clinical training. A board-certified primary care physician must have 4 years of medical school followed by at least three years of residency composed of about 10,000 hours of clinical training in the hospital and outpatient clinics.
Previously, as a faculty member at the University of Utah School of Medicine, I was involved in the early physician assistant program development. I supervised a competent physician assistant at a Wendover, Utah, clinic. He was confident in his own medical capabilities but recognized his limitations. I monitored his practice by phone and weekly visits. Today telemedicine makes physician oversight even more efficient.
I still believe that physician assistants play a crucial role in providing primary medical care in rural areas. However, the original physician assistant program was based on the premise that physician assistants would be what their name implies: assistants to physicians, not independent physician-like practitioners. I believe that efforts to change that role are ill-advised and would place physician assistants in a precarious position in which their practice of medicine would be judged (both by patients and medicolegally) against the standard of primary care physicians whose experience and training far exceed their own.
King Udall, M.D.
Salt Lake City