There are an estimated 115,000 physician assistants in the U.S. It’s considered the fastest growing segment in the healthcare field and one of the fastest growing professions in the entire labor market.
According to the American Association of Surgical Physician Assistants (AASPA), about a quarter of all PAs have a surgical specialty or subspecialty.
This includes six PAs who were hired this fall by the Department of Surgery at SBH Health System.
“They act as first assists in the O.R., see patients post-op, put on casts, do injections, take care of inpatients,” says Dr. Mark Klion, director of orthopedics at SBH who oversees the team, rattling off just a few of the many duties they perform. “They are multidisciplinary and multi-specialty and foster a community environment that helps educate our patients and support our continuity of care. Simply put, it gives us more cooks in the kitchen.”
According to the AASPA, surgical PAs are formally trained to provide diagnostic, therapeutic, surgical and preventive care under the supervision of a surgeon. The typical PA program is two years long with a curriculum that parallels that of a medical student. This includes classes in human anatomy and physiology, biochemistry, pharmacology, physical diagnosis, pathophysiology, microbiology, clinical laboratory sciences, behavioral sciences and medical ethics. They complete an average of 2,000 hours of supervised clinical practice before graduation.
Surgical PAs typically handle routine problems and procedures that free the surgeon to focus on more complex issues. They are involved in the O.R. as first assistants; perform post-op procedures and work with patients and families in the recovery room; and participate in discharge planning by writing prescriptions and dictating discharge summaries.
Evelina Badelov comes to SBH with 15 years of PA experience, working in cardiothoracic surgery and critical care before being recruited to work for a world-acclaimed liver transplant surgeon. “I would be his hands and feet and mind before he would physically arrive in the O.R. and that is one of the things we do here as PAs as well. We understand what the surgeons like and prep to make the workflow a lot easier.”
Surgery PAs at SBH rotate through all surgical specialties – with the exception of neurosurgery, which has its own PAs dedicated to the specialty. This includes orthopedics, hand, urology, plastics, vascular and ENT, giving the team of six a well-rounded experience that is not available at most hospitals.
“As a PA coming to work here you should be excited because you’re getting such a unique experience,” says Badelov, who conducts the interview from a room on the first floor of the hospital that has been dedicated to the surgical PA staff and which includes, placed unobtrusively in the corner, a large sleep pod which will be used once the team begins full 24/7 coverage in 2021. “If you love surgery, you are going to be such a well-rounded, knowledgeable PA.”
She chose to become a PA after hearing the war stories of her mother, an ER nurse at a level 1 trauma center in New York City. “I was thinking of maybe becoming a nurse at one point, but I have always wanted to have the opportunity to write prescriptions, assist in the OR, and do a little bit more, which is why I became a physician assistant.”
Having a team of PAs at SBH should be viewed positively by clinicians both at the hospital and throughout the Bronx, says Badelov. “They should care because if they send their patients here they’ll know we have well-rounded PAs,” she says. “We have the personnel to take care of everything that needs to be done. A physician just can’t do everything on his or her own. It’s impossible. You need the right team members – hashtag teamwork – to get things from A to Z to go smoothly.”