More than an assistant; an addition

From the U.S. Navy's loblolly boys to the Army's battalion surgeon's assistant, the title has changed over the course of history but the need hasn't. Physician Assistants (PAs) have been around for centuries but it wasn't until World War II that the United States surgeon general replaced one of two surgeons assigned to Army battalion aid stations with PAs, as the fast-tracked medical curriculum of PAs was developed.

In the Army, PAs serve under Army Medical Department's Medical Specialist Corps and provide sustained health services from tactical to strategic levels, increasing readiness of Soldiers in addition to caring for their families and retirees.

"We're very versatile," said Maj. Raul Villalobos, Interservice Physician Assistant Program (IPAP) clinical coordinator at William Beaumont Army Medical Center. "(PAs) practice in any type setting in the civilian workforce, cardiology, dermatology; they could work in many fields."

October 6, 2017 marks the profession's 50th anniversary, commemorating the first graduating class of physician assistants from Duke University in 1967. In recognition of their contributions in medicine, PAs are recognized from Oct. 6 - 12 during National Physician Assistant Week.

While most Army PAs graduate into family medicine and known as Primary Care Managers (PCMs) their scope of practice varies with some PAs specializing in specific fields. Army PAs also receive an opportunity to further their education through doctorates in three fields: emergency medicine, orthopedic surgery and general surgery.

"For the most part, active-duty (Military Treatment Facility) PAs have specialized fields and are focused on the Soldier's chief complaint in that particular area of medicine," said Capt. Steven Davis, senior physician assistant, 3rd Armored Brigade Combat Team, 1st Armored Division. "PAs in battalions are typically the primary care providers and concerned with the overall well-being of (Soldiers). The health of the Soldier is most important to (United States Army Forces Command) PAs, but we also have to take into account the needs of our Commanders who are ultimately tasked with the great responsibility of ensuring their units are prepared to deploy and win wars."

The PA role at the brigade level are unique to the profession since PAs serve as the senior medical subject-matter experts while directly affecting the readiness of the unit. In addition to medical care, PAs in deployable units are also tasked with the training and education of combat medics in a unit.

"As a (battalion) PA, I feel like I can relate to the Soldier easier because I'm with them in the field, or on deployment, or standing in line for that unit level random UA," said Davis. "Physician assistants make all the difference in medical readiness. Wherever there is a maneuver (battalion), there is a PA with his or her medics. On the battlefield, the PA is the first credentialed health care professional an injured Soldier may see."

Aside from employing PAs for medical practice, WBAMC is a phase II site for IPAP and hosts anywhere from eight through 12 students at a time during their clinical rotations (after they complete their 16-month didactic phase). During the 13-month phase II training the students rotate through a variety of clinics to gain knowledge and experience. Clinics include: surgery, dermatology, obstetrics/ gynecology, orthopedics, behavioral health, internal medicine, otolaryngology (ENT/ Allergy), pediatrics, ophthalmology, emergency medicine and family practice.

Another unique aspect of the Army PAs is their diversified enrollment criteria, which invites service members from any Military Occupational Specialty with a few college credits to apply. The program is also open to commissioned and warrant officers interested in the practice as well as current PA-certified candidates outside the military.

"It's unique that Army PAs have a lot of diversity and it helps because it brings more knowledge of the Army and operations so PAs may understand better," said Villalobos, who enlisted as a laboratory technician before taking a commission as a PA. "There is a need for more PAs throughout the military."

For Davis, the root of his interest in the profession comes from his experience as a deployed dental technician in a detainee facility during which Davis was mentored by PAs.

"They seemed very confident in examining and treating patients and I knew from then that I wanted to do something similar to what they were doing," said Davis. "The best part of my job is that I get to care for Soldiers. It's extremely satisfying getting that 'Thanks Doc' at the end of patient encounters when Soldiers feel like they've been genuinely helped."