Education>> PA Program >>

Physician Assistants in the Department of Surgery
One of the greatest contributions that our physician assistants provide is the continuity of care that they provide for patients. The complexity of care for the surgical patient has increased yearly. In our teaching hospital the monthly rotation of residents through the various services often places novice physicians in a complex clinical setting. Physician Assistants serve as a "tie line" and not only preserve continuity but also help ensure that patient therapeutics and clinical procedures are carried out within the guidelines established by the Department of Surgery and with a high level of expertise. Fellows and surgical residents need time for electives and research in order to meet their educational requirements. Our Physician Assistants continue to provide the workforce and allow broader educational experiences for residents and fellows. Physician Assistants perform bedside procedures such as closed thoracostomy, central venous catheter insertion, arterial line placement, endotracheal intubation etc. All of these activities that are performed by our Physician Assistants are credentialed by the Department of Surgery and are provided with close direct and indirect supervision by a qualified physician.

New York Hospital Medical Center of Queens Experience
The New York Medical Center of Queens is a 457- bed acute care institution serving over 2.2 million people located in the borough of Queens. The Medical Center is a regional Level-I Trauma Center with a very active Emergency Department seeing over 60,000 patients each year. Forty percent of admissions to the surgical service are emergency admissions with an unusually large number of patients with complex general surgical and subspecialty problems with a high intensity of illness. The medical center maintains accredited residency programs in dental medicine, internal medicine, obstetrics and gynecology, oral pathology, pathology, radiation oncology and surgery, as well as accredited fellowships in gastroenterology, infectious disease, nephrology and pulmonary medicine.

In 1979 the medical center was concerned with the potential loss of surgical residents. Physician Assistants were implemented as a new workforce within the Department of Surgery. To date, the department of surgery has over 500-man years experience with the utilization of Physician Assistants on the surgical service as well as in the surgical intensive care unit. All of our Physician Assistants are graduates of approved Physician Assistant Program and hold and maintain current NCCPA Certification. All have completed Basic Life Support, Advanced Cardiac Life Support, Advanced Trauma Life Support and Pediatric Advanced Life Support.

Levels of clinical expectations are related to clinical resident education at our teaching institution. All entry level PAs begin at the PGY- 1 level. Total Number of hours worked is among 48-60 hrs Per week with a salary range depending on level beginning at $85,000 a year.

The PA's in the Department of Surgery at NYHQ are credentialed to perform common beside procedures that include placement of central lines, Swan Ganz catheters, arterial lines, chest tubes (insertion and removal), lumbar puncture, naso-enteral feeding tubes, sigmoidoscopy, endotracheal intubation, paracentesis, and thoracentesis. On occasion PA's have gone past these commonly performed procedures and have been credentialed to perform and supervise others in advance techniques such as bronchoscopy and bedside tracheostomy. All related complications are subjected to review through surgical quality improvement and quality issues are addressed in the same fashion as the resident and attending physicians. We do not establish arbitrary guidelines regarding PA credentialing but rather promote continued intellectual and technical growth.

Others and we have noted that our physician assistants have come with a "second sense" of knowing when to call for help. In the past twenty-five years at NYHQ there has been no legal settlement as a result of the activity of a Physicians' Assistant. There has been a high level of satisfaction among patients, families, nursing, ancillary staff and attending physicians. The PA's have become widely accepted and are highly regarded members of the healthcare team at NYHQ. Some of our physician assistants have further expanded their roles in the area of administration and have become invaluable assets to the Department of Surgery.