| Physician assistants
are a relatively new breed of health care professionals,
who are licensed to practice medicine under the
supervision of the doctors and physicians.
The profession of physician assistance was introduced
in the 1960s, when there was a growing need of
professionals with the license and education of
primary care physicians. It was in the end of
the 1960s that educators and physicians recognized
that there was a real need of physicians to expand
the delivery of quality medical care. In order
to cover the shortage of primary health care physicians,
Dr. Eugene Stead of the Duke University Medical
Center in North Carolina first proposed a plan
to introduce the health care physicians called
"Physician Assistants" with the aim
that these assistants in the future would cover
up the shortages in health care profession. The
first class of the physician assistants was put
together by Dr. Eugene Stead in 1965; Dr. Eugene
wanted individuals who had acquired some education
of medical training and thus selected Navy corpsmen
who had received medical education in the military
service. Moreover Dr. Eugene based his curriculum
of the physician assistant program on the concept
of fast track training which he had been giving
to doctors during Vietnam War [Roderick, 1999].
A physician assistant has now grown into a credible
profession and physician assistants are employed
by the federal government and authorized to practice.
Although the physician assistants are assistants
to the physicians and work under their supervision
they perform 80 percent of the tasks of a physician
and this is the reason they are often called 'physician
extender". The physician assistant has many
responsibilities and performs a variety of tasks,
a physician assistant is authorized to conduct
physical exams, and he is also credentialed to
treat illness and diagnose, order or interpret
tests. In most of the states in America a physician
assistant assists in surgery and also can write
prescriptions. The physician assistants are certified
and the certification entails that these physicians
have licensed, they have gone through a defined
course of study and have knowledge of the things
they are entitled to do (Roderick, 1999; Bureau
of Labor Statistics, 2003.
Role of the Physician's Assistance in the US
Prison health Care System and the Correctional
Facilities - Article Review
The following section of the paper will review
an article titled "Understanding Incarcerated
Populations" authored by Cooke, Cheryl L.,
and written for the AORN Journal issue of March
2002.
Though the said article discusses at length the
various aspects and characteristics of the incarcerated
populations in the US prison and correctional
facilities, there are but two aspects that are
imperative to note, and which have a profound
implication with respect to the role of the physician's
assistance in both the US prisons as well as the
various correctional facilities across the nation.
First is the difference between a prison and a
correctional facility or jails. Prisons are usually
located outside the parameters of a major city,
preferably in remote regions of the state and
provide housing for inmates who have been convicted
and sentenced to serve for a period of 12 months
of more. On the other hand, jails are usually
located within close proximity of the city limits
and more often than not have access to major trauma
centers and hospitals of the respective city.
With respect to the health care systems, inmates
of jails located in close proximity of city limits
have access to a number of health care services
including but not limited to a normal sick call,
ongoing treatment for a chronic illness, or a
limited facility for prenatal care. In addition,
since the location of the jails are close proximity
to major trauma centers and hospitals, emergency
care of severe nature can be attended to any given
time for services that are not immediately available
within the limits of the jail facility.
Inmates of prisons however are faced with a totally
different set of health care facilities, primarily
because of their remote locations, and more often
than not because of the limited number of health
care providers assigned to the respective prison.
It is the later, the prison system where the need
and importance of physician's assistance are most
needed and called for, simply because the senior
physician alone cannot handle all the health enquires
and needs of the prison inmates. The unavailability
or busy schedule of the senior physicians then
calls for the importance of the physician's assistance,
which according to one estimate perform more than
80 percent of the tasks of the senior physician.
Perhaps it is this factor that also gives these
people the distinguished name of "physician
extenders", as majority of the responsibilities
and tasks otherwise falling under the domain of
the physician are in fact handled by these physician
assistants.
These tasks may include, but are certainly not
limited to conducting physical exams, treating
ills, diagnosing patients, ordering and interpreting
tests results. Majority of the states in the US
also allow these physician assistants to assist
in surgeries as well as prescribe medications
to the patients according to the nature of the
illness.
A simple procedure followed by the physician's
assistants when dealing or treating with the incarcerated
populations reveals that the entire program commences
with a receipt from an inmate, and in response
the inmate is given an appointment, more often
than a few days later. In normal circumstances,
inmates are transferred to a larger health facility
where treatment for both major and minor illnesses
is handled. This also includes emergency and other
surgical procedures that are taken are of at off-site
health care facilities. It is a normal for security
personnel of the respective prison or correctional
facility to accompany the inmate to the requisite
health facility.
Secondary aspect that is of important for the
physician's assistants is the cooperation aspect
that may or may not be of help with respect to
the legal proceedings. This becomes all the more
important in cases where inmates develop a feeling
that the health care professional assigned to
them may want to collect some evidence during
the course of transfer from prison to the larger
health facility.
Though it is certainly not the case, nor is it
the responsibility of the physician assistants
to do so, yet it is important to clarify to the
inmate that the physician assistant is there to
assist and help the inmate in matters of medical
needs and requirements, and has nothing to do
with the legal or judicial system of the respective
state or facility. Once this feeling is embedded
into the inmates' minds, it would become all the
more easier for the physicians assistants to provide
more care and make them feel comfortable, which
would also help them recover from whatever illness
or diseases they may be suffering from.
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