Physician assistants (PAs)

Physician assistants (PAs) are employed in physician offices throughout the United States. Although PAs provide direct patient care, they are under the supervision of a licensed physician. Duties include taking patients’ medical histories, performing physical examinations, ordering diagnostic and therapeutic procedures, providing follow-up care, and teaching and counseling patients. In most states, PAs may write prescriptions. The PA may be the only health care practitioner a patient sees during his or her visit to the physician office. Therefore, patients often refer to a PA as “the doctor.” Ned, a PA for five years, says the patients he sees often address him as “doctor.”

Similarly, Marie, a long-time employee of a physician in private practice, is often called “the doctor’s nurse.” Although Marie has never had the training necessary to become a certified medical assistant or a registered nurse, she sometimes refers to herself as the “office nurse.”

1. What legal and ethical considerations are evident in these situations?
2. Should Ned and Marie allow patients to call them “doctor” or “nurse,” respectively? Why or why not?

Note: A health care practitioner is held to the standard of care practiced by a reasonably competent person of the same profession. A physician assistant using the title “doctor” and a medical assistant using the title “nurse” may be held to the standard of care of a physician and a nurse, respectively, and may be accused of practicing without the appropriate license.