Endocrine Physician Assistants A Powerful Ally In Patients’ Care

By Mary Green

Of all the medical specialties currently being practiced in the U.S., among the most in-demand services are those of endocrinologists, sub-specialists who manage diseases and conditions ranging from diabetes and obesity to reproductive system issues, osteoporosis, thyroid disorders and more. The supply of these specialists, however, is far outweighed by the need. According to the American Board of Internal Medicine (ABIM), there were only 5,811 board-certified endocrinologists in the U.S. in 2010 and many of those were involved in research, administrative or academic activities rather than providing clinical care.

When increasing numbers of prediabetes and diabetes cases, the growing epidemic of obesity and an aging population developing conditions within an endocrinologist’s area of expertise are factored in, the impact of the nationwide shortage of endocrinologists becomes profound. Fortunately for patients and the physicians who care for them, endocrine physician assistants (PAs) are helping to fill the void.

Roughly one-third of PAs practice in primary care, with the remainder practicing in specialty medicine such as endocrinology, according to the American Academy of Physician Assistants. “PAs provide a broad range of health care services under the supervision of a physician in private practice, clinic or hospital settings, including include physical exams, diagnosing and treating illnesses, ordering and interpreting tests, developing treatment plans, prescribing medications, and educating and counseling patients on preventative health care.,” says Sondra O’Callaghan, PA-C, a practicing endocrine PA and president of the American Society of Endocrine Physician Assistants (ASEPA).

After acquiring a bachelor’s degree, PA candidates are instructed for two to three years in an accredited graduate program similar to a medical school using what is known as a “fast track medical model,” developed during World War II to accelerate doctors’ training. the intensive curriculum offers training in internal medicine, an important foundation and prerequisite to moving into a specialty or sub-specialty area such as endocrinology. This classroom training is complemented by a minimum of 2,000 hours of clinical rotations. The PA candidate must then pass a rigorous board certification exam administered by the National Commission on Certification of Physician Assistants (NCCPA). In most states, certified PAs are licensed to practice medicine by the state medical board and are held to the same standards of care that physicians provide. They must complete 100 hours of continuing medical education every two years and take the board exam every 10 years in order to maintain their certification and licensure. They also continue hone their skills through allied memberships in organizations such as the American Association of Clinical Endocrinologists (AACE), which offers various educational, clinical programs and practice-related resources.

While endocrine PAs are trained in all aspects of endocrine diseases and disorders, they can also specialize further. For example, PAs can learn to do neck ultrasounds and thyroid biopsies. Others choose to run lipids (blood fat) or obesity clinics. And some work for physician practices where they manage the majority of patients with diabetes – a role known as a diabetologist. “The collaborative nature of the endocrinologist-PA team is such that the patients reap the benefits,” O’Callaghan notes. “With a continued shortage of endocrinologists and the rise in diabetes, prediabetes and resulting chronic conditions that demand our expertise, PAs can step in to provide increased access to quality endocrine care.”