Dr McMillen's comments on the value of surgical residents compared with surgical physician assistants in the October 1998 ARCHIVES1 displayed a misunderstanding of the strengths of the physician assistant profession and underestimated some of the inherent weaknesses of residency programs.
Dr McMillen points out that residents work "80 to 100 hours per week." Surgical physician assistants, on the other hand, work an average of 48.7 hours per week for their primary employer (excluding on-call hours), according to the 1998 American Academy of Physician Assistants Physician Assistant Census Survey.2 Residents may be gone in a few years; physician assistants, as staff, are there as employees. From the perspectives of a hospital interested in providing continuity of quality care, a patient interested in an alert staff, and a surgeon interested in having a team player who knows to place late-night telephone calls when a case is beyond his or her experience or education, physician assistants make sense.
The physician assistant profession has existed for more than 30 years, during which time the percentage of physician assistants working in general and subspecialty surgical settings has increased. If these quality health-care professionals were not cost-effective, one would think fewer hospitals and surgeons would be hiring physician assistants. The services physician assistants provide are reimbursed by Medicare and by third-party payers. According to the 1998 American Academy of Physician Assistants Physician Assistant Census Survey, the median total annual income from primary employers for surgical physician assistants was $67,288. In its Physician Compensation and Production Survey: 1998 Report Based on 1997 Data,3 the Medical Group Management Association estimated that the mean ratio of compensation to gross charges was 0.418 for physician assistants in a surgical practice.
Surgical physician assistants will never replace surgical residents. This is because good surgeons are still essential to the delivery of quality medical care in the United States, and good surgeons are the outcome of good residency programs. Patients need experienced surgeons and surgeons need a strong medical team working with them—one that includes physician assistants.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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