There was an interesting confluence of news items in the March 30th issue of AAPA News. Perhaps you noticed it too. One headline announced the passing of Malcolm Beinfield, MD,1 and another highlighted the opening of the Eugene A. Stead, Jr. Center for Physician Assistants in Durham, NC.2 These two events—one sad, one celebratory—seem very much connected in my mind, even though Dr. Beinfield's contribution to the PA profession began 30 years ago and the opening of the Stead Center was in February of this year. But first, a bit of PA history.

How I became a PA

Dr. Beinfield, a general surgeon at the Norwalk Hospital-Yale University School of Medicine, Norwalk, Conn, founded a postgraduate, community-hospital-based surgical program for PAs in 1976. He served as the program's medical director for the next 20 years. It was a telephone conversation with Dr. Beinfield (whose colleague, incidentally, took out my mother's inflamed appendix) that set the wheels in motion for my becoming a PA. I'll bet this story, albeit with different details, is similar to yours.

In 1977, while I was idly perusing the local paper, pausing to read the police reports, the obituaries, and what was playing at the Fine Arts Cinema, I saw a picture of Dr. Beinfield with about half a dozen people, all of whom were wearing long, white coats, standing in front of the local hospital in Norwalk, Conn. By what they were wearing, I thought these folks must be related to the medical profession in some way. In the photo's caption (there was no accompanying article), the people standing next to Dr. Beinfield were identified as physician assistants (whatever they were)—not doctors, not nurses, not emergency medical technicians, and not any other medical professional that I had ever heard of.

At the time, I was working for an heirloom collectibles company—the furthest away you can get from anything “medical.” The salary was good, the challenge was fair, but the satisfaction was small. Something about the photograph of medical somethings-or-other piqued my curiosity. I needed to know more. To my regret, I had gone only halfway toward becoming a baccalaureate nurse 12 years earlier. I could still be sparked by what might be an opportunity to enter the medical profession.

I went to the telephone book, riffled through the pages, found Dr. Beinfield's office number, and called him. When we finally connected, I told him I had seen the picture in the paper. I asked, “What are physician assistants, and what are they doing at Norwalk Hospital?” I can't recall exactly what he said, but he very briefly described a profession that sparked me even further. He then said, “Go talk to the people at Yale,” a 40-minute drive from where I lived. Within a week, I had an appointment with Yale's PA program director, from whom I learned the basic information about PAs—how the profession developed, what training was required, and what PAs did when they graduated. The proverbial bell rang in my head, it seemed almost instantaneously, and I believe I said out loud, “I want to be a PA!”

How right this decision seemed at the time. How right it still feels today, almost 30 years later. I have never regretted it, even though I had to jump through a few hoops to be accepted into a PA program and through a lot of other hoops along the way. Since entering PA school, I've heard many personal stories from other PAs. Amazingly, whenever I've asked them to tell me how they became interested in being a PA, what I've heard makes it clear that the same bell went off for them. Almost all the PAs I've talked to have described having the same “aha!” moment when they learned about PAs and saying to themselves, “That's what I want. I want to be a PA.”

Why we all are PAs

What is it about being a PA that captured our imagination, helped us to find our professional “voice,” and snagged us almost immediately into thinking we wanted to take that journey? Here are just a few of what I believe are universal qualities in PAs. I believe they help to explain why we got started in the profession and why we've stayed.

Helping others is a major motivation behind wanting to become a PA. Certainly, there are many ways to help others, but I believe that PAs bring two special qualities to the professional table: compassion and empathy. These two characteristics together blend an awareness of another person's suffering with the ability to identify with and understand that person's situation. Compassion and empathy mean more than just caring for a patient. They mean also being willing to step out of our own shoes and into those of another. The connection that PAs have with our patients is not founded on the traditional doctor-patient hierarchy but is more of a collaborative relationship.

Medical curiosity is another driving force behind becoming a PA. Granted, curiosity was probably not the emotion you were feeling when you anxiously applied to PA school and even more anxiously took the certification or recertification examinations. Nonetheless, I believe PAs have a strong urge to know as much as they can about the field of medicine—what happens when people get sick and what needs to be done to get them well. Who isn't challenged by developing a plan of care or intrigued by learning about a new and more effective therapy? Who doesn't enjoy sitting around telling war stories about an unusual patient, an interesting finding, an amazing recovery?

Our diversity is one of the most interesting aspects of the physician assistant profession. We come from a wide variety of backgrounds and experiences. Some PA students are new college graduates. Other PA students are older and beginning a second career. Some PAs are men in their 20s; others are women in their 40s. Some of us have been emergency medical techs, nurses, lab techs, teachers, ministers, or working mothers. It's the range of our differences that, ironically, is one of our strengths. Thank goodness there is no such thing as a “typical” PA.

Being part of a respected health profession is one of the key motivators in becoming—and staying—a PA. By definition, PAs are always a part of a team—the physician-PA team. The PA profession is committed to practicing medicine with supervision, using the strengths of each team member in the clinical practice setting.3 Strong support and advocacy for PAs is the mission of our national organization, the AAPA, which promotes the professional and personal development of PAs while also promoting high-quality, cost-effective, accessible health care.4

The Eugene A. Stead, Jr. Center pays tribute to a man known as the “father of the PA profession.” It also houses the new headquarters of the North Carolina Academy of Physician Assistants and the Physician Assistant History Center (www.pahx.org/). Established in 2001, the Physician Assistant History Center is dedicated to the study, preservation, and presentation of the history of the PA profession. This repository of information was gleaned from many different people and places. Its development speaks to the importance of documenting our profession's past and should be a source of pride for all of us. This shared history is our heritage and is another reason, I believe, why so many PAs are still PAs.

Remembering our stories

Perhaps I have jogged your memory and now you remember what you felt when you learned about the PA profession. Perhaps I have reminded you that a similar bell went off in your head. For a faculty member of mine, the ringing of the bell and applying to PA school happened the same day. She told me the story of how she learned about PAs from a physician neighbor. Coincidentally, she lived near a PA program. She was so enthusiastic when her “bell” rang that she got in her car, drove to the PA program, went to the front desk, and said with a smile, “I want to be a PA. Where do I sign up?” JAAPA

Th author is the editor in chief of JAAPA.

REFERENCES

1. Torrieri M. In memoriam: Malcolm Beinfield, M.D., founder of first community-based PA surgical program. AAPA News. March 30, 2006:3.

2. Doscher C. North Carolina PAs enter new era. AAPA News. March 30, 2006:3.

3. American Academy of Physician Assistants. Issue Brief. The Physician-PA team. Available at: http://www.aapa.org/gandp/issuebrief/pateamb.pdf. Accessed May 3, 2006.

4. American Academy of Physician Assistants, Mission Statement. Available at: http://www.aapa.org/mission.html. Accessed May 3, 2006.