James F. Cawley, MPH, PA-C

The first PAs trained during the 1970s are now making retirement choices. Instead of dropping out of the medical workforce at 65, some are choosing to remain, though not necessarily maintaining the same activity level or doing the same kind of work.

The authors discuss some of the implications of PA career flexibility, which has long been a hallmark of the profession and was one of its founding principles.

Reforming the health care system will require addressing health workforce issues such as the impending physician shortage and a greater role for PAs.

The prospect of doctoral degrees for PAs is a controversial issue that invokes strong responses and passionate views. Most PAs are at best ambivalent and at worst downright contemptuous of the notion of doctoral degrees, particularly for entry-level PA education.

My patient "Bill" is a 59-year-old Vietnam veteran who has lived on the streets of Boston for many years. He suffers from chronic alcohol abuse, has never married, and has no kids. Bill doesn't talk a lot about his past, but he did tell me that he was hit by a car as a young child and suffered a brain injury. During baseball season, Bill lives near Fenway Park, where the panhandling can be fairly rewarding. When the weather gets frigid, he heads northeast to an alley between Newbury and Boylston Streets. He sleeps next to a blower that emits warm air from a building.

This article reviews nine key points that experts at an NIH conference said characterize the challenges associated with improving end-of-life care.

A 47-year-old woman presented with increased exertional heart rate of a few months' duration. She was a coffee drinker and initially attributed the tachycardia to her caffeine intake. However, avoiding caffeine did not resolve her symptoms. The patient was told that the results of a thyroid panel ordered by another clinician a few days earlier were within normal limits.

Ms. X, a G2P1 23-year-old pregnant Navajo woman, came with her mother to an Indian Health Service clinic on the Navajo reservation. Her complaint was a bloody discharge for 1 week, and Ms. X and her mother were very concerned. The patient had been receiving regular prenatal care but had missed her last appointment.

Will we need more physician assistants in the health care workforce of the future? Once again, perceptions have shifted as past predictions have proven to be wrong.