PAs may practice longer than expected and need to bridge their retirement in unprecedented ways. Who, what, and why remain challenging questions.

The PA profession is undeniably critical to the future of medicine, and we all have a responsibility to represent PAs the best we can.

More than 90% of women survive when ovarian cancer is caught early. The key is awareness, for both the patient and the PA.

All patients should be offered a trained chaperone for intimate exams in advance of the consultation. The gender of either patient or provider should not influence the discussion.

One way to address the Healthy People 2020 goals is the patient-centered medical home, which focuses on enhanced access to care and improved care at a decreased cost.

The month she spent practicing medicine in Niger taught the author much about the value of each individual life. She learned, too, that PAs can play a major role in patients' lives, whether they practice in the United States or the Sahara Desert.

A PA ruminates on unemployment—her own, and the nation's—and what it might mean for the future of the profession.

The author argues that to maintain themselves as a "disruptive innovation," with all the value that brings to the American health care system, PAs must tend to their profession carefully.

A PA participating in a South Australian trial reflects on her experience and the future of the PA profession in Australia.

The author reflects on the pain and confusion her family experienced watching her sister struggle with frontotemporal dementia.

The art and science of medicine that serves patients' best interest is defended against the overwhelming need to avoid malpractice lawsuits.

This physician assistant learns a valuable lesson on how difficult it can be to describe pain when she becomes a patient with acute abdominal pain.

Reviewing the symptoms, taking the history, and coming up with a diagnosis is just the first part of the process. Following up with effective teaching is key.

Somehow, with all the recent advancements we have made in medicine, we have lost an important element: continuity of care.

An FDA alert intended to halt life-threatening combination use of triptans and antidepressants could prevent effective migraine therapy.

A few precautions and a minimum of initial investigation can steer you toward a rewarding career and help you avoid accepting a far less desirable position.

Isn't it more ethical to give our patients a plan with the tools that can help them succeed than merely to state the obvious need for weight loss and exercise at their annual appointment?

As PAs, we know what needs to happen in order to create positive health outcomes for each patient. We may need more information from the patient's file or we may just need to know if the patient's condition has improved.

As the first PAs contracted to work clinically on Australian soil, we face a great challenge.

We've heard a lot of talk this year about needing change in our political system. It's also time to change the model of our health care system—from a disease model to a wellness model. By many estimates, close to our entire population will be overweight by 2040 if we don't take steps now to reverse the trend

After more than 3 decades as a proud member of the PA profession, and as one who has focused on patient care exclusively during that entire time, I feel able to speak with some clarity about what has always been the most sensitive of subjects: our profession's title—physician assistant.

As frontline health care providers, PAs know better than most how important it is for patients to understand and act on health information. But a recent report from my agency, the Agency for Healthcare Research and Quality (AHRQ), found that only 12% of 228 million American adults have proficient health literacy skills.

We may have chosen the field because of our passion for a challenge. Or maybe for some of us, it was love for the art of medicine. No matter the reason, we are all PAs today, providing care to thousands of patients in innumerable ways.

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.

Ever since the beginning of the PA profession, students have been drilled never to misrepresent themselves as doctors to their patients. The recent introduction of doctoral level PA programs could result in some amusing confusion—not in the university research laboratory—but in the clinical exam room. The author offers the following dialogue between clinician and patient in the spirit of Abbott and Costello's "Who's On First?"

Estimates are that more than 100 million prescriptions for antibiotics are written annually in the United States. Many of these prescriptions are given to patients with acute, uncomplicated bronchitis, sinusitis, pharyngitis, and other nonspecific upper respiratory infections (URIs). These conditions are largely self-limited in nature. The media has rightfully acknowledged public health concerns in regard to the increase in bacterial drug resistance perpetuated by frequent, often unnecessary, antibiotic administration. So, why do clinicians give in to their patients' requests for antibiotics? There

As an African American who grew up in the South during the civil rights movement and integration, I have been exposed to racial slurs and barbs all my life. Despite this, it is still so very unsettling when racial slurs make their way into common conversation. Working as a PA in emergency medicine, I am often called on to treat patients and families at vulnerable times in their lives. Many things are said during an emotional moment. However, I have never gotten used to hearing racial remarks from women.

Your patient is a healthy woman who eats right, exercises, and doesn't smoke. She presents with a painful, coffee-bean-sized new lump in her right axilla. Now imagine the patient is your wife.

When I became a PA, I knew the acronym PA would present problems. I imagined facing a patient, or a stranger at a cocktail party, and hearing that person say, "And what exactly does that stand for?"

The Human Genome Project, a 13-year international research effort, ended in 2003 with the complete mapping of the human genetic sequence. The US Department of Energy and the National Institutes of Health sponsored this project, which may be described as a "gateway" through which an architectural paradigm of the biology of human essence is provided.

Justice, cost-effectiveness, and the ethics of prescribing

I was struck by an article in The Wall Street Journal announcing that the Journal of Thoracic and Cardiovascular Surgery had prohibited some authors from publishing in it because they did not fully disclose their affiliations with the companies that produced the products they discussed in their submitted and accepted manuscripts.

In 2003, the National Health and Nutrition Examination Survey (NHANES) provided a large national database on normative BP levels throughout childhood and revised BP tables to include the 50th, 90th, 95th, and 99th percentiles by gender, age, and height. These data permit clinicians to identify children with abnormally elevated BP and to define hypertension in children and adolescents as systolic BP and/or diastolic BP that, on repeated measurement, is above the 95th percentile (higher than 120/80 mm Hg).

Primary care practitioners repeatedly admit that they seldom ask patients about their sexual practices when taking a history. They are reluctant to address sexual health issues for several reasons, including embarrassment, feeling ill prepared, existing time constraints, and a belief that the sexual history is not relevant to the chief complaint. When clinicians convey discomfort with sexual problems, patients become uncomfortable too; they report that this discomfort is the primary barrier to discussing sexual health issues during the health care visit.

While applying for PA school, I shadowed a PA at a busy pediatric clinic. During a wellness visit, the PA asked a 16-year-old male if he had a girlfriend. The young man shifted his gaze downward and bashfully answered "no." The PA had assumed that this patient was heterosexual when to me he appeared to be gay. This assumption, however benign it may seem on the exterior, probably sent a subtle yet powerful message to this young man: It's not okay to be gay; you aren't like the rest of us.

Between 1978 and 1980, a cohort of 6,875 homosexual men were studied at the University of California, San Francisco, to determine the incidence and prevalence of a new T-lymph tropic virus, type III/lymphadenopathy-associated virus (HTLV-III/LAV), which was later called human immunodeficiency virus (HIV).

I recently finished the most difficult and rewarding year of my career in medicine. It was not PA school or my first year of practice as a PA; it was residency. I completed the US Army Physician Assistant Emergency Medicine Residency at Brooke Army Medical Center (BAMC) in San Antonio, Texas. In conjunction with the emergency medicine residency program for physicians, the army conducts a program for selected PAs in San Antonio and at another army medical center in Tacoma, Washington.

Emergency department overcrowding is becoming a serious problem. One option that is to create a system by which these patients are seen outside the ED.