They came to the stage one at a time, trailing parents, siblings, spouses and significant others who took white coats from a rack, holding them up as the graduates shrugged into them, getting a feel for a new level of responsibility in the medical world.
And just like that, Point Loma Nazarene University minted its first 28 physician assistants Friday, injecting a fresh set of trained troops into an ongoing battle to keep up with the increased demands for health care caused by an aging population and an exodus of burnt-out medical providers in the wake of the COVID-19 pandemic.
It was the first graduating class of the university’s new physician assistant program and the first crop of locally trained PAs for any institution in San Diego County. But that will not be the case for long. UC San Diego has its own PA program underway and, in a few years, will be graduating its own groups of specialists in addition to the doctors its medical school has been producing annually since the 1960s.
The title physician assistant does not accurately describe the role they play in modern medicine. Though they’re called assistants, and work under the oversight of medical doctors, PAs wield a massive amount of medical authority. They can perform physicals, take health histories, order tests and even make diagnoses.
But educating a physician assistant takes only about two and a half years compared to about eight for a medical doctor. Physician assistants, along with nurse practitioners, are seen as a key way to address the increasing demand for health care that has recently led to long waits for care and overflow into emergency departments.
In its most recent estimate, the American Association of Medical Colleges projects increasing physician shortages nationwide. A 2020 assessment predicts a shortage of between 21,400 and 55,200 primary care doctors by 2033. The shortfall is expected to be even more among specialists — 33,700 to 86,700 in the same timeframe.
Physician assistants are already helping take up a lot of that slack and are expected to become even more crucial in the coming decades.
Janet Coffman, co-associate director for policy programs at UC San Francisco’s Institute for Health Policy Studies, said these workers are like the Swiss Army knives of medicine, possessing enough training to fit many needs.
“Physician assistants help to alleviate the shortage of primary care physicians because they are trained to provide many primary care services and to practice collaboratively with physicians,” she said.
This is not a field that is open to anyone who went to college.
Applicants are required to have a bachelor’s degree with a minimum grade point average of 3.0 and a minimum of 1,000 hours of paid, hands-on experience caring for patients. And applicants must already have a very solid background in the sciences, including anatomy, physiology, chemistry, microbiology and statistics.
Fresh from receiving his white coat, Evan Moore, 26, said he earned those health care experience hours as an emergency medical technician in San Diego.
Moore, who lives in Escondido, said he has already found a job as a physician assistant, and it’s not anywhere near where he grew up. He has signed on, he said, to see patients at Pioneers Memorial Hospital in Brawley.
It’s a destination that has a massive need for trained medical professionals of all types, and Moore said he was intrigued by the idea of going somewhere he knows he will be needed.
“It’s more of a rural ER out there, and I like that because everybody’s tight-knit and eager to teach, so it seemed like a good opportunity,” Moore said.
Amber Cargill said she worked as a medical assistant for a year for a local OBGYN clinic doing fetal monitoring and other medical tasks before staring PLNU’s inaugural physician assistant class. While she said that work was fulfilling, she found herself wanting to go deeper.
“I wanted the ability to take the next step with patients and be a bigger part of their health care,” she said, adding that she already has a job offer to do just that for a medical provider in the San Diego market.
Janet Coffman, the UCSF expert, said that while increasing the numbers of physician assistants clearly extends the reach of physicians, their impact is not infinite.
“There impact is limited for two major reasons,” Coffman said. “First, their numbers are small relative to physicians, although they are growing substantially.”
And, she added, PAs don’t tend to distribute themselves evenly throughout health care, tending to cluster in “medical and surgical specialties” that tend to be better paid.
While building a new PLNU program requires the work of many, two in particular have been at the core of the university’s efforts to educate this first class, and those that come after it. Dr. Lac T. Vu and his wife, Amy Vu, a physician assistant and the program’s director of clinical education, were key in helping the new program find its footing. The couple helped build alliances with local health care organizations finding places for students to work alongside doctors to gain the clinical experience necessary to earn a PA degree.
To see 28 students pass across the stage Friday, Amy Vu said, was particularly amazing given that the result started with a conversation over coffee six years ago.
She and her husband, who both still work in the emergency department at Grossmont Hospital in La Mesa, have enjoyed the experience of not just providing health care, but also helping to expand its reach.
“In the classroom, if you’re teaching 30 students who some day are going to each have 30 patients a day, that’s amazing,” Vu said. “I think we all get to a point in our career where we have done a thing for a while, and now it’s time to lean back in and teach more, get it out there further into the community.”
This story was originally published in The San Diego Union-Tribune. It has been adapted for our platform and can be read in its entirety here.
Cover photo by Sandy Huffaker/for The SD Union-Tribune