HCV Research and News: What is the role of a physician assistant in the fields of gastroenterology and hepatology?

February 7, 2012

What is the role of a physician assistant in the fields of gastroenterology and hepatology?

GIPA Scope of Practice

GIPA offers the following guidelines for the role of Physician Assistants (PAs) practicing in Gastroenterology and Hepatology. These guidelines are meant to serve as a guide in practice, but are not to take the place of state/federal legislation or other regulatory boards. State laws and regulations define the PA profession in each state and establish registration and competency requirements, as well as the responsibilities of the supervising physician.

In most states the Board of Medical Examiners is responsible for licensing and regulating PAs. Gastrointestinal Physician Assistants (GI PAs) may provide care for patients in various settings including outpatient clinics/offices, HMOs, inpatient hospital settings, and government institutions. Most GI PAs have hospital privileges and membership on the medical staff. GI PAs may also be involved in education, teaching, and administrative functions pertaining to the fields of Gastroenterology and Hepatology. Some GI PAs are involved with research and publication.

GI PAs always practice with the supervision of a physician, but exercise autonomy in diagnosing and treating illnesses within their scope of practice and that of their supervising physician. Individual PA duties are dependent on the scope of his or her supervising physician's practice and the desire of the physician to delegate certain tasks or responsibilities. The range of duties and responsibilities of a GI PA are as varied as the number of different GI practices. Besides performing routine duties such as histories & physical exams, daily patient rounds, patient education, and discharge summaries, GI PA's may perform diagnostic/therapeutic procedures. Whether a GI PA performs these procedures is subject to state regulation, PA training/experience, the scope of the supervising physician, and the needs of the practice. Such procedures may include, but are not limited to:

Flexible Sigmoidoscopy
Paracentesis
Liver Biops

GI PAs report that the most frequent work-ups they are presented with include, but are not limited to, the following chief complaints:

Work-up of abdominal pain
Work-up of dyspepsia
Work-up of nausea/vomiting
Work-up of dysphagia
Work-up of constipation
Work-up of diarrhea
Work-up of gastrointestinal bleeding
Work-up of elevated liver enzymes

GI PAs obtain medical histories and perform physical exams, order and interpret laboratory data, order and read radiological studies, formulate a differential diagnosis and establish a working diagnosis, formulate a treatment plan, prescribe medication, perform procedures, round in the hospital, and dictate H & Ps and daily progress notes for patients with Gastrointestinal and Liver Disease including, but not limited to the following diagnoses: