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GERI ANNE KAIKOWSKI gkaikowski@timesleader.com

Justine Samanas is spending her workday seeing patients, listening to descriptions of their aches and pains, prescribing medication, setting up tests and doing some basic surgical procedures in the Nanticoke office of family medicine where she works.

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Physician assistant Justine Samanas checks out Lou Ann Pangilinan as Dr. Richard Hiscox looks on at Mercy Special Care Hospital in Nanticoke.

S.John Wilkin/The Times Leader

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Physician assistant Justine Samanas goes over a chart with Dr. Richard Hiscox at Mercy Special Care Hospital in Nanticoke.

S.John Wilkin/The Times Leader

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No, she’s not a doctor. She’s a physician assistant.

And if the recent enrollment figures in area colleges are any indication, many area residents will be treated by a physician assistant in various health settings — including their doctor’s office, urgent care center or hospital emergency room — in the future. Maybe even instead of a family physician.

Samanas knew she wanted a career in the medical field, but she wasn’t sure whether she wanted to go into the nurse practitioner or physician assistant professions. After doing research, the PA program won out and she graduated from King’s College with her master’s degree in 2007. After that, she accepted a job in the office of Dr. Richard Hiscox. Her name is on the door below his.

She’s just one of many graduates who have entered the growing physician assistant workforce. “It was the best match for me,” said Samanas. “I really wanted to go into medicine and keep furthering my training.”

A growing awareness

Entering a PA program is an academic choice that is becoming more and more popular with incoming freshman students and even adult learners, looking to combine a love for medicine with a shorter curriculum and lower tuition fees, along with a better chance to find a job after graduation.

But it wasn’t always that way.

When Jocelyn Hook graduated with a PA degree from King’s College in 1975, there were eight members in her class — the first graduating class of its kind.

“When I started 30 years ago, nobody knew who we were,” she said. “Today, the difference is like night and today.”

As the clinical director of the Department of Physician Assistant Studies at her alma mater, Hook oversees 44 students in the PA program.

The program has come a long way, and it’s growing strong as PAs celebrate National Physician Assistant Week, today through Oct. 12. The American Academy of Physician Assistants (AAPA) has declared the theme this year to be “Celebrating Physician Assistants: Valued Partners in Care.” The week serves to celebrate the significant impact PAs have made and continue to make in health care, expand awareness of the profession and to salute the outstanding growth of the PA profession.

King’s has graduated more than 800 PAs since 1977, with graduates working in all fields of medicine and all over the country.

As a matter of fact, both Hook and Jean Denion, academic coordinator of the program, only foresee a steady increase in enrollment over the next few years and growth in the field. “Our numbers keep growing each year,” said Hook, who also works in the field as a PA.

She expects the program to keep on growing, thanks to the economy, the uncertain job market in other industries and the ever-changing health care industry.

A lot has changed in those 30 years, namely, the popularity of PA as a career choice and the stigma society had of this unknown medical title. “When the physician assistant profession began, it took a while for acceptance,” said Denion. “But we’re part of the medical team.”

Samanas is continuing to see more acceptance by patients since she began working at the doctor’s office. “Sometimes there is hesitancy because a patient is not sure of what you are capable of,” she said. “But now, I have a lot of patients who book appointments specifically with me.”

One source of frustration among practitioners remains and that is the mispronunciation and spelling of their title: It is physician assistant, not physician’s assistant, or as Hook says, “We work with the physician. We don’t belong to him.”

A varied role

A physician assistant is a health care provider who is licensed to practice medicine under the supervision of a physician. This can be in a physician’s office, hospital or urgent care center. A PA can diagnose and assess medical conditions, order laboratory tests, assess studies, treat illnesses and even prescribe medication.

What a PA can’t do is set up his own practice or perform surgery in an operating room, although he can assist during surgical procedures. While the guidelines of the Pennsylvania Board of Medicine state that a physician assistant must be under the supervision of a physician, it does not mean that the PA can’t see a patient without a physician being present. “The doctor doesn’t have to be on site in order for the physician assistant to take office visits,” said Hook. “Many times, the doctor isn’t even in the office. He may be making hospital visits. What’s great about a physician assistant is that having one gives the doctor the ability to handle more complicated cases or go outside of the office.”

Samanas said she has a good working relationship with Dr. Hiscox, who has regularly used PAs in his office. “He is very flexible and lets me do my own thing,” she said. “Yet, he is available to answer any questions I might have.”

While it is more commonplace to see a PA in your doctor’s office, they are viable in a variety of fields, including neurosurgery, OB/GYN, emergency room, cardiology and pediatrics.

Samanas said she chose the field of family practice because it offered her the most opportunities to use her skills. “I can do everything a doctor can basically,” she said. “I can prescribe medicine, diagnose conditions, do simple surgeries in the office and send someone for testing. I didn’t want to specialize in a specific field, but in a doctor’s office, there is so much variety with different medical conditions. Every illness is different. Every patient is different.”

Getting there

There are two routes that a student can take in order to become a PA, according to Hook. The first is to enter college as an undergraduate, take the five-year physician assistant program and graduate with a Bachelor of Science and master’s degree.

The first three years of the program are undergraduate studies; the last two years are 10 1/2 months in the classroom and 13 1/2 months of clinical work.

The second is for those who have a bachelor’s degree or higher degree. These students take a 24-month straight-through program, with no seasonal break, which involves 10 1/2 months in the classroom and 13 1/2 months clinical work.

The educational route for a physician is four years in college for a bachelor’s degree in pre-med or biology followed by four years of medical school and then a residency.

Hook noted that a PA must maintain continuing education credits.

Upon successful completion of the Physician Assistant National Certifying Exam (PANCE), a physician assistant is licensed to practice medicine under the supervision of a physician. The test must be taken every six years for a PA to maintain his license. In addition, the PA must complete 100 continuing education credits every two years.

“We get into the work force in a shorter amount of time,” said Denion, noting that some PAs do continue into medical school. “With the way the current health care industry is progressing, there will be less physicians going into family practice. More doctors are specializing. This is where the physician assistant will play a large role.”

Samanas said she carefully researched the PA program before entering King’s, doing her homework before making her final career choice. “I talked to the physician assistant at my own doctor’s office,” she said. “I interviewed him about what he did. My advice to someone considering this as a profession is that if you’re interested in health care, this is a really dedicated program. But you have to want to do it.”