Understanding academic rank among PAs practicing in academic medical centers.

OBJECTIVE: To evaluate the attitudes and prevalence of academic/clinical rank among practicing physician associates/assistants (PAs) in different specialties and geographic locations. METHODS: We surveyed PAs in clinical practice with a bias toward hospital/academic-based clinicians. The survey was a modified instrument to evaluate perceptions, attitudes, barriers, and prevalence of academic rank. RESULTS: Overall, 65% of respondents indicated academic/clinical rank opportunities were of interest, but 60.8% noted that they were not eligible to hold rank in their institutions. Nearly 55% indicated a desire to hold rank, but 81.9% of respondents did not hold rank. The survey response rate was 22.9%. A lack of departmental emphasis was a common barrier to rank. CONCLUSIONS: Clinically practicing PAs clearly have a desire or interest in academic/clinical rank, but barriers persist. Further development of opportunities to hold academic/clinical rank with mentorship may improve PA careers and propel professional advancement and parity.

Fecal impaction in adults.

ABSTRACT: Fecal impaction is a common digestive disorder and is considered an acute complication of chronic and untreated constipation. Generally, the factors responsible for fecal impaction are similar to those associated with constipation. Early identification and treatment minimize complications and patient discomfort. Common treatment options to address fecal impaction of the rectum include manual disimpaction or fragmentation, the use of distal and/or proximal softening or washout procedures such as enemas and suppositories, and oral or nasogastric tube placement for the administration of polyethylene glycol solutions containing electrolytes. In severe cases, surgical intervention is necessary. Post-treatment evaluation should include a colonic evaluation by flexible sigmoidoscopy, a colonoscopy, or a barium enema after the fecal impaction resolves. Following treatment, conduct an evaluation of causes and create a preventive therapy plan.

Understanding attributes and characteristics of the PA leader-physician relationship.

PURPOSE: This study sought to evaluate the attributes and characteristics of physician mentors, dual-roled physician assistant (PA) leaders, and how this relationship affects PA leaders and the PA leader-physician relationship. Dual-role PA leaders may possess additional formal job titles and duties as well as having direct reports. METHOD: We surveyed PA leaders at a single large academic medical center and its associated health system. The survey instrument evaluated perceptions, attitudes, and characteristics of the PA leader and influential physician and their relationship. RESULTS: Of the 56 PA leaders surveyed, 34 responded, for a 60.7% response rate. Effective communication was the most prevalent relational characteristic ranked as most important for both PA leaders (30%) and physician mentors (36%). Additional self-identified positive attributes of the team included collaborative mindset, reliability/trustworthiness, work ethic, and delivery of patient care. Influential physician mentors may have a significant effect on PA leader job satisfaction and career advancement. CONCLUSIONS: This is a novel study of PA leaders examining perceptions, beliefs, and characteristics of the PA leader-physician relationship. PAs are integral healthcare team members and medical providers. As PAs work closely in physician-led teams, further understanding the PA leader-physician relationship could influence PA and physician professional development, career trajectory, and healthcare team outcomes.