Medicosocial Conflict and Crisis due to Illegal Physician Assistant System in Korea.

The Korean Medical Association opposes the illegal attempt to implement the physician assistant (PA) system in Korea. The exact meaning of 'PA' in Korea at present time is 'Unlicensed Assistant (UA)' since it is not legally established in our healthcare system. Thus, PA in Korea refers to unlawful, unqualified, auxiliary personnel for medical practitioners. There have been several issues with the illegal PA system in Korea facing medicosocial conflicts and crisis. Patients want to be diagnosed and treated by medically-educated, licensed and professionally trained physicians not PAs. In clinical settings, PAs deprive the training and educational opportunities of trainees such as interns and residents. Recently, there have been several attempts, by CEO or directors of major hospitals in Korea, to adopt and legalize this system without general consensus from medical professional associations and societies. Without such consensus, this illegal implementation of PA system will create new and additional very serious medical crises due to unlawful medical, educational, professional conflicts and safety issues in medical practice. Before considering the implementation of the PA system, there needs to be a convincing justification by solving the fundamental problems beforehand, such as the collapsed medical delivery system, protection and provision of optimal education program and training environment of trainees, burnout from excessive workloads of physicians with very low compensational system and poor conditions for working and education, etc.

[Support in the general practice: legal aspects]. / Ondersteuning in de huisartspraktijk: juridische aspecten.

Over the years an increasing number of general practitioners (GP) have been employing assistants with various levels of competence and experience to take over certain aspects of patient care. This raises several legal questions. The responsibility for the quality of care provided by these assistants remains with the GP. If the quality of care is to be safeguarded and legal problems avoided, then a GP who wants to employ assistants must meet a number of requirements.

An analysis of theme content in CASPA personal statements.

PURPOSE: Personal statements are a required component of the Central Application Service for Physician Assistants (CASPA) application package submitted to physician assistant (PA) programs that participate in the service. Prior research involving the use of personal statements in the selection process of graduate and professional programs has found a significant amount of homogeneity within the statements. This study sought to determine the major theme content and frequency of occurrence of these themes in the personal statements submitted by applicants to a Midwestern PA program. METHODS: After receiving signed consent, personal statements were extracted from the application packages of 63 students. Statements were identified with a random number. Each statement was reviewed and content themes were identified and manually coded by two separate reviewers. The reviewers and primary investigator then met and determined the major content categories by consensus. RESULTS: The review identified seven major content themes. Four of these themes were present in 70% or more of the statements: health care experience, altruism, patient interaction, medical profession. CONCLUSION: The personal statements reviewed contained similar content, confirming prior research that these statements may follow some formula for success. This may be evidence that applicants feel these attributes demonstrate that they are qualified candidates for admission. Further study should be conducted to see how these statements are used in the PA program admissions process.

My brother's keeper: assisting the impaired PA.

Impairment is defined as the inability to practice medicine with reasonable skill and safety to patients because of physical or mental illness, including deterioration through the aging process, loss of motor skills, or excessive use or abuse of drugs, including alcohol. A practitioner is also impaired when personal problems interfere with the administration of medical care. Acknowledging the issue of impairment can be unpleasant. By doing so, practitioners often realize that their perceptions of themselves and their colleagues as invulnerable guardians of public health and healers of disease, are delusions. This growing problem reflects not only on the individual practitioner suffering from impairment, but on the profession as a whole. Thus, the problems of the impaired PA must be addressed in a reasonable and compassionate manner. The authors discuss how to deal with affected colleagues, and outline an alternative, nonpunitive, and humanitarian model for assisting impaired PAs, established by the Michigan Academy of Physician Assistants.

Is that your final answer? Relationship of changed answers to overall performance on a computer-based medical school course examination.

BACKGROUND: Whether examinees benefit from the opportunity to change answers to examination questions has been discussed widely. PURPOSE: This study was undertaken to document the impact of answer changing on exam performance on a computer-based course examination in a second-year medical school course. METHODS: This study analyzed data from a 2 hour, 80-item computer delivered multiple-choice exam administered to 190 students (166 second-year medical students and 24 physician's assistant students). RESULTS: There was a small but significant net improvement in overall score when answers were changed: one student's score increased by 7 points, 93 increased by 1 to 4 points, and 38 decreased by 1 to 3 points. On average, lower-performing students benefited slightly less than higher-performing students. Students spent more time on questions for which they changed the answers and were more likely to change items that were more difficult. CONCLUSIONS: Students should not be discouraged from changing answers, especially to difficult questions that require careful consideration, although the net effect is quite small.