Physicians' assistants on a university cardiothoracic surgical service. A five-year update.

In 1973 two physicans' assistants (P.A.'s) were employed on a cardiothoracic surgical service at Emory University Hospital. In 1974 our initial experience with these paramedical personnel was presented to this Association. Since that time eight additional P.A.'s have been added to our service. They are now employed in four hospitals of the Emory University Woodruff Medical Center. New guidelines and regulations have been imposed at both the state and federal levels regarding P.A.'s, and their role in our center has become rather well defined. With over 1,700 cardiac cases and 600 thoracic cases per year to cover on our service, the P.A. has assumed a position of increasing importance both in operating room assistance and in preoperative and postoperative care. Since the university has maintained a constant number of residents and fellows during this interval, P.A.'s have filled needs of expanded clinical service in the various hospitals. In the pediatric and community hospitals associated with a university, the P.A. now functions as a junior house officer. In our university center, with a large resident staff, their role has become narrowed with definite guidelines. A Credentials Committee now governs the hiring of all P.A.'s by the University. When properly utilized and supervised, the P.A. can be a vital member of the cardiothoracic team. This report details our experience with P.A.'s for the past 5 years--culminating in a staff of ten P.A.'s working on our service in four types of hospitals within our university medical center.