The Russian feldsher: A PA prototype in transition.

The feldsher is a physician assistant (PA) prototype. Developed in Russia during the 19th century to serve as healthcare personnel at a time of physician scarcity, feldshers provided medical services throughout the Russian Empire and later Soviet Union. Their medical role from the mid-19th century until the Bolshevik revolution in 1917 was crucial, particularly in rural and underserved regions. During wartime, many served in the military as medics. During the late 20th century, feldshers' numbers waned compared with physicians and nurses. In the 21st century, they remain a presence in the Russian medical system but their future is in transition as their numbers decline. However, earlier this year, Russian President Vladimir Putin urged the Russian State Duma to create more feldsher-midwife stations in rural areas. This indicates that the Russian government, at the highest levels, see the need for more feldshers to serve, essentially, as PAs in remote areas.