Physician assistants (PAs) are valuable members of the cancer care team. To explain their role, Cancer.Net welcomes Todd Pickard, MMSc, PA-C, medical liaison for the American Academy of Physician Assistants (AAPA), and David Coniglio, MPA, PA-C, president of the Association of Physician Assistants in Oncology (APAO). The AAPA is the only national organization to represent physician assistants in all medical and surgical specialties, and the APAO is a nonprofit specialty organization affiliated with the AAPA that consists of PAs working in the field of oncology.

Q: What should patients know about the role of PAs in the health care team?

TP & DC: PAs play a crucial role in expanding access to health care through their collaborative partnership with supervising physicians. As licensed health care providers, they can acquire medical histories; perform physical examinations; order, perform, and interpret diagnostic and therapeutic tests and procedures; prescribe medication; and provide medical education and counseling. This assistance enables physicians—who are in great demand—to care for more patients. PAs work in all the medical disciplines and may be found practicing medical oncology, surgical oncology, or radiation oncology, providing care to patients of all ages.

Q: What training is required to become a PA?

TP & DC: PAs are trained with a standardized medical curriculum through programs commonly associated with a university or medical school at a graduate level, and they are required to pass a national board certification examination after completing the training. A typical PA also has an undergraduate degree and significant experience in health care, often having served as an emergency medical technician, paramedic, or medical assistant. The PA curriculum includes education in the basic medical sciences, such as anatomy and physiology, clinical assessment, clinical and behavioral medicine, surgery, pharmacotherapeutics (the study of the therapeutic uses and effects of drugs), health policy, and health information literacy. In addition, the clinical phase of training includes extensive supervised clinical experience in pediatrics, obstetrics and gynecology, behavioral medicine, primary care, surgery, emergency medicine, internal medicine, and long-term care. To maintain certification, PAs must earn 100 hours of continuing medical education credit every two years and pass a national board recertification examination every six years.

Q: How do PAs participate in the care of a person with cancer?

TP & DC: Working collaboratively with a supervising physician, PAs may participate in all aspects of the care of a patient with cancer, including performing regular cancer screening tests, diagnosing cancer, discussing treatment options, writing chemotherapy orders, assisting in surgery, monitoring patients during active therapy, treating symptoms, counseling and educating people about their disease, and helping conduct clinical trials.

Q: Why did you become a PA, and how did you end up working in oncology?

TP: I chose the PA profession because I believe that I can make a positive contribution to health care. I want to practice medicine in a collaborative team approach that allows me to maximize my ability to care for people, while having the flexibility to work in different fields of medicine. I currently serve as the Physician Assistant Program Director at the University of Texas M. D. Anderson Cancer Center. My administrative role allows me to directly affect institutional policy, staff recruitment, and utilization of PAs while being an advocate and role model for the PA profession. I still see patients with head and neck cancers, as well as perform bone marrow biopsy and aspiration in our bone marrow aspiration clinic.

DC: I was working in hospital administration many years ago when I visited my twin brother who was completing his PA education. Between my interactions with the clinical care providers and my time spent talking with my brother, it became obvious to me that this was a profession that offered an opportunity to make a significant contribution to the well-being of patients, beyond that which I was doing in health care administration.

I had the distinct privilege of working with people with urologic cancers in my first position after I completed training. After a brief stint in another discipline, I was then given the opportunity to join a clinical research program, which focused on the care of people with breast cancer. I have continued working with people with breast cancer for the past two decades, collaborating with a number of outstanding clinical oncologists and other members of the health care team. I currently work as Associate Professor in the Department of Physician Assistant Practice at Campbell University’s College of Pharmacy & Health Sciences in Buies Creek, North Carolina.

Q: What tips do you have for patients interacting with PAs?

TP: Think of PAs as partners and extensions of your oncologist who will be with you at every step of your journey. PAs can be an invaluable resource for you because they have many of the skills of the physician while having the ability to connect with you and help you understand the complexities of cancer care.

DC: PAs will offer you practice knowledge, skills, and compassion, along with all other members of the health care team; and each team member has the same goal of seeing the patient successfully through the process. As with all other aspects of care, I encourage you to ask questions and seek information, ensuring that you are comfortable with the health care plan.

Q: How is the role of PAs in cancer care evolving?

TP: PAs are becoming increasingly responsible for facilitating and providing care to patients throughout the entire spectrum of cancer, including prevention, screening, diagnosis, treatment, clinical research, surveillance, and survivorship. Patients and doctors now have a better understanding of the PA profession and see the potential for their significant role in health care. From large academic centers to small group oncology practices, more and more PAs are being recruited to help care for an ever-increasing number of patients being diagnosed and living with cancer.

DC: I can’t think of a more exciting time to be a PA in oncology. Despite the difficulties presented by a growing demand for services in the face of increasing shortages of health care providers, the current emphasis on collaborative care models offers the opportunity for continued expansion of the role of PAs in oncology care. In academic settings and in community settings, PAs are being presented with the opportunity to participate in patient care, patient education, and the education of clinical providers at a time when novel therapies and novel practice settings may offer more options to our patients.

More Information

The Oncology Team

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Last Updated: April 05, 2010