Spotlight on Physician Assistants in The Galilee Medical Center
Written by: Smadar Ocampo, The Galilee Medical Center Magazine, February 2020.
Translated to English by: Roi Ozer, Physician Assistant, Department of Emergency Medicine, Sheba Medical Center.
In the last three years Physicians Assistants are employed full time in the Galilee Medical Center, located in the city of Nahariya, in the northern region of Israel. The presence of physician assistants creates a good influence on the medical and nursing staff and also on the patients visiting the department of emergency medicine. Most of the PAs employed at the medical center are veteran paramedics, who began their career at Magen David Adom, Israel's National Emergency Pre-Hospital Medical organization. But burnout due to exhausting shifts in field conditions and difficulties in career advancement due to lack of enough management positions and opportunities, has led them to the physician assistant profession, following exposure to the American model of the profession.
The training program, built by the Israeli ministry of health, included theoretical frontal studies and clinical training in the medical center and the emergency department. At that time, the director of the internal emergency department, Dr. Arie Eisenman, wanted to bring paramedics to work in the emergency department, and together with the ED director, Dr. Benny Raviv, built an integration program, while placing emphasis on working interfaces, responsibilities, scope of practice and privileges.
At the beginning, there were many challenges and obstacles, mainly within working interfaces with the nursing sector, a phenomenon that occurred in all medical centers were the Physician Assistant program was introduced. This situation occurred due to lack of knowledge and understanding with the new profession, the Pas scope of practice, roles and privileges. As time went by, and as relationships and acquaintance between the staff got stronger, a better understanding of the PA role was established. Today the physician assistants in the Galilee Medical Center work side to side, with doctors, nurses and other medical staff in the emergency department and medical center, with emphasis on professionalism, while maintaining great work relations with all sectors. According to the PAs, this was possible thanks to the strong support they received from the medical and nursing management of the emergency department, that recognized the PAs strengths and took advantage of their professional capabilities.
Physician Assistants are assigned to most of the ED shifts and are mainly posted in the internal ED, and when needed reinforce the Trauma ED / Bay. There presence is needed in every medical emergency that necessitates the usage of a trauma bay and during resuscitation of critically ill patients, due to their extensive experience in the field of trauma and emergency medicine.
The PAs work under ongoing medical supervision, conduct patient history taking and physical exams, and execute treatment plans according to the guidance of the emergency department doctors. Their main impact is during the evening and night shifts, when there is less staff during the shifts.
On January 2018, the PAs where sent by the Galilee Medical Center and the center's external affairs unit, to the city of Toledo in Ohio, USA, for a training visit in the Toledo Medical Center Department of Emergency Medicine, there they were exposed to the American Physician Assistant Model. They discovered am expanded model of the profession, in which PAs are employed in other fields of practice, including outpatient clinics, operation rooms, etc. The Physician Assistants hope that within time, the Israeli model will evolve and become more similar to the American model, and this will facilitate the expansion of their responsibilities, scope of practice, privileges and will open for them the opportunity to advance to management roles.