BOOK
Physician Assistant: A Guide to Clinical Practice E-Book
Ruth Ballweg | Darwin Brown | Daniel Vetrosky
(2012)
Additional Information
Book Details
Abstract
Prepare for every stage of your physician assistant career with Physician Assistant: A Guide to Clinical Practice, 5th Edition - the one text that takes you from your PA coursework through clinical practice! Concise, easy to read, and highly visual, this all-in-one resource by Ruth Ballweg, Edward M. Sullivan, Darwin Brown, and Daniel Vetrosky delivers the current, practical guidance you need to know to succeed in any setting.
- Consult this title on your favorite e-reader with intuitive search tools and adjustable font sizes. Elsevier eBooks provide instant portable access to your entire library, no matter what device you're using or where you're located.
- Master all the core competencies you need to know for certification or recertification.
- Navigate today's professional challenges with new chapters on NCCPA Specialty Recognition; Communication Issues; the Electronic Health Record; Patient Safety and Quality of Care; Population-Based Practice; and Physician Assistants and Supervision.
- Meet ARC-PA accreditation requirements with coverage of key topics such as Student Safety in Clinical Settings, Health Care Delivery Systems, Population-Based Practice, and Mass Casualties/Disasters.
- Keep up with the PA competencies that are endorsed by the AAPA, PAEA, NCCPA, and ARC-PA.
- Master key concepts and clinical applications thanks to a succinct, bulleted writing style; convenient tables; practical case studies; and clinical application questions throughout.
- Retain what you’ve learned and easily visualize every aspect of clinical practice with a new full-color design and illustrations throughout.
- Explore global options with expanded coverage of physician assistants in international medicine.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
IFC | IFC | ||
Physician Assistant: A Guide to Clinical Practice | iii | ||
Copyright | iv | ||
Contributors | v | ||
Foreword | xi | ||
Preface | xiii | ||
Acknowledgments | xv | ||
Section I - Overview | 1 | ||
Chapter 1 - History of the Profession and Current Trends | 3 | ||
China’s Barefoot Doctors | 4 | ||
Developments in the United States | 4 | ||
Developments at Duke University | 5 | ||
Concepts of Education and Practice | 5 | ||
Military Corpsmen | 6 | ||
Other Models | 7 | ||
Controversy about a Name | 7 | ||
Program Expansion | 8 | ||
Accreditation | 10 | ||
Certification | 11 | ||
Organizations | 13 | ||
Trends | 19 | ||
National Health Policy Reports | 19 | ||
“Futures” Events | 20 | ||
Current Issues and Controversies | 21 | ||
Conclusion | 26 | ||
Clinical Applications | 26 | ||
Chapter 2 - International Development of the Physician Assistant Profession | 28 | ||
The Netherlands | 29 | ||
India | 29 | ||
Germany | 29 | ||
Saudi Arabia | 29 | ||
Afghanistan | 30 | ||
South Africa | 30 | ||
Case Studies | 30 | ||
Where Next | 34 | ||
References | 35 | ||
Chapter 3 - Education | 36 | ||
The Mid-1960s through the 1970s—Pioneer Period | 37 | ||
The 1980s—Maturation Period | 40 | ||
The 1990s—Boom or Bust Time | 43 | ||
The 2000s—Moving Forward | 46 | ||
The Future—What will PA Education Look like Beyond 2010 | 48 | ||
Conclusion | 49 | ||
Clinical Applications | 50 | ||
References | 51 | ||
Chapter 4 - Credentialing: Accreditation, Certification, Licensing, and Privileging | 52 | ||
Program Credentialing | 52 | ||
Graduate Credentialing | 56 | ||
Clinical Applications | 61 | ||
References | 61 | ||
Chapter 5 - National Commission on Certification of Physician Assistants Specialty Recognition: Certificate of Added Qualifications | 62 | ||
History | 63 | ||
AAPA and NCCPA | 63 | ||
Remediation and Retooling | 64 | ||
Institutional Concerns | 64 | ||
External Threats | 64 | ||
National Meeting | 64 | ||
NCCPA Consensus Points | 65 | ||
Feedback from the Field | 65 | ||
Outcomes—Future Plans | 66 | ||
References | 67 | ||
Chapter 6 - Financing and Reimbursement | 68 | ||
Government-Sponsored Programs | 69 | ||
Private Insurance | 73 | ||
Conclusion | 77 | ||
Clinical Applications | 77 | ||
References | 78 | ||
Chapter 7 - The Political Process | 79 | ||
Individual Responsibilities | 79 | ||
Practice Laws | 80 | ||
Individuals: Part of the Whole | 82 | ||
State Legislative Process | 84 | ||
Federal Regulatory Process | 86 | ||
State Regulatory Process | 87 | ||
Case Studies | 89 | ||
Conclusion | 90 | ||
Clinical Applications | 91 | ||
References | 91 | ||
Section II - Medical Knowlege | 93 | ||
Chapter 8 - Evidence-Based Medicine | 95 | ||
What is Evidence-Based Medicine | 96 | ||
Conclusion | 107 | ||
Clinical Applications | 107 | ||
References | 108 | ||
Chapter 9 - Research and the Physician Assistant | 109 | ||
Defining Research | 110 | ||
Medical Literature | 115 | ||
Conclusion | 117 | ||
Clinical Applications | 117 | ||
References | 117 | ||
Chapter 10 - Safety in Clinical Settings | 118 | ||
Universal Precautions | 119 | ||
International Travel | 119 | ||
Needlestick and Sharps Injuries | 119 | ||
Tuberculosis Screening | 120 | ||
Latex Allergy | 121 | ||
Student Mistreatment | 122 | ||
Sexual Harassment | 122 | ||
References | 125 | ||
Chapter 11 - Clinical Procedures | 127 | ||
Wounds and Their Treatment | 128 | ||
Commonly Performed Clinical Procedures | 143 | ||
Clinical Applications | 156 | ||
References | 156 | ||
Chapter 12 - Genetics in Primary Care | 157 | ||
Genetic Skills Needed in Primary Care | 158 | ||
Future | 166 | ||
Clinical Applications | 168 | ||
Chapter 13 - Chronic Care Perspectives | 171 | ||
Current Care Shortfalls | 171 | ||
A New Model of Care | 172 | ||
Chronic Illness Care Creates a Paradigm Shift: the Patient-Professional Partnership | 172 | ||
Elements of the Chronic Care Model | 172 | ||
Motivational Interviewing and Action Planning | 174 | ||
Support Self-Efficacy | 175 | ||
Population-Based Management of Chronic Disease | 179 | ||
Role of the Pa in Chronic Illness Care: an Integration of the Physician Assistant Core Competencies | 180 | ||
Clinical Applications | 183 | ||
Chapter 14 - Pharmacology: The Use of Medications | 186 | ||
Risk-Benefit Ratio | 188 | ||
Drug Allergies | 188 | ||
Limiting the Armamentarium | 189 | ||
Routes of Administration | 190 | ||
Drug Interactions | 191 | ||
Safety in Pregnancy | 192 | ||
Cost-Effectiveness | 192 | ||
The Prescription | 192 | ||
Inpatient Orders | 196 | ||
Dispensing | 196 | ||
Pharmaceutical Industry | 197 | ||
Conclusion | 198 | ||
Clinical Applications | 198 | ||
References | 199 | ||
Chapter 15 - Complementary and Alternative Medicine | 200 | ||
Government Response | 201 | ||
Prevalence of Use of Cam in the United States | 202 | ||
Trends | 202 | ||
Herbals and Supplements | 204 | ||
Implications for Physician Assistants | 206 | ||
What PAs should Know When Managing Patients and CAM Use | 207 | ||
Role of the Physician Assistant | 208 | ||
Conclusion | 211 | ||
Clinical Applications | 211 | ||
References | 212 | ||
Section III - Interpersonal and communication skills | 213 | ||
Chapter 16 - Communication Issues | 215 | ||
Online Communication in Health Care Office Settings | 216 | ||
Telemedicine | 217 | ||
Patient-Provider Communication | 217 | ||
Health Literacy and Intercultural Communication | 218 | ||
Conclusion | 218 | ||
Clinical Applications | 218 | ||
References | 219 | ||
Chapter 17 - Electronic Health Record | 221 | ||
Development | 221 | ||
Implementation | 222 | ||
Security | 224 | ||
Clinical Applications | 224 | ||
References | 225 | ||
Chapter 18 - Using Consultants and Community Resources | 226 | ||
Using Consultants | 227 | ||
Using Community Resources | 231 | ||
Overview of Typical Community Services | 233 | ||
Conclusion: Help for the S Family | 237 | ||
Clinical Applications | 237 | ||
Section IV Patient Care | 239 | ||
Chapter 19 - Health Promotion, Disease Prevention, and Patient Education | 241 | ||
History and Physical Examination | 243 | ||
Immunizations | 244 | ||
Barriers to Implementation | 245 | ||
Patient Education and Counseling | 246 | ||
Conclusion | 247 | ||
Clinical Applications | 248 | ||
References | 248 | ||
Chapter 20 - Family Medicine | 249 | ||
Primary Care Concepts | 249 | ||
Congruence of Family Practice and Internal Medicine | 251 | ||
Primary Care Incomes | 251 | ||
Expanding Crisis in Primary Care and Family Practice | 252 | ||
Partnership Between Family Physicians and PAs | 253 | ||
History of Family Practice | 254 | ||
History of Internal Medicine | 254 | ||
What is Family Practice | 255 | ||
What Distinguishes Family Practice from Internal Medicine | 255 | ||
PAs Employed in Family Practice and Internal Medicine | 256 | ||
Conclusion | 263 | ||
Clinical Applications | 266 | ||
References | 266 | ||
Chapter 21 - Internal Medicine | 267 | ||
What is Internal Medicine | 267 | ||
Internal Medicine Practice | 269 | ||
Typical Internal Medicine Cases | 270 | ||
References | 276 | ||
Chapter 22 - Emergency Medicine | 277 | ||
Principles of Emergency Medicine | 278 | ||
Problem-Oriented History and Physical Examination | 283 | ||
The Community | 286 | ||
Role of the Emergency Department within the Health Care System | 287 | ||
General Approach to the Evaluation of Abdominal Pain | 288 | ||
Female with Lower Abdominal Pain and Vaginal Bleeding | 291 | ||
Management of the Febrile Child Younger Than 2 Years | 293 | ||
Eye Emergencies | 294 | ||
Ear, Nose, and Throat Emergencies | 297 | ||
Neck Pain and Low Back Pain | 298 | ||
Sprains | 300 | ||
Miscellaneous Conditions | 313 | ||
Neurologic and Tendon Evaluation of the Forearm, Wrist, and Hand | 315 | ||
Wilderness Medicine | 317 | ||
Miscellaneous Conditions | 318 | ||
Drug and Alcohol Poisoning in the Emergency Department | 319 | ||
Legal and Ethical Decisions in Emergency Medicine | 321 | ||
Special Considerations | 322 | ||
Clinical Pearls in Emergency Medicine | 324 | ||
Clinical Applications | 326 | ||
References | 326 | ||
Chapter 23 - Pediatrics | 327 | ||
Historical Perspective | 327 | ||
Issues in Pediatrics | 328 | ||
What is the Practice of Pediatrics | 329 | ||
Choices for Practice | 341 | ||
Conclusion | 342 | ||
Clinical Applications | 342 | ||
References | 343 | ||
Chapter 24 - Obstetrics and Gynecology | 345 | ||
Counseling | 346 | ||
Tasks and Procedures | 351 | ||
Practice Choices in Obstetrics and Gynecology | 354 | ||
Conclusion | 354 | ||
Clinical Applications | 355 | ||
Chapter 25 - Surgery | 356 | ||
Learning the Ropes | 358 | ||
General Overview | 358 | ||
Assistant in Surgery | 359 | ||
Judgment, Hands, Tools, and Devices | 359 | ||
Who’s Who in the Operating Room | 360 | ||
Preoperative Patient Evaluation | 362 | ||
Blood and Blood Products | 368 | ||
Documentation | 370 | ||
Preparation for Surgery | 372 | ||
Asepsis and Infection Control in the Operating Room | 373 | ||
Skin Preparation | 376 | ||
Surgical Hand Scrub | 377 | ||
General Preparations | 377 | ||
Gowning and Gloving | 378 | ||
Maintaining a Sterile Field | 380 | ||
Patient Positioning | 381 | ||
Operative Site Draping and Equipment | 384 | ||
Surgical Assisting and Instrumentation | 384 | ||
Minimally Invasive Surgery | 393 | ||
Surgical Bleeding | 397 | ||
Concepts for Surgical Assisting | 401 | ||
Postoperative Care | 403 | ||
Conclusion | 408 | ||
Clinical Applications | 409 | ||
References | 409 | ||
Chapter 26 - Geriatric Medicine | 410 | ||
Chronic Conditions | 411 | ||
Age-Related Changes | 413 | ||
Geriatric Syndromes | 415 | ||
Common Problems in Geriatric Care | 420 | ||
Depression | 423 | ||
Sexuality and Aging | 424 | ||
Prostate Disease | 425 | ||
Unique Issues in Geriatric Care | 425 | ||
Community Resources and Services | 428 | ||
Conclusion | 430 | ||
Clinical Applications | 431 | ||
References | 431 | ||
Chapter 27 - Behavioral Science and Medicine: Essentials in Practice | 433 | ||
Mental Health | 434 | ||
Structure of the Physician Assistant–Patient Encounter | 435 | ||
Psychotherapy | 436 | ||
Supporting Behavioral Change | 437 | ||
Referral: How and When | 439 | ||
Mental Status Examination | 439 | ||
Depressive Disorders | 440 | ||
Major Depression (DSM-IV 296.2) | 441 | ||
Anxiety Disorders | 442 | ||
Discussion | 442 | ||
Psychotic Disorders | 445 | ||
Delirium and Dementia | 446 | ||
Summary | 447 | ||
Clinical Applications | 448 | ||
References | 449 | ||
Chapter 28 - Physician Assistants in Hospital Medicine | 450 | ||
Scope of Practice | 451 | ||
Clinical Applications | 454 | ||
References | 455 | ||
Chapter 29 - Orthopedics | 456 | ||
Physician Assistants in Orthopedics | 456 | ||
Orthopedic History | 457 | ||
Musculoskeletal Physical Examination | 458 | ||
Special Orthopedic Tests | 458 | ||
Common Orthopedic Problems | 458 | ||
Challenges and Rewards for Physician Assistants in Orthopedics | 471 | ||
Conclusion | 471 | ||
Clinical Applications | 472 | ||
References | 472 | ||
Chapter 30 - Dermatology | 473 | ||
History of Dermatology | 473 | ||
What is Dermatology | 474 | ||
Clinical Dermatology | 475 | ||
Conclusion | 483 | ||
References | 483 | ||
Chapter 31 - Oncology | 485 | ||
Patient Care | 486 | ||
For The Student | 487 | ||
Salary Ranges | 489 | ||
Cancer Care | 490 | ||
Goals of Treatment | 491 | ||
Clinical Applications | 492 | ||
References | 493 | ||
Chapter 32 - Infectious Disease | 494 | ||
History of Infectious Disease | 494 | ||
Common Roles of the PA in an Infectious Disease Practice | 495 | ||
Student Mentoring | 496 | ||
Problem-Based Clinical Assessment in the Infectious Disease Setting | 496 | ||
References | 503 | ||
Chapter 33 - Occupational and Environmental Medicine | 505 | ||
What Should you Know before you Start the Rotation | 505 | ||
History of Occupational Medicine | 505 | ||
Labor Organizations’ Contribution | 506 | ||
Legislation | 507 | ||
What to Expect | 515 | ||
Clinical Applications | 522 | ||
Section V Professionalism | 525 | ||
Chapter 34 - Professionalism | 527 | ||
Elements of the PA Competency of Professionalism | 528 | ||
Behavior Toward the Patient | 529 | ||
Behavior Toward other Professionals | 530 | ||
Behavior Toward the Public | 531 | ||
Behavior Toward Oneself | 532 | ||
Fostering Professionalism | 532 | ||
Conclusion | 533 | ||
Clinical Applications | 533 | ||
References | 534 | ||
Chapter 35 - Clinical Ethics | 536 | ||
Skills, Competence, and Confidence | 537 | ||
Character and Virtue | 538 | ||
Ethics and Morals and Theories | 538 | ||
Short History of Clinical Bioethics | 539 | ||
Data to Collect for a Clinical Ethical Analysis | 540 | ||
How to Collect Data for a Clinical Ethical Analysis | 541 | ||
Recognition of Ethical Issues in Practice | 542 | ||
Conclusion | 548 | ||
Clinical Applications | 548 | ||
References | 549 | ||
Chapter 36 - Medical Malpractice and Risk Management | 550 | ||
Physician Assistant’s Reaction to Notification of a Lawsuit | 550 | ||
Reasons That Physician Assistants are Sued | 551 | ||
Commonsense Risk Management Strategies | 552 | ||
Interpersonal Communications | 554 | ||
Discovery Rule | 554 | ||
Medical Malpractice Defined | 555 | ||
National Practitioner Data Bank | 555 | ||
Clinical Applications | 559 | ||
References | 559 | ||
Chapter 37 - Postgraduate Residency Programs | 560 | ||
History of Postgraduate Residency Education | 561 | ||
Association of Postgraduate Programs | 562 | ||
Appap Membership | 562 | ||
Residency Program Accreditation | 563 | ||
Current Available Programs | 564 | ||
General Characteristics of Existing Programs | 564 | ||
Resident Perceptions of Training | 566 | ||
Residency Graduate Employment Opportunities | 566 | ||
Conclusion | 569 | ||
Clinical Applications | 569 | ||
Chapter 38 - Dealing with Stress and Burnout | 571 | ||
Decision to Become a Physician Assistant | 571 | ||
Experience of Stress in Training | 572 | ||
Stress on the Job | 574 | ||
Burnout | 576 | ||
Conclusion | 578 | ||
Clinical Applications | 579 | ||
References | 579 | ||
Section VI Practice-Based Learning and Improvement | 581 | ||
Chapter 39 - Health Disparities | 583 | ||
What are Health Disparities | 585 | ||
Health Literacy and its Impact on Health Disparities | 585 | ||
Health Disparities: Scope of the Problem | 586 | ||
Clinical Applications | 590 | ||
References | 591 | ||
Chapter 40 - Patient Safety and Quality of Care | 593 | ||
Quality Care Movement in America | 593 | ||
Types of Medical Errors | 595 | ||
Patient Safety Strategies | 600 | ||
Clinical Applications | 602 | ||
References | 603 | ||
Chapter 41 - Population-Based Health | 604 | ||
History | 604 | ||
What is Population-Based Medicine | 605 | ||
Prevention of Medical Errors | 606 | ||
Determinants of Health | 607 | ||
Premature Mortality | 608 | ||
Disparity in Health | 610 | ||
Clinical Applications | 613 | ||
Summary | 614 | ||
References | 615 | ||
Section VII systems-Based Practice | 617 | ||
Chapter 42 - Health Care Delivery Systems | 619 | ||
Health Care Systems | 620 | ||
Integrated Systems | 620 | ||
Patient-Centered Medical Homes | 622 | ||
Accountable Care Organizations | 623 | ||
Implications for Physician Assistants | 623 | ||
Recruitment/Hiring/Employment Issues | 623 | ||
State and Federal Regulations | 624 | ||
Reporting Patterns | 624 | ||
New Delivery Systems—Medical Homes | 624 | ||
Planning for the Future | 625 | ||
Conclusions/Projections | 625 | ||
References | 628 | ||
Chapter 43 - Rehabilitative and Long-Term Care Systems | 629 | ||
Home Care—Informal Caregivers | 630 | ||
Home Care—Home Care Organizations | 631 | ||
Hospice | 631 | ||
Medical House Calls | 632 | ||
Assisted-Living Facilities | 633 | ||
Nursing Homes | 633 | ||
References | 634 | ||
Chapter 44 - Health Care for Homeless Populations | 636 | ||
Adults | 637 | ||
Pediatrics | 638 | ||
Adolescents | 639 | ||
Military Veterans | 639 | ||
Conclusion | 640 | ||
Clinical Applications | 641 | ||
References | 642 | ||
Chapter 45 - Correctional Medicine | 643 | ||
Working in a Correctional Environment | 644 | ||
Providing Health Care in Correctional Institutions | 644 | ||
Staffing in Correctional Medicine | 646 | ||
Communicable Disease in Correctional Institutions | 648 | ||
Chronic Disease in Correctional Institutions | 652 | ||
Managing Mental Health in Correctional Institutions | 654 | ||
Special Issues in Corrections | 655 | ||
Managing Ethical Conflicts in Correctional Institutions | 656 | ||
Future Directions | 658 | ||
Conclusion | 658 | ||
References | 660 | ||
Chapter 46 - Military Medicine | 662 | ||
Scope of Practice | 664 | ||
Role of Physician Assistants in the Military | 665 | ||
Cost-Benefit Analysis | 666 | ||
Clinical Applications | 667 | ||
Chapter 47 - Inner-City Health Care | 668 | ||
Can you Answer These Questions | 668 | ||
What do we Mean by Inner City | 669 | ||
Diversity in the Inner City | 670 | ||
Health Disparities | 670 | ||
Health Care in the Inner City | 671 | ||
Recent Trends in the Inner City | 671 | ||
Role of Public Teaching Hospitals | 671 | ||
Role of Public Health Departments | 672 | ||
Role of Community Health Centers | 672 | ||
Increasing Complexity of Inner-City Practice | 673 | ||
Unique Health Concerns | 674 | ||
The Children, the Future | 675 | ||
References | 676 | ||
Chapter 48 - Rural Health Care | 678 | ||
What is Rural and why Does it Matter | 678 | ||
Characteristics of Rural Populations and Communities | 679 | ||
Rural Demographics | 680 | ||
Access to Health Care | 682 | ||
Rural Clinics: Frontline Access | 686 | ||
Funding and Reimbursement for Rural Health Services | 688 | ||
Rural Health Workforce Issues | 689 | ||
Physician Assistants and Rural Medicine | 690 | ||
Requisites for a Rural Physician Assistant | 692 | ||
Challenges and Rewards of Rural Practice | 693 | ||
Clinical Applications | 693 | ||
References | 694 | ||
Chapter 49 - International Health Care | 696 | ||
Practical Considerations | 697 | ||
Qualifications | 699 | ||
Other Considerations | 700 | ||
Clinical Applications | 704 | ||
Chapter 50 - Patients with Disabilities | 705 | ||
Providing Appropriate Care for Patients who are Deaf and Hard of Hearing | 706 | ||
Providing Appropriate Care for Patients with Mobility Disabilities | 709 | ||
Providing Appropriate Care for Patients with Visual Impairments | 712 | ||
Providing Appropriate Care for Patients with Intellectual and Developmental Disabilities | 714 | ||
Clinical Applications | 716 | ||
References | 717 | ||
Chapter 51 - End-of-Life Issues | 718 | ||
Truth-Telling | 718 | ||
Helping Patients Make Informed Decisions | 719 | ||
Planning for Death | 719 | ||
Emerging Issues | 720 | ||
Advance Directives | 720 | ||
Hospice | 721 | ||
Having the Conversation | 722 | ||
Stages of Dying | 723 | ||
Stages of Grief | 724 | ||
Clinical Applications | 724 | ||
References | 725 | ||
Chapter 52 - Mass Casualty and Disaster Management | 727 | ||
Physician Assistants as Educators | 727 | ||
Physician Assistants as Providers | 729 | ||
Physician Assistants in Aftercare | 730 | ||
Long-Term Effects | 730 | ||
Special Populations | 730 | ||
Physician Assistants in Policy | 731 | ||
Physician Assistant Training for Disaster Response | 732 | ||
Summary | 737 | ||
Clinical Applications | 737 | ||
References | 738 | ||
Chapter 53 - Physician Assistants and Supervision | 739 | ||
Historical Perspective | 740 | ||
Shared Knowledge Base | 740 | ||
Dependent Practice Versus Interdependent Practice | 740 | ||
Communication, Coordination, and Continuity of Care | 741 | ||
Delegated Scope of Practice | 741 | ||
Autonomous Medical Decision-Making | 742 | ||
Agency Relationship | 743 | ||
Supervision | 743 | ||
Flexibility in Supervision | 745 | ||
Practice Ownership | 746 | ||
Summary | 747 | ||
Clinical Applications | 747 | ||
References | 748 | ||
Appendix - Competencies for the Physician Assistant Profession | 749 | ||
Preamble | 749 | ||
Introduction | 749 | ||
Medical Knowledge | 749 | ||
Interpersonal and Communication Skills | 750 | ||
Patient Care | 750 | ||
Professionalism | 750 | ||
Practice-Based Learning and Improvement | 751 | ||
Systems-Based Practice | 751 | ||
Index | 753 | ||
IBC | IBC |