Weatherford Democrat

October 5, 2013

How physician assistants help you and your doctor

Weatherford Democrat

Oct. 6-12 is National Physician Assistant Week, which honors the contributions of these medical practitioners who deliver high quality patient care in doctors’ offices, hospitals, urgent care centers, and medical clinics every day.  

By Dr. Neal Zeigler and PA Ben Brackett

Weatherford Regional Medical Center

If you need to visit an emergency room you want the best treatment possible from the best medical staff. Today, that staff probably includes not only physicians but other health care providers, and certified physician assistants (PAs) are often key members of strong medical teams.

At Weatherford Regional Medical Center, Neal Zeigler, MD, and Ben Brackett, PA-C, work as a seamless team that treats a wide range of illnesses and emergencies, from colds to car wrecks.

In an emergency room, providers see new patients, often without any prior history, and providers have to quickly discern the problem, for example, is it heartburn or a heart attack?

“Ben has a broad recognition of differential diagnoses,” said Zeigler.  “I don’t have to ask if he thought about this or that. He has the experience to consider options, and he brings me in where he needs me.

“There is an art to being a PA as well as a science, in terms of medical knowledge,”  Zeigler said. “It’s important to establish rapport with the patient, and Ben has a knack for that.  He is a good listener and thorough when explaining options.” 

With a growing physician shortage in Texas, PAs can improve access to health care because their availability allows patients to be seen in a timelier manner. In addition, as reimbursement pressures increase, the physician-PA team model for delivering health care is more sustainable.

In June, Gov. Rick Perry signed a new law improving access to health care by making it easier for physician assistants to practice in under-served and rural areas and enhancing their prescriptive authority.

Dr. Zeigler and Brackett have worked emergencies together for three years and have achieved a balance of trust and mutual respect.

“Neal has tremendous medical skills, and I have no problem asking him for guidance,” Brackett said. “I feel welcomed and encouraged to approach him with anything.”

“We discuss symptoms for the benefit of the patient,” said Dr. Zeigler. “Ben is a professional who asks to watch, learn and do.  He stays current with the latest research.”

Certified PAs are highly educated medical providers who graduate from accredited, masters-degree level PA programs, pass a rigorous national certification exam, and maintain certification through ongoing education and re-certification exams. They are also licensed by state medical boards.

Certified PAs practice medicine with the supervision of a physician. They routinely obtain medical histories; examine, diagnose and treat patients; order and interpret diagnostic tests; and develop and implement treatment plans. They can perform minor surgery and assist in major surgery, instruct and counsel patients, order or carry out therapy and prescribe medications. 

According to self-reported data collected by the National Commission on Certification of Physician Assistants, every week certified PAs work 3.8 million hours enabling them to increase health care access by seeing 7 million patients. Approximately 6,300 of the nation’s 92,000 certified PAs practice in Texas.

PAs Practice in Primary Care and Specialties

Brackett became interested in a medical career after joining a volunteer fire department at 16.  He was an Army combat medic and a paramedic, and received a master’s degree in Public Health before also graduating with a master’s degree in Physician Assistant Studies from the University of Texas-Southwestern.

Brackett is still a full-time firefighter, another adrenaline-filled career, in addition to working in emergency rooms. He enjoys being a PA because it allows him the flexibility to work as a firefighter and the ability to educate patients.

“It is exciting and rewarding to see a cardiac arrest or insulin shock patient come back to consciousness,” he says. “However we also see abscesses and flu. So much of what we do in the ER is primary care, and I help patients understand their own health and how to avoid recurring problems. I feel as though I treat not only their physical ailments but sometimes their psyche as well.”

Brackett also appreciates a PA’s ability to move laterally between specialties. “We are trained as generalists, although we do clinical rotations in various specialties.”

Most of Brackett’s career has been spent in emergency care. He was among the first PAs in Texas to receive a Certificate of Added Qualification in Emergency Medicine from NCCPA. The CAQ has rigorous requirements that include specialty-focused experience, continuing education, and knowledge of procedures, in addition to passing a national exam.

For Brackett, it is about the challenge to be better at everything he does.

“Ben is one of the most current people I know in emergency medicine,” Zeigler said. “In fact, he taught me a technique to reduce a shoulder without pain or anesthesia. He is always looking to expand his knowledge base.”

This new environment calls for a team-based approach to delivering coordinated health care, and the physician-PA team concept is working and growing in every state, specialty and medical setting. 

Certified PAs must pass rigorous standards to earn the PA-C designation after their name.  

This designation validates their clinical knowledge and cognitive skills, because it is only granted after they have graduated from an accredited PA program and passed the Physician Assistant National Certifying Exam, administered by the NCCPA.

To maintain NCCPA certification and retain the right to use the PA-C designation, PAs must complete continuing medical education credits every two years and successfully pass a recertification exam every six to 10 years.

For those PAs who commit to a medical specialty, the CAQ credential is available in seven specialties: Cardiovascular and Thoracic Surgery, Emergency Medicine, Hospital Medicine, Orthopaedic Surgery, Nephrology, Pediatrics and Psychiatry. CAQs are not needed for certification or licensing by the state, but they recognize PA’s for their additional abilities to perform specialty-focused patient care.

Since it is a matter of public record, anyone can check to see if a PAs certification is current just by entering the name and state on the NCCPA web site at