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Over
the years, in sports medicine as in most other areas of
medicine, there developed a need to allow some allied health
professionals to assume some of the responsibilities of the
physician. With
today’s dynamic health care environment, this need is
particularly evident. Two
“mid-level” providers play a significant role in the
practice of orthopedics and sports medicine.
The
first is the physician’s assistant or PA as they are commonly
known. PAs are
employed in virtually all fields of medicine and all areas of
the country. The
level at which they are allowed to practice is generally
governed by the state in which they practice medicine and
applicable local standards of care.
In most areas, PAs have privileges, which allow them to
have much more freedom and autonomy than a nurse or technologist
but significantly less than an MD.
PAs
must work under the supervision of a licensed doctor. Under his or her oversight they are allowed to perform many
of the same duties as the physician.
PAs can generally meet, interview and examine patients in
their respective fields and formulate an impression of what is
wrong with the patient. In
many cases PAs have the expertise to diagnose and treat patients
with the physician serving only as a consultant.
In other more complex or complicated fields and/or
situations the PA may require the direct supervision of the
doctor.
In
the practice of orthopedics, PAs often see patients and perform
a standard “work up” for whatever the patient is complaining
of. Then, depending on the situation, the PA may order diagnostic
studies, lab work or other tests.
Depending on the individual situation and the probable
diagnosis, the patient may be managed by the PA or he or she may
present the information to the doctor for definitive treatment.
PAs
routinely assist surgeons in the operating room. Often, the PA can serve as a first assistant where he or she
actually performs portions of the procedure while the
surgeon’s hands are busy elsewhere.
Postoperative
care is also a common responsibility of the PA in the orthopedic
surgery and sports medicine office.
After surgery and according to a set protocol,
physician’s assistants see and evaluate patients after
surgery. They make
sure that the bone or joint is healing according to schedule,
that the surgical wounds look good, that there is no infection
and that physical therapy is going according to schedule.
Along
with physician’s assistants, nurse anesthetists can also play
a valuable role in the practice of orthopedic surgery.
CRNAs (certified registered nurse anesthetists) perform
many of the same duties as MD anesthologists in certain settings
under the supervision of a licenced doctor.
This
naturally includes many of the things that most people associate
with anesthesia such as “putting people to sleep” for
surgery. Most
outpatient orthopedic surgeries are relatively short and are
done on mostly healthy people.
CRNAs, though quite capable in most any area of
anesthesia, are experts in this type of medicine.
Sports
medicine and orthopedics frequently involves small office
procedures that require either local or regional anesthesia.
CRNAs often provide this sort of service in the sports
medicine office. Again,
CRNAs are trained to perform these procedures deftly.
The
nature of sports medicine makes it ideal for a variety of alied
health professionals from athletic trainers to physical
therapists to physician’s assistants and so on.
Though the quarterback of the sports medicine team is the
sports doctor, these professionals provide excellent care in the
broad field of sports medicine.
Please take advantage of the knowledge and expertice of
all of these specialists should you have a sports related
problem.
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