Running head: WRITING AS A PHYSICIAN ASSISTANT

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The Magnitude of Writing as a Physician Assistant Aaron D. Yagoda Northeastern University

WRITING AS A PHYSICIAN ASSISTANT An aging population, a growing shortage of physicians, and the anticipated influx of patients arriving with the Patient Protection and Affordable Care Act (PPACA) have left America with a demand. This need for high quality medical care at an efficient cost only continues to increase. The Physician Assistant field has grown immensely to fill this gap. As knowledgeable and respected healthcare professionals, Physician Assistants have become an integral part of our healthcare system. PAs work as a team with doctors and nurses to provide service to those most in need. With a strong vocation, I hope to dedicate my life to healthcare as a Physician Assistant. After vigorous training and instruction, Physical assistants dive into the overwhelming and simultaneously rewarding responsibilities of a healthcare provider. PAs provide physical examinations of patients, diagnose illness and abnormalities, prescribe medications, and decide the most effective course of treatment. They interpret lab tests and perform a variety of medical

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procedures in the outpatient setting. PAs also assist in surgeries and make rounds while working in hospital settings. Before discharge, PAs focus on patient education and counseling to improve health outcomes and reduce readmission (AAPA, 2013, p.1). However, these responsibilities may grow and adapt to our rapidly changing healthcare system under the PPACA. To look more into these changes, Americans turn to the White House government website run by the President Barack Obama Administration. There readers can find an overview titled “Healthcare that Works for Americans” which outlines the Affordable Care Act’s main provisions and accomplishments to date. The website does a phenomenal job in effectively reaching Americans of all levels of health literacy and competency. With the use of appropriate language and well-planned organizational design, the text highlights the administration’s mission to provide the best and most cost-effective healthcare to all Americans.

WRITING AS A PHYSICIAN ASSISTANT With the Affordable Care Act in mind, Physician Assistants take a vow to maintain a set of core characteristics and values throughout their career. Physician assistants must become leaders in their field, using experience and expertise to provide care with the highest patient satisfaction. Their training may adapt and change to what is most needed in healthcare. As physicians move toward specialization, Physician Assistants must demonstrate flexibility and provide the crucial primary care for our population. However, what is most intriguing about the PA field is its dedication to preventative care. By promoting healthy behaviors and preemptive measures to avoid chronic disease and illness, the demand for healthcare decreases as a whole. These preventative methods provided by Physician Assistants will improve patient outcomes,

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lower prevalence of fatal chronic illness, and benefit our nation’s economy. Physician Assistants are an investment in the health of our future generations. The American Academy of Physician Assistants publishes the “Guide to Ethical Conduct of the Physician Assistant Profession” which outlines standard values every Physician assistant should embody. Their number one priority concerns the “health, safety, welfare, and dignity of all human beings” (Ethnical Conduct, 2013 p.4). The first rule is to do no harm; healthcare providers must only do what helps the patient. The “…all human beings” implies treating every patient they see with the same level of respect and equity; the ethical code promotes recognizing diversity. To accomplish this task, they must hold true to “patient autonomy, beneficence, nonmaleficence, and justice” (Ethics Conduct, 2013, p.4). Teamwork and unity are other key components to the Physician Assistant field. Physician Assistants technically practice under the supervision of a physician. This phrase may be interpreted loosely, but Physican assistants must “respect their professional relationship with physicians” (Ethic Conduct, 2013, p.4) and work together. The last segment of Physican Assistant values regards their own personal knowledge

WRITING AS A PHYSICIAN ASSISTANT and improvement. PAs should be confident in their knowledge and skill. However, Physician Assistants must consistently determine their own strengths and limitations expand their intelligence, work on their weaknesses, and always continuing the learning process. Physican assistants incorporate a large amount of writing into their work. From the moment they complete their education program, PAs are studying verbal and written communication for their national certification boards and state licensure exams. Once PAs are working and employed, writing does not stop. Every patient requires extensive written communication as soon as they walk in the door. When PAs complete an initial assessment, effective writing is applied to medical histories, observations, clinical interviews, and symptom overviews. As part of many diagnoses, Physician Assistants will have to order tests of certain conditions, and then interpret those tests for conclusions. Treatment protocols require writing prescriptions and direct medication orders. A lack of proper written instructions fails to provide high quality care. For insurance purposes, all medical care must be heavily documented to meet legal standards. Written patient notes must be thorough and accurate, especially to fulfill a

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continuity of care. Physician Assistants focusing in primary care will refer patients to specialists, psychologists, physical therapists, and other healthcare professionals. Without an in depth written assessment and directions, care may be halted or altered for the worse. Physician assistants also pride themselves with preventative medicine and patient education. The targeted writing audience now shifts from insurance companies and fellow medical professionals, to patients with wide variation in comprehension abilities. Some patients may be very familiar with healthcare procedures and jargon, while others may need simplified instructions and diction. In addition to Physician Assistants, our government and legislative body must provide accurate and effective written communication in healthcare, as seen with the Patient Protection

WRITING AS A PHYSICIAN ASSISTANT and Affordable Care Act. The act has increased the need for Physician Assistants dramatically, but how is the language of this act translated to the public? By analyzing the White House website for the Affordable Care Act we can see how written communication is used. On the overview of the new healthcare law, http://www.whitehouse.gov/healthreform/healthcareoverview, there are no specified authors. However we know this website is official media from the President of the United States Barack Obama. Because this information comes directly from his administration, we can assume the authors are a team of writers in the communication and policy divisions of his staff. As the highest office in the country, few would question the credibility of the source. Some could argue the website pushes a liberal bias, but because the

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Obama Administration spearheaded the bill themselves, it is safe the say the information is valid. The main purpose of the website is to inform Americans on the key features of Affordable Care Act; this particular subpage provides an overall summary. The content shows little argument or evaluation, but it does provide instruction on where to find more information. One could also argue that the website is written persuasively to address skeptics and opponents to the law. However, they are not the intended readers. Instead, the target population is all Americans wanting to learn more about a new bill. The text targets beginners who may not be familiar of the different functions of the Affordable Care Act. The language is simplified and direct to accommodate an audience with varying health policy knowledge and background information. Looking at the content and format, the website was meticulously planned and executed well. The top of the website contains a summary and overview of the article. As the reader scrolls, there are four tabs on the left to choose from as the four key facts: stronger consumer rights and protections, more affordable coverage, better access to care, and stronger Medicare. When selecting one of the four tabs, between two and three facts appear on the left of the screen.

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These statements include specific numbers and data to support the claim such as “more than 17.6 million children with pre-existing conditions can no longer be denied coverage” (White House, 2013, 1). At the bottom of the facts in each section, there is a link to learn more. These links redirect the reader further down the page. Those four main facets have a section description with greater detail. These subsections provide external links to other websites related to the topic. The main points are right at the top, and the author has used eye-opening statistics with impressive numbers to draw the reader in. Once they have grasped those four ideas, they can read more about the topics. These sections are broken up into separate paragraphs for new ideas. For example the “Better Access to Care” section has separate paragraphs for free prevention benefits, coverage for young adults, coverage for Americans with pre-existing conditions, and affordable insurance exchanges. This allows the audience to skim over points that may not peak their interest. Due to the prestige and traffic of the website, language was very carefully chosen and crafted. The bill is a national platform and arguably President Obama’s largest movement, so the messaging of the new bill cannot show any faults or negative connotations. On the right side of the screen, a quote from President Barack Obama reads, The stories of everyday Americans and, more importantly, the courage it took to share those stories is what kept this effort alive and moving forward even when it looked like it was lost. They are why we got this done. They are why I signed this bill into law. (Barack Obama, 2010, p.1) This powerful language gives that rhetoric speech needed to support a movement and the descriptions are all written in active voice. The sentences are kept short and to the point. Elaborations and figurative language were omitted to maintain a sense of professionalism.

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Visuals representations are used very well on the website. The authors use an infographic summarizing the main points of the Affordable Care Act with what looks like a hand-written checklist. Below, there is a link for an interactive map of the United States. Viewers can click on a state and see figures on what is happening in their home state. This provides great, relatable context for the reader. Physician Assistants, the Patient Protection and Affordable Care Act, and writing composition all complement each other quite well. In respected writing, authors must back up their thesis or claims with evidence and support. In the case of the Affordable Care Act, the White House website did a thorough job to back up every key point with solid facts and figures demonstrating its accomplished and anticipated successes. Physician Assistants use this same process of evidence-based medicine during diagnosis and assessment. First decide the best treatment, and then consult their team of physicians to support or challenge the diagnosis and treatment. Logistically, writing played a key factor in the making of the 900-page Affordable Care Act with notorious edits to pick the most suitable language. However, the Physician Assistant role has also influenced the Affordable Care Act. The Affordable Care Act exemplifies the PA preventative care model, providing 32.5 million seniors free preventative services such as flu shots and diabetes screenings; 54 million Americans received free preventative cancer screenings through private insurance. The ACA increases the number of people with access to healthcare, while Physician Assistants help provide primary care to the growing population. Ultimately, both the Physician Assistant role and the Affordable care act improve the quality and lower the cost of healthcare in the United States.

WRITING AS A PHYSICIAN ASSISTANT Works Cited

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American Academy of Physician Assistants. What is a PA? Retrieved from http://www.aapa.org/the_pa_profession/what_is_a_pa.aspx

American Academy of Physician Assistants (2013). Guidelines for Ethical Conduct for the Physician Assistant Profession. Retrieved from http://www.aapa.org/your_pa_career/becoming_a_pa/resources/item.aspx?id=1518

The White House – President Barack Obama Administration. Healthcare that Works for Americans. Retrieved from http://www.whitehouse.gov/healthreform/healthcare-overview