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 orthopaedics and sports medicine.
The first is the physician’s assistant or PA, as they are commonly known. Physician’s assistants are employed in virtually all fields of medicine and are in 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 according to applicable local standards of cares. 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 orthopaedics, 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 PA may manage the patient or he or she may present the information to the doctor for definitive treatment.
PAs routinely assists surgeons in the operating room. Often the PA can serve as a first assistant where an extra set of knowledgeable hands are invaluable. Postoperative care is also a common responsibility of the PA in the orthopaedics 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 anesthesiologists in certain settings under the supervision of a licensed doctor. This naturally includes many of the things that most people associate with anesthesia such as “putting people to sleep” for surgery. Most outpatient orthopaedic surgeries are relatively short and are done on mostly healthy people.
CRNAs, though quite capable in most any area of anesthesia, can excel in these types of surgeries. Sports medicine and orthopaedics 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 ideally suits various allied health professionals from athletic trainers to physical therapists to physician’s assistants. 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 expertise of these specialists should you have a sports related problem.