Generally, the first 12 months of PA education consists of didactic training in medical science. The last 13 months consist of clinical rotations where the students are involved with direct patient care. In 39 states, Guam, and the District of Columbia, physician assistants are permitted to prescribe medications. PAs have prescriptive privileges in Nebraska. Other rules and regulations for PA practice vary from state to state.
Recent studies indicate that in many practice settings PAs are being underutilized.
Research conducted by Kaiser Permanente suggests that this is partially due to the comfort level of physicians in delegating medical tasks to PAs. Another study, conducted by the Veterans Administration, also revealed that the supervising physician's attitudes and style of delegation of tasks was a greater factor in the utilization of PAs than the physician assistant's education and clinical skills level. These guidelines are also endorsed by the American Academy of Physician Assistants . The physician is responsible for managing the health care of patients in all practice settings. Health care services delivered by physicians and Physician Assistants must be within the scope of each practitioner's authorized practice as defined by state laws.