The Differences Between OPA-C/OA-Cs and PA-Cs
The Orthopaedic Physician's Assistant (OPA-C)/Orthopaedic Assistant (OA-C):
The certified Orthopaedic Physician's Assistan/Orthopaedic Assistant is a professional, mid-level physician extender who works strictly in the field of orthopaedic medicine under the supervision of an orthopaedic surgeon(s). The title, Orthopaedic Physician's Assistant Certified/Orthopaedic Assistant Certified (OPA-C/OA-C) can be used only after an individual has successfully passed the certification examination set forth by the National Board for Certification of Orthopaedic Physician's Assistants/National Board for Certification of Orthopaedic Assistants (NBCOPA/NBCOA).
To be eligible to sit for the examination, candidates must have a solid background with a minimum of five years in orthopaedic medicine encompassing anatomy, physiology, pharmacology and knowledge of musculoskeletal disease process and treatment. Furthermore, candidates to become an OPA-C/OA-C must have demonstrated proficiency with technical skills related to patient care, casting, bracing, splinting, and surgical assisting. Candidacy to becoming a certified OPA/OA can be achieved through completion of a formal, recognized OPA-C/OA-C program or in some cases through cross-training of other health care personnel who are already certified or licensed. In a study commissioned by the American Society of Orthopaedic Assistants (ASOA) most certified OPA-C/OA-C's have a bachelor's or more advanced educational degree and have formal training as such an orthopaedic nurse, certified orthopaedic technologist, or military corpsman/corpswomen.
An OPA-C/OA-C works within the scope of practice as defined by his or her supervising physician. The employing physician takes into account the OPA/OA's experience and expertise in delegating duties to the OPA-C/OA-C. The American Society of Orthopaedic Assistants in conjunction with the National Board for Certification of Orthopedic Physician's Assistant/National Board for Certification of Orthopedic Assistants has drafted a Standardized Guidelines of Practice for certified OPA/OAs, which lists duties the OPA-C/OA-C should be competent performing based on the areas covered by the certifying examination.
Currently, the scope of an OPA-C/OA-C's practice is governed by the medical staff and credential committees of the hospitals where they perform many of their duties and by applicable state laws. However, due to the high demand for these individuals, some states such as Tennessee, California, and New York have adapted practice guidelines for these physician extenders. Many more states are currently reviewing these guidelines and establishing uniform criteria with the help of the orthopaedic community and the OPA/OA.
The Physician Assistant (PA-C):
Physician Assistants (PA-C) are professional physician extenders who have received generalist training in medicine and work under the supervision of a physician. This training includes: Family Medicine, Internal Medicine, Pediatrics, and Obstetrics and Gynecology. The average length of the PA curriculum is 26 months of didactic and clinical training. This is provided at many levels, from the diploma-producing level to the post-graduate level. However, the curriculum is essentially the same regardless of that level. Training consists of didactic (classroom and laboratory) instruction in the basic medical and behavioral sciences (anatomy, physiology, pharmacology, pathophysiology, clinical medicine, and physical diagnosis), followed by clinical rotations in Internal Medicine, Family Medicine, Pediatrics, Obstetrics and Gynecology, Emergency Medicine, and Geriatric Medicine. The student can then choose to take an elective rotation in General Surgery or Orthopaedics that is often no longer than 6 weeks. Upon completion of the training program, the student may sit for the NCCPA Examination. Even though many will deny its existence, the NCCPA had a clause that allowed for " informally " trained individuals to take the examination up until 1986.
In general, the PA-C is trained to provide diagnostic and therapeutic health care services in a variety of settings including rural and under-served areas. The original concept was brought about by a perceived physician shortage that was to occur in the late 1970 and 1980s.
Despite the similarity in titles, Physician Assistants (PA-C) are not Orthopaedic Physician's Assistants/Orthopaedic Assistants (OPA-C/OA-C). While Physician Assistants are required to complete an intensive formal educational program covering primary care medicine, training in orthopaedics is limited to a short elective rotation. Physician Assistants can become certified by passing the NCCPA examination. Orthopaedic Physician's Assistants/Orthopaedic Assistants on the other hand are required to have a solid background in clincial and surgical orthopaedics with additional technical skills that are not commonly taught in formal PA-C programs. The current model of OPA-C/OA-C learning is similar to that of hands-on residency training by a physician.
While there is some overlap in regards to scope of practice for PA's and OPA/OA's, OPA/OA's by definition have specialty training within the field of orthopaedics and provide an invaluable service to their supervising physician(s).