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The Advent Of Physician Assistants In The Navy

Navy-PA-Plankowners-in-August-1974-comp First class of Physician Assistants (PA) in the United States, each former Hospital Corpsmen

Below is reprinted with permission from the article "A Short History Of Navy Physician Assistants. Part I: The Advent Of Physician Assistants In The Navy" by Andre B. Sobocinski, which was published in the January 2021 edition of the US Navy Medical Service Corps newsletter The Rudder.

 

A Short History Of Navy Physician Assistants

Part I: The Advent Of Physician Assistants In The Navy

 

This is one article of a three-part series:
Part I: https://navypa.com/navy-pa-info/blog/advent-of-physician-assistants-in-the-navy
Part II: https://navypa.com/navy-pa-info/blog/through-heavy-weather-and-fair-winds-1975-1999
Part III: https://navypa.com/navy-pa-info/blog/becoming-the-cornerstone-of-operational-medicine-2000-present

 

During the Russo-Japanese War of 1904-1905, the Bureau of Medicine and Surgery (BUMED) sent two physicians - Surgeons William Braisted and Raymond Spear - to observe the medical practices of the Japanese and Russian militaries. While embedded with the Russian Navy, Spear noted with interest of the use of “feldshers” aboard warships and in providing frontline care.

 

Originally coined in the 15th century, the term feldsher came from the German word meaning “field shearer,” which was another name for the fabled barber surgeons. For centuries, the feldsher held a unique status as a protypical “middle medical worker” existing somewhere between physician and nurse. In the Russian military, the feldsher was an indispensable medical provider attending to wounds, setting fractures, and treating a host of ailments. Although this may seem anecdotal for the purpose of this article, medical historians have looked at the feldsher as being the proto-Physician Assistant (PA).

 

When Spear released his report in 1906, Hospital Corpsmen were the closest the Navy came to having their own feldshers. Over the ensuing decades BUMED began elevating the role of its Corpsmen through new training programs, specialization (“C” Schools) and the advent of independent duty.

 

The concept of advanced Corpsmen working in conjunction with physicians to provide clinical care helped inspire Dr. Charles L. Hudson, President of the American Medical Association, to propose the establishment of a non-physician clinical support specialty to “help alleviate a growing disparity between supply and demand for health care services.” As Hudson was planting the seeds of a physician assistant specialty in 1961, Duke University physician and researcher Dr. Eugene Stead had already personally witnessed non-physician clinical support put into practice with great success. At a rural medical office in eastern North Carolina, Dr. Amos Johnson worked with a proprietary trained assistant named Mr. Henry Lee “Buddy” Treadwell in providing care to the local community. Recognizing the benefits of training non-physician professionals like Treadwell, Stead established a 2-year PA program at Duke University - the first of its kind.

 3 first pas

 

It may be of no surprise that the first class was comprised of four former Navy Hospital Corpsmen - Ken Ferrell, Vic Germino, Don Guffey and Dick Scheele - three of whom would become the nation’s first certified PAs when they graduated in 1967 (Guffey left the program before graduating).

 

During the waning years of the Vietnam War, as the obligations of the Berry Planners (physicians drafted into service) ended, and the outpatient to doctor ratio increased, the Navy began exploring new ways to address its own physician shortage. In 1971, BUMED initiated a program to train Hospital Corpsmen to become PAs. Ultimately, these Navy prospective PAs were to act as “physician extenders” helping to ensure that the Navy could deliver healthcare “at a level equal to or not severely denigrating from the level existing during the draft.”

 

In 1972, the Navy selected 30 Hospital Corpsmen - 12 for a Navy program and 18 for an academic program at The George Washington (GW) University.

 

First class of PAs at Duke University 1965

 First class of PAs at Duke University, 1965

 

The following year, BUMED merged its in-house training program with the Air Force (Joint-Program) and sent 12 students to the School of Health Sciences at Sheppard Air Force Base in Texas.

 

The prospective Navy PAs going through Sheppard were then required to complete one year of didactic training and one year of clinical training at service hospitals. The Joint-Program soon after became accredited by the University of Nebraska Medical School and graduates were awarded bachelor’s degrees.

 

Thirty students - two from the Joint Program and 18 from the GW program - graduated in 1974 from the two programs becoming the first Navy PAs. Remarkably, by November 1975, the number of certified PAs in the Navy had grown to 222. All was not smooth sailing for the Navy PA program in those early days though. Throughout the 1970s and 1980s, Navy PAs contended with issues relating to utilization, status and relevance - all of which we will explore in the next installment.

 

First class of Physician Assistants (PA) in the United States, each former Hospital Corpsmen

 First class of Physician Assistants (PA) in the United States, each former Hospital Corpsmen

 

Sources:
- Buddy Treadwell, B. “Physician Assistant History Society.” Retrieved from: https://pahx.org/assistants/treadwell-henry-lee-buddy/
- Carter, R., et al. “In the Beginning: A PA History Roundtable.” JAAPA, October 2005.
- Johnson, A. “Physician Assistant History Society.” Retrieved from: https://pahx.org/assistants/johnson-amos-n/
- Spear, R. “Report on the Russian Medical and Sanitary Features of the Russo-Japanese War to the Surgeon-General, U.S. Navy.” Washington, DC, 1906.
- Stead, E. “Physician Assistant History Society.” Retrieved from: https://pahx.org/assistants/stead-jr-eugene/
- Tandy, R. “P.A. Program in the Navy: A Preliminary Report.” 17 November 1978.
- Vasquez, M. “Physicians’ Assistants: Can They Augment the Navy Medical Service?” Naval War College Review, October 1971.

Through Heavy Weather and Fair Winds, 1975-1999
Regional NAPA East and NAPA West Board of Director...
 

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