Our client’s husband was seen in Urgent Care, then in an Emergency Department the same day and died the next day from an undiagnosed acute lung condition. He never saw a physician. How could this have happened? Physician Extenders (often referred to as physician assistants) are being utilized on a more frequent basis in Emergency Departments, in fact, over 75% of Emergency Departments across the country utilize their services.

State law requires they be under the supervision of a physician, but the physician does not have to even be present in the room. Often a review of the chart by the physician is done after the patient has already been discharged.

Physician assistants often manage low acuity patients, while the emergency physician attends to the more acute or complex patients. The scenario we often see is a patient is deemed to be low acuity and is funneled into “fast track” or “urgent care” and the physician assistant does not have the knowledge and experience to determine the more subtle signs of a serious illness and may not ask for help by a physician. The serious illness is then misdiagnosed or underdiagnosed only to have tragic consequences later on.

It is difficult for a patient to distinguish between a physician and physician assistant. They both might be wearing white coats and one often does not pay attention to their name badges.

So what can one do to protect oneself? Be your own advocate - know who is treating you in the Emergency Department. If you want to be seen by a physician rather than a physician assistant, that is certainly within your rights, just ask!