The Evolutionary Role of Physician Assistants across the United States, Canada, and the United Kingdom

International Journal of Exercise Science 6(1) : 1-8, 2013. With physician shortages looming ominously on the horizon, healthcare systems across the globe are awaiting a surge of eager young doctors to enter the field. Much to the dismay of these systems, it does not appear that there will be a collective sigh of relief in the coming years. Fortunately there still remains a promising position to fill the gaps and potentially overcome the growing inundation of patients, shortage of general practice physicians, and ever growing underserved rural populations: the position of physician assistant (PA). Through this review, the evolution of the PA position will be discussed from the perspective of healthcare systems in the United States, Canada, and the United Kingdom. Further, an outline of the educational requirements, projected student debt-to-income ratios, and position availability will be touched upon

Is digital photography an accurate and precise method for measuring range of motion of the hip and knee?

Abstract Background Accurate measurements of knee and hip motion are required for management of musculoskeletal pathology. The purpose of this investigation was to compare three techniques for measuring motion at the hip and knee. The authors hypothesized that digital photography would be equivalent in accuracy and show higher precision compared to the other two techniques. Methods Using infrared motion capture analysis as the reference standard, hip flexion/abduction/internal rotation/external rotation and knee flexion/extension were measured using visual estimation, goniometry, and photography on 10 fresh frozen cadavers. These measurements were performed by three physical therapists and three orthopaedic surgeons. Accuracy was defined by the difference from the reference standard, while precision was defined by the proportion of measurements within either 5° or 10°. Analysis of variance (ANOVA), t-tests, and chi-squared tests were used. Results Although two statistically significant differences were found in measurement accuracy between the three techniques, neither of these differences met clinical significance (difference of 1.4° for hip abduction and 1.7° for the knee extension). Precision of measurements was significantly higher for digital photography than: (i) visual estimation for hip abduction and knee extension, and (ii) goniometry for knee extension only. Conclusions There was no clinically significant difference in measurement accuracy between the three techniques for hip and knee motion. Digital photography only showed higher precision for two joint motions (hip abduction and knee extension). Overall digital photography shows equivalent accuracy and near-equivalent precision to visual estimation and goniometry