C. 1650

Feldshers, Originally medical assistants in German Military service, are introduced into the Russian Army by Peter the Great.

1778

The US Congress provides for a number of hospital mates modeled after the “loblolly boys” of the British Royal navy, to assist physicians in providing care.

1803

Officers de sante’ are introduced in France by Fourcroy to help alleviate health personnel shortages in the military and civilian sectors.

1891

The first US Military company to train medics is established in Ft Riley Kansas.

1892

Officers de sante’ are abolished in France.

1940

Community Health aides are introduced in Alaska to improve the health status of Native Americans in villages.

1959

The US Surgeon General identifies a shortage of medically trained personnel.

1961

Charles Hudson, in an editorial in the Journal of American Medical Association, calls for a “midlevel” provider to be formed out of the ranks of former military corpsmen. The World Health Organization introduces and promotes health care workers in developing countries ( medecin African, dresser, assistant medical officer, rural health technician, and so on).

1965

Duke University enrolls the first class in the first PA program.

1966

Barefoot doctors emerge in China in response to Chairman Mao’s purge of the elite and intellectual, which sent many physicians into the fields to work and left peasants without medical personnel.

1967

The first class of PA’s graduate from Duke University.

1968

The PA Program at Alderson-Broaddus College enrolls it’s first class. The Health Manpower Act funds the training of a variety of health providers. Vol 1 No 1 of the Physicians Assistant is published. The journal later ceases publication. The American Association of Physicians Assistants, later to become the American Academy of Physicians Assistants (AAPA), is founded.

1969

The first class enters the MEDEX program at the University of Washington. Colorado becomes the first state to enact legislation enabling child health associations to work.

1970

Kaiser Permanente becomes the first health maintenance organization (HMO) to employ a PA.

1971

The American Medical Association 9AMA) recognizes the PA profession and begins work on a program of national certification and codification of PA practice characteristics. The comprehensive Health Manpower Training Act contracts for PA education and deployment.

1972

The Physicians Assistant: Today and Tomorrow by Sadler, Sadler, and Bliss, the first book about the PA profession, is published. The Association of Physician Assistant Program (APAP) is founded. The four year PA program at Alderson-Broaddus College graduates its first class. The Essentials- accreditation standards for PA programs-are adopted by the AMA; the Joint Review Committee on Educational Programs for Physicians Assistants is formed to evaluate compliance with standards. Federal support for PA education is authorized by the Health Resource Administration.

1973

The First Annual Physician Assistant Conference is held at Sheppard Air Force Base in Texas and draws 275 attendees. The AAPA and APAP establish a national office in Washington, DC. The National Commission on Certification of Physician Assistants is established. The National Board of Medical Examiners administers the first certifying examinations for primary care Pas. The American Association of Surgeon Assistants, later known as the American Association of Surgical Physician Assistants, is founded.

1974

The AAPA becomes an official collaborating organization on the Joint Review Committee on Educational Programs for Physician Assistants. The committee reviews physician and surgeon assistant programs and makes accreditation recommendations to the Committee on Allied Health Education and Accreditation. The American College of Surgeons becomes a sponsoring organization of the Joint Review Committee.

1975

The Physician Assistant, by Ford, is published.

1976

Federal support of PA education continues under grants from the Health Professions Educational Assistance Act.

1977

The Physician’s Assistant: A Baccalaureate Curriculum, by Myers, is published. The AAPA Educational and Research Foundation (later renamed Physician Assistant Foundation) is incorporated to recruit public and private contributions for student financial assistance and to support research on the profession. The Rural Health Clinic Services Act, passed by congress, provides Medicare reimbursement of PA and nurse practitioner services in rural clinics. The journal Health Practitioner (later renamed Physician Assistant) appears. Still later, the publication is distributed as the official publication of AAPA.

1978

The Physician Assistant: Innovation in the Division of Medical Labor, by Schneller, is published. The House of Delegates becomes the policy-making legislative body of the AAPA. The US Air Force first appoints PA’s as commissioned officers.

1979

The Graduate Medical Education National Advisory Committee predicts a surplus of physicians and non-physician providers in the near future.

1980

The AAPA Political Action Committee is established to support candidates for federal office who support the PA profession.

1981

Staffing Primary Care in 1990: Physician Replacement and Cost Savings, by Record, is published, documenting that PA’s in HMO’s provide 79% of the care provided by a primary care physician at 50% of the cost. The Art of Teaching Primary Care, by Golden and Hagor is published.

1982

Physician Assistants: Their Contribution to Health Care, by Perry and Breitner, is published.

1984

First Annual Report on Physician Assistant Education Programs in the United States, by Oliver and APAP, is issued. The Health Care Industry Advisory Council is established. Alternatives in Health Care, by Carter and Perry is published.

1985

The AAPA’s first Burroughs Wellcome Health Policy Fellowship fellow is named. AAPA membership surpasses 10,000; categories are expanded to include physicians, affiliates, and sustaining members. The AAPA and APAP begin a joint project, PA Job Find, to provide PA graduates with a national job-bank service.

1986

The AAPA succeeds in a legislative drive for coverage of PA services under Medicare Part B in hospitals and nursing homes and when assisting in surgery (Omnibus Budget Reconciliation Act). A videotape, A Dynamic Profession: Past-Present-Future, is produced by the AAPA. Physician Assistants: New Models of Utilization, by Zarbock and Harbert, is published.

1987

The Physician Assistant in a Changing Health Care Environment, by Schafft and Cawley is published. National PA Day (October 6) Is established; the date is also the anniversary of the first graduating class of PA’s from the Duke University program 20 years earlier. New AAPA headquarters in Alexandria, VA, open. The AAPA contracts to publish the Journal of the American Academy of Physician Assistants (JAAPA). The new editor is the first PA hired for the AAPA professional staff. Additional Medicare coverage of PA services (in rural, underserved areas) is approved by Congress.

1988

Vol 1 No 1 of JAAPA is published. The Duke University PA program awards the first master’s degree for PA education.

1991

The AAPA assumes the administrative responsibility for the Accreditation Review Committee on Education for Physician Assistants (formerly the Joint Review Committee). US Navy PA’s are commissioned.

1992

US Army and US Coast Guard PA’s are commissioned.

1993

The Roles of Physician Assistants and Nurse Practitioners in Primary Care, edited by Clawson and Osterweis, is published. 24,600 PA’s are recognized for practice in all but one of the 50 states, all US territories and the District of Columbia.

1994

Physician Assistant: A Guide to Clinical Practice, edited by Ballweg, Stolberg, and Sullivan, is published.

1995

The Physician Assistant Medical Handbook, edited by Labus, is published

1996

The AAPA is granted observer status in the House of Delegates of the AMA

1997

The number if PA Programs approaches 100. Approximately 30,000 practicing PA’s are in the American health workforce. Physician Assistants in American Medicine, by Hooker and Cawley, is published. JAAPA marks its 10^th year of publication. SIU admits first class.