1965

Eugene A. Stead, Jr., M.D. develops the first formal training program for physician assistants at Duke University (Holt, 247, 257-262), with two-year training program (nine months of basic sciences + 15 months of apprentice-like clinical training) operated by Department of Medicine. It had no ties to Duke Nursing School, and nurses were not the recruiting pool for the new role; male, especially military corpsmen returning from Vietnam, were the preferred candidates. When the AMA finally decided to support the program in 1970, it reinvented the physician assistant concept, proposing that inactive registered nurses become PAs with higher pay and new status. This further antagonized the ANA, with which it never communicated, much less collaborated, in a manner that “cast the physician assistant as protagonist in the historical drama between the AMA and the ANA” (267). It was also in 1965 that the nurse-practitioner movement began with Dr. Henry Silver and Loretta Ford training pediatric nurse practitioners and clinical nurse specialists at University of Colorado (264, 272). There were, however, reports of “newly negotiated nurse-physician practices” in the literature of the early 60s in which nurses assumed tasks upon which many patients judged the quality of the physician-patient relationship, e.g., psychosocial care, well-child care, patient education, and dispensing minor medical advice. More frequently, however, nurses performed tasks physicians considered less complex, routine, and time consuming – well-child examinations, typical cold or flu, sick-child visits – the very tasks that “made primary pediatric practice intellectually unstimulating and boring” (Fairman, 120-121).