Social accountability of the physician assistant: A fit-for-purpose health workforce

In the context of the crisis in the health workforce globally, during the late 2000s to the early 2010s, there was a reinvigoration of academic and professional interest in both the theory and practical applicability of socially accountable health professional education and schools. While recognizing the importance of other health professionals, the conversation around socially accountable health professional education has been dominated by medicine. One group of health care professionals who have not enjoyed the same exposure to inquiry of social accountability are the PA-like providers. Although, before such a probe can be conducted, one would have to decide on a globally inclusive term for this professional. Many attempts have been made to find a common international name for these health care providers, including mid-level medical providers and advanced practice clinicians. Non physician clinicians (NPCs) were described by Mullan and Frehywot as "health workers with training beyond the secondary school level, who have fewer clinical skills than physicians but more than basic nurses." Their definition included workers who were trained to deliver a range of health services, but not those who specialized in health administration, population health activities, or focused clinical activities. For purposes of this article, NPC will be used to describe physician assistant (PA)-like roles both in and outside high-income countries. This article demonstrates how the creation of NPCs has influenced the development of the theory and conceptualization of socially accountable health professional education.