Welcome! You are on the website of the NAPA, the Dutch Association of Physician Assistants.
Physician Assistant, shortly PA, is the name of a relatively new profession, introduced in the Netherlands in 2000, using the extensive experiences from the United States of America.
The PA profession is positioned in the medical continuum. De PA works under supervision of a physician and offers professional medical care. The introduction of PA’s has resulted in both better continuity and higher quality of medical care and has improved efficiency and productivity in pre-hospital and hospital care.
At this moment we have about 1000 PA working in the Netherlands. A lot of PA are NAPA member. This website informs you about the PA profession, the professional organization and links to other web locations with relevant information about the PA and the PA programs.
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The Physician Assistant (PA) was introduced to the Dutch public health system in 2001. The PA works in various settings, with different tasks, both in primary, secondary and tertiary health care services. The PA is active within almost all areas of the medical domain. This Professional Profile forms the framework for the variable professional practices of the PA.
The profile is written based on cumulative 10 years’ work experience of the PA and cooperating physicians. It is a reflection of the actual professional practice of the PA, as performed within the medical profession. The PA training profile was also used as a guide, for it has had a big impact on the development of the PA profession (practice). A third source was the CBO-framework (CBO = Centraal Begeleidings Orgaan) for professional practice. During the development of the professional profile, the NAPA cooperated closely with The Royal Dutch Medical Association (Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst, or KNMG). The NAPA is grateful for the advice received from the policy department of the KNMG. During the preparation for the new task realignment act, there was also close collaboration with the KNMG and the Ministry of Health, Welfare and Sport (Ministerie van Volksgezondheid, Welzijn en Sport, or VWS). This collaboration mainly focused on the description of the boundaries in which the PA may practice independently. The NAPA’s professional profile, together with the nationwide competency profile, was recorded in an experimental article of the BIG (Beroepen Individuele Gezondheidszorg Profession Act in individual Health Care Act and the corresponding General Disposition of Management. This was affected and introduced on 1 January 2012 for a period of 5 years. Within this legislation the PA, as a profession, is protected. It is expected that this legislation will become permanent after the 5 year period.
The professional code was developed by the Commission for Quality and Education of the Netherlands Association of Physician Assistants (NAPA). It represents the common values, standards and code of conduct applicable to the physician assistant (PA). The code does not refer to the daily tasks of the PA. These are described in the professional profile as developed by the NAPA.
PAs who apply for membership to the quality register (BIG-register), automatically endorse this professional code. This is also applies to PAs still in training.
One of the most important aims of the NAPA is to be able to guarantee the quality of all Dutch Physician Assistants. The following means have been developed to achieve this aim, the establishment of:
- Quality Assurance Register
- Professional code of conduct
- Professional profiles
Independency of Physician Assistants (PA) and Nurse Practitioners (NP) regulated in the Netherlands
(3 October 2017) After a five-year experiment, the Dutch parliament and Dutch Senate agreed to give PA and NP full independence in diagnosing, initiating treatment and performing medical procedures. These medical tasks are mostly non-complex procedures that can be executed autonomous by an NP or PA. This also includes prescribing medication.
Both professions are trained to take medical and organizational tasks from medical doctors. The results of evaluation studies of the experiment are positive: PA and NP provide efficient and high quality care. The Dutch Minister of Health Ms. Schippers decided to change the act BIG (law on individual medical professionals) which regulates the performances of medical professionals.
The amendment will take effect on July 1, 2018. PAs and NPs will have a legal position to perform the following medical tasks independently:
- surgical procedures,
- prescribe medication,
- elective, electrical cardioversion and
This autonomous legal role means that the PA can provide independent diagnosis and start the treatment, but the PAs has to make agreements with their employer and the medical doctors about the scope of practice.
There are also some other conditions. The quality of the performance of the medical tasks must be according to national guidelines and protocols.
From July 1, 2018 the title Physician Assistant in the Netherlands is a protected title that only PAs can use who successfully completed a accreditated Master’s degree Physician Assistant. Also from July 2018 every PA is listed in a public register.
De Bruijn-Geraets, Van Eijk-Hustings, Bessems-Beks, Essers, Dirksen & Vrijhoef ‘National mixed methods evaluation of the effects of removing legal barriers to full practice authority of Dutch nurse practitioners and physician assistants’ BMJ (2018)