What Is a Doctor? Braided Global Histories of Medical Assistants, Intermediaries and Auxiliaries

The 'Physician Associate' (PA) is one of numerous assistants and auxiliaries that staff healthcare systems across the world. Advocates for the role often trace its origins to North American manpower experiments that aimed to address the 'doctor shortage' of the 1960s in creative and cost-effective ways. As this article explores, this geographically narrow origin story not only omits the careful 'crafting' of the American PA role over six decades, but importantly, obscures the interconnected histories of medical assistants and auxiliaries across the world. To address this geographic myopia, this article traces a braided history of the PA and explores, first, how the role emerged from and in relation to the already widespread use of medical assistants across many developing and developed countries. It then examines the imbrication of the PA role within international efforts to develop solutions to medical manpower shortages across developing and developed countries from the 1960s onwards.