Physician Assistants Easing the Primary Care Shortage

Posted By: Kubin   |   The Basics

After logging five decades of high-quality, cost-effective care, physician assistants are gearing up for their time in the spotlight.

The stage is set: fewer physicians are entering primary care, older family practice physicians are retiring, and the U.S. population is growing, aging and — thanks to the Patient Protection and Affordable Care Act  (Obamacare) — increasingly covered by health insurance. As a result, demand for primary care is hitting higher levels, yet fewer physicians are around to provide it. The United States is looking at a shortage of an estimated 20,400 primary care physicians by 2020. Who is going to provide primary care?

The same health care providers that have been dependably providing it for years are set to play a starring role going forward: physician assistants.

According to the National Center for Health Workforce Analysis, full deployment of physician assistants and nurse practitioners could slash the primary care physician shortage by two-thirds.

Demand Soars for PAs

Demand for physician assistants is already at an all-time high, according to a recent Forbes report. “Physician assistants are so in demand,” the article explained, “they are gaining part of the signing bonus pie traditionally reserved for doctors.” Signing bonuses for PAs more than doubled from $3,000 in 2013 to $7,500 just a year later, according to a health care recruiter interviewed for the piece. Physician assistants were the fifth most frequently placed health care provider in 2014, the recruiter reported, outpacing several categories of physicians.

Fittingly, the PA profession was launched in 1965 in response to a shortage of primary care physicians. Since then, many physician assistants have provided medical care in underserved rural areas. More than 90,000 physician assistants are currently certified in the United States, and nearly a third of them practice in primary care, according to the American Academy of Physician Assistants.

Most physician assistants earned a bachelor’s degree and worked in health care in jobs ranging from emergency medical technician to a medical assistant before undergoing an additional two to three years in an accredited PA program to practice as a physician assistant. Similar to the physicians they work with, PAs routinely diagnose and treat illnesses, order lab tests and other services, prescribe medications, and provide patient education. In fact, studies show that physician assistants perform around 85 percent of the same duties performed by physicians.

It’s also worth noting that PAs offer value that physicians cannot. While family physicians garner annual salaries averaging $189,000, physician assistant salaries average about $107,000 a year. What’s more, physician assistants are quicker to educate and train than physicians, resulting in increased numbers of competent health care providers at less expense. Studies have shown that care provided by PAs is of high quality and similar to physician-provided care, and that many patients don’t even distinguish between PAs and physicians.

No wonder, then, that both Congress and President Obama have recognized the PA profession as essential for improving the country’s health care system.

PAs Increase Primary Care Access

Physician assistants work in collaboration with physicians, who delegate specific duties PAs may perform. The Affordable Care Act’s emphasis on team-based models of care fits seamlessly with the PA philosophy that emphasizes a patient-centered, collaborative approach to health care.

Having physician assistants in the office increases accessibility to primary care. In a recent AAPA poll, 92 percent of more than 650 patients who had seen a PA in the previous year said it was easier to get an appointment because the practice employed a physician assistant, and 93 percent agreed that PAs are trusted health care providers. In addition, 93 percent noted that PAs will be part of the solution to address the shortage of health care providers in coming years.

“The survey results prove what we have known to be true for years: PAs are an essential element in the health care equation, and America needs PAs now more than ever,” said John McGinnity, MS, PA-C, DFAAPA, president of the American Academy of Physician Assistants. “When PAs are on the health care team, patients know they can count on receiving high-quality care.”

Julie Sweet is an editor of healthcare information for www.2U.com. She is a recent graduate of Fordham University in New York and lives in North Carolina.

4 comments

  1. Paul,
    Thank you for a great web resource! I’m considering becoming a PA and have a few questions….

    I’m truly somewhat concerned about the future of health care when I see surveys, discussions, and news posts (e.g. from The New York Times, etc) about how many doctors and nurses want to leave (and are leaving) medicine because of the ever increasing stress, long hours, paperwork, regulations, decreases in reimbursements, etc. Various surveys say anywhere from 5 out of 10 to 9 out of 10 doctors/other health providers would not recommend medicine to their children as a career and more than 50% of those surveyed want to leave medicine because of the reasons above and many of those say they are overloaded and/or burntout. This makes me concerned, even if it’s only 50% which is pretty significant. I know things are vastly changing in medicine, especially with the Affordable Care Act, but these numbers seem pretty high. Are you worried at all about the future or medicine and being a PA?

    On a similar note, do you think medicine will see a “trickle down effect?” That is, it seems logical and to be expected that if many doctors are doing ever more work and are not particularly happy, then how could those working with and under them not be affected via trickle down? If the doctors are overloaded then I would think that any work that can be handed down to others would be done so, thus increasing the workload, stress, etc for PA’s, NP’s, nurses, etc. and potentially affecting the “great work/life balance” that is such a hallmark of being a PA/NP. Am I being reasonable with these concerns? Or am I blowing them up out of proportion?

    Any thoughts would be soooo great to hear since I must decide very soon on my future path.
    thank you!
    Jim

    1. Good questions, all.

      1) Medicine is in a time of enormous flux right now. In the US, the jigsaw puzzle that had been cobbled together for years (with many pieces in the wrong place, on the floor, under the couch, etc.) has been thrown up in the air and the pieces are still landing and will be for some time. I think you are likely to hear frustration more from MDs than PAs. The golden age of easy money for those who have an MD is over. Period. PAs, NPs, and other provider forms are burdened by more patients, and depending on the setting where you work, it CAN be exhausing. My favorite PA T-shirt slogan: “Behind every good doctor is an EXHAUSTED physician assistant.” I can’t agree 100%, but I understand the sentiment. That said, I think the surveys by the NCCPA (the licensing body for PAs) show pretty consistently that PAs overwhelmingly love their work.

      2) There will be some trickle down. If you want to do 80% of the work of a physician, you will need to accept…(wait for it)…SOME OF THEIR WORK. But if you are a hard working person who stays focused on doing the work you love, and you insist on working only where you feel valued and respected, you’re going to be fine.
      But the reason the trickle down effect is less of an issue for PAs is that if an MD gives you his/her work to do, they are held liable (too) if you screw it up. This means that there is only so much that an MD will be willing to push off on his or her hard working PA. And think what you want about doctors, they jealously guard their licenses, and rightly so.

      What I hear more and more is applicants who shadow doctors and are told by the doctors they shadow that “I wish I had gone the PA route.” I think a lot of physicians see that the trade off for what they get from all their hard work in terms of money and overload just isn’t worth it sometimes. They make more money, but not as much more as they used to, and few doctors have time to truly enjoy that money. So I think PAs have it good, plain and simple.

  2. Hey Paul I have a question for you. I really am interested in primary care, my mother is who got me interested in medicine and is an outpatient internist. My only concern is the pay. I will be around 100k in debt if all things go according to plan (in-state undergrad and PA school hopefully). Do you think a primary care PA in Maryland can have a good lifestyle with that amount of debt? I don’t need to drive a brand new german car I just want a house in a safe neighborhood with the ability to save a healthy amount for retirement and raise a couple of kids. Thanks and I absolutely love your site by the way! And keep writing articles about your day to day at work, its my favorite part of the site.

    1. Hi, Alex!

      That’s a tough question to answer with any exactitude, but I’d say sure. I have a coworker with similar debt. She makes a very good living in urgent care (~$120K). In fact, I can’t think of many careers that you could join and make as much as you will as a PA without doing business or the like. If you go into surgery, you can make even more. Some of the ER PAs at Kaiser in CA make $90/hour, which is $180K/year! Typical for primary care in CA is 100K, but it varies widely. Not sure about Maryland, but probably a little less.

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