There could not be a more exciting time to enter the Physician Assistant (PA) profession. With a nationwide primary care provider shortage looming, the “baby boomer” generation reaching retirement age, and the upholding of the Affordable Care Act, there exists the impetus to expand the roles and responsibilities of PAs in every aspect of patient care. Between an exponential boom in the establishment of new PA programs, introduction of novel PA training modalities, and an expansion of the PA scope of practice in various states, PAs are more prepared than ever to do their part in providing safe, affordable, quality care for all.
As higher education costs have skyrocketed and Medicare reimbursements have fallen, interest in PA programs has steadily increased; and universities have responded. Over the last twenty years, the number of accredited PA programs in the United States has risen dramatically from 60 to 196 – an increase of 227%. These programs all aim to help fill the void of primary care providers; particularly in rural, urban, and underserved areas. Many of the top PA schools specifically state a preference for applicants that show a commitment to working with these populations, and that have volunteer experience that demonstrates this commitment. Providing improved access to care for the underserved constitutes the root of the PA profession, and rightly so.
As of June 2014, there were 6,100 primary care Health Professional Shortage Areas (HPSAs) designated by the Health Resources and Services Administration of the US Department of Health and Human Services. In keeping with this theme, the National Health Service Corps offers full-tuition scholarships in exchange for providers committing to working a certain number of years in approved HPSAs. There are more incentives than ever to begin a rewarding career working with the populations that need providers most! Worthy of mention for the unprecedented nature of its model within PA education, the Yale School of Medicine has applied to be the first to offer an online PA program for its students. While this is admittedly a hotly-debated step for PA education from both inside and outside Yale’s program, in the Digital Age it is inevitable that online education will become at least a component of the typical PA education. Outside of the PA sphere, online medical education is certainly nothing new, with many nurse practitioner programs offering distance-learning doctorate programs. However, simply increasing the number of PAs isn’t going to solve the fundamental issues of the US healthcare system.
PAs have to be allowed to work to the full extent of their abilities and not be handicapped by restrictive regulations that can vary widely between states. Particularly disheartening is that the states which tend to have underserved populations that could benefit most from PAs are also those that regulate PAs so severely. Such restrictions only serve to discourage an influx of PAs to the communities that need them most, instead encouraging PAs to bring their skills to states where they can be used more effectively. With the lobbying efforts of the American Academy of Physician Assistants (AAPA), many states have loosened these restrictions, while others have bills pending in legislature to do the same.
For example, in June 2014 Kentucky lifted the requirement that supervising physicians countersign every intervention ordered by PAs before they can be executed, allowing for more efficient and effective care. It’s not only states getting on the action. This April, a Medicare reform bill was passed that was a two-pronged victory for the PA profession. While preventing a 21% drop in reimbursements for PAs, it also approved an annual 0.5% reimbursement increase for the next five years. The physician assistant is a vital member of the healthcare team, and it’s up to PAs to uphold their tradition of providing primary care to those that need it most.
With increasing acknowledgement by individual states and the Federal government of the substantial contributions PAs have to offer the healthcare system, and the general public’s increased awareness and acceptance of PAs, now is the time to join the burgeoning ranks of these highly-motivated healthcare professionals.
