The physician shortage and its Implications on the Physician Assistant Workforce

The United States healthcare system faces a shortage of primary care physicians. The crisis is likely to worsen in the next decade with the ageing of the country’s population and expansion of insurance coverage based on government policies such as the Affordable Care Act.[1] The crisis reveals that the American healthcare system requires an effective solution to overcome the shortage and maintain safety and quality of care. Involving alternative health care providers, such as physician assistants (PAs), may play a significant role in overcoming the crisis. For more than four decades, PAs have proven to be essential partners in the evolving health care settings. They are easily adaptable to the changing needs of patients and health care systems.[2] Although PAs have been instrumental in health care delivery, their role will become more significant in the face of physician shortages.

 

The healthcare system in the United States spends considerable resources when hiring qualified practitioners. As a result, policymakers should address the problem of physician shortage without stretching the budget further.[3] Engaging PAs is one of the policy recommendations that can address the challenge without spending more on physicians. The healthcare system would take decades to fill the gap created by physician shortages even with major changes and increased spending. Hence, PAs will play a critical role in filling the gap and supporting physicians to provide care. They will reduce the current physician to patient ratio and improve patient and organizational outcomes, such as quality of care and satisfaction.

 

PAs’ role is becoming almost indispensable in the modern health care system. Physician shortages will increase demand, especially in the primary care setting.[4] PAs are critical players in primary health, a trend that is likely to continue in the future. For instance, 25.8% of certified PAs currently work in primary care. Although the percentage has decreased in the last five years, major changes are expected in the future as the demand for physicians exceeds their supply.[5] It is expected that PAs will be hired to fill the gap left by the inadequate number of physicians in primary care. The shortage will potentially create new roles in interprofessional teamwork in health care. More than 90,000 certified PAs are already working in the United States health care system.[6] In addition, the country has 173 accredited programs that graduate over 6,545 PAs per year. The current PAs in training and practice provide critical information regarding the opportunities available to address the issue of physician shortage.

 

Health providers offer quality services to patients in primary care. Physician shortage affects the potential for safe and quality patient-centred care. PAs will address the current and future needs since they require shorter training compared to physicians and are readily adaptable to changes in the clinical setting. They can work in a diverse health care setting to support care in addressing medical conditions. With the satisfactory quality of the services provided by PAs, the current focus should be on how to engage them through the training pipeline and involve them in collaborative work with physicians. Although the shortage is affecting physicians, the solution lies in training more PAs because it is cheaper and less budget intensive. Overall, the role of PA is becoming more important in contemporary health care in the United States.

[1] Green LV, Savin S, Lu Y. Primary care physician shortages could be eliminated through use of teams, nonphysicians, and electronic communication. Health Aff. 2013;32(1),11-19.

[2] Glicken AD, & Miller, AA. Physician assistants: from pipeline to practice. Acad Med, 2013: 88(12), 1883-1889.

[3] Bodenheimer TS, Smith MD. Primary care: proposed solutions to the physician shortage without training more physicians. Health Aff. 2013;32(11),1881-1886.

[4] Glicken AD, & Miller, AA. Physician assistants: from pipeline to practice. Acad Med, 2013;88(12), 1883-1889.

[5] National Commission on Certification of Physician Assistants, Inc. 2018 statistical profile of certified physician assistants. An annual report national commission on certification of physician assistants, 2019, 1-21.

 

[6] Glicken AD, & Miller, AA. Physician assistants: from pipeline to practice. Acad Med, 2013; 88(12), 1883-1889.