A new report from Jackson Healthcare indicates nearly one-third of physician respondents (30%) say their use of advanced practice professionals, including physician assistants, has increased over the last 2 years.
Similarly, a recent study from the Agency for Healthcare Research & Quality forecasts that the current number of physician assistants, which stands at approximately 72,000, will grow almost 72% by 2025.
Those statistics don’t surprise Jay Amrien, MPAS, PA-C, director of the physician assistant program at Bryant University. With more than 20 years of experience as a physician assistant, Coast Guard medical officer, and emergency medical technician under his belt, Amrien has experienced the changing landscape.
“More physicians are hiring physician assistants not just because they realize the potential of what a physician assistant brings to the practice,” Amrien explains, “but because they can provide a lot of the primary care services that a practice offers.”
Expanding a practice
Amrien says it’s easy to look at physician assistants as a means to alleviate the burden on a medical practice, and he agrees that part of what a physician assistant does is reduce some of the pressure on overworked physicians. But he says a physician assistant’s role is more about helping expand a medical practice rather than reduce the number of patients a practice sees.
“A physician assistant adds to the practice by providing the ability to bring in more patients,” Amrien says. “These are patients the practice might not have seen initially.”
Amrien says he’s a huge fan of universal access to care, but he has found that providing people with universal healthcare doesn’t necessarily provide them with uniform access. A gold insurance card is nice, but it means nothing if there isn’t an available healthcare professional.
“We have to expand access to care. Not insurance. Not coverage.”
Numbers don’t work
Medical schools are addressing the issue, Amrien says, by creating primary care medical tracks. But the predicted shortage of 90,000 physicians can’t be met solely by increasing medical school classes. Physician assistants could be part of the answer, but there’s a numbers problem there as well.
The problem, says Amrien, is that the projected physician assistant growth rate will only provide 16% of the physician assistants needed to address the shortage of primary care physicians. Bryant University is looking to help fill that gap.
“When we were investigating the landscape, we found that Rhode Island had no physician assistant programs,” Amrien says. “If you take the statistics of Rhode Island and compare them to any of the other New England states, it only has about half the PAs per hundred thousand of population, and about half the number of nurse practitioners per hundred thousand patients. It’s a very underserved state.”
But Bryant University is answering the call. Its new School of Health Sciences will house the recently launched graduate program in physician assistant studies (MSPAS). It’s the first school, the university says, to be built primarily to serve the physician assistant degree.
Ready to impact the bottom line
Amrien says that in many respects physician assistants experience the same medical model of education as physicians. The core, basic principles of science, anatomy, and physiology are the same. The second year of physician assistant education is very similar to the third year of medical school, including clinical rotations in in-patient and out-patient medicine, general surgery, pediatrics and emergency medicine.
The biggest difference, Amrien says, is that physician assistants tend to go straight into practice from their education. The average physician assistant program in the U.S. is 27 months. That means in 27 means they’re able to begin impacting patient care—and impact a practice’s bottom line.
“There is pretty much no way you can hire a physician assistant, even if they were brand new with no experience, and they wouldn’t positively impact a practice’s bottom line,” Amrien says. “When you look at my salary compared to a physician’s salary, I make significantly less. But I can tell you that where I work, I bring in the same reimbursement that the practice that a physician would.”
That means, he explains, that as a physician assistant he enables a medical practice to expand the scope of the patients seen—but at a significant cost savings to the practice.
“Physician assistants frequently practice in orthopedic surgery,” Amrien says. “If you have a surgery that requires a surgeon and a first assist, the option is to have 2 orthopedic surgeons in the operating room, or to have an orthopedic surgeon and a physician assistant as first assist. Clearly, if you have a physician assistant as a first assist, you can have a second orthopedic surgeon in a second operating room running another case. And that’s a benefit for the practice.”