Women, family medicine, and career choice: An opportunity cost analysis.

OBJECTIVE: This study compared the cost of physician versus physician assistant (PA) education for women practicing in family medicine. METHODS: Using 2013 salary survey data from both the Medical Group Management Association and the American Academy of PAs as well as other publicly available data sources, the authors compared the current net present value (NPV) of physician and PA training for women practicing in family medicine. RESULTS: Considering a base case scenario involving a 24-year-old woman, the NPV to become a family medicine physician was $2,015,000 compared with an NPV of $1,751,000 to become a family medicine PA. Alternative projections produced an NPV for PA training that slightly exceeded the NPV for family medicine physician training. CONCLUSIONS: For a woman practicing in family medicine, becoming a physician or a PA offers similar financial rewards.

Ambulatory and chronic disease care by physician assistants and nurse practitioners.

As the US population increases and ages, more patients require care. A reengineered health care system relies on physician assistants and nurse practitioners; however, the extent to which they care for medical conditions is marginally known. We analyzed ambulatory visits by provider type and diagnosis focusing on chronic diseases to identify differences in patients seen by each type of provider. Both physician assistants and nurse practitioners attended 14% of 777 million weighted visits. Overall, diabetes and hypertension accounted for 2% to 4% of visits. The distribution of visits for chronic disease diagnoses appears to be similar for all 3 providers (physicians, nurse practitioners, and physician assistants). These findings may improve organizational efficiency in ambulatory systems.