Physician assistants/associates in psychiatry: a workforce analysis.

BACKGROUND: Physician assistants/associates (PAs) provide services in diverse medical specialties globally, including psychiatry. While health professionals in psychiatry have been described for many years, little is known about PAs practicing in this discipline. METHODS: We describe US PAs practicing in psychiatry using robust national data from the National Commission on Certification of Physician Assistants (NCCPA). Analyses included descriptive and inferential statistics comparing PAs in psychiatry to PAs in all other medical and surgical specialties. RESULTS: The percentage of PAs practicing in psychiatry has increased from 1.1% (n = 630) in 2013 to 2.0% (n = 2 262) in 2021. PAs in psychiatry differed from PAs practicing in all other specialties in the following: they identified predominately as female (71.4% vs. 69.1%; p = 0.016), were more racially diverse (Asian [6.6% vs. 6.0%], Black/African American [5.5% vs. 3.4%], multi-race [2.8% vs. 2.1%], and other races [Native Hawaiian/Pacific Islander, American Indian/Alaska Native, or other; 3.7% vs. 3.6%]; p < 0.001), and resided in the South (43.8% vs. 34.1%; p < 0.001). PAs in psychiatry vs. all other specialties were more likely to work in office-based private practice settings (41.6% vs. 37.3%; p < 0.001) and nearly twice as likely to provide telemedicine services for their patients (62.7% vs. 32.9%; p < 0.001). While one-third (31.9%) of PAs in psychiatry experienced one or more burnout symptoms, and 8.1% considered changing their current position, the vast majority of PAs in psychiatry (86.0%) were satisfied with their position. CONCLUSIONS: Understanding the attributes of PAs in psychiatry is essential in medical labor supply and demand research. Our findings suggest that the number of PAs working in psychiatry is steadily increasing. These PAs were predominantly female, exhibited greater racial diversity, and were primarily located in the South and Midwest regions of the US. A striking difference was that PAs in psychiatry were almost twice as likely to provide telemedicine services for their patients. Although nearly a third of PAs in psychiatry acknowledged having one or more symptoms of burnout, few were considering changing their employment, and the vast majority reported high job satisfaction.

Providing care in underresourced areas: contribution of the physician assistant/associate workforce.

BACKGROUND: Prior studies suggest that physician assistants/associates (PAs) are more likely than physicians to work in underresourced areas. However, data characterizing the current PA workforce in health professional shortage areas (HPSAs) and medically underserved areas (MUAs) are lacking. METHODS: We analyzed the 2022 cross-sectional dataset from a comprehensive national database to examine the demographic and practice characteristics of PAs working in HPSAs/MUAs compared to those in other settings. Analyses included descriptive and bivariate statistics, along with multivariate logistic regression. RESULTS: Nearly 23% of PAs reported practicing in HPSAs/MUAs. Among PAs in HPSAs/MUAs, over a third (34.6%) work in primary care settings, 33.3% identify as men, 15.6% reside in rural/isolated areas, and 14.0% are from an underrepresented in medicine (URiM) background. Factors associated with higher odds of practicing in a HPSA/MUA included residing in rural/isolated settings, URiM background, and speaking a language other than English with patients. CONCLUSIONS: As the PA profession grows, knowledge of these attributes may help inform efforts to expand PA workforce contributions to address provider shortages.

Physician Assistants in Plastic Surgery: A Descriptive Analysis Using the National Commission on Certification of Physician Assistants Dataset.

ABSTRACT: Physician assistants (PAs) play a vital role in the US health care system, particularly amid the persistent surgeon shortage and escalating health care demands. We aim to characterize the current cohort of PAs in plastic surgery by comparing them to PAs in all other specialties. Using a cross-sectional analysis of the 2022 National Commission on Certification of PAs dataset, we examined demographic and practice characteristics of PAs in plastic surgery with those in all other specialties. Analysis included descriptive and bivariate statistics. In 2022, 1.0% of PAs worked in plastic surgery, with the specialty's numbers nearly doubling from 2015 (n = 647) to 2022 (n = 1186). Bivariate analysis among PAs in plastic surgery and those in other settings revealed several important attributes (all P's < 0.001); PAs in plastic surgery were younger (median age, 36 vs 39), identified as female (91.0% vs 69.4%), resided in urban locations (97.6% vs 92.5%), and performed a higher proportion of clinical procedures (66.5% vs 33.9%). Furthermore, a statistically significant higher percentage of PAs in plastic surgery reported high job satisfaction and was more likely to report no symptoms of professional burnout. The expanding PA profession amid the scarcity of surgeons presents an ideal prospect for enhanced collaboration. In an era where surgeon burnout is increasingly common and PAs express a readiness to function at an advanced level, expanding PAs' role becomes desirable and imperative. This collaborative approach has the potential to address workforce challenges, elevate patient care, and enhance provider satisfaction.

The association of physician assistant/associate demographic and practice characteristics with perceptions of value of certification.

BACKGROUND: To determine physician assistant/associate (PA) perceptions of the value of certification and explore how they vary across demographic and practice characteristics. METHODS: We conducted a cross-sectional online survey between March and April 2020 with PAs participating in the longitudinal pilot program for recertification administered by the National Commission on Certification of Physician Assistants (NCCPA). The survey was distributed to 18,147 PAs, of which 10,965 participated (60.4% response rate). In addition to descriptive statistics, chi-square tests were conducted on demographics and specialty to examine if perceptions of value of certification (1 global and 10 items measuring specific domains) were associated with a particular PA profile. A series of fully adjusted multivariate logistic regressions were performed, exploring the relationship between PA characteristics and the value of certification items. RESULTS: Most PAs strongly agreed/agreed that certification helps with fulfilling licensure requirements (9,578/10,893; 87.9%), helps with updating medical knowledge (9,372/10,897; 86.0%), and provides objective evidence of continued competence (8,875/10,902; 81.4%). The items receiving the lowest percentage of responses for strongly agreeing/agreeing were for certification providing no value (1,925/10,887; 17.7%), helping with professional liability insurance (5,076/10,889; 46.6%), and competing with other providers for clinical positions (5,661/10,905; 51.9%). Age 55 and older and practicing in dermatology and psychiatry were among the strongest predictors of less favorable views. PAs from underrepresented in medicine (URiM) backgrounds had more positive perceptions. CONCLUSIONS: Overall, the findings indicate that PAs value certification; however, perceptions varied by demographics and specialties. PAs who were younger, from URiM backgrounds, and practicing in primary care specialties had among the most favorable perspectives. Continued feedback monitoring is critical in ensuring certification is relevant and meaningful in supporting PAs across demographics and specialties. Measuring PA perceptions of the value of certification is essential to understanding how to support the PA profession's current and future credentialing needs and those who license and hire PAs.

Public experience with and perspectives on medical care provided by PAs.

OBJECTIVE: We sought to assess public experiences with and perspectives about physician associates/assistants (PAs), who are taking on increasingly important roles in healthcare. METHODS: We conducted a survey using a Qualtrics panel assessing whether participants (N = 1,388) received care from PAs, their perceptions of the care received, and their intentions of seeking care from PAs in the future. RESULTS: About 67% of participants reported receiving care from PAs; 61.7% believed PAs have more time to communicate with patients. Most respondents were satisfied with the care received, said they were likely to see a PA again, and recommended PAs. Of those not treated by PAs, 30.6% were willing to receive care from PAs, 43.8% were willing to receive care from PAs for minor medical needs, 21.3% were unsure, and 4.3% were unwilling. Older participants and those with more education had consistently more favorable views. CONCLUSIONS: Public experiences with and perceptions of PAs are positive. Future research should employ longitudinal designs to assess trends as the PA workforce continues to grow.

Physician assistant/associate retirement intent: seeking the exit ramp.

BACKGROUND: Retirement patterns for American physician assistants/associates (PAs) are in flux as the first substantial cadre trained in the 1970s makes their retirement choices. The growing and aging of the US population is increasing the demand for healthcare services. At the same time, provider retirement can decrease patient access to care, disrupt continuity of care and lead to poorer health outcomes. Knowing PA intentions to retire and the retirement patterns can be useful to health system employers and workforce policymakers. The purpose of this study was to investigate the retirement patterns of PAs within the United States. We investigated their characteristics, career roles, and intent to depart from clinical practice. METHODS: Drawing on the National Commission on Certification of Physician Assistants (NCCPA) 2020 health workforce data (N = 105,699), the associations of demographics (age, gender, US region, and years certified), and practice attributes (specialty and practice setting) of clinically active PAs were assessed with intending to retire in the next five years. Analyses for this national cross-sectional study included descriptive statistics, Chi-square, and Fisher's Exact test, as appropriate. A p-value of 0.05 or less was considered statistically significant for all analyses where a comparison was made. RESULTS: Overall, 5.8% of respondents indicated that they intend to retire within five years. We detected significant differences (all p < 0.001) on intentions to retire by age group, gender, US region, years certified, specialty, and practice setting. Respondents 70 years and older compared to those 60-69 were more likely (66.5% vs. 48.9%), males compared to females (8.8% vs. 4.4%), those who have been certified for more than 21 years compared to 11-20 years (25.6% vs. 4.0%), PAs practicing in family medicine compared to dermatology (7.7% vs. 3.4%) and those in the federal government practice setting compared to rural health clinic (13.6% vs. 9.8%) reported they were more likely to retire in the next five years. CONCLUSIONS: Our study provides a comprehensive snapshot of PA retirement intentions using a robust national dataset. Among the most important factors associated with intent to retire in this study were older age and duration of PA career. Most PAs are remaining clinically active into their seventh decade-suggesting that they are integrated into medical systems that value them and they, in turn, value their role.

Demographics of Physician Associates (PAs) in Obstetrics and Gynecology: Where They Work and How They Compare to Other PAs.

As of 2020, maternal and infant health in the US has worsened. At the same time, the number of health professionals available to manage female health issues is changing; the number of physicians in obstetrics and gynecology (Ob-Gyn) and midwives is decreasing, whereas the number of Ob-Gyn physician associates (PAs) is growing. We analyzed PAs practicing in the Ob-Gyn discipline, drawing on the PA Professional Profile, a database maintained by the National Commission on Certification of PAs. In 2021, there were 1,322 Ob-Gyn PAs (1.2% of all clinically active PAs). This health profession has grown by 66.9% since 2013, when only 792 PAs practiced in this specialty. As of 2021, their median age was 38, and 98.0% were female (70.1% of all PAs were female). The practice setting was between office (54.7%) and hospital (34.0%) employment, with 11.3% described as "other." In 2021, the median annual income of Ob-Gyn PAs was $105,000. With the reduction of obstetrician-gynecologists, the relative growth of PAs in this area of medicine and surgery is a natural part of the solution to the projected obstetrical physician deficit.

Characteristics of physician associates/assistants in dermatology.

The dermatology workforce includes physicians, nurse practitioners (NPs), and physician associates/assistants (PAs). The number of dermatologists is growing slowly while the growth of PAs working in dermatology is rapid and accelerating. To understand their characteristics, a descriptive study of PAs practicing in dermatology utilizing the National Commission on Certification of Physician Assistants (NCCPA) workforce dataset on PA practices was undertaken. NCCPA certifies PAs who practice in the United States and queries them about their role, employment, salary, and job satisfaction. Analyses consisted of descriptive statistics, Chi-Square, and Mann-Whitney tests for comparisons between PAs practicing in dermatology versus the total of all other PA specialties. As of 2021, 4,580 certified PAs reported practicing in dermatology-a nearly twofold increase since 2013, when 2323 worked in the specialty. This cohort's median age was 39 years, and 82% were female. Almost all (91.5%) are office based, and 81% work more than 31 h per week. The median salary was $125,000 (2020 dollars). Dermatology PAs work fewer hours and see more patients than their counterparts compared to all 69 PA specialties. At the same time, dermatology PAs are more satisfied and less burnt out when compared to all PAs. The increased number of PAs selecting dermatology as their discipline can help lessen the projected physician shortage in this field.