Physiotherapy education is a good financial investment, up to a certain level of student debt: an inter-professional economic analysis.

QUESTIONS: What is the economic value of a physiotherapy career relative to other healthcare professions? Is the graduate debt reported for physiotherapy manageable according to recommended salary-weighted debt service ratio benchmarks? DESIGN: Net present value (NPV) is an economic modelling approach that compares costs and benefits of an investment such as healthcare education. An economic analysis using the NPV approach was conducted and reported in US dollars for the Doctor of Physical Therapy degree. Comparable calculations were made for a range of other healthcare qualifications. Debt service ratios were also calculated under a range of scenarios. OUTCOME MEASURES: Entry-level salaries and rate of salary growth were obtained from government databases. Student debt levels were obtained from published sources. Because no national estimate exists for physical therapy student debt, debt was modelled for recent Doctor of Physical Therapy (DPT) graduates and for several hypothetical debt tiers. The NPV modelled future physical therapy earnings less the cost of education and the opportunity cost of foregone earnings from alternate careers. RESULTS: At the debt level reported by recent graduates (US $86563), physical therapy NPV was higher than occupational therapy, optometry, veterinary medicine, and chiropractic but lower than dentistry, pharmacy, nurse practitioner, physician assistant, and all medical specialties. At $150000 debt, physical therapy NPV falls below all careers except veterinary medicine and chiropractic. Students with>$200000 debt may not achieve recommended repayment benchmarks. At high debt levels (>$266000), physical therapy NPV no longer exceeds that of a bachelor's degree. CONCLUSION: Physiotherapy education is a good financial investment, up to a certain level of student debt. Students should carefully consider the amount of debt they are willing to incur in order to pursue a physiotherapy career. Likewise, physiotherapy education programs should consider the role they may play in bolstering the economic value of their graduates' future careers. [Shields RK, Dudley-Javoroski S (2018) Physiotherapy education is a good financial investment, up to a certain level of student debt: an inter-professional economic analysis. Journal of Physiotherapy 64: 182-190].

Nurse practitioners, certified nurse midwives, and physician assistants in California.

California's health care industry includes workers prepared in many ways to perform many jobs. One significant group of health care workers prepared to provide care that often overlaps with physician-generated services is known as "nonphysician providers." Commonly, this label refers to nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs). In this article, we will describe this group in five main areas: (1) the characteristics of the current and projected workforce and programs preparing these professionals; (2) the current skill expectations and knowledge bases of each; (3) trends in the education of these health professionals; (4) innovative models of education of these health professionals; and (5) the inclusion of NPs, PAs, and CNMs in workforce planning in a changing health care system. We conclude that, particularly in light of the overlapping functions of this provider group with many physician functions, the NP, CNM, and NP workforces must be recognized and considered when planning for the future of the physician workforce.