Physician assistants turn away from primary care


Twenty percent fewer physician assistants chose to go into primary care in 2010 than in 1996, according to a recent study in Annals of Family Medicine. “Although the absolute number of PAs working in primary care has increased overall, the percentage of PAs in primary care has declined from 50.8 percent in 1996 to 31 percent in 2010,” the study states.

The study (http://www.annfammed.org/content/11/1/75.full.pdf+html) notes that health care has a problem with primary care. Fewer physicians are taking that career path at a time when — thanks to the Affordable Care Act — the system will begin relying more heavily on PCPs. However, the study adds that “Demographics associated with an increase likelihood of primary care practice among PAs appear to be similar to those of medical students who choose primary care. Knowledge of these characteristics may help efforts to increase the number of primary care PAs.”

The study, in the January/February issue, defines primary care as family medicine, general pediatrics, and general internal medicine. Women, Hispanic and PAs over age 40 are more likely than their colleagues to go into primary care. “Overall, we found that PAs working in primary care have demographic characteristics similar to those of medical students who choose general primary care specialties,” the study states. “A 2010 systematic review determined that six factors are associated with a medical student’s commitment to primary care practice: female sex, older age, Latino ethnicity, lower socioeconomic status, receipt of a National Health Service Corps scholarship, and intention to practice in primary care at the time of medical school matriculation.” The study says that the PA profession might want to consider pushing “policy measures that successfully increase the number of primary care clinicians, including loan repayment, improved levels of reimbursement for primary care physicians, and expansion of Title VII, Section 747 of the Public Health Service Act, which aims to increase the quality, size, and diversity of the primary care workforce.”

Percentage of physician assistants practicing in primary care by demographic characteristics: point estimates and 95% confidence intervals

Trend in the percentage of primary care PAs by year of graduation from 1975 to 2008

% of PAs in primary care practice

Source: “Physician Assistants in Primary Care: Trends and Characteristics,” Annals of Family Medicine, January/February 2013

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