Your office is busy, and it’s time to add to your professional staff. But how difficult will it be for you to locate qualified physicians to satisfy your staffing needs? The Association of American Medical Colleges (AAMC) estimates that by 2015, the shortage of doctors across all specialties will quadruple from current levels. Previous estimates showed a baseline shortage of 39,600 doctors in 2015, but AAMC’s current estimates are closer to 63,000, with a worsening of shortages through 2025, including 29,000 primary care doctors and 33,100 physicians in specialties such as cardiology, oncology, and emergency medicine.
Some argue that the forecasting models used to determine these data overestimate this shortage because they assume that there is a set limit to the number of patients that a physician can handle. In the past, this was true; however, our health care system is changing. Doctors are increasingly joining large practices, where they are able to share staff and space. Also, the workforce itself is changing, and non-physicians such as physician assistants (PAs) are taking on additional responsibilities that free up time for doctors. With that in mind, the answer to your need for additional professional staff may be to hire a PA to expand your practice.
PAs are graduates of accredited PA educational programs who are nationally certified and state licensed to practice medicine under the supervision of physicians. PA educational programs are modeled on the medical school curriculum, with a combination of classroom and clinical instruction. The course of study is rigorous and intense, averaging 27 months, and admission to PA school is highly competitive.
Applicants must complete at least 2 years of college courses in basic and behavioral sciences as prerequisites, which is analogous to premedical studies required of medical school applicants. Most Physician Assistant programs include prerequisites such as chemistry, physiology, anatomy, microbiology, and biology, and a majority of programs require or prefer that applicants have prior healthcare experience. PA education includes instruction in core sciences: anatomy, physiology, biochemistry, pharmacology, physical diagnosis, pathophysiology, microbiology, clinical laboratory science, behavioral science, and medical ethics.
Graduation requirements include completion of more than 2000 hours of clinical rotations, with an emphasis on primary care in ambulatory clinics, physician offices, and acute or long-term care facilities. Rotations include family medicine, internal medicine, obstetrics and gynecology, pediatrics, general surgery, emergency medicine, and psychiatry. Practicing PAs participate in lifelong learning, and in order to maintain national certification, a PA must complete 100 hours of CME every 2 years.
PAs deliver a broad range of medical and surgical services, including:
- Conducting physical examinations/obtaining medical histories
- Diagnosing and treating illnesses
- Ordering and interpreting lab tests
- Performing procedures
- Assisting in surgery
- Prescribing medications
- Providing patient education and counseling on preventive health
- Making rounds in hospitals and nursing homes
PA-provided services are covered by all government-funded public payers and nearly all private payers. Each payer has its own guidelines regarding service coverage and payment. Medicare pays for medical and surgical services provided by PAs at 85% of the physician fee schedule in all practice settings, and certain services are reimbursed at 100%.
So before you begin interviewing potential physician candidates to grow your practice, consider the value of hiring a PA.
- Kliff S. Doctor shortage? What doctor shortage? Washington Post Web site. http://www.washingtonpost.com/blogs/wonkblog/wp/2013/01/15/doctor-shortage-what-doctor-shortage/.
- The PA profession. American Academy of Physician Assistants Web site. http://www.aapa.org/the_pa_profession.aspx.
- Physician shortage to quadruple. Modern Medicine Web site. http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Now/Physician-shortage-to-quadruple/ArticleStandard/Article/detail/697162.
- Rosenberg SM, Rosenthal DA, Rajan DK, et al. Position statement: the role of physician assistants in interventional radiology. J Vasc Interv Radiol. 2008;19(12):1685-1689.
- What is a PA? American Academy of Physician Assistants Web site. http://www.aapa.org/the_pa_profession/what_is_a_pa.aspx.