We have been hearing about the doctor shortage for some time now. We’ve also been hearing that it’s going to get worse before it gets better. None of this is news to anyone who follows the healthcare industry and its employment numbers. And as always, talking about the doctor shortage inevitably leads to more discussion on physician assistants.
Most states regulate physician assistant jobs in such a way as to force PAs to be supervised by doctors. Very few give PAs total autonomy to practice up to the limits of their training and licensing. In light of the doctor shortage, this needs to change.
Creating and filling more physician assistant jobs in primary care would make a difference. Especially since primary care is where the doctor shortage problem is most severe. Fill the gaps in primary care and you have more physicians for other specialties.
Addressing the Drivers
Giving physician assistants greater autonomy does more than just fill the gaps in primary care. It does more than just put white-coated bodies in a clinical setting. Freeing PAs to work without supervision actually encourages them to go into primary care. In turn, this addresses the very things driving the doctor shortage.
1. Financial Concerns
One of the main drivers of the shortage are financial concerns among both educational institutions and healthcare facilities. Educational institutions lack the funding to expand their medical training programs. Meanwhile, healthcare facilities are constantly trying to stretch every dime. Hiring more doctors does not look good on the annual balance sheet.
Physician assistants are less costly to train and hire. Expanding training programs would get more clinicians into the field without requiring as much funding. As for healthcare facilities, they could save more money by hiring physician assistants to handle primary care.
2. Student Debt Relief
Crushing amounts of student debt are undoubtedly dissuading young people from becoming doctors. Who wants to graduate from college with hundreds of thousands of dollars in debt that could take decades to repay?
Again, physician assistants do not spend as much on their education and training. They don’t spend as much time in school, either. If the lower cost of training could be coupled with a combination of public and private sector subsidies, it could be easier to convince young people to pursue careers as physician assistants.
3. Expanding the Team Concept
Physician assistants are trained from the get-go to be part of a healthcare team. Just the fact that most states require them to be supervised by licensed physicians creates that team mentality. Likewise, promoting and expanding the healthcare team concept reduces the need for doctors to shoulder so much responsibility in primary care.
Physician assistant autonomy actually promotes the team concept by encouraging PAs to work more closely with nursing staff and other clinicians, rather than relying solely on a supervising doctor. PAs are much more likely to adopt the team concept because it is part of their training.
Slow Legislative Progress
Unfortunately, the states are making slow progress in improving physician assistant jobs by granting PAs autonomy. The COVID pandemic helped somewhat, encouraging states to suspend supervision requirements at least temporarily in order to guarantee patient care. But with the pandemic quickly being relegated to memory, state legislators are dragging their feet once again.
It is time to recognize that physician assistants are more than capable of providing primary care without supervision. Grant them autonomy and you change physician assistant jobs drastically. The result should be one of alleviating the doctor shortage in primary care. The solution seems so obvious, but there is still much resistance.