Looking into tomorrow. Health workforce issues confronting physician assistants.

An important issue facing the physician assistant (PA) profession is how it can achieve a balance between supply of, and demand for, the services that PAs provide in the health workforce of the future. Recently, there has been debate and discussion about the implications of the recent expansion of the supply of PAs. In this article, we review and discuss (1) workforce data on physicians, PAs, and nurse practitioners and (2) projections of the number of these clinicians who will be trained in the future. We then analyze (1) data that describe the past 11 years of PA education and (2) data that address the experience of recent graduates of PA education programs who have sought employment. Some evidence suggests that, although demand has kept pace with expanding supply, a perception clearly exists that the PA job market may be tightening in some regions of the United States.

Implications for practice and education. Clinical activities of Iowa family practice PAs.

A survey of family practice physician assistants (PAs) in Iowa was undertaken to determine the frequency with which they utilized specific clinical skills. A response was received from 55 of 77 (74%) PAs surveyed. Average age of respondents was 42 years (range, 35 to 50). Respondents had, on average, been practicing for 13 years, mostly in family medicine; on average, they saw 25 patients a day. All reported providing patient education, prescribing and dispensing medication, interpreting radiographs, referring patients, and providing a wide range of services similar to their physician counterparts in Iowa. In regard to 62 activities identified, few differences emerged among respondents when population setting was considered--except that PAs who work in communities of fewer than 10,000 residents often perform a wider range of services than those who work in larger communities. Activities that have been ranked as important by Iowa family practice physicians in other surveys were also the clinical skills that PAs in this survey reported performing most often. This study supports mounting evidence that PAs are an important aspect of primary care delivery across society. Their activities in the delivery of care are similar to those that the physicians with whom they are most closely associated consider important.