scholarly journals The Physician Assistant/associate Medical Workforce: 2020-2035

2021 ◽  
Author(s):  
Roderick S. Hooker ◽  
Violet A. Kulo ◽  
James F Cawley ◽  
Gerald Kayingo
Keyword(s):  
Health Care Professionals ◽  
Physician Assistant ◽  
Universal Access ◽  
Supply And Demand ◽  
Physician Assistants ◽  
Critical Parameters ◽  
National Commission ◽  
Medical Workforce ◽  
Shortage Of Physicians ◽  
The Mean

Abstract Background: Physician assistant/associates (PAs) are health care professionals whose roles expand universal access to a broad range of people across many nations. In the US, there is a growing shortage of physicians. PAs and advanced practice registered nurses (APRNs) were developed to help span medical providers' supply and demand gap. A forecasting project was undertaken to predict the likely census of PAs in the medical workforce spanning 2020 to 2035. Methods: Microsimulation modeling of the American PA workforce was performed using standard stock and flow format. The number of clinically active PAs employed in 2020 formed the baseline. Graduation rates and PA program expansion were factored as critical parameters to predict annual growth; attrition estimates balanced the equation. Two models, one based on data from the Bureau of Labor Statistics (BLS) and another based on data from the National Commission on Certification of Physician Assistants (NCCPA), were analyzed to estimate future annual PA numbers. Results: As of 2020, the BLS estimated 125,280 PAs were employed in the medical workforce; the NCCPA estimate was 148,560 PA in active practice. The mean age was 40, and 76% were female. The Accreditation Review Commission accredited 277 PA education programs for the Physician Assistant (ARC-PA), and 99% had a graduating class. The mean annual graduation cohort was 45. The BLS model predicted approximately 204,243 clinically active PAs by 2035; the NCCPA-based model predicted 211,537 PAs in clinical practice. Conclusions: A physician assistant/associate predictive model based on two data sources projects the supply of PAs by 2035 between 204,000 and 212,000: a growth rate of ± 35% (3.5% model differences). If the most likely scenario is realized, the 15-year growth of the PA will help improve the gap in the supply and demand of American medical service.

Planning for the Future: The Role of Nurse Practitioners and Physician Assistants in Survivorship Care

2012 ◽  
pp. e56-e61 ◽  
Author(s):  
Mary S. McCabe ◽  
Todd Alan Pickard
Keyword(s):  
Nurse Practitioners ◽  
Supply And Demand ◽  
Physician Assistants ◽  
The United States ◽  
Health Care Team ◽  
True Value ◽  
Shortage Of Physicians ◽  
Patients At Risk ◽  
Increase In Productivity

Overview: The number of cancer survivors in the United States now approaches 12 million individuals, with an estimated 7.2% of the general population aged 18 years or older reporting a previous cancer diagnosis. These figures highlight a number of questions about the care of survivors—how patients at risk for a known set of health problems should be followed, by whom, and for how long. At the same time that oncologists are developing strategies to provide services to this growing population, there are economic and systems challenges that have relevance to the previous questions, including a predicted national shortage of physicians to provide oncology services. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as members of the health care team who can help reduce the oncology supply and demand gap in a number of ways. The ASCO Study of Collaborative Practice Arrangements (SCPA) in 2011 concluded that oncology patients were aware and satisfied when their care was provided by NPs and PAs; there was an increase in productivity in practices that utilized NPs and PAs; utilizing the full scope of practice of NPs and PAs was financially advantageous; and, physicians, NPs, and PAs are highly satisfied with their collaborative practices. Increasingly, the oncology and health policy literature contains evidence supporting innovative provider models. There is still much work to be done to move beyond pilot data to establish the true value of these models.

scholarly journals Determinants of the physician assistant/associate concept in global health systems

2018 ◽  
Vol 4 (1) ◽  
pp. 50 ◽  
Author(s):  
James F. Cawley ◽  
Roderick S. Hooker
Keyword(s):  
Health Systems ◽  
Policy Development ◽  
Physician Assistant ◽  
Physician Assistants ◽  
Government Officials ◽  
Medical Needs ◽  
Workforce Policy ◽  
Shortage Of Physicians ◽  
Population Ratio ◽  
The 1960S

Introduction: A global shortage of doctors has led to strategies to improve access to care. The physician assistant/associate (PA) was established in North America and Africa in the 1960s in response to medical shortages. PA activity was cataloged to understand what determines their utilization in a country’s health system.Methods: A mixed-method study design began with searching the available literature regarding the development of PAs worldwide. Key words included “physician assistants”, “non-physicians”, “physician associates”, and “advanced practice providers”. Additional data was through an online search of reports; personal communications with researchers, policymakers, government officials, and practitioners in each country; visits by the authors to a number of the countries; and a review of official documents. In each country interviews included educators, policymakers and government officials who had direct involvement with the introduction of the PA concept, and clinically active PAs. Domain analyses were based on stratification of differences among countries: global region, income, physician to population ratio, attitudes of medical professionals, and practice/regulatory authority. Countries were segmented into two categories: well resourced and less well resourced.Results: The history and status of the PA concept into the health systems of 15 states were reviewed. The determinants for the successful incorporation of PAs include prevailing medical needs, a shortage of physicians or an aging physician workforce; support and sponsorship by physician organizations and government agencies; the ability to mobilize and establish a legal and regulatory framework to accommodate PAs; and evidence that their introduction is acceptable to patients, physicians, and other health professionals.Discussion: The introduction of PAs into health systems occurs because their education is less expensive and time intensive than physicians. In addition, graduates are more likely to occupy roles where there is scarcity of doctors such as in rural and underserved areas. In most instances, a physician-dependent role permits their introduction into health systems in a non-threatening manner to doctors and their practices. The utilization of PAs, particularly in primary healthcare roles, increases access to services, is cost-beneficial, and shows a physician-equivalent quality of care.Conclusion: The PA has been a remarkable health workforce policy development that has spread among countries’ health systems and is likely to continue.

Physician Assistant – Informierend

ergopraxis ◽  
2020 ◽  
Vol 13 (09) ◽  
pp. 53-53
Keyword(s):  
Physician Assistant ◽  
Physician Assistants

Die neue Zeitschrift richtet sich an Interessenten, Studierende und im Beruf tätige Physician Assistants (PA).

Information Visualization to Assist in the Audit of Supply and Demand for Exams at a Cooperative of Health Care Professionals

2020 ◽  
Author(s):  
Luiz Felipe de Camargo ◽  
Evandro Cesar Estevam ◽  
Luiz S.S. Baglie ◽  
Fabricio Quintanilha Baptista ◽  
Fabricio Baptista ◽  
...  
Keyword(s):  
Health Care ◽  
Information Visualization ◽  
Health Care Professionals ◽  
Supply And Demand

Correlates of Ageism Among Health Care Professionals Working With Older Adults

2018 ◽  
Vol 30 (3) ◽  
pp. 303-312 ◽  
Author(s):  
Ziyafet Uğurlu ◽  
Sultan Kav ◽  
Azize Karahan ◽  
Ebru Akgün Çıtak
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Data Analysis ◽  
Health Care Professionals ◽  
Educational Status ◽  
Descriptive Study ◽  
Descriptive Statistics ◽  
The Mean ◽  
Student’S T ◽  
Student’S T Test

Introduction: The changing proportion of older adults in society necessitates the need to determine the attitudes of health care professionals toward older adults. The purpose of this study was to explore attitudes of ageism and its correlates among health care professionals working with older adults. Method: This descriptive study was conducted in seven hospitals in five cities in Turkey. A total of 628 health care professionals participated in this study. The Fraboni Scale of Ageism (FSA) was used to collect data. Descriptive statistics, student’s t test, one-way analysis of variance and multivariate linear regression were used for data analysis. Results: The mean total score from the FSA was 56.9 ( SD = 8.0). Education (β = −.18, p < .001) and difficulty with the care of older adults (β = −.10, p < .05) were statistically significant predictors of the FSA score. Conclusions: The attitudes of health care professionals toward older adults were generally positive and affected by difficulty in providing care and the educational status of the health care professionals.

scholarly journals Determination of the Firing Pin Critical Velocity and the Critical Power in the Percussive Initiation of Primer Caps

2016 ◽  
Vol 7 (4) ◽  
pp. 33-66
Author(s):  
Andrzej FARYŃSKI ◽  
Andrzej DŁUGOŁĘCKI ◽  
Jarosław DĘBIŃSKI ◽  
Łukasz SŁONKIEWICZ
Keyword(s):  
Experimental Data ◽  
Critical Velocity ◽  
Hot Spot ◽  
Pulse Power ◽  
Critical Parameters ◽  
Simplified Model ◽  
Initiation Mechanism ◽  
The Mean ◽  
Institute Of Technology ◽  
Explosive Reaction

This work involved testing of the probability of initiating a KWM-3 type of primer cap as a function of the firing pin velocity upon impact. The tested firing pin was accelerated to the required velocity by a falling mass. The measurements under this work were made with a measurement system and methodologies developed at Air Force Institute of Technology (AFIT) in Warsaw (Poland). The percussive pulse velocity and power was altered by modifying the percussive mass to keep the initiating pulse energy constant at two levels: Ewe = 272 mJ and 343 mJ. The firing pin velocity values estimated by experimental data to bring a 50% probability of percussive primer cap initiation were within the interval vi50% = 0.34÷0.51 m/s. It was found that the mean primer cap ignition delay rose from approx. 0.7 ms at a percussion velocity of 1.5 m/s to 6 ms at 0.17 m/s. The experimental data suggest the values of Ewe x vi50% = 0.136. A simplified model was proposed for the deformation of the primer cap base and compressed pyrotechnical mixture shape. The model served to determine the approximate time trend for the penetration of the primer cap by the firing pin, including velocity, power and emitted energy, by assuming a complete energy transfer from the percussive mass to the primer cap. The mean initiating pulse power calculated from the model at the vi50% interval was Pavg = 120÷180 W, whereas the maximum initiating pulse power was Pmax = 170÷250 W. The calculated time values for firing pin penetration were very close to the aforementioned primer cap ignition delays at the respective velocity and percussive mass values. This indirectly indicates nearly complete energy transmission from the percussive masses to the primer caps. A location was identified within the compressed pyrotechnical mixture shape volume which could form the hot spot for initiation of the explosive reaction. Based on the calculation results using the simplified model, and assuming that the energy and diffusive heat flux output to and from the explosive reaction initiation hot spot were equivalent, the expression of Ewe x vi50% derived from the result was approx. 0.18. This means that the two critical parameters of primer cap initiation: (i) velocity, which can be identified with vi50% (and the respective power) and (ii) Ewe50%, i.e. the energy threshold below which the probability of primer cap initiation is less than 0.5, are interrelated. Aside from the initiation mechanism proposed and applied to calculate the firing pin critical velocity, this work discusses several other initiation mechanisms, all of which were ruled out during the testing process.

scholarly journals Preceptors in Medical Residency Programs: Epidemiological Profile and Pedagogic Training

2020 ◽  
Vol 44 (4) ◽  
Author(s):  
Aderval de Melo Carvalho Filho ◽  
Almira Alves dos Santos ◽  
Rozangela Maria de Almeida Fernandes Wyszomirska ◽  
Isabella Costa Figueiredo Medeiros
Keyword(s):  
Health Care Professionals ◽  
The State ◽  
Public Institution ◽  
Medical Residency ◽  
Residency Programs ◽  
Service Training ◽  
The Mean ◽  
Definition Of ◽  
Epidemiological Profile ◽  
Mean Time

Abstract: Introduction: Medical Residency is a specialization course characterized as in-service training, considered in Brazil as the gold standard in the development of specialist physicians’ training. The medical residency preceptorship is an activity carried out by a specialist physician, responsible for monitoring resident physicians. However, there is neither a definition of the main requirements for such a preceptor, nor of his/her academic background to carry out the due teaching training, and it was possible to notice a relative lack of preparation regarding the pedagogical aspects. Methods: Descriptive study based on a quantitative approach, comprising 200 preceptors, of both genders, from medical residency programs in Maceió, state of Alagoas, Brazil. Results: The mean age was 43.31 ± 10.31 years, with a slight majority of female participants (52.5%). The mean time since graduation was 19.5 ± 10.58 years, and 83% of the participants had graduated in the state of Alagoas. Moreover, 78.5% said they had their Medical Residency certification, with an increased trend of public institution preceptors getting their degree at the stricto sensu level. The mean time of their completed postgraduate course was 12.63 ± 10.87 years and 7.07 ± 6.99 years being a preceptor. Only 19% mentioned they had some qualification for exercising the preceptorship, and 29.5% work as the teachers at the undergraduate level. The state of Alagoas has followed the expansion of the Residency programs, justifying the mean age found, similar to other studies. The majority of female participants can be associated with the feminization of health care professionals. The high percentage of preceptors with medical residency qualification is in accordance with Resolution n. 4/1978. We found experienced preceptors, but some authors differed. The low percentage of preceptors with qualification for exercising preceptorship indicates low interest and lack of available training. Conclusion: This study population is characterized as being young, and most are females. They have had long professional experience, and most have graduated in the state of Alagoas. There is a predominance of medical residency as their main qualification, and few of them have had training in the field. Finally, preceptors from public institutions have mostly got their degrees at the stricto sensu level.

scholarly journals The Efficacy of an Antioppression Curriculum for Health Professionals

2019 ◽  
Vol 51 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Diana Wu ◽  
Lamercie Saint-Hilaire ◽  
Andrew Pineda ◽  
Danielle Hessler ◽  
George W. Saba ◽  
...  
Keyword(s):  
Health Care ◽  
Teaching Methods ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Health Care Disparities ◽  
Unconscious Bias ◽  
Survey Response Rate ◽  
The Mean ◽  
Skill Building

Background and Objectives: Health professionals increasingly recognize the role that social determinants play in health disparities. However, little focus is placed on how health care professionals themselves contribute to disparities through biased care. We have developed a curriculum based on an antioppression framework which encourages health professionals to evaluate their biases and combat health care disparities through an active process of allyship. Methods: Teaching methods emphasize skill building and include lectures, guided reflections, and facilitated discussions. Pre- and postsurveys were administered to assess participants’ confidence level to recognize unconscious bias and to be an ally to colleagues, patients, and staff. In total, we conducted 20 workshops with a total of 468 participants across multiple disciplines. Results: The survey response rate was 80%. Using a paired t-test, the mean difference in the pre- and postsurveys revealed a statistically significant improvement across all measures. Participants showed the greatest improvements (large effect size d&gt;0.8) in their understanding of the process of allyship, their ability to describe strategies to address, assess, and recognize unconscious bias, and their knowledge of managing situations in which prejudice, power, and privilege are involved. Conclusions: Results show that an antioppression curriculum can enhance health professionals’ confidence in addressing bias in health care through allyship. For those who value social justice and equity, moving from the role of bystander to a place of awareness and solidarity allows for one’s behaviors to mirror these values. Allyship is an accessible tool that all health professionals can use in order to facilitate this process.

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