‘Tis the season for an influx of new grad physician assistants. The growth in PA training since I graduated in 1981 has been amazing. There are currently 156 PA programs in the U.S., with some 15,000 individuals in training at any given time. Each year, more than 6,000 individuals will graduate from those PA programs and join the 81,000 certified PAs currently in the workforce.
PA training averages about 27 months, with the majority of programs matriculating students at the master's level. About half of this training is spent in clinical rotation in a variety of inpatient and outpatient settings. All PAs are trained in general medicine, and must pass a PA national certification examination, administered by the National Commission on the Certification of PAs (NCCPA).
Physician assistants have the great fortune to perennially be in one of the hottest professions according to the folks who track these things each year (Money and Forbes, for instance, have ranked the profession and the degree number two and one respectively), and demand for PAs in clinical settings continues to grow rapidly. The Affordable Care Act is one reason for this need, since more people will be insured than we have the physicians, PAs, and nurse practitioners to serve them. This trend is projected to continue, and production of primary healthcare providers is a major crisis in healthcare reform.
That said, I spend a lot of time interacting with physicians each day, and the conversation many times finds its way to, “How do I recruit and hire a good PA?”
This is a very difficult question to answer easily. There are many reasons to hire a PA. PAs are acculturated in their training for team practice with physicians. The scope of practice of the PAs, in most states, is the scope of practice of the physician with whom they work. PAs can take on a heavy clinical and administrative workload in virtually any practice, in any setting. That alone makes hiring a PA a cost effective move for any busy physician practice in any specialty.
Perhaps the most important reason is that PAs are an important part of the healthcare team. I work in a busy surgical practice, in a hospital environment, and the demands on my surgeons’ time are routinely overwhelming. I do my best to keep my physician colleagues at the point of the sword in the OR, and shield them from the endless work of hospital medicine. Maybe that’s why they were so happy when I returned from my recent vacation.
Recruiting and hiring the right PA is a time consuming and expensive process. I used to have a staffing company in California, and I know this from first-hand experience. I can tell you what can make it a bit easier.
• Participate as a rotation site for a local PA program. There is no better way to screen and evaluate individuals than to actually work with them in the clinical setting. While PA students come to your practice with minimal costs attached, and with paid liability insurance, there are significant opportunity costs to precepting students. It takes time and significant effort to safely supervise medical students in training, and this may be overwhelming in a busy practice. But, I will tell you from long experience that many newly graduated PA go to work in the practices in which they train.
• Utilize word of mouth. Finding experienced PAs is equally hard, but the best place to start is with any PA colleague with whom you work and interact in your community. Put the word out to them and let the grapevine do its work. Many of the PAs working at our hospital are recruited in this manner.
• Contact your state’s PA organization or AAPA. All states have organizations representing PAs, and can both help in the job search and are a good place to advertising for a PA. These organizations — working with the national American Academy of Physician Assistants — can also help you understand the laws and regulations regarding PA practice in your jurisdiction, and how PAs are credentialed and licensed. Like their physician counterparts, there are also many specialty PA organizations.
• Contact local PA programs. Most states have PA training programs, and it is worth a call as most programs actively assist their graduates with placement.
We all struggle meeting the demands of our practices and the healthcare systems in which we work. All clinicians have to adapt to the ever-evolving healthcare environment. Healthcare reform, whatever ultimate form it takes, will add to the burden borne by those who practice medicine. I believe that PAs will be a strong part of the team-based solution to healthcare delivery into the foreseeable future.
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This blog was provided in partnership with the American Academy of Physician Assistants. For more information, visit www.aapa.org.