Physician assistants (PAs) are increasingly choosing to work in hospitals over office-based practices, according to a report issued last week by the National Commission on Certification of Physician Assistants (NCCPA). While this may seem like welcoming news to those in the industry (especially as PA ranks swell to fill essential gaps during the COVID-19 pandemic), reality paints a different picture.
The NCCPA says that approximately 10,000 newly-certified PAs entered the healthcare marketplace last year. And geographically, states with the largest certified PA numbers include some hit hardest by COVID-19, including New York and California. However, PAs have been among the most challenged to adapt to the pandemic:
- A survey released last week by the American Academy of Physician Assistants (AAPA) reveals that significant numbers of respondents have tested (52 percent), diagnosed (47 percent) and/or treated (40 percent) COVID-19 patients.
- More than one in five PAs are currently furloughed and nearly four percent have had their jobs terminated.
- Findings also show that an additional 58 percent have seen their work hours reduced, and roughly 31 percent have been forced to take a reduced base pay.
Loosening restrictions, new opportunities
One of the most important revelations to emerge from the crisis is the need for broadly-skilled clinical professionals. PAs are trained as generalists, able to work across disciplines, provide essential medical and surgical care and help comfort family members and caretakers. However, almost a third of PAs also work in secondary positions that mimic their primary; NCCPA data show this most commonly occurs in emergency medicine, a speciality that accounts for 51 percent of dueling responsibilities.
The coronavirus outbreak has revealed cracks in the healthcare industry’s overall organizational framework and ability to protect providers in extreme circumstances. During the pandemic, traditional hospital income generators – such as routine surgeries and outpatient visits – have been altered, delayed or permanently postponed, resulting in financial shortfalls.
Yet, there is a silver lining: this past March, Health and Human Services Secretary Alex Azar called on U.S. governors to issue executive orders that would waive physician supervision or collaboration requirements during the COVID-19 pandemic. At last count, eight states (Maine, Michigan, New Jersey, New York, Louisiana, South Dakota, Tennessee and Virginia) have risen to charge. Concurrently – and in a move to ease healthcare facility capacities – the March passage of the Health Care Planning Improvement Act enabled PAs to order home healthcare services for Medicare patients.
What’s on the horizon?
Still, there’s more to do. The ability to transcend and move between traditional silo specialties reinforces the PA’s valued role in health care, especially in the midst of the current crisis. But overstrained hospital resources, coupled with financial uncertainties, may be a harbinger for tough times ahead. The COVID-19 pandemic may trigger a much-needed change in how the nation thinks about healthcare and its essential workforce, including a resurrection or broader expansion of the U.S. Public Health Service. In the interim, eased restrictions may ultimately provide new pathways that allow PAs to address lost incomes and fill essential, yet-to-be realized clinical gaps.
- 2019 Statistical Profile of Certified Physician Assistants Annual Report. National Commission on Certification of Physician Assistants.
- AAPA Releases First National Survey of Physician Assistants on COVID-19 Crisis. American Academy of PAs.
- COVID-19 State Emergency Response. Suspended/Waived Practice Requirements. American Academy of PAs.
- Federal COVID-19 Emergency Legislation Authorizes PAs to Order Home Health Services. American Academy of PAs.