One reality of healthcare in America is that many Americans lack reliable access to a regular source of primary healthcare in their communities. According to the National Association of Community Health Centers, 60 million Americans — nearly one in five — lack adequate access to primary care due to a shortage of primary-care physicians in their communities.
It takes a significant amount of time and resources to train physicians, and there is a significant disparity between primary-care physicians and specialty physicians, with physicians entering primary-care specialties at a fraction of the projected present and foreseeable future need.
We have seen the same problem in the physician assistant profession. Our training is in primary care at its base, and we practice medicine in teams led by physicians. As physicians increasingly specialize, it makes sense that PAs follow their physician team members into specialty practice. We did not, and could not, have envisioned the diversity of current specialty PA practice when the PA profession was envisioned in the 1960s. PAs were initially seen as a good use of highly trained military medics and corpsmen to expand the ability of organized medicine to address the ever-present shortage of primary-care practitioners.
It seems as we have come full circle. One of many provisions of the Affordable Care Act addresses the need to educate more primary-care providers. On Aug. 2, HHS Secretary Kathleen Sebelius, announced $2.3 million in grants to train primary-care physician assistants and help veterans transition from the military to civilian PA careers when they return home. “If you can save a life on the battlefield in Afghanistan, you can save a life here at home,” said Sebelius. “These grants will help ensure veterans who served our country can use their military medical training and get good jobs serving patients.”
As a PA, I know firsthand that this is a great use of highly trained and experienced military medical veterans to help to rectify the domestic primary care provider shortage problem. It is a win-win.
This $2.3 million in grants is a drop in the bucket when compared to need, however. Twelve PA training programs received a portion of this money to expand training of veterans in preparing them to enter the PA programs and help to solve the primary care provider shortage in the United States.
The human resource problem in medicine is complex, and requires a comprehensive and multifaceted approach to be successful. Training additional PAs just makes sense in solving a part of the problem, but we need to do more and quickly to make a dent in the challenges and problems of extending accessible and affordable care to millions of additional Americans.
Training more PAs is a critical part in the short- and long-term plans for addressing this challenge.
On average, programs that educate PAs at the master’s degree level can turn out PAs in an average of 27 months. Contrast that with physicians, who require a minimum of seven years of postgraduate education to reach practice. Ensuring adequate primary-care providers into the foreseeable future is a challenge that will require action at every level of the healthcare system, including significant government investment in educating healthcare providers.
Training a portion of our veterans to take up provider roles in the healthcare system is a great use and extension of the already excellent training of the medical personnel in our armed forces. The unemployment rate for veterans is unacceptably high. According to the U.S. Bureau of Labor Statistics, in 2011, the unemployment rate of young male veterans who had served since 9/11 was 29 percent — over 10 percent higher than the national average for that same male age group.
These grants may seem like a drop in the bucket when confronted with the overwhelming scope of the human resource problem in medicine, let alone unemployment in America. However, this is a step in the right direction in that it helps our deserving veterans, helps our healthcare system, and most importantly, helps our society move towards better health and well being of our citizens. Multiple wins no matter how you look at it, and a great use of our government resources.
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This blog was provided in partnership with the American Academy of Physician Assistants.