National Rural Physician Assistant Content of Care Study


    Background: In the 1970s, graduates of physician assistant (PA) programs practiced largely in primary care settings serving rural and other underserved populations. By the 1990s, PAs were practicing in a much wider variety of settings in many medical specialties. Aim: To describe the demography, practice arrangements and content of practice of a nationally representative sample of PAs collected in the 1990s. Methods: A stratified random sample of PAs was surveyed in 1993-1994. The demography, practice characteristics and content of PA practice were analyzed across practice location and medical specialty. Results: Of all the living PAs ever trained, 95% were active in the health care delivery system at the time of the survey. Eighty-seven percent of those trained were practicing as PAs, nearly all of whom were practicing full time. Rural PAs were more likely to be white and male than their urban counterparts and had lower levels of education prior to entering PA training. Generalist PAs performed many more outpatient visits than specialist PAs, and fewer inpatient visits. In urban areas, PAs were making a large contribution to surgical care. About three-fourths of the rural PAs were generalists. Conclusions: The broader scope of practice of generalist PAs, especially those serving rural populations, points to the need to ensure that training programs, especially those emphasizing generalist care for rural and underserved populations, provide sufficient breadth in medical training to meet those needs. Funded by HRSA’s ORHP.

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