Commentary
The Power of Two: Revisiting PA Autonomy
A thriving PA-physician relationship has been the cornerstone of quality care. So, are we threatening to uproot the foundation of the profession...
Predicting the future, particularly in the ever-changing realm of health care, is always a gamble. The variables with the potential to impact health care—among them, unpredictable political agendas, unforeseen economic upheaval, and technological issues—make it difficult to identify one “expected” outcome. However, one forecasted trend will certainly make a difference: the quantity of well-educated health care practitioners.
This factor will be one of the most important determinants of our ability to deliver quality, accessible health care in a diverse society with increasingly complex medical needs. Some may say that this is an irrational fear—the US health care system is remarkably adaptable, and as far as we can tell, no serious problems have arisen due to a shortage of providers. So are we overreacting, or is there a viable reason for concern?
While more and more Americans are covered by health insurance thanks to the Affordable Care Act, fewer physicians are entering primary care. The Association of American Medical Colleges (AAMC) has projected a shortage of between 46,000 and 90,000 physicians by 2025. AAMC forecasts a shortage of 12,500 to 31,100 primary care physicians and 21,200 to 63,700 non–primary care physicians; much of the latter deficit will be in the surgical specialties.1 The report emphasizes the need for immediate action because it takes almost a decade to educate a physician for entry into the workforce.
On the surface, these numbers are quite staggering. They may even elicit a sense of doom about access to quality (or even simply adequate) health care in the next decade. To put these projections in context, here are some key statistics
- About 915,000 physicians actively practice in the US.2
- Each year, about 20,000 medical school students graduate and enter postgraduate education.3
- Thirty percent of physicians are older than 60.2
- In 2015, there were 100,000 practicing PAs, with an average age of 38.4
- As of 2016, there are 222,000 practicing NPs, with an average age of 49.5
The US population is projected to increase from 310 million in 2015 to 335 million in 2025.6 There are approximately 45 million Americans older than 65, a number that is projected to increase to almost 70 million by 2025.7,8