Increasing Patient Access to Care by Empowering Physician Assistants

Objectives: The accessibility and affordability of health care is key to improving population health. In the U.S health system, physician assistants (PAs) are health professionals licensed to practice medicine with physician supervision. In this study, we will discuss how PAs can help to socio-geographically balance health services and increase access to less costly care if they are regulated to do so from a policy perspective.

Methods: Socio-geographical patterns of practicing physicians and PAs in the U.S. were examined with data from the U.S. Health Resources and Services Administration, the U.S. Census and the national PA database maintained by the American Academy of Physician Assistants.

Results: PA profession was historically established to meet the high demand and subsequent physician shortages. However, rather than distributed to areas with high physician shortage and health needs, we found PAs are geographically distributed in a way that is proportional to physicians across the country. The low PA density areas--such as Mississippi (3 PAs per 100,000 population) and Arkansas (5 PAs per 100,000 population)--are those with high poverty and poor population health, and thus high health care needs. In other words, physician assistants neither work proportionally in those medically underserved areas nor fill the demand gap from physician shortages.

Discussion: The PA profession is experiencing rapid growth in the U.S. To be brought to patients in great needs, PAs should be allowed to practice medicine in locations of their choice and be overseen by their supervisory physicians in less formal ways rather than physically with their supervising physicians. In addition, health services provided by PAs need to be clearly priced before patients so that patients know the financial benefits to see PAs and can choose right type of health service providers based on both their disease complexity and financial affordability.