Published: Monday, December 16, 2013 at 12:15 p.m.
Last Modified: Monday, December 16, 2013 at 11:53 a.m.
If you have a doctor’s appointment, chances are the first cloaked professional who greets you in the exam room will be a physician assistant .
And there’s an even better chance in the future.
The doctor is always in, however.
Physician assistants, better known as PAs, work under the supervision of licensed physicians, but they are North Carolina’s fastest growing clinical licensee group, according to a recent report by the North Carolina Medical Board.
From a group of 3,500 in 2009, PAs now number more than 5,000 across the state.
The NCMB expects the growth of PAs will continue, along with the much larger physician licensee population, which has grown about 10 percent over the past five years.
Myriad reasons are driving the PA population, according to medical professionals, not the least of which is the practice lends itself to a more flexible lifestyle and dynamic workplace as opposed to a physician, especially one in specialized care.
Jennifer Chapman, 34, a PA at North Davidson Center for Family Health, became a physician assistant because she wanted a family, time to spend with her children and to work in the medical field.
She saw first-hand what would be required to become a licensed physician, which led her to a career as a PA.
“Quite honestly, I saw what my husband was going through in medical school,” said the Denton native who is married to Dr. Brandon Chapman, an otolaryngologist at ENT Head and Neck Surgery — Lexington.
“I wanted the best of both worlds. That’s the beauty of the profession.”
The Chapmans have two children, ages 1 and 8.
Both graduated from East Carolina’s Brody School of Medicine. When Brandon was matched to a residency at Wake Forest Baptist Medical Center, Jennifer saw an opportunity to move back to Davidson County.
She began practicing as a PA at age 26.
“I love it. North Davidson is the first place I ever worked. I hope it’s the last,” she said.
Like other PAs, Chapman is trained in a wide variety of medicine. According to the Robert Graham Center, which analyzes the health care landscape, 43 percent of PAs in the United States practice in primary care, which is family medicine, general internal medicine and pediatrics
She notes that PAs do whatever their supervising doctors are comfortable with them doing.
“I can even do minor procedures, things like mole removals and sutchering,” she notes.
Reamer Bushardt, professor chairman of the department of physician studies at Wake Forest Baptist Medical Center, says one reason North Carolina may be seeing growth in PA practice is that the Tar Heel state is the birthplace of the field’s training grounds.
In fact, the NCMB lists four in-state PA programs among the top five in the country: Wake Forest School of Medicine; Duke University School of Medicine; East Carolina University; Methodist College.
“The laws and regulations are very favorable here,” Bushardt said.
The state’s metropolitan areas are experiencing the largest growth in PAs, according to the NCMB. Wake, Mecklenburg, Cumberland and Forsyth counties have seen the largest increase in the past five years.
Counties with more rural areas — Davidson, Bertie, Washington and Avery — experienced the largest decrease in PA population over the same period.
Bushardt notes that PA students generally tend to settle and begin practice in the regions in which they are trained, and most are trained in the metro areas. That’s the primary reason there are few PAs in rural areas. In response to that he points out that a new Wake Forest new distant campus will be located at Appalachian State University in Boone and affiliated with its College of Health Sciences.
“PAs can be used to extend the reach and access for patients by teaming up with physicians who are in areas of critical need, underserved communities,” he said.
The Affordable Care Act will also play a significant role in the influx of PAs.
Bushardt’s information from the Association of Medical Colleges indicates the Act will bring 32 million more insured patients into the spectrum as the nationwide health care focus begins a paradigm shift from treating diseases to preventative medicine.
“We’re starting to think beyond just treating the sick,” he said.
The complex piece of legislation will also have hospitals “reinventing themselves,” said Bushardt, as they deal with the influx of patients, which will be exacerbated by cuts in Medicaid, and subsequent expanding medical staff.
Already there is a shortage of primary care physicians and by 2020 the Association of American Medical Colleges predicts the deficit will grow to some 90,000.
Bushardt points to data from the Dartmouth Atlas Project that suggests the issue is not physician shortage but a distribution issue. “They say generally physicians do not practice in the areas of greatest need.”
The average salary for a PA in the southeast is around $80,000 per year, he said. A primary care physician can expect to earn $150,00 and above.
Bushardt is not only a teaching professional, he is also a practicing PA and researcher. “I love it,” he said.
Dwight Davis can be reached at 249-3981, ext, 226 or email@example.com.
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