Physician and Advanced Practice Staffing

National Physician Assistant Week (October 6 – 12) is a good time to reflect on how PAs are making a difference for patients across the United States.

First and foremost, they are serving on the front lines of care during the coronavirus pandemic. PAs often are the first to diagnosis COVID-19 patients at physician offices, urgent care centers, minute clinics and other venues. They also serve in the emergency room and in intensive care, putting themselves at risk while treating the sickest coronavirus patients.

In addition, they are making it much easier for Americans to obtain timely access to care. In its June, 2020 study of physician supply and demand, the Association of American Medical Colleges (AAMC) projected that the nation would face a shortage of up to 139,000 physicians by 2033 – an unprecedented shortage that could seriously undermine patient access to care.

The shortage of physicians would be much more severe, however, without the presences of a growing number of PAs, as the AAMC clearly states in its study.

Contrary to popular perception, the physician shortage will not be confined to primary care. The AAMC indicates that by 2033 the nation will have up to 55,000 too few primary care doctors but more than 84,000 too few specialists. PAs are playing an important role in alleviating the shortage of both primary care doctors and specialists, as most PAs now practice in specialty areas.

In addition, the proliferation of the “convenient care movement,” which is most visibly reflected in the rapid construction of urgent care centers nationwide, would be virtually impossible without the services of PAs. Federally Qualified Health Centers (FQHCs), which now see close to 25 million underserved patients a year, were early adopters of the team-based model of care and employ PAs in comparatively high numbers.

Ninety percent of patients surveyed in a study conducted by the Harris Poll on behalf of the American Academy of Physician Assistants (AAPA), said PAs make it easier to get an appointment and improve quality of care, showing that the important role PAs play has not gone unnoticed by the public.

Merritt Hawkins is proud to recruit PAs to hospitals, medical groups, urgent care centers, FQHCs and other facilities across the country. We extend our best wished to PAs nationwide and welcome any comments readers may have on the role PAs are playing in today’s evolving healthcare system.

In 2008, Merritt Hawkins conducted its first national physician survey on behalf of The Physicians Foundation, a nonprofit seeking to advance the work of practicing physicians and help them facilitate the delivery of high-quality healthcare to patients.

Twelve years later, the Survey of America’s Physicians is established as one of the largest and most comprehensive physician surveys conducted in the United States. It provides benchmark data on physician morale and burnout levels, physician career plans and preferences, and physician practice metrics. Merritt Hawkins conducts the survey on a biennial basis for The Physicians Foundation and was set to do so again in April of 2020 when the coronavirus pandemic struck.

Given the impact of Covid-19, The Physicians Foundation determined to complete a special edition of the survey centered around the virus and how it has affected physicians and their patients. The survey was conducted in three parts. Each part focused on a different aspect of Covid-19. Part One, released in August, looked at how the virus has affected physician practices and their patients. Part Two, released in September, examined how the virus has affected physician well-being. Part Three released in October, reflects future steps physicians believe should be taken to improve the healthcare system in light of the pandemic.

Physicians responding to Part Three were asked to rate four different options for the healthcare system, as follows:

Q. Considering all relevant issues such as patient access, value and quality, health system efficiency, physician autonomy and compensation, and the COVID-19 public health response, what direction should the health care system take? Rank the options below 1-4, with 1 being the best approach.                                                                                                               

As these numbers indicate, 67% of physicians gave a two-tiered healthcare system featuring single payer insurance available to all, combined with private pay options the highest rating of one or two. The two-tiered option received the highest rating for all physician types, including males, females, primary care physicians and specialists, older and younger physicians and independent physicians and specialists. Other options, such as single payer/Medicare for All and a market-driven system, received some high ratings of one or two but a greater number of lower ratings of three or four.

When asked what immediate policy steps could be made to improve the healthcare system, physicians rated “streamlining/simplifying prior authorizations” as the most important step, followed by simplifying access to mental health services. Physicians also identified “adding more physician leaders” as a key step to be taken to enhance the healthcare system.

Part Three of the survey includes further data regarding how physicians view the importance of addressing the social determinants of health, limiting or eliminating surprise medical bills, determining the impact on drug costs of Pharmacy Benefit Managers (PBMs) and a range of other topics.

Combined with Parts One and Two, the 2020 Survey of America’s Physicians: Covid-19 Edition, offers valuable insights into how physicians on the front lines of care have been affected by the coronavirus pandemic, how they have reacted to it, and where they believe we should go from here.

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