New patterns of practice of Utah physicians assistants

Physician assistants (PAs) have become an integral part of the United States (U.S.) health care system since the profession began in the late 1960s. Physician assistants have been suggested as the solution to predicted physician shortages, especially in primary care. Utah has experienced unprecedented growth in the profession over the last 10 years. This study will determine the new patterns of physician assistant practice in the state of Utah. A cross sectional survey design was utilized. A paper-based survey tool was mailed to 700 physician assistants practicing in Utah. The survey was sent from October 2008 through January 2009. The outcome variables of interest were practice specialty (primary care versus specialty practice) and practice location (urban versus rural). The predictor or independent variables were age, gender, number of years in practice, location of upbringing, and professional school of graduation. The survey was developed by a group of PA stakeholders based on the literature and relevant clinical and academic experiences. There was a response rate of 67.7%. The Utah Division of Occupational and Professional Licensing (DOPL) provided the list of licensed PAs in the state, while population projections were used from the Utah Governor's Office of Planning and Budget (GOPB). iv Projection models for PAs in the state of Utah were developed using methods adapted from the Association of American Medical Colleges (AAMC) Center for Workforce Studies. One model used data on the number of PAs currently in practice, the current utilization of PAs in primary care and specialty care, and future population estimates by age from the GOBP. The second model used data about the number presently in practice and the number that leave the profession through retirement, attrition or death. Practice patterns are shifting to specialty practice and urban environments in Utah. Physician assistants brought up in a rural area were more likely to practice in rural environments. Female PAs had lower odds of practicing in a rural area. Age and years of practice was not significantly associated with predictors of rural practice. Female PAs had lower odds of practicing in primary care versus their male counterparts. PAs had lower odds of practicing primary care if they reported a rural upbringing. Graduation from the Utah PA Program was more likely to result in primary care practice.