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2012 Arizona Physician Assistant (PA) Workforce Survey

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A PROFILE OF ARIZONA’S PHYSICIAN ASSISTANT WORKFORCE

Key findings from the 2012 Arizona Physician Assistant Workforce Study


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ACKNOWLEGEMENTS

Created and conducted for the Arizona State Association of Physician Assistants (ASAPA) by

Randy D. Danielsen, PhD, PA-‐C, DFAAPA

Cynthia Reilly, MS, PA-‐C Michelle DiBaise, MPAS, PA-‐C

Appreciation is also extended to Linda Brozewicz, B.S., Data/Assessment Manager for the Arizona School of Health Sciences (A.T Still University), for her excellent data management and assessment skills to make this possible. Also thanks to current and past ASAPA leaders for their editing and content suggestions, particularly Michael Goodwin, Steve Nunn, and Chris Davis.


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Table Of Contents

Acknowledgements ................................................................................................................................... 2 Introduction ................................................................................................................................................. 4

Key Findings ................................................................................................................................................. 5 National Perspective On The Pa Workforce ................................................................................... 5

Arizona Perspective On The Pa Workforce .................................................................................... 6

Legislative History ................................................................................................................................ 6 Education ....................................................................................................................................................... 8

A.T. Still University PA Program ..................................................................................................... 8 Midwestern University PA Program ............................................................................................. 8

Northern Arizona University PA Program .................................................................................. 9

Employment .............................................................................................................................................. 10 Methods ....................................................................................................................................................... 10

Survey Administration ......................................................................................................................... 10

Key Findings .............................................................................................................................................. 10 Survey Data ................................................................................................................................................ 12

Conclusion .................................................................................................................................................. 57 References .................................................................................................................................................. 58


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Introduction For several decades, federal and state policymakers have been challenged with developing policies for tomorrow’s workforce. America is faced with a dwindling primary care workforce that is not meeting the healthcare needs of the country. In the next decade Arizona, like the rest of the United States, faces an expanding elderly population, but Arizona will also experience greater demands from a continuing disproportionate growth of population of all ages. Increased demands for the care of newly insured as a result of the Federal Patient Protection and Affordable Care Act will add stress to all patient care delivery systems. Physician Assistant (PA) employment growth is expected in order to provide care for the expanding patient population and healthcare needs of the aging in addition to increased chronic medical conditions from extended life spans. Health services research over the past 30 years has found that the introduction of the PA profession in the late 1960’s has been one of the successful strategies to expand the delivery of primary care, particularly in rural and underserved areas. PAs are certified healthcare professionals licensed to practice medicine, within the scope of practice of a licensed physician and specified by the medical practice act of their particular state. Within the physician-‐PA delegated-‐authority relationship, PAs may exercise relative autonomy in medical decision-‐making, providing a broad range of therapeutic services. To gain a better understanding of the characteristics of Arizona’s PA workforce, the Arizona State Association of Physician Assistants (ASAPA) surveyed PAs licensed in Arizona. This report presents a picture of the demographic attributes of Arizona PAs and highlights key findings as they relate to workforce policy. Specifically, this report discusses factors that are associated with:

1. Educational preparation

2. PAs in primary and specialty care

3. Practice settings of PAs

4. PAs contribution to primary care access in rural and other underserved areas

of the state

5. Barriers to expanding PA practice

6. Evolving supply of PAs


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National Perspective on the PA Workforce Table 1. Clinicians in the United States

2010 Numbers Total % of Total

Allopathic Physicians 921,904 77% Osteopathic Physicians 63,120 04% Physician Assistants 79,706 07% Nurse Practitioners 140,000 12%

Source: Daniesen, R, Ballweg, R, Vorcik, L, Sefcik, D (2012) The Preceptors Handbook for Supervising Physician Assistants, Page 9. Jones & Bartlett.

The U.S. Bureau of Labor Statistics (BLS) projects that the employment of PAs is expected to increase 30 percent from 2010 to 2020, much faster than the average for all occupations.

As more physicians enter specialty areas of medicine, there will be a greater need for primary healthcare providers, such as PAs, who have an increasing role in both primary and specialty care.

In addition, employment growth is expected because the large baby-‐boom generation is getting older. As they age, baby boomers will be increasingly susceptible to chronic conditions such as heart disease, stroke, and diabetes. Physician assistants are expected to have an increasing role in keeping these people healthy and caring for them when they get ill.

With 83,600 PA jobs in 2010, there is a predicted 30 percent increase to 108,300 by the year 2020.

Healthcare providers are also expected to use more PAs in new ways as states continue to allow increased autonomy and the ability to perform more procedures.1

In a primary care practice, PAs take medical histories and see patients, including examining, diagnosing and treating them, and ordering and interpreting labs tests and x-‐rays. PAs have prescriptive authority in all 50 states and work in virtually all health care settings. 2 Residents of rural communities who might otherwise be without a healthcare provider may have primary care access as a result of a PA-‐staffed clinic. PAs always work with a licensed physician, as required by state statute, and consult with their physician and other health care providers as needed.


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As reported by the National Commission on the Certification of Physician Assistants (NCCPA), the number of certified PAs on December 31, 2011, was 84,855 (54,678 females, 30,163 males, excluding 14 who did not report gender). Of interest is the number of certified PAs who are aged 60 years and older with 5,702 (males 3,687/2,015 females). The number of nationally certified PAs in Arizona was noted as 1,899. 3 Figure 1. Certified PAs in the United States (2011 Data)

Arizona Perspective on the PA Workforce Table 2. Health Care Providers in Arizona

Arizona Providers Number % # of licensed Allopathic physicians in Arizona* 22,250 76% # of licensed Osteopathic Physicians in Arizona** 1,743 06% # of licensed Physician Assistants in Arizona*** 2,214 08% # of licensed Nurse Practitioners in Arizona**** 3,000 10% *Source: Arizona Medical Board, Personal Communication Lisa Wynn, 11/25/12 **Source: Arizona Osteopathic Medical Board, Personal Communication Jenna Jones, 11/25/12 ***Source: Arizona Medical Board, Personal Communication Lisa Wynn, 11/25/12 ****Source: Arizona Nurse Practitioner Council, http://arizonanp.enpnetwork.com/


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Arizona PA Legislative History The PA profession was recognized and codified into law in Arizona in 1972. House Bill 2229 mandated that the Board (Joint Board of Medical Examiners and Osteopathic Examiners in Medicine and Surgery) adopt rules, regulations, and standards for the approval of PAs on or before January 2, 1973. In 1977 the Arizona legislature declared that health care personnel and facilities available to residents of rural and medically underserved areas of Arizona were inadequate to afford the basic elements of care necessary for their health and well being. Therefore, the legislature created an Act to enhance the level of healthcare available in rural and medically underserved areas by expanding the involvement of PAs. The impetus for addressing these concerns was Senate Bill 1372. Subsequently a PA regulatory program was established in broad terms under the joint control of the Board of Medical Examiners and the Board of Osteopathic Examiners in Medicine and Surgery. This statute granted the authority for PAs to prescribe and administer drugs for the first time in Arizona history. Administrative Rules were promulgated allowing PAs to write prescriptions for Schedule II and II medications for up to 48 hours and non-‐controlled substances for up to 30 days. These Rules provided the foundation for regulation of PAs through 1984. The 1984 Legislative session brought about significant changes for PAs in Arizona. House Bill 2449 repealed the Joint Board of Medical Examiners and Osteopathic Examiners in Medicine and Surgery and established the Joint Board on the Regulation of Physician Assistants (JBORPA). The Act created a nine-‐member Board that consisted of the Chair (Dean of the College of Medicine), two PAs appointed by the Governor, one public member appointed by the Governor, two Osteopathic physicians appointed by the Board of Osteopathic Examiners, and three Allopathic physicians appointed by the Board of Medical Examiners. This new Act in 1984 defined the PAs regulatory program by incorporating the current rules at the time into statute with an attempt to create a firm legal foundation for the regulatory program. Senate Bill 1322 (1988) made several minor changes to the Board and also made it an act of “unprofessional conduct” for a PA to use the term “doctor” or the abbreviation “Dr.” in a way that leads the public to believe the PA is licensed to practice as an Allopathic or Osteopathic physician. This Act also allowed for performance of healthcare tasks by a PA in a place, which was geographically separated from the supervising physician’s (SP’s) primary place for meeting patients if adequate communication was available, if the PA was appropriately supervised, and a printed announcement was posted in the waiting room. In 1993 a sweeping delegatory law was enacted. Senate Bill 1397 removed the requirement that the board approve a PAs performance and employment (called the “job description”) and instead stipulated that the Board approve the supervising physician (SP) through a “notice of supervision” (NOS) form. For the first time in


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Arizona history, SPs could delegate health care tasks directly to the PA following Board approval of the NOS. This Act also allowed the Chair (Dean of the Medical School) to appoint a designee to represent him or her on the Board. Additional criteria for “unprofessional conduct” were expanded. During the 1994 Legislative session, House Bill 2527 established the definition of minor surgery as those invasive procedures which may be delegated to a PA by an SP that were consistent with the training and experience of the PA which were normally taught in courses of training approved by the Board. This Act also removed the provision that prohibited PAs from prescribing parenteral preparations for use outside the place of employment or a health care institution. In 1998 further sweeping statutory changes (House Bill 2404) included reconfiguration of the Board to eliminate the requirement that the Board Chair be the Dean of the Medical School and added more Governor appointed PAs and two public members to the Board. Certification was changed to licensure. As a result of this legislative action, the Board was mandated to elect a chairperson and vice chairperson on an annual basis leading to the first PA elected chairperson of a regulatory board.4 In a process, which began with the filing of a sunrise application with the Arizona Legislature on September 1st, 2010, Senate Bill 1030 passed and was signed into law on April 19, 2011. This legislation, effective July 20, 2011, authorized Physician Assistants (PAs) to prescribe Schedule II and III Controlled Substances under the supervision of a physician for up to 30 days. 5

Arizona’s "PA Modernization Act" (HB 2021) Law went into effect January 1, 2011. The Modernization Act eliminated a requirement that physicians file a notice of supervision with the regulatory board, it removed a requirement that physicians designate an "agent" to supervise in the doctor's absence, it increased the number of PAs a physician may supervise at any one time from 2 to 4, and allowed weekly meetings required for PAs practicing in remote areas to be conducted via telecommunication.6


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Education Currently there are 170 accredited entry-‐level PA programs in the United States.7 Among these programs are three PA programs within Arizona: A.T. Still University, Midwestern University, and Northern Arizona University.

A.T. Still University PA Program

The Arizona School of Health Sciences (A.T. Still University) Physician Assistant Program (Circa 1995), located in Mesa, Arizona, is an entry-‐level, 26 month course of study that leads to a Master of Science degree upon successful completion. The first 14 months of the program consist of courses that develop a strong academic foundation for clinical practice and the remaining 12 months are supervised clinical rotations.8

Midwestern University

Midwestern University (Glendale Campus), circa 1996, PA program leads to a Master of Medical Science in Physician Assistant Studies (M.M.S.). This full-‐time 27-‐month professional program offers students the opportunity to earn a graduate degree and satisfy the eligibility requirements for the PA national certifying examination. The program is a combination of didactic and clinical education with the first 13.5 months covering a variety of didactic courses. During the remaining 13.5 months, students rotate through core clinical rotations and two elective rotations. The second-‐year clinical program is delivered at affiliated clinical sites and facilities. Students are required to complete a minimum of one clinical rotation in a rural/medically-‐underserved community.9

Northern Arizona University PA Program

The NAU PA Program is a collaboration between Northern Arizona University and the University of Arizona College of Medicine, located in Phoenix, Arizona. The program length is 24 continuous months, and courses are taught utilizing resources from the University of Arizona’s College of Medicine and Northern Arizona University College of Health and Human Services. The first year of curriculum consists of courses taught at the Phoenix Biomedical Campus, and the second year of curriculum includes supervised clinical rotations located in diverse geographical areas of Arizona, as well as regularly scheduled multi-‐day meetings at the Phoenix campus. 10


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Employment The 2012 PA Workforce Study ASAPA developed the 2012 Arizona Physician Assistant Workforce Study to identify and analyze key factors and issues affecting the supply and distribution of PAs in the state. The study included an examination of current PA workforce literature and a survey to collect primary data from PAs in Arizona. Methods Literature Review A review of recent literature was conducted to provide background on the physician assistant profession, to identify national trends in the PA workforce and to pinpoint key factors affecting the Arizona PA workforce. The 2011 National Physician Assistant Census Report (conducted annually by the American Academy of Physician Assistants), data from the National Commission on Certification of Physician Assistants (NCCPA), and data from the Accreditation Review Committee for Physician Assistants (ARC-‐PA) were useful in providing context for the 2012 Arizona PA survey data. Survey Administration In October 2012, ASAPA sent 2,052 emails to known licensed Arizona physician assistants (both ASAPA members and non-‐members) with a link to a Survey Monkey instrument. Only six emails “bounced back” leaving 2,046 viable emails. Key Findings Response Rates and Data Analysis ASAPA received completed surveys from 318 PAs, representing a 16% percent response rate. Profile of Arizona’s Practicing PAs

• 2,214 PAs were licensed to practice in Arizona in 2012 (Source: Arizona Regulatory Board of Physician Assistants)

Based on survey respondents to the AZ PA Workforce Survey: • 28% were aged 55 or older • 86.9% were White, non-‐Hispanic • 57.5% of respondents were female • 23% of respondents spent their childhood in a rural community


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• The majority of respondents (53.4%) spent their childhood in a suburban setting

• The majority of respondents (86.9%) listed their ethic racial background as White, Non Hispanic with multi-‐racial and Hispanic ranking second

• 6.6% were fluent in Spanish • 84.5% of the respondents reported only being fluent in English with 8.9%

noting other • The majority of respondents were either satisfied (36%) or very satisfied

(54%) with their career as a PA while only 25% and 1% were either very dissatisfied or dissatisfied

• The majority of respondents we either satisfied (50%) or very satisfied (29%) with their compensation as a PA while only 3 (1%) and 26 (9%) were either very dissatisfied or dissatisfied with their compensation

• Almost 90% of all respondents were members of the AAPA and a little over 80% were members of ASAPA

• Interestingly 38.8% of respondents felt that ASAPA’s membership fee (of $125 was too high with the next majority of 20% listing lack of membership benefits

• Respondents reported most commonly ‘to provide easily accessible job bulletin board’ as to what ASAPA could best do for them

• The majority of respondents had a bachelor’s degree prior to attending PA school

• The majority of respondents (43.8%) had EMT/Paramedic training before entering PA school while 45.4% listed other degrees

• 12% have a PA certificate • The highest number of respondents graduated from PA school in either 2010

(9.0%) or 2012 (9.0%) • 48.3% of respondents completed their PA program within Arizona with

Pennsylvania ranking as second (6.4%) and Texas (4.1%) as third • 25.2 % of respondents attended ATSU and 25.6% attended Midwestern

(Glendale) • Interestingly, a majority of respondents (22.2%) noted they did not have

school loans for PA School while the next majority (18.3%) had indebtedness of $60,001-‐80,000 followed by 12.9% of $80,001-‐100,000

• 5.2% of respondents do not have a DEA number while those that do have Scheduled II-‐V delegated to them

• 81.1% of respondents have MD’s as their supervising physician while only 18.9% have DOs


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Survey Findings What is your gender?

Answer Options Response

Percent Response Count

Female 57.5% 183 Male 42.5% 135

answered question 318 skipped question 0

In what year were you born?

Based on the respondents birth year: 14 respondents were in the Silent Generation or sometimes called the Traditionalist Generation (born 1925 through 1945, is the generation that includes those who were too young to join the service during World War II. 107 respondents were in the Baby Boom Generation is the generation that was born following World War II, (1946 up to 1964) a time that was marked by an increase in birth rates. The majority of the respondents (125) were Generation X (1965-‐1979) and is the generation generally defined as those born after the baby boom ended. Demographers, historians and commentators use beginning birth dates from the early 1960s to the early 1980s.

Female Male


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89 respondents (1980-‐2000) were Millennials, also known as Generation Y, Generation Next, Net Generation, Echo Boomers, describes the generation following Generation X who were born from 1982 to the early 2000s (decade).

Zero respondents were in Generation Z, also known as Generation I, or Internet Generation, the Pluralist Generation,, Generation AO (always on) or Generation Text.


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How would you describe the community in which you spent most of your chi ldhood? [Mark one box]

Answer Options Response Percent

Response Count

Urban 23.6% 74 Rural 23.0% 72 Suburban 53.4% 167


The majority of respondents (53.4%) spent their childhood in a suburban setting.

Urban

Rural

Suburban


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How would you describe your ethnic/racial identi f ication? [Mark the one box that most closely represents your ethnic/racial background]


Percent Response

Count

Multi-racial/multi-ethnic 3.5% 11 Native American or Alaska Native 1.9% 6 Asian 1.0% 3 Black/African American 1.9% 6 Hispanic/Latino 3.5% 11 Native Hawaiian or Other Pacific Islander 1.3% 4 White, not Hispanic 86.9% 273


The majority of respondents (86.9%) listed their ethic racial background as White, Non Hispanic with multi-‐racial and Hispanic ranking second.


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In what languages are you f luent?


Percent Response

Count

Only fluent in English 84.5% 267 Spanish 6.6% 21 Other 8.9% 28 (please specify) 33


84.5% of the respondent reported only being fluent in English with 8.9% noting other (See below). Arabic 1 Assyrian 1 Chaldean 1 Finnish 1 French 8 German 5 Portuguese 4 Russian 4 Sign Language 1 Spanish 12 Ukrainian 1

Only fluent in English

Spanish

Other


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How satisf ied are you with your career as a PA?

Very Dissatisf ied

Dissatisf ied Neutral Satisf ied Very Satisf ied

Rating Average

Response Count

5 4 20 103 152 4.38 284 answered question 284

skipped question 34

The majority of respondents we either satisfied (36%) or very satisfied (54%) with their career as a PA while only 25 and 1% were wither very dissatisfied or dissatisfied. Overall , how satisf ied are you with your compensation for your work as a PA?

Very

Dissatisf ied Dissatisf ied Neutral Satisf ied Very

Satisf ied Rating

Average Response

Count

3 26 32 141 82 3.96 284 answered question 284

skipped question 34

The majority of respondents we either satisfied (50%) or very satisfied (29%) with their compensation as a PA while only 3 (1%) and 26 (9%) were either very dissatisfied or dissatisfied with their compensation

0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50 5.00

0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50


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In general, how important do you think the fol lowing policies or regulations would be with regard to the abil i ty of PAs to practice successful ly in Arizona? [Mark the relat ive importance of each factor]

Answer Options Not

Important Somewhat Important

Very Important

Response Count

Enforceable reimbursement policies, applicable to the private insurance market, that establish reimbursement levels that reflect equal pay for equal work

2 47 231 280

State- or privately-sponsored incentives to establish PAs in practices in medically underserved areas, with off-site physician supervision

9 84 189 282

Increased access to state and federal loan forgiveness programs available to PAs who agree to practice in an underserved area of Arizona

12 70 198 280

Medicare statute revisions that clearly permit physicians to delegate to PAs the ability to order home health, hospice, and skilled nursing facility care, as well as provide hospice care

4 46 230 280

Statutory and/or regulatory changes that allow physician assistants as licensed practitioners (statutes currently only allow MDs, DOs, Dentists, Chiropractors, Podiatrist, and Naturopaths) to perform the positioning of the x-ray beam with respect to the patient, anatomical positioning of the patient, selecting exposure factors, and initiating the exposure without certification by the MRTBE.

59 106 116 281



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Indicate your memberships in the fol lowing professional organizations:


Percent Response

Count

American Academy of Physician Assistants (AAPA) 89.9% 223 Arizona State Association of Physician Assistants (ASAPA) 80.6% 200 PA Specialty Organization 23.8% 59 (please specify) 48


Almost 90% of all respondents were members of the AAPA and a little over 80% were members of ASAPA.

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0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

100.0%

American Academy of Physician Assistants (AAPA)

Arizona State Association of Physician Assistants

(ASAPA)

PA Speciality Organization


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I f not a member of the ASAPA, please indicate reason(s) for not joining:


Response Count

Membership fee is too high 38.8% 31 Lack of membership benefits 20.0% 16 Unhappy with leadership 3.8% 3 Simply not interested 12.5% 10 Other 37.5% 30 (please specify) 31


Interestingly 38.8% of respondents felt that ASAPA’s membership fee (of $125) was too high with the next majority listing other as a reason (see below). Cannot afford 3 Federal Employee 1 Forgot to apply 7 Not currently practicing 5 Not reimbursed by employer 4 Not sure 2 Out of State 3 Previous member 1 Retired 3 Unemployed 1

0.0% 5.0%

10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0%

Membership fee is too high

Lack of membership

benefits

Unhappy with leadership

Simply not interested

Other


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The top three things the ASAPA could do for me as a PA are:

Answer Options Response Count

113 answered question 113

skipped question 205 Response Text Categories

Allow ongoing schedule drug refills for PA's 3 Allow PA's to perform fluoroscopy 1 Begin a job share program 2 Benefits for being a member 2 Bring back PA week special events 2 Build relations with other organizations 2 Champion PA to MD/DO bridge programs 1 Change name to Physician Associate 7 Current problems that PA's are having 1 Decrease school acceptance into PA program 1 Do something for PA's in Flagstaff 1 Easily accessible job bulletin board 41 Educate community of PA's expertise 9 Educate on acceptable billing practices 1 Educate on liability issues 1 Forum for professional questions 3 Improve loan forgiveness opportunities 3 Improve practice environment 1 Increase compensation 6 Informed of changes that impact practice 11 Lobby for rights to write hospice orders 1 Lower membership fee to ASAPA 2 National/presidential recognition 1 Networking events 13 News articles 1 Organize a state medical outreach program 2 Orientation/Information for new PA graduates 3 Policy updates 3 Provide avenue to communicate to PA's across state 3 Provide better representation for PA's 5 Provide better resources 4 Provide high quality CME events 35


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Provide malpractice/liability insurance 8 Provide more volunteer opportunities in community 2 Support Affordable Care Act 3 Support medical marijuana 2 Updates on legislation and lobbying for PA's 37 Work to keep DEA and state license process simple 2 PRIOR to completing your PA education/training program, what other education degrees had you previously completed? [Mark al l that apply]


Percent Response

Count

Associate's Degree 20.7% 54 Bachelor's Degree 80.1% 209 Master's Degree 12.3% 32 Ph.D. 0.4% 1


The majority of respondents had a bachelor’s degree prior to attending PA school.

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

Associate's Degree Bachelor's Degree Master's Degree Ph.D.


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PRIOR to completing your PA education program, what other educational programs had you previously completed? [Mark al l that apply]


Percent Response

Count

EMT/Paramedic Training 43.8% 81 Medical Assistant Training 9.7% 18 Nursing Training 13.5% 25 Other Degree 45.4% 84 (please specify) 96


The majority of respondents (43.8%) had EMT/Paramedic training before entering PA school while 45.4% listed other degrees (see below). (please specify) Categories

Adult Assisted Living Care 1 Computer Information Systems 1 Athletic Training 2 Dental Assistant Training in Military 1 BA 4 Dietetic Technician 3 BA Psychology 3 EEG Technologist 1 BS 3 Engineering 1 BS in Biology 1 Kinesiology 1 BS in Biomedical Engineering 2 Lab Technician 3 BS in Education 2 MA Exercise Physiology 1 BS in Natural Science 1 MBS 1 BS in Nutrition 1 Medic 6 Business 2 Medical Assistant 1 Cardiopulmonary Perfusion 1 Medical Technology 5 Certified Tissue Banking Specialist 1 Military Medical Training 6 Certified Veterinary Technician 2 Military Training 2 CNA 11 MPH 1

0.0% 5.0%

10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0%

EMT/Paramedic Training

Medical Assistant Training

Nursing Training Other Degree


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MS 2 Physical Therapy 1 Nursing Assistant 5 Physiology 1 Ophthalmic Technician 2 Pre-‐Med BS Degree 1 Orderly and Research Therapist 1 Radiology Technology 1 Pharmacy Technician 2 Respiratory Therapist 3 Phlebotomy 3 RN 2 In what year did you complete your PA education/training program?

Response

Year Count Percentage

1970-‐1980 36 13%

1981-‐1990 29 11%

1991-‐2000 53 19%

2001-‐2012 159 57%

Total 277 100% The highest number of respondents graduated from PA school in either 2010 (9.0%) or 2012 (9.0%). In what state did you complete your PA education/training program? [Select from drop down box]


Percent Response

Count

AZ 48.3% 129 CA 3.0% 8 IL 3.0% 8 NE 2.2% 6 NY 2.2% 6 NC 3.0% 8 ND 2.6% 7 OH 2.6% 7 OK 2.2% 6 PA 6.4% 17 TX 4.1% 11 48.3% of respondents completed their PA program within Arizona with Pennsylvania ranking as second (6.4%) and Texas (4.1%) as third.


25

What is the name of the PA education program where you completed your init ial training? [Mark one box]


Percent Response

Count

A.T. Still University 25.2% 64 Midwestern University (Glendale) 25.6% 65 Other 49.2% 125 (please specify) 145


25.2 % of respondents attended ATSU and 25.6% attended Midwestern (Glendale).

A.T. Still University

Midwestern University (Glendale)

Other


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Which of the fol lowing describes the degree or cert i f icate you were awarded upon COMPLETION of your init ial PA training? [Mark one box]


Response Count

PA Associate's Degree 5.4% 15 PA Bachelor's Degree 22.6% 63 PA Master's Degree 58.1% 162 PA Certificate 11.8% 33 PA Military Training Certification 0.4% 1 Other 1.8% 5 (please specify) 5


58.1% of respondents received a master’s degree from their PA Program with 22.6% receiving a bachelor’s degree.

PA Associate's Degree

PA Bachelor's Degree

PA Master's Degree

PA Certificate


27

What is the highest degree you have completed to date ( including PA and non-PA related education)? [Mark one box]


Percent Response

Count

Associate's Degree 5.0% 14 Bachelor's Degree 18.3% 51 Master's Degree 71.9% 200 Ph.D./Ed.D/DHSc 1.1% 3 Professional Doctorate [e.g. MD, DO, DrPh, PsyD] 1.8% 5 Other 1.8% 5 (please specify) 11


71.9% of respondents listed a master’s degree as their highest degree completed to date with 18.3% listing bachelor’s degree. Only 1.8% listed a doctoral degree.

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0%

Associate's Degree

Bachelor's Degree

Master's Degree

Ph.D./Ed.D/DHSc

Professional Doctorate [e.g. MD, DO, DrPh, PsyD]

Other


28

What was your total loan indebtedness for your init ial PA education/training program? [Do not include loans incurred to complete prerequisite coursework -- mark one box]


Response Count

Did not have loans 22.2% 62 $20,000 or less 12.2% 34 $20,001 to $40,000 9.0% 25 $40,001 to $60,000 7.5% 21 $60,001 to $80,000 14.3% 40 $80,001 to $100,000 12.9% 36 $100,001 to $120,000 8.2% 23 More than $120,000 13.6% 38


Interestingly, a majority of respondents (22.2%) noted they did not have school loans for PA School while the next majority (18.3%) had indebtedness of $60,001-‐80,000 followed by 12.9% of $80,001-‐100,000.

0.0%

5.0%

10.0%

15.0%

20.0%

25.0% Did not have loans

$20,000 or less

$20,001 to $40,000

$40,001 to $60,000

$60,001 to $80,000

$80,001 to $100,000

$100,001 to $120,000

More than $120,000


29

Which Cert i f icates of Added Quali f ications (CAQ), awarded by the National Commission of Cert i f ication of Physician Assistants (NCCPA), do you have currently? [Mark al l that apply]


Percent Response

Count

I do not have any CAQs currently 98.5% 260 Cardiovascular and Thoracic Surgery 0.0% 0 Emergency Medicine 1.1% 3 Nephrology 0.0% 0 Orthopedic Surgery 0.4% 1 Psychiatry 0.0% 0


98.5% of respondents do not have a CAQ (NCCPA) while 1.1% had a CAQ in Emergency Medicine and 0.4% in Orthopedic Surgery.


30

Are you currently employed in Arizona in one or more cl inical PA posit ions?


Percent Response

Count

Yes [Go to Q23] 85.8% 236 No [Go to Q22] 14.2% 39


85.5% of respondents are employed in Arizona in one or more clinical PA positions while 14.2% are not. (Responses for No are listed below) I f you have answered NO to Q21, which factors have contr ibuted to your decision not to practice in a cl inical sett ing as a PA at this t ime? [Mark al l that apply - when complete go to Q55]


Percent Response

Count

I practice as a PA in another state 30.80% 12 Other 20.50% 8 I retired from the active workforce 17.90% 7 I'm employed in a PA educational program 15.40% 6 There are no PA positions available 7.70% 3 Maternity leave or other family responsibilities 5.10% 2 I'm currently pursuing additional education 2.60% 1 Work is not professionally challenging 2.60% 1 Insufficient wages 2.60% 1 I'm employed in a primary care setting that does not utilize my PA training

0.00% 0

I'm employed in a health-related position that does not utilize my PA training

0.00% 0

Lack of respect for PAs by physicians and employers

0.00% 0

My health does not allow me to work as a PA 0.00% 0 answered question 39

skipped question 279

Yes [Go to Q23]

No [Go to Q22]


31

I f you have a current DEA number, which of the fol lowing schedules are you delegated by your supervising physician to prescribe? [Check al l that apply]


Percent Response

Count

Schedule II 90.7% 245 Schedule III 90.0% 243 Schedule IV 87.0% 235 Schedule V 81.9% 221 I do not have a DEA number 5.2% 14


A small number of respondents (5.2%) do not have a DEA number while those that do have Scheduled II-‐V delegated to them. I f you marked NO to having a current DEA number, why? [Mark al l that apply]


Response Count

I have no desire to write prescriptions for controlled substances

0.0% 0

I do not need to write prescriptions for controlled substances in my current position(s)

46.7% 7

The fee for acquiring a DEA number is too costly 6.7% 1 Other reason 53.3% 8 (specify, e.g. retired) 6


0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

100.0%

Schedule II Schedule III Schedule IV Schedule V I do not have a DEA number


32

How many years have you worked or did you work in a clinical position as a PA?

Response Years Count Percentage 0-‐10 118 49%

20-‐Nov 70 29% 21-‐30 27 11% 31+ 27 11%

Total 242 100%

The majority of respondents have worked in their clinical practice for 10 years or less. How long have you been practicing as a PA in your current clinical practice?

Response Years Count Percentage 0-‐10 160 80%

20-‐Nov 30 15% 21-‐30 7 4% 31+ 3 1%

Total 200 100%

The majority of respondents have worked in their current clinical practice 10 years or less.


33

In addit ion to your primary cl inical PA posit ion, are you employed in another posit ion as a PA? [Mark one box]


Response Count

Yes, I work in two or more clinical PA positions 16.4% 41 Yes, I work in both clinical and non-clinical (e.g. faculty in PA program) PA positions 7.2% 18

No, I work in only one clinical PA position 76.4% 191 answered question 250

skipped question 68

76.4% of all respondents work in only one clinical PA position while 16.4% work in two or more positions. 7.2% work in non-‐clinical positions.

Yes, I work in two or more clinical PA positions

Yes, I work in both clinical and non-clinical (e.g. faculty in PA program) PA positions

No, I work in only one clinical PA position


34

I f YES to Q27, which of the fol lowing best describes the reason you are employed in more than one PA posit ion? [Mark al l that apply]


Response Count

To supplement the earnings from my primary clinical PA position 45.8% 27

Wasn't offered full time work in my primary clinical PA position

6.8% 4

To gain experience in a different aspect of clinical care 27.1% 16 Enjoy working in various clinical settings 39.0% 23 Other 15.3% 9 (please specify) 8


Other (please specify) National guard 1 Practice and adjunct faculty 1 See patients who I cannot contract with 1 To supplement earnings 1 To work in education 1 Two different positions in same hospital 1 Volunteer at free clinic for uninsured 2

0.0% 5.0%

10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0%

To supplement the earnings from

my primary clinical PA

position

Wasn't offered full time work in

my primary clinical PA

position

To gain experience in a different aspect of clinical care

Enjoy working in various clinical

settings

Other


35

Please indicate your Primary and Secondary ( i f applicable) area of PA cl inical practice. I f you are not presently working as a PA, complete for your last posit ion.

Answer Options Primary Secondary Response Count

Dermatology 4 1 5 Emergency medicine 38 12 50 Family/general medicine 66 14 80 Internal medicine (general) 25 4 29 Internal medicine (sub-specialty) 12 1 13 Obstetrics and gynecology 3 1 4 Occupational medicine 9 2 11 Oncology 3 0 3 Pediatrics (general) 3 3 6 Pediatrics (sub-specialty) 4 0 4 Prevention/wellness 1 3 4 Psychiatry 3 2 5 Radiology 3 1 4 Surgery (general) 5 2 7 Surgery (specialty) 34 5 39 Other 46 12 58 (please specify) 84



36

Other (please specify)

Addiction medicine 2 Otolaryngology 2 Asthma/Allergy/Immunology 2 Pain management 7 Consultant to pharmaceutical company 1 Palliative care 1 Education 3 Pediatric cardiothoracic surgery 1 Endocrinology -‐ emphasis on DM 1 Pediatric urology surgery 1 ENT 2 Physical medicine and rehabilitation 4 Gastroenterology 1 Public health 1 Hormone replacement 1

Radiation oncology 1

Hospice 1 Research 1

Hospital medicine 3 Rheumatology 1

Infectious disease 1 Sleep medicine 1

Integrative medicine 1 Surgical critical care 1

Neurology 2 Urgent Care 25

Occupational medicine 1 Urology 5

Ophthalmology 1 Weight loss clinic 1

Orthopedic surgery 3 Wound care 1

Orthopedics 5

0

10

20

30

40

50

60

70

80

90

Der

mat

olog

y

Fam

ily/g

ener

al m

edic

ine

Inte

rnal

med

icin

e (s

ub-s

peci

alty

)

Occ

upat

iona

l med

icin

e

Ped

iatr

ics

(gen

eral

)

Pre

vent

ion/

wel

lnes

s

Rad

iolo

gy

Sur

gery

(sp

ecia

lty)

Primary

Secondary


37

Approximately how many hours do you work during a typical workweek? [Provide both total & Posit ion-specif ic]


Response Count

All PA Positions [Clinical and Non-Clinical] 84.4% 211 Primary Clinical PA Position 64.4% 161 Secondary Clinical PA Position 22.0% 55


Approximate hours worked during a typical workweek:

All PA Positions

Primary Clinical

Secondary Clinical (Hrs/Week)

(Hrs/Week)

( Hrs/Week)

26 (0-‐35)

39 (0-‐35)

53 (0-‐35)

68 (36-‐40)

68 (36-‐40)

0 (36-‐40) 83 (41-‐50)

39 (41-‐50)

1 (41-‐50)

29 (51-‐70)

12 (51-‐70)

0 (51-‐70)

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

All PA Positions [Clinical and Non-Clinical]

Primary Clinical PA Position Secondary Clinical PA Position


38

Which category most closely approximates your total income before taxes in 2011 from all your PA posit ions combined? [Mark one box]


Percent Response

Count

Not working as a PA in 2011 7.5% 19 Less than $40,000 2.0% 5 $40,001 to $50,000 2.0% 5 $50,001 to $60,000 1.6% 4 $60,001 to $70,000 1.6% 4 $70,001 to $80,000 10.2% 26 $80,001 to $90,000 12.9% 33 $90,001 to $100,000 14.5% 37 $100,001 to $110,000 12.2% 31 $110,001 to $120,000 11.8% 30 $120,001 to $130,000 7.5% 19 More than $130,000 16.5% 42


The majority of respondents (16.5%) indicated their total income as more than $130,000 with the next largest group (14.5%) as $90,001 to $100,000.


39

In your primary cl inical PA posit ion, which other types of l icensed health professionals work in your practice? [Mark al l that apply]


Response Count

I am a solo practitioner with an off-site licensed physician supervisor 7.1% 17

Physician(s) 90.0% 216 Advanced Practice Nurse(s) 40.0% 96 Registered Nurse(s) 35.8% 86 Other PAs 65.0% 156 Other health professionals 36.3% 87 (please specify) 44


0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

100.0%

I am a solo practitioner with an off-

site licensed physician supervisor

Physician(s) Advanced Practice Nurse(s)

Registered Nurse(s)

Other PAs Other health professionals


40

Which of the fol lowing best describes the type of practice sett ing in which your PRIMARY cl inical PA posit ion is located? [Mark one box]


Response Count

Office-based private practice 45.1% 105 Hospital (non-VA) 26.2% 61 Other 9.0% 21 Community health center (Federally Qualified Health Center) 4.7% 11

Office-based multi specialty or HMO 3.4% 8 Occupational health setting 3.0% 7 VA facility/hospital 2.6% 6 Community health clinic (non-Federally Qualified) 2.1% 5 Indian Health Service facility 1.7% 4 Rural health clinic (federally certified) 1.3% 3 Rehabilitation facility 0.4% 1 State or local governmental facility (e.g. public health clinic) 0.4% 1 Ambulatory surgical center 0.0% 0 Extended care facility/nursing home 0.0% 0 Home health care agency 0.0% 0 Hospice 0.0% 0 School-based or college-based health center or school clinic 0.0% 0


Other (please specify) Multi-‐specialty physician practice 1 Office based orthopedic group 1 Public health service 1 Retail clinic 3 Single-‐specialty practice 1 Tribal health clinic 1 University -‐ education 1 Urgent care 16 VA clinic 1

My primary supervising physician is a...


Percent Response

Count

MD 81.1% 193 DO 18.9% 45


81.1% of respondents have MD’s as their supervising physician while only 18.9% have DOs.


41

Which of the fol lowing best characterizes the board cert i f ication of your supervising physician? [Mark one box]


Percent Response

Count

Not board certified 2.9% 7 Board certified in both a primary care specialty and a subspecialty 12.2% 29

Board certified in a primary care specialty [Family practice, general internal medicine, general pediatrics] 41.2% 98

Board certified in a specialty/subspecialty area of practice [e.g. cardiology, dermatology, gastroenterology, obstetrics/gynecology, otolaryngology, pulmonology, surgery]

43.7% 104


Describe the level of physician supervision/chart review you have in your primary cl inical PA posit ion. [Mark one box]


Percent Response

Count

My supervision is limited to an annual performance review by my supervising physician 11.5% 27

About half of the charts for my patient visits are reviewed and co-signed 3.4% 8

The charts for all of my complex patient visits are reviewed and co-signed

8.5% 20

Selected patient charts are periodically reviewed and co-signed 36.8% 86

My physician-supervisor conducts all initial patient visits and I do follow-up care only 3.8% 9

The charts for all of my patient visits are reviewed and co-signed

35.9% 84



42

Do you have routine communication/col laboration with your supervising physician in your primary cl inical PA posit ion? [Mark one box]


Percent Response

Count

Yes, I routinely consult with my supervising physician [Go to Q40] 73.8% 175

No routine direct consultation, supervising physician is off-site [Go to Q41] 10.1% 24

No routine direct consultation, supervising physician is on-site as needed [Go to Q41]

16.0% 38


Yes, I routinely consult with my supervising physician [Go to Q40]

No routine direct consultation, supervising physician is off-site [Go to Q41]

No routine direct consultation, supervising physician is on-site as needed [Go to Q41]


43

I f YES to Q39, describe the level and kind of routine communication you have with your supervising physician. [Mark one box]


Percent Response

Count

I engage in regular, reciprocal consultation with my supervising physician 62.8% 118

Physician-supervisor routinely consults on complex patient visits 27.1% 51

Physician-supervisor routinely consults on about half of all patient visits

2.7% 5

Physician routinely consults on initial patient visits only 1.6% 3 Physician consults on every patient visit 5.9% 11


I engage in regular, reciprocal consultation with my supervising physician Physician-supervisor routinely consults on complex patient visits

Physician-supervisor routinely consults on about half of all patient visits

Physician routinely consults on initial patient visits only


44

Are you satisf ied with the level of routine communication you experience with your supervising physician(s)? [Mark one box]


Percent Response

Count

Yes, I am satisfied 86.5% 205 No, I wish I had less interaction/consultation 4.2% 10 No, I wish I had more interaction/consultation 9.3% 22


Yes, I am satisfied

No, I wish I had less interaction/consultation

No, I wish I had more interaction/consultation


45

Please rate whether the fol lowing factors routinely occur in your primary cl inical PA posit ion. [Mark one frequency for each factor l isted below]

Answer Options Never Sometimes Always Response Count

I am a member of a healthcare team that allows me to participate in decisions related to my patients

3 13 220 236

The practice is able to bill private insurance companies for reimbursement of my services

17 46 169 232

I have positive relationships with the physicians with whom I work

1 22 214 237

I make autonomous treatment decisions for my patients

1 42 193 236

I am culturally competent to address the health needs of all my patients

0 47 190 237

I believe the quality of care is high at my current work setting

0 22 213 235


0

50

100

150

200

250

I am

a m

embe

r of

a

heal

thca

re te

am th

at

allo

ws

me

to p

artic

ipat

e in

de

cisi

ons

rela

ted

to m

y pa

tient

s

The

pra

ctic

e is

abl

e to

bill

pr

ivat

e in

sura

nce

com

pani

es fo

r re

imbu

rsem

ent o

f my

serv

ices

I hav

e po

sitiv

e re

latio

nshi

ps w

ith th

e ph

ysic

ians

with

who

m I

wor

k

I mak

e au

tono

mou

s tr

eatm

ent d

ecis

ions

for

my

patie

nts

I am

cul

tura

lly c

ompe

tent

to

add

ress

the

heal

th

need

s of

all

my

patie

nts

I bel

ieve

the

qual

ity o

f ca

re is

hig

h at

my

curr

ent

wor

k se

tting

Please rate whether the following factors routinely occur in your primary clinical PA position. [Mark one frequency for each factor listed below]

Never

Sometimes

Always


46

How much of a problem is each of the fol lowing issues with regard to your abi l i ty to provide high quali ty care in your primary cl inical PA posit ion? [Mark the best response for each factor]

Answer Options Signif icant

problem

Somewhat of a

problem

Not a problem

Response Count

Having sufficient time with patients during office visits 13 110 111 234

Communicating with patients whose language or cultural background is different from my own

12 112 111 235

Having enough qualified specialists to whom I can refer patients

14 62 158 234

Receiving reports from other providers and facilities in a timely manner

32 116 85 233

Reduced reimbursement from private insurance companies

34 107 83 224

My patients' access to needed care is limited based on their ability to pay

50 115 65 230

Non-paying patients/bad debt

35 108 88 231

High cost of liability insurance 29 78 121 228

Lack of call coverage for weekends and vacations

21 36 171 228

Other 1 2 26 29

(please specify) 3 answered question 235

skipped question 83


47


Colleague turnover In our community, doctors are refusing to take Medicare and Social Security patients so we are imbalanced International clinic seeing Americans and locals (prn) Medicare is only paying us as PA's 80%

0

50

100

150

200

250 H

avin

g su

ffici

ent t

ime

with

pat

ient

s du

ring

offic

e vi

sits

Com

mun

icat

ing

with

pat

ient

s w

hose

la

ngua

ge o

r cu

ltura

l bac

kgro

und

is

diffe

rent

from

my

own

Hav

ing

enou

gh q

ualif

ied

spec

ialis

ts to

w

hom

I ca

n re

fer

patie

nts

Rec

eivi

ng r

epor

ts fr

om o

ther

pro

vide

rs

and

faci

litie

s in

a ti

mel

y m

anne

r

Red

uced

rei

mbu

rsem

ent f

rom

priv

ate

insu

ranc

e co

mpa

nies

My

patie

nts'

acc

ess

to n

eede

d ca

re is

lim

ited

base

d on

thei

r ab

ility

to p

ay

Non

-pay

ing

patie

nts/

bad

debt

Hig

h co

st o

f lia

bilit

y in

sura

nce

Lack

of c

all c

over

age

for

wee

kend

s an

d va

catio

ns

Oth

er

How much of a problem is each of the following issues with regard to your ability to provide high quality care in your primary clinical PA position? [Mark

the best response for each factor]

Significant problem

Somewhat of a problem

Not a problem


48

During the regular hours of a typical workweek, what proport ion of t ime do you spend on the fol lowing activi t ies at your primary cl inical sett ing? [Percentage should add up to 100%]


Response Count

Direct, face-to-face patient care 99.6% 224 Indirect patient care (e.g., phone calls, reviewing labs, charting)

90.7% 204

Administration (e.g., of own practice, hospital committees) 58.7% 132

Teaching/precepting 48.4% 109

Continuing education (e.g., courses, journal reading, video and audiotapes)

62.2% 140

Research 41.3% 93

Activities related to quality improvement or patient safety

43.1% 97

Commuting between practice sites

38.2% 86

Other activities 25.3% 57


0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9

1

!Dire

ct, f

ace-

to-f

ace

patie

nt

care

CIn

dire

ct p

atie

nt c

are

(e.g

., ph

one

calls

, rev

iew

ing

labs

, ch

artin

g)

;Adm

inis

trat

ion

(e.g

., of

ow

n pr

actic

e, h

ospi

tal

com

mitt

ees)

Tea

chin

g/pr

ecep

ting

KC

ontin

uing

edu

catio

n (e

.g.,

cour

ses,

jour

nal r

eadi

ng,

vide

o an

d au

diot

apes

)

��Res

earc

h

;Act

iviti

es r

elat

ed to

qua

lity

impr

ovem

ent o

r pa

tient

sa

fety

Com

mut

ing

betw

een

prac

tice

site

s

Oth

er a

ctiv

ities

During the regular hours of a typical work week, what proportion of time do you spend on the following activities at your primary clinical setting? [Percentage

should add up to 100%]


49

Outside of your regular practice hours, on average, how much on-call t ime do you typically provide? [Mark one box]


Response Count

None 57.3% 133 On-call for less than 15 hrs./month 15.9% 37 On-call between 15 and 24 hrs./month 7.3% 17 On-call for more than 24 hrs./month 19.4% 45


None

On-call for less than 15 hrs/month

On-call between 15 and 24 hrs/month On-call for more than 24 hrs/month


50

Please estimate the current payer mix in your primary cl inical PA practice. [Percent should add up to 100%]


Response Count

Private insurance 88.4% 160 Medicare 82.9% 150 Medicaid (AHCCCS) 75.7% 137 CHP+ 20.4% 37 Worker's Compensation 46.4% 84 Self-pay or sliding-fee schedule 66.3% 120 Uncompensated care 35.4% 64 Other 18.2% 33


0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

100.0%

Priv

ate

insu

ranc

e

Med

icar

e

Med

icai

d (A

HC

CC

S)

CH

P+

Wor

ker's

C

ompe

nsat

ion

Sel

f-pa

y or

sl

idin

g-fe

e sc

hedu

le

Unc

ompe

nsat

ed

care

Oth

er


51

How are your professional services bi l led in your primary cl inical practice? [Mark one box]


Percent Response

Count

Both directly and indirectly ("incident to" -- under physician in practice) 35.3% 79

Direct billing only 11.2% 25 Indirect billing only ("incident to" -- under physician in practice)

9.4% 21

Do not know 44.2% 99


Do you bi l l your charges under your own NPI or UPIN?


Response Count

Yes 67.4% 145 No 32.6% 70


Both directly and indirectly ("incident to" -- under physician in practice)

Direct billing only

Indirect billing only ("incident to" -- under physician in practice)

Do not know

Yes No


52

Do you carry your own separate medical malpractice l iabi l i ty insurance?


Response Count

Yes 23.7% 55 No 76.3% 177


Do you have a part ial ownership in your primary cl inical practice? [Mark one box]


Percent Response

Count

No 95.2% 219 Yes, 0-25% ownership 1.3% 3 Yes, 26-49% ownership 0.4% 1 Yes, 50-75% ownership 0.9% 2 Yes, more than 76% ownership 2.2% 5


Yes No

Yes, 0-‐25% ownership



Yes, more than 76% ownership


53

Are you planning to leave your primary cl inical PA posit ion in the next 12 months?


Response Count

Yes [Go to Q52] 21.2% 49 No [Go to Q53] 78.8% 182


Yes [Go to Q52]

No [Go to Q53]


54

I f YES to Q51, which of the fol lowing factors is inf luencing your decision to leave your primary cl inical PA posit ion? [Mark the relat ive importance of each factor]

Answer Options Not Important

Somewhat Important

Very Important

Response Count

Plan to retire from the active workforce 36 3 3 42 Desire a PA position in another clinical practice

7 14 23 44

Desire a primary care position that does not utilize my PA training/interest/experience

34 5 1 40

Desire a non-clinical health-related position (e.g. research, administration)

30 8 3 41

Desire a position outside of health care 33 4 5 42

Want to pursue additional education 33 4 4 41

Want to work in an educational institution

29 7 4 40

Lack of respect for PAs by physicians and employers

21 14 8 43

Work is not professionally challenging

28 6 7 41

Insufficient wages given the workload and responsibilities involved

8 10 23 41

Maternity leave or other family responsibilities

32 5 3 40

Health does not allow me to continue working as a PA

37 2 1 40

Other

4 0 7 11

(please specify) 13 answered question 48

skipped question 270

Benefits 2 Burn-‐out 1 Contract ends at end of year 1 Contract w/hospital ended with my physician group 1 Desire a better physician/PA relationship 1 Higher paying clinic out of state 1 Inadequate supervision 1 Lack of respect and support from current company 1 Moving 1



55

New experience and expand my knowledge 1 Not enough hours 1 Plan to open my own clinic 1

Are you interested in serving as a preceptor for PA students? [Mark one box]


Response Count

No [Go to Q55] 45.0% 103 Yes [Go to Q55] 35.8% 82 Already a preceptor [Go to Q54] 19.2% 44


No [Go to Q55]

Yes [Go to Q55]

Already a preceptor [Go to Q54]


56

I f ALREADY a preceptor, what students do you precept? [Mark as applicable for each option]


Percent Response

Count

Physician assistant students 96.6% 57 Medical students 37.3% 22 Advanced practice nursing students 10.2% 6 Residents 13.6% 8


0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Physician assistant students

Medical students Advanced practice nursing students

Residents


57

Do you have an interest in becoming a core faculty member or a cl inical preceptor at an Arizona PA education program? [Mark one box]


Percent Response

Count

No 36.7% 88 Undecided 30.4% 73 Yes 26.3% 63 Already a faculty member 6.7% 16


Conclusion The results of this survey, as with any survey, become outdated the day it is published. It is unfortunate that of the 2,052 viable emails sent to known licensed Arizona PAs (both ASAPA members and non-‐members alike) with a link to the Survey Monkey instrument, only 318 PAs (representing 16%) completed the survey. Nonetheless, the survey and subsequent report is the first of its kind accomplished by ASAPA in well over a decade…if not longer. So it is a start. Thank you to those who took the time to complete this important survey! The information generated by this survey does give us a basic look into the PA workforce in Arizona. We do know that the typical Arizona PA is female, white and only fluent in English. She is very satisfied with her role as a PA and the compensation she receives. She is a member of both AAPA and ASAPA and had a bachelor’s degree prior to going to one of the Arizona PA schools where she received a master’s degree. Future studies should be accomplished through a partnership between ASAPA, the Arizona Regulatory Board of PAs, and the Arizona AHEC.

No

Undecided

Yes

Already a faculty member


58

References

1 Bureau of Labor Statistics (BLS) (2012). Retrieved October 23, 2012 from http://www.bls.gov/ooh/Healthcare/Physician-‐assistants.htm#tab-‐6). 2 American Academy of Physician Assistants (2010) (Retrieved October 24, 2012 from http://www.aapa.org/research/data_and_statistics.aspx)

3 Danielsen, RD; Lathrop, J; Arbet, S. “The certified physician assistant in the United States: A 2011 snapshot.” The Journal of the American Academy of Physician Assistants. April 20, 2012. Accessed on October 23, 2012 at http://www.jaapa.com/the-‐certified-‐physician-‐assistant-‐in-‐the-‐united-‐states-‐a-‐2011-‐snapshot/article/235550/

4 Legislative History of the joint Board on the Regulation of Physician Assistants (1972-‐2001) approved by the Joint Board on August 29, 2001.

5 Arizona State Association of Physician Assistants website, Accessed on October 224, 2012 at http://www.asapa.org/displaycommon.cfm?an=1&subarticlenbr=13

6 Arizona State Association of Physician Assistants website, Accessed on October 224, 2012 at http://www.asapa.org/displaycommon.cfm?an=1&subarticlenbr=13

7 Accreditation Review Commission on Education for the Physician Assistants, Inc. from http://www.arc-‐pa.org/acc_programs/ accessed on October 23, 2012.

8 Arizona School of Health Sciences, A.T. Still University. Accessed on October 23, 2012 at http://www.atsu.edu/ashs/programs/physician_assistant/index.htm

9 Midwestern University Physician Assistant Program. Accessed on October 23, 2012 at http://www.midwestern.edu/programs-‐and-‐admission/az-‐physician-‐assistant-‐studies.html#Program%20Description

10 Northern Arizona University Physician Assistant Program. Accessed on October 23, 2012 at http://nau.edu/CHHS/PA/Program/

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