Physician Assistants Filling Gaps in Rural Health Care

May 19, 2017

Anne Brown will graduate from UAMS as a Physician Assistant this August.
Credit UAMS

Physician assistants don’t have the same level of education as a doctor but do many of the same things, but they're being credited with helping to fill some of the scheduling gaps that have long been a problem in rural Arkansas.

Supporters of the profession say physician assistants can help with writing prescriptions for common illnesses, setting simple fractures and assisting with long-term management for illnesses such as diabetes.  Physician assistants were also the highest level of medical professional to attend the recent executions in Arkansas.

PA's, as they're called, study for an average of 28 months beyond their undergraduate education.  Supporters say the education has a lot in common with a medical degree but spares students the quarter-million dollars in debt that often comes with a medical school degree, and helps them get started in their careers earlier.  From a patient’s perspective, they can very often see a physician assistant much faster than a doctor.

“The way that our current health care crisis is, we are rapidly reaching a point where we don’t have enough doctors to fill in all the slots, and the primary care doctors are particularly less available,” said Mario Hofheinz, who teaches Physician Assistant degree courses at Harding University.

Some students say they were drawn to the profession because they saw that the need is for mid-level professionals who can help with the most common of illnesses.

“In Arkansas, right now, we’re seeing a lot of satellite clinics pop up,” said Anne Brown, a student at the University of Arkansas for Medical Sciences, which is the only school other than Harding that offers a Physician Assistant program in the state.  

PA’s in rural areas can practice in fields such as primary care, family practice and dermatology, and they may make use of telecommunication systems to consult with a supervising physician in a larger city.

It’s also a satisfying profession, according to Caleb Keese, a Harding student who will graduate in December 2018.

“One of the things I have learned the most from PA school is just to be humble when you’re dealing with people and listening to their problems,” said Keese, who worked as a firefighter before taking a second job at an urgent care clinic in Searcy and finding himself inspired by the physician assistants who worked there to look into the career himself.

“I really feel like physician assistant kind of chose me,” he said.

According to a U.S. Department of Labor salary survey in 2014, physician assistants in Arkansas earn an average salary of close to $75,000 per year, far less than a medical doctor but more than a nurse.

Harding University student Caleb Keese, left, with Assistant Professor Mario Hofheinz.
Credit Jeff Montgomery / Harding University

Some have worried that an emphasis on recruiting physician assistants will reduce the urgency to graduate and retain more doctors to work in rural health care.  Brock Slabach of the Kansas-based National Rural Health Association said there’s a need for more medical professionals at every level in rural communities.

“I think it’s all hands on deck when it comes to workforce training for rural communities," he said, citing a need for more doctors, physician assistants and nurse practitioners.

Retention of new doctors should be built into the recruitment process, so that communities are not just working to recruit more physicians but also to keep them for many years.

Supporters of the profession say patients don't typically demand to see a doctor over an assistant, that is, for routine medical needs. If a physician assistant can see them faster and spend more time with them than a physician, patients are satisfied.

“I think once they see how knowledgeable they are and how professional they are, the satisfaction rates for seeing a PA are always really high,” said Benjamin Willett, who teaches Physician Assistant classes at UAMS.

Benjamin Willett teaches Physician Assistant Studies at UAMS.
Credit UAMS

Both programs in Arkansas are fairly new.  Harding graduated its first class of physician assistants in 2007 and UAMS in 2015.