Where physician assistant shortages may deepen by 2038
Physician assistants and other advanced practice providers have helped offset the exit of physicians from the workforce, but the additions are unlikely to meet demands for care well into the next decade.
A shortage of physicians persists in rural and urban areas alike and is compounded by recent changes to H-1B visas and federal tuition borrowingrates that are expected to make it more challenging for physicians to join the workforce.
Physicians are projected to meet 42% of demand in non-metropolitan areas by 2038, a percentage that is largely unchanged from today, according to data from the National Center for Health Workforce Analysis. Physician assistants are expected to pick up a growing portion of that slack. The center is part of the federal Health Resources and Services Administration.
Physician assistants are an integral part of many health systems’ strategy to lower costs and increase care access. Their education and training requirements are lower, they can be paid less than a physician and they can provide professional-level care across multiple specialties.
Their increased use in healthcare has not been without controversy. The trade group representing physician assistants changed its name in 2021 to the American Academy of Physician Associates. However, only a handful of states legally use the term “physician associate” and the American Medical Association has as recently as this month sought to distinguish physicians from these providers.
The AMA also has made multiple statements on “scope creep” — where nonphysicians are given expanded responsibility.
Because of the increased demand for physician assistants, they have more employment options. That is likely to lead to a have-and-have-not scenario across the country by 2038, with some states having a surplus of these providers while other areas can’t meet demand, according to the center’s data.
By 2038, the supply of physician assistants is projected to meet 112% of national demand, according to the center. However, non-metro areas are projected to have 76% of the physician assistants needed to satisfy that demand, while metropolitan areas will have a surplus.
Among states, Mississippi, Arkansas, Hawaii and Alabama will have fewer than half the physician assistants they’re projected to need by 2038.
States are taking steps to attract more people to the profession. Some are offering tax incentives as well as loan and scholarship support to help offset education debt, said Suzanne Reitz, a spokesperson for the American Academy of Physician Associates.
Reitz said exposing students studying to join the profession to rural practices, along with offering postgraduate fellowships and other training opportunities in these communities, helps with recruitment and retention.
“Students who complete clinical rotations in rural communities often develop stronger connections to those communities and are more likely to consider practicing there after graduation,” she said.
Reitz also said efforts to expand the clinical role of physician assistants, allowing them to practice without physician involvement, has been key in attracting people to the profession.
Earlier this month, during its annual meeting in Chicago, the AMA voted to oppose the use of the word “provider” when referring to physicians to further separate physicians from advanced practice providers.
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