On June 26, the Government Accountability Office (GAO) issued a report in response to a request from Congress titled, “Physician Workforce: Locations and Types of Graduate Training Were Largely Unchanged, and Federal Efforts May Not Be Sufficient to Meet Needs.” While the report focuses on deficiencies in current graduate medical education for physicians, the GAO also dedicated notable attention in their findings to the role that growth in the PA profession is expected to play in alleviating projected workforce shortages — particularly in medically underserved and rural areas.
In the analysis, the authors write, “In November 2016, HRSA [the Health Resources and Services Administration] projected a shortage of up to 23,640 primary care physicians by 2025 — although it indicated that changes in health care delivery, such as greater use of nurse practitioners and physician assistants, could affect the extent of that shortage.” This projected shortage poses a severe threat to the ability of the health care system to provide care to all patients. The GAO’s report acknowledges that the skills taught to PA students throughout their education are critical in ensuring an adequate future supply of quality primary care providers.
In an appendix, the GAO also highlighted the workforce impact generated by Expansion of PA Training (EPAT) grants — a short-term PA education program funded by the Affordable Care Act: “Though the [initial] number of 2013 EPAT graduates was smaller, they were more likely than 2013 graduates of the nurse practitioner programs to be practicing in primary care or rural or medically underserved areas one year after graduating.” This finding illustrates the clear impact that federal funding for PA programs can have in fulfilling the goal of providing equitable care to all patients.
In the description of the impact of federal funding for PA education programs, the GAO goes on to write, “[Of] 22 EPAT grantees responding to a survey, 82% planned on maintaining all expanded positions, 4% intended to maintain a portion of the expanded positions, and 14% intended to revert to their previous training levels,” further highlighting the sustainable impact that federal investments have in the expansion of PA program capacity.
What does this mean for Title VII funding and PA education?
Informed by the empirical conclusions reached by the independent GAO, Congress should act to enhance federal funding for Title VII programs, which are crucial in preparing the next generation of PAs. Through programs such as Primary Care Training and Enhancement (PCTE) grants, Scholarships for Disadvantaged Students, and Area Health Education Centers (AHECs), Title VII initiatives have equipped PA education programs to expand capacity, train more diverse students with the ability to provide culturally competent care, and implement innovative educational strategies that provide students with the skills necessary to meet the nation’s health care needs. The value of these initiatives within a health care system expected to face daunting workforce challenges is clear — and policymakers must be made aware of their impact.
How can this research inform advocacy?
Lawmakers and their staffs strive to engage in evidence-based policymaking. The GAO’s findings provide independent support for the need to encourage PA programs to expand capacity and train sufficient numbers of students to fulfill the nation’s workforce requirements. Program directors, faculty, and supporters of PA education should use this report to emphasize the value of Title VII programs to their elected representatives and urge them to reject President Trump’s detrimental cuts to Title VII programs in his proposed FY18 budget.
The current reductions proposed by the Trump administration would have a devastating impact on students trained at rural sites funded by the AHEC program and on programs expanding capacity through PCTE grants. Supporters of PA education should use the evidence-based findings of the GAO to make the case for continued and enhanced funding for PA education in the interest of students, programs, and — ultimately — patients.
How can you help?
As Congress works to finalize the budget for the upcoming fiscal year, PA educators and supporters of PA education can use this legislation tracking tool to find the contact information for their elected representatives.
When engaging with lawmakers and their staff, emphasize the GAO’s findings and the vital role that federal funding plays in providing access to care for patients. PAs will be crucial to ensuring a sufficient supply of providers of high-quality care, and your voice can help ensure PA education has the resources necessary to meet this challenge.