The overall theme of the conference, “Building Bridges and Breaking Down Barriers: Diversity, Inclusion, and the Health Workforce,” was threaded throughout the keynote addresses and panels during the conference. Opening keynote speaker David Hayes-Bautista, PhD, set the tone with a historical look at how American racial categories have changed through time and functioned as hierarchical systems of power.
Many of the conference sessions focused on research to understand the current state of diversity and inclusion in the health professions, as well as factors that either increase or decrease diversity in health professions.
Diversity and the PA Pipeline
Diversity and inclusion is an issue of increasing importance and a key component of the PAEA Strategic Plan, and several of the conference presentations focused on diversity and the PA pipeline.
First, Bettie Coplan, MPA, PA-C, associate clinical professor at Northern Arizona University, presented findings from a study on holistic admissions in PA programs, which she conducted with James Stoehr, PhD, of Midwestern University–Glendale. The data were from a study that received a 2017 PAEA Support to Advance Research (STAR) award. Coplan and Stoehr found that programs using holistic admissions had greater proportions of students of minority races among matriculating students, compared to programs not using holistic admissions.
PAEA, NCCPA, and AAPA also collaborated on a panel titled “Diversity Throughout the PA Pipeline,” which provided original analyses of racial, ethnic, and gender representation and inequities from the PA student stage to re-certification:
Xin Yuen, MA, lead data analyst at PAEA, presented on the likelihood of matriculation into PA school for under-represented minorities (URMs) versus non-URMs. The data presented shows that URMs without GRE scores were about 27 percent less likely to matriculate than their URM and non-URM peers with GREs. Older students were also less likely to matriculate.
Josh Goodman, PhD, director of psychometrics and research at NCCPA, focused on newly certified PAs. He has found that URM groups have smaller starting salaries and carry more educational debt than their non-URM peers. Additionally, Goodman presented demographic statistics showing that Black/African American PAs and PAs of Latino or Hispanic descent remain underrepresented compared to the overall US population.
Tim McCall, PhD, manager of research at AAPA, presented findings from AAPA’s salary survey, which found that there were no differences in reported levels of enthusiasm for work or in a sense of personal accomplishment between URMs and non-URMs. There were also no differences in the number of hours worked in a week, and URM and non-URM PAs were equally likely to be in a leadership role. Other key takeaways from McCall’s talk included:
- There are differences between URM PAs and non-URM PAs on perceived importance of several workplace-related psychological stressors.
- URM PAs are more likely than non-URM PAs to report difficult colleagues or staff, difficult employers, compassion fatigue, and an inability to provide patients with the quality care they need.
- When controlling for compensation-relevant factors, women PAs were paid 94 cents for every dollar paid to male PAs for the same work.
Bridging the gap between education and practice, Gayle Bodner, MMS, PA-C, director of clinical education at Wake Forest University, presented evaluation results from a job fair that the Wake Forest PA program recently started. She found that recruitment events for PA students in the latter half of their clinical education year were beneficial to their job search. She also learned that recruiters interested in hiring new graduates found the event to be valuable, that PA students found the event to be useful in their professional development, and that the recruiters were satisfied with the professionalism displayed by the students.
Structure of the Job Market and PAs
Several other talks at the conference touched on the changing job market structure. Melinda Blazar, MHS, PA-C, assistant professor and clinical coordinator at Duke University, provided updated data on her project regarding the number of job openings in primary care versus specialty care, which was conducted with Perri Morgan, PhD, PA-C, associate professor at Duke University, and funded by a 2017 PAEA Don Pedersen Research Grant. In this presentation of preliminary findings, Blazar and Morgan discussed why the majority of job openings for PAs are in specialties as opposed to primary care.
Tami Ritsema, MMSc, PA-C, assistant professor at George Washington University, presented from her work using AAPA data. Her research shows that, concurrent with the increase in urgent care practices over the last 20 years, the percentage of PAs reporting urgent care to be their primary practice has risen from 2.5 percent to 5.0 percent since 1998. Ritsema, et al, also found that PAs practicing urgent care were the most likely to perform minor surgical procedures and the least likely to confer with their supervising physicians, as compared to those in emergency medicine and those in all other specialties.
Perri Morgan, PhD, PA-C, associate professor at Duke University, presented her newest work, which compares utilization and costs by primary care provider type. This study analyzed a national sample of 368,481 diabetes patients within the VA health care system between 2012 and 2013. Morgan, et al, found that patients of physicians were more likely than patients of PAs or NPs to incur a hospitalization, and visited the emergency department more frequently. Furthermore, patients of physicians incurred 6 percent greater expenditures than PA patients and 5 percent greater expenditures than NP patients, which translates to a difference of $694 and $542 annually per patient, respectively. The results suggest that PAs and NPs may be safely used in VA primary care for patients with diabetes without increasing total care costs.
PA faculty wishing to submit an abstract to be considered for presentation at the 15th Annual AAMC Workforce Research Conference in Alexandria, Virginia, should plan to submit their abstract in early January 2019. More information about the conference can be found here.