Job market lures more physician assistants to specialties over primary care

PAs are seen as a partial solution to an expected shortage in the primary care workforce in the coming years due to an aging population, rising rates of chronic disease and increased access to health care, said Perri Morgan, Ph.D., director of research at the Duke Physician Assistant Program.

But the study, published in February by the journal Medical Care Research and Review, found that in 2014, PAs were overwhelmingly being recruited for specialty positions.

According to the study, 82 percent of PA job postings that year were for specialty positions, while only 18 percent were for primary care jobs. The researchers found that nearly three-fourths of 100,000 PA jobs occupied in 2014 were in specialty care rather than primary care practices. They created online maps that show the distribution of PA jobs across the U.S.

"Even though there are already more PAs working in specialties than in primary care, there are proportionately even more ads seeking PAs for specialty-care jobs," said Morgan, one of the principal investigators. "For years we have encountered students who came to PA school wanting to work in primary care, but when they graduated they had difficulty finding those primary care jobs."

"This trend is troubling, especially given the need for more primary care providers and the resources that are being invested, primarily by the federal government, to bolster the primary care pipeline," Morgan said.

The study used an emerging source of data -- real-time labor market information from online job postings -- as an indicator of market demand for PAs. National data on 2014 job postings for PAs were purchased from Burning Glass Technologies, which uses automated systems to continuously crawl over 38,000 websites in search of job postings. The study team eliminated duplicate postings for their analysis.

"We have known for some time that salaries are usually higher for PAs in specialty practice than for those in primary care," Morgan said. "But we now know that there is also a proportionately larger number of jobs in the specialties."

If the job market is pulling more PAs toward specialty care than primary care, Morgan said, new approaches may be required to address the bottleneck in the primary care pipeline.

In addition to Morgan, study authors include Kristine A. Himmerick; Brandi Leach; Patricia Dieter; and Christine Everett.

The Physician Assistant Education Association funded the study.