Physician assistants working in the Department of Veterans Affairs.

There is broad consensus among medical workforce analysts that the demand for physician assistants (PAs), physicians, nurses, allied health, and other medical providers has substantially increased since the late 1990s. While researchers tend to examine the deployment of various providers in private medical offices, they often overlook federally-employed PAs. Since the late 1980s, the Department of Veterans Affairs (VA) has been a major employer of PAs. The demand for services is projected to increase by 30% over the next decade as the VA undergoes expansion. We examined the characteristics of PAs in the Veterans Health Administration (VHA), the medical arm of the VA. In 2010, 1,878 PAs were employed in 153 VA medical centers and many of the more than 900 community-based outpatient clinics. The majority work full time, and 49% are female. VHA PAs are distributed broadly across medical services (38%), surgery (47%), mental health (11%), and other services (4%). Thirty-one percent of PAs have prior military experience. The average years of VHA PA employment is 10.5, and the average age of a VHA PA is 49 years (range 23-74 years); one-third (34%) are within 5 years of retirement eligibility. Annual attrition for PAs is 9%, consistent with doctors, nurses, and pharmacists in the VHA. Projected demand for PA services in the VHA is expected to grow to 2,550 by 2018. Strategies are under way to improve the PA workforce in the VA.