Twombly Lauren Anne, Rizzolo Denise, Chen Rong, Kelchen Robert
Lauren Anne Twombly, PhD, PA-C, recently graduated from Seton Hall University's PhD program in Higher Education, Leadership, Management and Policy in South Orange, New Jersey. Denise Rizzolo, PhD, PA-C, is an assistant clinical professor at Pace University, Department of Physician Assistant Studies, New York, New York and an assessment specialist for the Physician Assistant Education Association in Washington, DC. Rong Chen, PhD, is an associate professor at Seton Hall University in South Orange, New Jersey. Robert Kelchen, PhD, is an assistant professor at Seton Hall University in South Orange, New Jersey.
J Physician Assist Educ. 2019 Mar;30(1):34-40. doi: 10.1097/JPA.0000000000000235.
Research and data analysis show that there is a shortage of primary care providers throughout the United States. Physician assistants (PAs) play an important role in health care delivery; however, the percentage of PAs practicing in primary care has dramatically decreased in the past 15 years. The purpose of this study was to identify potential factors that influence PA students' first job choice following graduation from a PA program to determine whether they have a relationship to the choosing of primary care. The 2016 End of Program Survey data were analyzed using a multinominal logistic regression to determine what factors influenced PA students' selections of primary care as their first job choice: individual factors, program factors, and external factors. Of the 3038 subjects, 269 (8.9%) accepted a job in primary care, 847 (27.9%) accepted a specialty job, and 1922 (63.3%) did not accept a job. When comparing no job accepted versus primary care job choice, marital status and racial/ethnic differences influenced first job choice. Financial factors were also found to be significant predictors. In the second model, comparing specialty versus primary care job choice, marital status influenced first job choice along with financial factors. In addition, one program variable (moderate clinical rotation experience) was found to be statistically significant in the model of specialty versus primary care job choice. Financial factors were found to be the greatest predictor in first job choice. Focusing on policy to help reduce student debt and increase reimbursement rates could help increase the number of students choosing primary care.
研究与数据分析表明,美国各地的初级保健提供者短缺。医师助理(PAs)在医疗保健服务中发挥着重要作用;然而,在过去15年里,从事初级保健工作的医师助理比例大幅下降。本研究的目的是确定影响医师助理专业学生毕业后第一份工作选择的潜在因素,以确定这些因素与选择初级保健工作是否存在关联。使用多项逻辑回归分析了2016年项目结束调查数据,以确定哪些因素影响了医师助理专业学生选择初级保健作为他们的第一份工作:个人因素、项目因素和外部因素。在3038名受试者中,269人(8.9%)接受了初级保健工作,847人(27.9%)接受了专科工作,1922人(63.3%)未接受工作。在比较未接受工作与选择初级保健工作时,婚姻状况和种族/民族差异影响了第一份工作的选择。财务因素也被发现是重要的预测因素。在第二个模型中,比较专科工作与初级保健工作的选择,婚姻状况以及财务因素影响了第一份工作的选择。此外,在专科工作与初级保健工作选择的模型中,一个项目变量(适度的临床轮转经验)在统计学上具有显著意义。财务因素被发现是第一份工作选择中最大的预测因素。关注有助于减少学生债务和提高报销率的政策,可能有助于增加选择初级保健工作的学生人数。