Valentin Virginia, Potter Daniel
From the Department of Physician Assistant Studies, University of Kentucky, Lexington.
South Med J. 2025 Jul;118(7):400-405. doi: 10.14423/SMJ.0000000000001847.
The purpose of this study was to provide a description of the physician assistant (PA) workforce in Kentucky and the perspective of current Kentucky PA students regarding factors to influence rural work. This study intends to provide insights into the practice patterns of Kentucky PAs and alumni and desires of current students to assist policy leaders in understanding the impact that PAs could have on this medically underserved part of the country.
The Kentucky Board of Medical Licensure database of licensed PAs and physicians was used to locate all currently practicing PAs in Kentucky and PA graduates from a large public university in Kentucky, 2016-2022. These practice locations were used to demonstrate movement of PA alumni before school matriculation, current practice areas by Health Professional Shortage Area and Medically Underserved Areas/Populations by counties and area of specialty. A cross-sectional survey was given to PA students at a large public university in Kentucky aimed at assessing the perceptions and influential factors regarding the PA profession and personal employment opportunities among PA students.
There are 1649 PAs who have active licenses in Kentucky and practice in 92 counties with 28 counties with no PAs; 42.5% of Kentucky PAs serve primary care Health Professional Shortage Areas and 20.0% serve in Medically Underserved Areas/Populations. The most common areas of practice are emergency medicine (14.5%) and internal medicine (14.5%). PAs from rural areas had significantly higher odds of holding a rural license compared with those from metropolitan areas (odds ratio, 6.42; = 6.76; < 0.00001). Students reported choosing the PA profession due to length of education, work-life balance, and career mobility.
Addressing the critical healthcare access issue in the southern United States will require innovation and utilization of the entire healthcare team. With 34% of PAs working in rural counties in Kentucky, policy leaders need to focus on methods to incentivize the next generation of PA providers to rural counties. As the dependency on nonphysician providers increases, future policy decisions and research needs to center around PA practice patterns and understanding of the needs of the next generation of providers.
本研究旨在描述肯塔基州医师助理（PA）劳动力的情况，以及肯塔基州目前的PA学生对影响农村工作因素的看法。本研究旨在深入了解肯塔基州PA及其校友的执业模式，以及当前学生的期望，以帮助政策制定者理解PA对该国医疗服务不足地区可能产生的影响。
利用肯塔基州医疗执照委员会的持牌PA和医生数据库，找出肯塔基州所有目前执业的PA以及2016 - 2022年毕业于肯塔基州一所大型公立大学的PA。这些执业地点用于展示PA校友入学前的流动情况、按卫生专业人员短缺地区划分的当前执业领域，以及按县和专业领域划分的医疗服务不足地区/人群。对肯塔基州一所大型公立大学的PA学生进行了横断面调查，旨在评估PA学生对PA职业的看法和影响因素以及个人就业机会。
肯塔基州有1649名持有有效执照的PA，在92个县执业，其中28个县没有PA；42.5%的肯塔基州PA服务于初级保健卫生专业人员短缺地区，20.0%服务于医疗服务不足地区/人群。最常见的执业领域是急诊医学（14.5%）和内科（14.5%）。与来自大都市地区的PA相比，来自农村地区的PA持有农村执照的几率显著更高（优势比，6.42； = 6.76； < 0.00001）。学生们表示，选择PA职业是因为教育时长、工作与生活的平衡以及职业流动性。
解决美国南部关键的医疗服务可及性问题需要创新并利用整个医疗团队。由于34%的PA在肯塔基州的农村县工作，政策制定者需要关注激励下一代PA提供者前往农村县的方法。随着对非医师提供者的依赖增加，未来的政策决策和研究需要围绕PA的执业模式以及对下一代提供者需求的理解展开。
