Demand for a Master of Physician Assistant Program

1101 Connecticut Ave. NW, Suite 300, Washington, DC 20036 P 202.756.2971 F 866.808.6585 www.hanoverresearch.com Demand for a Master of Physician Assistant Program Prepared for XYZ In this report, Hanover Research analyzes the demand for graduates of a Master of Physician Assistant program in Nevada, the Southwestern region of the United States, and the United States as a whole. Additionally, we profile several physician assistant master s degree programs in the Southwestern region. MARKET EVALUATION SURVEYING DATA ANALYSIS BENCHMARKING INNOVATIVE PRACTICES LITERATURE REVIEW

Introduction The physician assistant (PA) profession has continued to grow and evolve since Duke University graduated the first class of physician assistants in the mid-1960s. Whereas physician assistants were originally intended to help physicians perform highly technical procedures, such as renal dialysis and hyperbaric chamber therapy, their value in other areas of health services was soon realized. 1 Today, the size of the physician assistant workforce and the diversity of roles individual PAs take on have expanded dramatically since the mid-1960s. A Changing Profession As mentioned above, the role of physician assistants has changed over time. Originally, the profession was designed to meet the demands of rural populations underserved by general medical practitioners. This was especially true in the Midwest, and a large proportion of physician assistants in that region continue to serve underserved rural populations. In the Wisconsin State Journal, columnist David Wahlberg reports, Nationally, 15 percent of physician assistants work in rural areas, slightly higher than the percentage of doctors who do. Among graduates of University of Wisconsin-Madison s program, the percentage serving rural communities is 33 percent, and is expected to grow. 2 Across the nation, the role for physician assistants and registered nurses will likely only increase in the primary care field as more and more doctors specialize and move away from general practice. However, following the doctors lead[s], many physician assistants are also choosing to specialize rather than practice primary care. 3 In 2008, just 25.9 percent of all physician assistants practiced family and general medicine, according to the American Academy of Physician Assistants (AAPA) the largest associational body of physician assistants in the United States. This 25.9 percent saw approximately 257 million patients in 2008, and prescribed or recommended almost 332 million medications. 4 However, in spite of a rawnumbers increase in the work that physician assistants do largely because there are more of them the number of PAs practicing primary care declined by 13 percent from 1996 to 2005. 5 The table below illustrates the distribution of physician assistants across the medical disciplines: 1 Physician Assistant Program. Samuel Merritt University. http://www.samuelmerritt.edu/physician_assistant/about 2 Wahlberg, D. Physician Assistants Provide a Broad Range of Care. Wisconsin State Journal. March 28, 2010. http://host.madison.com/wsj/article_2e61e414-86b9-5e28-b8fe-164fe99b85f5.html 3 Avery, S. Physician Assistants Drawn to Specialty. The News & Observer (Raleigh, NC). May 21, 2010. 4 Our Practice Areas. American Academy of Physician Assistants, 2010. http://aapa.org/about-pas/our-practiceareas 5 Physician Assistants Also Choosing Specialties Over Primary Care. State News Service. May 19, 2010. 2

Table 1: Practice of Physician Assistants, 2008 Practice type Share of PAs (percent) Family and general medicine 25.9 General surgery and surgical subspecialties 25.1 General internal medicine and its subspecialties 15.6 Emergency medicine 10.5 Pediatrics and pediatric subspecialties 4.3 Dermatology 3.6 Occupational medicine 2.3 Obstetrics and gynecology 2.3 Other 10.4 Source: AAPA 2008 Census report 6 Expanding Roles, Expanding Opportunities Under the Obama administration s latest round of health care reform, physician assistants are set to play an integral role in the delivery of quality, affordable medical care to all Americans. 7 The role of PAs is being expanded legally to allow them to work in a broader range of settings. The Baucus Bill, also referred to as America s Healthy Future Act of 2009, fully integrates PAs into new team-based models of care that are designed to promote primary care and the coordination of care for patients with chronic medical conditions. The bill also contains provisions to allow PAs to order skilled nursing facility care and to provide hospice care for Medicare beneficiaries, eliminating two key barriers to care for Medicare patients who primary health care professional is a PA. 8 Assistant Surgeon General Adm. Michael R. Milner hopes that PAs will become an important part of preventative care and sees a role for PAs in helping make health care more equitable by bringing cultural sensitivity to bear in their service of diverse communities. 9 Elizabeth Carter, director of the Virginia Department of Health Professions Healthcare Workforce Data Center, adds that non-physician professionals like PAs can help meet tomorrow s demands borne by aging baby boomers and 6 Ibid. 7 President Obama Acknowledges Value of Physician Assistants in Health Care Reform. Targeted News Service. March 12, 2010. 8 Baucus Bill Integrates Physician Assistants in Health Care Delivery. American Academy of Physician Assistants. September 17, 2009. http://www.aapa.org/news/media-resources/news-releases/1368-baucus-bill-integratesphysician-assistants-in-health-care-delivery 9 Kruzick, S. Physician Assistant Students Encouraged. Hartford Courant (Connecticut). August 9, 2009. http://articles.courant.com/2009-08-09/news/1milner0809.art_1_health-care-care-system-physician 3

retiring physicians, [which suggest] the need for primary-care providers will only grow. 10 Anecdotal and hard data support the notion that employment prospects for aspiring physician assistants will be strong for years to come. We discuss this data and its implications at greater length in subsequent sections of this report. Scope and Methodology Current research casts some doubt on the accuracy of calculating demand for new degree programs based on projected labor force needs. 11 Nonetheless, it is still useful for institutions of higher education to examine the projected needs of the labor force as they attempt to assess academic program offerings. To determine potential career opportunities for graduates of physician assistant master s programs (MPA, MSPA, MPAS etc.), we reviewed occupations that graduates of physician assistant master s programs qualify for upon entering the job market. We selected these occupation categories based on the Occupation to Training Crosswalks provided by the National Crosswalk Service Center (NCSC). The NCSC crosswalks match degree programs with occupations in which graduates of those programs typically find work. This is done by matching each degree program s Classification of Instructional Program (CIP) code (assigned by the U.S. Department of Education) with the Standard Occupation Classification (SOC) codes of each related occupation (assigned by the U.S. Bureau of Labor Statistics). Matching SOC codes represent likely career opportunities for graduates of Master of Physician Assistant (MPA) programs. Pairing the CIP code assigned to physician assistant degree programs (51.0912) with related SOC codes revealed that graduates of a Master of Physician Assistant program are likely to be qualified for the positions outlined in Table 2 below. Table 2: SOC Codes Related to Physician Assistant Degree Programs CIP CIP Title SOC Code SOC Title Code Physician 25-1071 Health Specialties Teachers, Postsecondary 51.0912 Assistant 29-1071 Physician Assistants Source: National Crosswalk Service Center 12 Comparing degree completions data for physician assistant master s programs over the past five years to ten-year employment projections in related occupations 10 United States: Health-Care Reform May Expand Roles for Non-Physician Professionals. TendersInfo. April 26, 2010. 11 Robert K. Toutkoushian, What Can Institutional Research Do to Help Colleges Meet the Workforce Needs of States and Nations? Research in Higher Education, December 2005. 12 National Crosswalk Service Center. http://www.xwalkcenter.org/ 4

provides an indication of the level of unmet demand in the labor market for graduates of these programs. Degree completions data for the years 2005-2009 were gathered from the U.S. Department of Education s Integrated Postsecondary Education Data System (IPEDS) and employment projections for 2008-2018 were obtained from the Bureau of Labor Statistics (BLS) online database. In this report, we analyze these data to infer the level of demand nationally, regionally, and in the state of Nevada for graduates of physician assistant master s programs. The crosswalking process does not factor in the fact that graduates with a master s or doctorate degree in a discipline are likely to be more qualified than a graduate with a bachelor s degree in the same discipline. However, both occupations paired with physician assistant degree programs in the crosswalk typically require at least a master s degree, which is the degree of interest in this study. According to the BLS, a master s degree is the most significant source of postsecondary education or training for physician assistants, 13 and a doctoral degree is the most significant source for all postsecondary teachers, including health specialties teachers. 14 However, when analyzing several physician assistant programs, we found that most faculty members did not hold doctorate degrees, and that most faculty members highest level of education was an MPA degree. Since several types of degree programs qualify employees for work as postsecondary health specialties teachers, and national employment projections for the profession are currently unavailable, we focus the bulk of our analysis on the employment outlook for physician assistants. An analysis of the degree completions data for institutions in the state of Nevada suggested that none of the state s institutions have conferred physician assistant master s degrees in the past five years. This does not mean that there are no PA degree programs in the state. According to the Nevada Academy of Physician Assistants, Touro University-Nevada offers the only physician assistant master s program in Nevada. 15 The Touro Master of Physician Assistant Studies program is profiled in the last section of this report. The possible existence of other programs unknown to the Nevada Academy of Physician Assistants that also have not reported data to IPEDS cannot be entirely ruled out. However, an internet search failed to identify any such programs. We expanded the scope of our analysis beyond Nevada to include other states comprising the Southwestern United States namely Arizona, California, and Utah to provide an indication of the regional demand for graduates of physician assistant master s programs. National degree completion and employment projection data 13 Selected Occupational Projections Data. Bureau of Labor Statistics. http://data.bls.gov:8080/oep/servlet/oep.noeted.servlet.actionservlet 14 Selected Occupational Projections Data. Bureau of Labor Statistics. http://data.bls.gov:8080/oep/servlet/oep.noeted.servlet.actionservlet 15 PA Students and Information. Nevada Academy of Physician Assistants. http://www.nevadapa.com/students.html#programs 5

were also analyzed to provide a national employment outlook for physician assistant graduates and serve as a benchmark for the level of demand in Nevada and the Southwest. Key findings from our analysis are outlined in the section that follows. 6

Key Findings Our research revealed only one physician assistant master s program in the state of Nevada: Touro University-Nevada, also located in XXX. Our research indicates only six physician assistant master s programs in the Southwestern states of Arizona, California, Nevada, and Utah: The average number of physician assistant master s degrees granted by these institutions each year is less than a quarter of the projected number of job openings expected each year between 2008 and 2018 in related occupations. At the national level, the average number of physician assistant master s degrees granted is approximately four-fifths of the projected number of job openings expected each year between 2008 and 2018 in related occupations. The physician assistant profession is expected to be one of the fastest growing occupations over the next few years: The BLS projects a 39 percent increase nationwide in the number of physician assistants. The profession is also expected to grow by 39 percent in Nevada over the same time period. Among faculty in physician assistant master s programs, an MPA degree is often the highest level of education attained: This suggests that there are postsecondary teaching opportunities for MPA graduates who teach within their field. Admission to physician assistant master s degree programs in the Southwest is extremely competitive: It is common for the average overall GPA of entering classes to be 0.5 or more above the minimum required, and many of the programs profiled in this study receive several hundred applications for a few dozen spots. This suggests there is a healthy student demand for physician assistant master s programs. 7

Supply of Physician Assistant Master s Degrees In this section, we present and discuss the number of graduates that will compete for job openings in physician assistant-related professions. To determine this number, we used the IPEDS Data Center tool to gather degree completions data for master s degree-granting physician assistant programs. Since IPEDS did not report any PA master s degree completions at Nevada institutions, we compiled degree completions data for the states comprising the Southwestern region of the United States as well as national degree completions data. Please note: bachelor degree completions data for PA programs were deliberately excluded from the analysis. Regional Supply Between 2005 and 2009, on average 287 physician assistant master s degrees were conferred each year at institutions in Arizona, California, and Utah (Table 3). In 2009, the overwhelming majority of the completions came from institutions in California, with Californian institutions accounting for 199 degree completions out of a total of 316 for the region that year. The other 117 came from one institution in Arizona (79 completions) and one in Utah (38 completions). As Figure 2 illustrates, the number of degree completions at institutions in the Southwest trended upward between 2005 and 2009. In 2009, there were 33 percent more degree completions at institutions in these states than there were in 2005. 16 350 Figure 2: Physician Assistant Master s Degree Completions in the Southwest, 2005-2009 Degree Completions 300 250 200 150 100 50 0 2005 2006 2007 2008 2009 Year Arizona California Utah Southwest Source: IPEDS Data Center 16 IPEDS Data Center. National Center for Education Statistics. http://nces.ed.gov/ipeds/datacenter/login.aspx 8

Table 3: Master of Physician Assistant Degree Completions in the Southwest, 2005-2009 Number of Physician Assistant Degree Completions State 2005 2006 2007 2008 2009 Average Arizona 51 57 53 82 79 64 California 148 192 206 175 199 184 Utah 39 40 40 36 38 39 Southwest 238 289 299 293 316 287 Source: IPEDS Data Center Six institutions comprise all of the degree completions in the Southwest. Each of these programs is profiled later in this report. National Supply The growth in the amount of physician assistant master s degrees conferred nationally has been nearly as strong as it has been in the Southwest. In 2009, 3,975 degrees were conferred by institutions across the United States, which is 27 percent higher than the number of degrees conferred in 2005. 17 Of these 3,975 degrees, only 316, or roughly eight percent, were conferred by institutions in the Southwest. To put this into perspective, Arizona, California, Nevada, and Utah comprise approximately 16 percent of the entire U.S. population, according to the latest Census data, 18 suggesting a significant opportunity for aspiring physician assistants in those states. Table 4 below presents the total number of physician assistant master s degree completions at institutions in the United States for each year between 2005 and 2009. It also provides a yearly average based on completions over that same period. Figure 3, which illustrates the growth in degree completions nationally over that same time period. Table 4: National Degree Completions in Master of Physician Assistant Programs, 2005-2009 Number of Physician Assistant Degree Completions State 2005 2006 2007 2008 2009 Average Nationwide 3,127 3,559 3,246 3,774 3,975 3,536 Source: IPEDS Data Center 17 Ibid. 18 2010 Census Data. U.S. Census Bureau. http://2010.census.gov/2010census/data/ 9

Degree Completions 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 Figure 3: National Degree Completions Trend 2005 2006 2007 2008 2009 Year Source: IPEDS Data Center 10

SOC Code Projected Job Openings in Occupations Related to Physician Assistant Master s Programs In this section, we outline job opening projections for physician assistants and postsecondary health specialties teachers in the Las Vegas Paradise Metropolitan Statistical Area (MSA), the state of Nevada, the Southwestern region of the United States, and the United States as a whole. Job projection data was obtained from each state s employment-focused department or agency as well as the U.S. Bureau of Labor Statistics for national data. The labor projections, beginning with the Las Vegas Paradise Metropolitan Statistical Area, are presented and discussed below. Local Projections 19 As XXX, Nevada lies within the Las Vegas Paradise MSA, it is useful to analyze employment projections in that area for the two occupations related to an MPA degree. The Nevada Department of Employment Training and Rehabilitation s (DETR) Research and Analysis Bureau provides projection data for physician assistants and postsecondary health specialties teachers in the Las Vegas Paradise MSA up to 2018. On average, the DETR projects there will be 18 physician assistant job openings each year over the next eight years due to growth and replacement needs and 23 job openings per year for postsecondary health specialties teachers, for a combined total of 41 annual job openings on average. Table 5 below displays the DETR s ten-year employment projections for both occupations in the Las Vegas Paradise MSA. Table 5: Physician Assistant Employment Projections for the Las Vegas - Paradise MSA SOC Title 2008 Estimated Employment 2018 Projected Employment Growth (Number) Growth (Percent) Average Annual Openings 29-1071 Physician Assistant 313 442 129 41.2 18 25-1071 Health Specialties Teachers, 410 548 138 33.7 23 Postsecondary Total 723 990 267 36.9 41 Source: DETR Research and Analysis Bureau 20 19 10 Year Occupational Employment Projections. Nevada Department of Employment Training and Rehabilitation, Research and Analysis Bureau. http://www.nevadaworkforce.com/cgi/dataanalysis/areaselection.asp?tablename=occprj 20 Ibid. 11

SOC Code Projections for Nevada While Nevada has been hit harder than most states by the current economic recession, the state s healthcare industry is expected to continue to grow. As of 2008, hundreds of thousands of Nevadans lived in areas underserved by primary care practitioners. The percentage of the state s residents that live in underserved areas (13.3 percent) is higher than the national average (11.8 percent). 21 According to Allied Health World, This shortage [of health professionals in some areas], along with the increase in the number of hospitals built in Nevada makes it a good state to seek employment as a Physician Assistant. 22 This is especially true of under-resourced areas, as physician assistants are a more cost-effective method of delivering most health services typically delivered by physicians. State employment projections support the notion that there will continue to be a market for trained physician assistants as well as postsecondary health specialties teachers. On average, the Nevada DETR projects there will be 25 physician assistant job openings annually as well as 39 annual job openings for postsecondary health specialties teachers, for a combined total of 64 annual job openings. 23 Comparing these figures with those presented in the Local Projections subsection, it is clear that most job openings in both occupations will be in the Las Vegas Paradise MSA, especially openings for physician assistants. Table 6 below presents the DETR s ten-year projections for these two occupations in the state of Nevada. Table 6: Physician Assistant Employment Projections for Nevada SOC Title 2008 Estimated Employment 2018 Projected Employment Growth (Number) Growth (Percent) Average Annual Openings 29-1071 Physician Assistant 470 653 183 38.9 25 25-1071 Health Specialties Teachers, 822 1,018 196 23.8 39 Postsecondary Total 1,292 1,671 379 29.3 64 Source: DETR Research and Analysis Bureau 24 21 Nevada: Estimated Underserved Population Living in Primary Care Health Professional Shortage Areas (HPSAs), as of September, 2008. statehealthfacts.org. http://www.statehealthfacts.org/profileind.jsp?cmprgn=1&cat=8&rgn=30&ind=682&sub=156 22 Physician Assistant Education in Nevada NV. Allied Health World. http://www.alliedhealthworld.com/nevada-physician-assistant-schools.html 23 10 Year Occupational Employment Projections. Op. cit. 24 Ibid. 12

Projections for the Southwest There is evidence of future job growth in the physician assistant profession in states bordering Nevada. In Arizona, which has fewer physicians per 100,000 residents than the national average, physician assistants are seen as a way of meeting the demand for health services traditionally provided by physicians. According to an article in The Arizona Republic, recent legislation in Arizona may contribute to physician assistants assuming a greater proportion of primary care services in the state going forward. After noting how physician assistants and nurse practitioners are increasingly providing primary care services in place of physicians, the article states, Lawmakers slashed funding to train graduate-student doctors at Arizona hospitals. One result is fewer graduating doctors will launch their careers here, medical experts say. 25 Fewer doctors, particularly primary care doctors, and a growing population provide opportunities for physician assistants to fill some of the health services gap. A recent report from the Utah Medical Education Council (UMEC) posits that several factors are contributing to PA employment growth in the state. For example, the report notes the shorter training period (compared to physicians) as an attractive option to aspiring healthcare workers, as well as their cost effectiveness to employers. Additionally, physician assistants are beginning to branch into specializations in which there are severe physician shortages. 26 The UMEC report also offers PA employment projections extending to 2025. According to UMEC s medium-growth projections, the PA workforce in Utah is expected to grow at more than 5 percent per year until 2015, when annual growth will begin to slow, reaching 3.4 percent in 2025. 27 Employment projections for the four Southwestern states support the notion that physician assistants will fill some of the health services gap left by stagnating employment growth in primary care physicians. California, with its massive population and high projected PA job growth (42 percent), is where most of the PA job growth in the region will occur. In all four states, however, physician assistant employment is expected to grow by over 30 percent between 2008 and 2018. Employment growth is also expected in the postsecondary health specialties teacher profession in all four Southwestern states, but it is expected to be modest compared to physician assistant employment growth. Between these two professions, there will be nearly 1,200 job openings per year across the four states between 2008 and 2018 due to growth and replacement needs, according 25 Alltucker, K. Primary Care Doctors in Short Supply in Arizona, Nation. The Arizona Republic. August 14, 2010. http://www.azcentral.com/arizonarepublic/news/articles/2010/08/14/20100814primary-care-doctorsshortage.html 26 Chappel, B., S. Koduri, and C. Ruttinger. (2010). Utah s Physician Assistant Workforce: 2010. Utah Medical Education Council, 28-29. http://www.utahmec.org/uploads/umec%20utah%20physician%20assistant%20report%202010.pdf 27 Ibid., 32. 13

to state projections. Figure 4, below, presents employment projections for the two professions in the Southwest region. Table 7, also below, contains the data on which Figure 4 is based. Figure 4: Physician Assistant and Health Specialties Teacher (Postsecondary) Employment Growth Projections by Percentage and Number for the Southwest, 2008-2018 45% 8000 40% 35% 30% 25% 20% 15% 10% 5% 7000 6000 5000 4000 3000 2000 1000 0% Arizona California Nevada Utah Southwest 0 Percentage Growth Growth (N) Sources: Arizona Workforce Informer, California Employment Development Department, Nevada Department of Employment Training and Rehabilitation, Research and Analysis Bureau, and Utah Department of Workforce Services. 14

SOC Code 29-1071 25-1071 SOC Code 29-1071 25-1071 SOC Code 29-1071 25-1071 SOC Code 29-1071 25-1071 Table 7: Physician Assistant and Health Specialties Teacher (Postsecondary) Employment Growth Projections for the Southwest, 2008-2018 Arizona 28 SOC Title Physician Assistant Health Specialties Teachers, Postsecondary SOC Title Physician Assistant Health Specialties Teachers, Postsecondary SOC Title Physician Assistant Health Specialties Teachers, Postsecondary SOC Title Physician Assistant Health Specialties Teachers, Postsecondary 2008 Estimated Employment 2018 Projected Employment Growth (Number) Growth (Percent) Average Annual Openings 1,293 1,731 438 33.9 67 1,996 2,320 324 16.2 67 2008 Estimated Employment California 29 2018 Projected Employment Growth (Number) Growth (Percent) Average Annual Openings 8,100 11,500 3,400 42 490 10,600 12,500 1,900 17.9 380 2008 Estimated Employment Nevada 30 2018 Projected Employment Growth (Number) Growth (Percent) Average Annual Openings 470 653 183 38.9 25 822 1,018 196 23.8 39 2008 Estimated Employment Utah 31 2018 Projected Employment Growth (Number) Growth (Percent) Average Annual Openings 830 1,320 490 59 60 1,540 1,970 430 27.9 70 Total (4 states) 25,651 33,012 7,361 30 1,198 28 Occupation Projections. Arizona Workforce Informer. http://www.workforce.az.gov/?pageid=67&subid=144 29 Occupational Projections of Employment. California Employment Development Department. http://www.labormarketinfo.edd.ca.gov/cgi/dataanalysis/areaselection.asp?tablename=occprj 30 10 Year Occupational Employment Projections. Op. cit. 31 Utah Job Outlook. Utah Department of Workforce Services. 15

Projections for the United States Since the U.S. Bureau of Labor Statistics only provides employment projections for postsecondary teachers as a whole and does not categorize the projections by subject taught, this sub-section focuses exclusively on projections for physician assistants. For the past few years, CNN Money and payscale.com have produced a list of the top 100 jobs in the United States, ranking occupations by pay, growth prospects, and quality of life. In both 2009 32 and 2010 33, physician assistant was rated the second best job in the United States. On job growth alone, the physician assistant profession ranks third, with 39 percent job growth nationwide projected between 2008 and 2018. 34 The BLS projects national PA employment in 2018 to be 103,900. This is up substantially from 2008 employment levels, which stood at 74,800. 35 CNN Money attributes this explosive growth to the cost-effectiveness of PAs compared to physicians. An article in U.S. News provides a brief account of the relationship between the economy and physician assistant job growth: With the economy tight in recent years, demand for physician assistants has increased, as they are capable of practicing medicine at roughly the same level as a full-fledged physician, but at a much lower cost, which makes them an appealing asset to medical providers looking to trim budgets. 36 If this assessment is true, the physician assistant profession may be one of the few that have actually been aided by the recession. The BLS believes job growth is likely to be particularly strong in inner-city and rural areas, because those settings have difficulty attracting physicians. Additionally, the BLS foresees a greater presence of PAs in hospitals, academic medical centers, public clinics, prisons, and other institutional settings. The BLS also claims public policy will factor into PA job growth, predicting greater employment prospects in states where regulations allow PAs a wide scope of practice. 37 32 2009 Rankings: Best Jobs in America. CNNMoney.com. http://money.cnn.com/magazines/moneymag/bestjobs/2009/index.html 33 2010 Rankings: Best Jobs in America. CNNMoney.com. http://money.cnn.com/magazines/moneymag/bestjobs/2010/ 34 Job Growth. CNNMoney.com. http://money.cnn.com/magazines/moneymag/bestjobs/2010/jobgrowth/index.html 35 Physician Assistants. Occupational Outlook Handbook, 2010-11 Edition, Bureau of Labor Statistics. http://www.bls.gov/oco/ocos081.htm 36 Burnsed, B. Why Physician Assistant School May be Right for You. U.S. News and World Report, August 6, 2010. http://www.usnews.com/education/best-graduate-schools/articles/2010/08/06/why-physician-assistant-schoolmay-be-right-for-you.html 37 Physician Assistants. Op. cit. 16

National job projections for the physician assistant profession support the anecdotal assertions of CNN Money and payscale.com as well as U.S. News journalists. As Table 8 shows, employment is projected to grow steadily between 2008 and 2018, with an annual average of over 4,200 job openings due to growth and replacement needs. Later on in this report, this figure will be compared with degree completions in physician assistant master s programs nationally to determine if there is a demand for more MPA (or other related degree, such as an MSPA or MPAS) graduates. SOC Code 29-1071 Source: BLS 38 Table 8: National Physician Assistant Employment Projections SOC Title Physician Assistant 2008 Estimated Employment 2018 Projected Employment Growth (Number) Growth (Percent) Total job openings due to growth and replacement needs Average Annual Openings 74,800 103,900 29,200 39 42,800 4,280 Physician Assistant Earnings Data Income varies by specialty, practice setting, geographical location, and years of experience. Employers often pay for their employees' professional liability insurance, registration fees with the Drug Enforcement Administration, State licensing fees, and credentialing fees. Nationwide, the median annual wage of physician assistants was $84,420 in May 2009. The middle 50 percent of physician assistants earned between $71,160 and $99,540. The lowest 10 percent earned less than $55,880, and the highest 10 percent earned more than $115,080. Median annual wages in the industries employing the largest numbers of physician assistants in May 2008 were: 39 General medical and surgical hospitals: $84,550 Outpatient care centers: $84,390 Offices of physicians: $80,440 Federal Executive Branch: $78,200 Colleges, universities, and professional schools: $74,200 According to the American Academy of Physician Assistants 2008 Census Report, median income for physician assistants in full-time clinical practice was $85,710 in 2008; median income for first-year graduates was $74,470. 40 38 Employment by Occupation. Bureau of Labor Statistics. http://bls.gov/emp/ep_table_102.htm 39 Physician Assistants. Occupational Outlook Handbook, 2010-11 Edition, Bureau of Labor Statistics. http://www.bls.gov/oco/ocos081.htm 40 Ibid. 17

Table 9: State Physician Assistant Salaries, 2009 State Average Annual Salary Median Annual Salary Arizona $84,460 $86,300 California $91,670 $89,880 Nevada $103,500 $88,270 Utah $88,190 $89,810 National $84,830 $84,420 Source: Bureau of Labor Statistics 41 41 Bureau of Labor Statistics. Occupational Employment Statistics. http://data.bls.gov:8080/oes/search.jsp?data_tool=oes 18

Comparing Job Projections to Degree Completions By comparing projected average annual job openings with average annual degree completions in degrees that correspond with those jobs, we are able to infer the level of unmet demand for graduates of physician assistant master s programs. Please note, however, that this methodology is far from perfect. For one, degree completion projections are currently unavailable, so we have instead used a figure for average annual completions over a recent five-year period as a proxy for future completions. Also, in many cases there are almost certainly other degree programs that place graduates in corresponding occupations. While physician assistant degree programs are the only programs associated with the physician assistant profession (according to the NCSC), several degree programs prepare students for careers as postsecondary health specialties teachers. This methodology merely serves to offer an indication of the level of demand for graduates of these degree programs and should not be regarded as a definitive projection. Nevada Comparison Given the lack of Master s degree completions data for the only physician master s program in the state (Touro University-Nevada), it is difficult to offer an accurate assessment of the market for graduates of a new program. Combining the projections for physician assistant and postsecondary health specialties teachers, there are expected to be 64 job openings per year. The room in the Nevada labor market for more PA graduates will depend on the size of the Touro program, as well as how many Nevada students participate in the University of Nevada University of Washington MEDEX Northwest partnership program. The MEDEX Northwest program allows Nevada students obtain their in-class PA training in Washington while completing clinical training in Nevada, and serving medically underserviced areas of Nevada upon graduation. The program s website mentions that at least three spots in the program are reserved for Nevada candidates. 42 It is certainly possible that physician assistant graduates from other states will seek employment in Nevada. Southwest Comparison For states in the Southwest, comparing degree completions data with employment projections for occupations related to physician assistant degree programs indicates a substantial pent-up demand for graduates of physician assistant master s programs. If average annual degree completions at institutions in the region remain around the average observed between 2005 and 2009, there will be more than four times as many job openings in occupations staffed by MPA graduates as there will be graduates each year. These numbers are indicative of the fact that the 42 MEDEX Physician Assistant Program. University of Nevada, Center for Education and Health Services Outreach. http://www.medicine.nevada.edu/cehso/medex.html 19

Southwest region confers relatively few physician assistant master s degrees relative to its population size and healthcare needs. National Comparison At the national level, comparing projected annual physician assistant job openings with average annual degree completions in physician assistant master s programs indicates unmet demand for MPA graduates in the future. On average until 2018, there will be 744 more job openings each year for MPA graduates than there will be degree completions, provided the 2005-2009 average remains accurate. As noted earlier, employment projections for postsecondary health specialties teachers are unavailable at the national level, so this figure only compares physician assistant job openings to degree completions. This implies that the gulf between job openings and degree completions could in fact be greater than 744, as it can reasonably be assumed that some graduates will pursue postsecondary teaching careers. Table 10 below shows the difference between projected average annual job openings in all jobs related to physician assistant degree programs (physician assistant, postsecondary health specialties teacher) and the average annual number of physician assistant master s degrees of all types (MPA, MSPA, etc.) conferred in Nevada, the Southwest, and the United States. Figure 5 presents a graphical representation of these data. Figure 5: Comparison of Degree Completions to Job Openings Nevada Southwest Average Annual Degree Completions United States Average Annual Job Openings (Projected) 0 1000 2000 3000 4000 5000 Number of Degree Completions and Projected Job Openings Sources: IPEDS Data Center, BLS, Arizona Workforce Informer, California Employment Development Department, Nevada Department of Employment Training and Rehabilitation, and the Utah Department of Workforce Services 20