Georgia Physician Assistant Workforce Report Based on 2017-2018 Licensure Renewal Data Georgia Board of Health Care Workforce State of Georgia Published July 2019 0 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Acknowledgements This report was produced under the direction of LaSharn Hughes, MBA, Executive Director; Leanna Greenwood, MA, Senior Data Analyst; G.E. Alan Dever, MD PhD, Consultant; Jocelyn Hart, Administrative Assistant III; Tommy Kelly, Systems Administrator. The Board would like to thank the Georgia Composite Medical Board for providing physician assistant licensure renewal data. This document is provided to the Georgia Board for Physician Workforce members on behalf of Executive Director LaSharn Hughes. Thank you to the Georgia Board of Health Care Workforce Board Members for their leadership and support. 1 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Table of Contents Acknowledgements ................................................................................................................................. 1 Executive Summary................................................................................................................................. 3 Methodology.............................................................................................................................................. 4 Physician Assistant Career Outlook ................................................................................................... 5 Table 1: 5-Year Age and Retirement Distribution ............................................................................ 6 Figure 1: Age and Retirement Distribution ....................................................................................... 7 Figure 2: PA Race Distribution ............................................................................................................. 8 Table 2: PA Race Distribution............................................................................................................... 8 Figure 3: PA Gender Distribution ........................................................................................................ 9 Table 3: PA Gender Distribution .......................................................................................................... 9 Figure 4: PA Gender x Race Distribution ........................................................................................ 10 Table 4: PAs by Primary Care/Core Specialty and MSA Status of Location .......................... 11 Figure 5: PA Specialty Mix................................................................................................................... 12 Figure 6: PA Primary Care/Core Specialty as a Percentage of Total ....................................... 13 Table 5: Practice Setting Distribution............................................................................................... 14 Table 6: PA Primary Care/Core Specialty by Practice Setting ................................................... 15 Table 7: Georgia Physician Assistants by County........................................................................ 16 Map 1: PAs per 100,000 Population, by County............................................................................. 19 Map 2: PAs per 100,000 Population, by MSA Status .................................................................... 20 2 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Executive Summary The 2018 Physician Assistant Workforce report marks the 4th year the Georgia Board of Health Care Workforce (GBHCW) has examined the supply and distribution of Georgia's physician assistants using data from licensure renewals. The physician assistants' data are analyzed by the GBHCW and the resulting information is reported on a biennial basis. There are 3,810 physician assistants who are licensed, currently working, and practicing in a Georgia county. This renewal cycle includes 89 physician assistants who are newly licensed in the state of Georgia. There are 36.16 physician assistants per 100,000 population who are licensed, currently working, and practicing in the state of Georgia. The top three (3) practice settings for physician assistants are hospital-clinic (30%), other (19%), and multi-specialty physician groups (17%). Whites represent 80% of the physician assistant workforce, while Blacks represent 10.0%, Asians 6%, and other race 4%. White women make up the largest gender-race group, at 49% of the physician assistant workforce. White men make up the second-largest group, at 31%. All other gender-race groups (Asian men and women, Black men and women, and "other" race men and women) make up the remaining 20% of the physician assistant population in Georgia. 63% of the physician assistants identify as female; 37% identify as male. Physician assistants working in non-MSA counties are more likely to be female (54%) than male (46%). Approximately 75% of the physician assistant workforce is 50 years old or younger. Approximately 5% of the workforce plans to retire within 5 years. The top three (3) primary care/core specialties are Family Medicine (11%), Emergency Medicine (10%), and Internal Medicine (5%). There are 34 counties with no physician assistants, representing a population of 432,000, according to the Governor's Office of Planning and Budget's 2018 population estimate (opb.georgia.gov, derived from U.S. Census Bureau data). The three (3) counties with the highest rate of physician assistants per 100,000 people are Decatur (86.6), Thomas (83.2), and Fulton (83.2). Of counties that have a rate of more than zero (0) physician assistants per 100,000 people, those with the three (3) lowest rates are White (3.3), Jackson (2.8), and Polk (2.4). Of the entire physician assistant workforce, 84% report working full time; 16% report not working full time. 1,220 (32%) physician assistants report having a second practice location; 255 (7%) report having a third practice location. 3 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Methodology This analysis was conducted on physician assistant renewals or original applications from the Georgia Composite Medical Board during the years 2017-2018. The survey is not mandatory to renew the license. Some physician assistants answered some, but not all, questions on the survey. The Georgia Board of Health Care Workforce (GBHCW) compiles, validates, and analyzes data from the surveys to prepare a report on physician characteristics, supply, and demand. Analyses were performed using Microsoft Excel and IBM SPSS. Data set exclusions: Physician assistants licensed during the years 2017 and 2018 in Georgia who answered they were not "currently working" or did not provide at least one Georgia county as a practice location. Data set inclusions: Physician assistants licensed during the years 2017 and 2018, who answered that they were "currently working," and who reported at least one Georgia county as a practice location. Count of total physician assistants: One license number corresponds to one physician assistant. The rate of physician assistants per 100,000 population was calculated using 2018 Census estimates of county population and the first practice county reported by each physician assistant licensure survey. 4 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Physician Assistant Career Outlook Physician assistants (PAs) partner with supervising physicians to practice medicine. Supervising physicians may delegate medical duties to physician assistants. Physician assistants perform a vital service to rural and underserved areas of Georgia where there is a shortage of practicing physicians. In doing so, physician assistants increase the quality and quantity of medical services in the state. The demand for physician assistants is on the rise and it is considered one of the fastest growing professions in the country.1 2019 nationwide Median salary: $108,6102 2018 Georgia Median Salary: $93,6421 Typical Education: Master's Degree including more than 2,000 hours of clinical rotations.3 Number of Jobs, 2018: 106,200 nationally.2 Job outlook, 2016-2026: 37% (much faster than average) 2 1 Southeastern Primary Care Consortium, Inc. 2018. "Health Careers in Georgia." Atlanta Area Health Education Center Health Careers. http://docs.wixstatic.com/ugd/3e5211_40fe2dc452d84a56a705a2c0d9bd2e95.pdf 2 Bureau of Labor Statistics, U.S. Department of Labor. 2018. "Physician Assistants." Occupational Outlook Handbook https://www.bls.gov/ooh/healthcare/physician-assistants.htm 3 Bureau of Labor Statistics, U.S. Department of Labor. 2018. "Physician Assistants: How to Become One." Occupational Outlook Handbook. https://www.bls.gov/ooh/healthcare/physician-assistants.htm#tab-4 5 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Table 1: 5-Year Age and Retirement Distribution Age Grouping <30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 >80 Total Count 230 783 705 564 515 357 247 205 145 44 14 1 3,810 Number Retiring within 5 Years 0 1 0 0 4 4 10 40 82 24 9 0 174 The mean average age of PAs in this renewal cycle is 43.3 years old. The lowest value for age is 26, while the highest value is 82. 174 PAs, or 4.6% of the total, are planning to retire within 5 years. 26.6% of the PAs are age 50 or older, and 16.7% of those aged 50 or older plan to retire in 5 years. 6 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Figure 1: Age and Retirement Distribution Age and Retirement Distribution 200 180 160 140 120 100 80 60 40 20 0 26272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071727374757677787982 Age Frequency Retiring in 5 Years 7 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Figure 2: PA Race Distribution PAs by Race Other Race 4% Asian 6% Black 10% White 80% Table 2: PA Race Distribution Response White Black Asian Other Race Total Number 3,051 397 208 154 3,810 Percent 80.1% 10.4% 5.5% 4.0% 100.0% 8 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Figure 3: PA Gender Distribution PAs by Gender Male 37% Female 63% Table 3: PA Gender Distribution Response Female Male Total Number 2,402 1,408 3,810 Percent 63.0% 37.0% 100.0% 9 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Figure 4: PA Gender x Race Distribution PA Gender x Race Distribution Asian Female 4% Asian Other Race Male Male Other Race Female 2% 1% Black Male 3% 3% Black Female 7% White Male 31% White Female 49% White female PAs make up nearly 50% (1,869) of the total workforce for this renewal cycle. White PAs, both male and female, make up 80% of the entire workforce for this renewal cycle. 10 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Table 4: PAs by Primary Care/Core Specialty and MSA Status of Location Primary Care/Core MSA Non-MSA Specialty Count of PAs Percent Count of PAs Percent Emergency Medicine 328 82.6% 68 17.1% Family Medicine 326 76.2% 102 23.8% Internal Medicine 177 82.7% 36 16.8% Pediatrics 63 90.0% 7 10.0% General Surgery 62 88.6% 8 11.4% OB/GYN 38 82.6% 8 17.4% Psychiatry 38 86.4% 6 13.6% Total 1,032 81.3% 235 18.5% Total by Specialty 397 428 214 70 70 46 44 1,269 81.3% of primary care/core specialty PAs practice in a MSA location, while 18.5% practice in a non-MSA. The primary care/core specialty with the highest MSA concentration is Pediatrics at 90.0%; the primary care/core specialty with the highest concentration in non-MSAs is Family Medicine at 23.8%. 11 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Figure 5: PA Specialty Mix PA Specialty Mix Gastroenterology 2% Dermatology 5% Pulmonary Cardiology 4% Medicine 1% Anesthesiology 23% Other 33% Primary Care/Core Specialties 32% Family Medicine 11% Emergency Medicine 10% General Surgery 2% Internal Medicine 5% OB/GYN 1% Pediatrics 2% Psychiatry 1% The "Other" category includes Endocrinology, Geriatrics, Hematology, Infectious Disease, Nephrology, Neurology, Occupational Medicine, Pulmonary Medicine, Radiology, Rheumatology, and all other specialties. 12 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Figure 6: PA Primary Care/Core Specialty as a Percentage of Total 12.0% 10.0% PA Primary Care/ Core Specialty as a Percentage of Total 11.2% 10.4% 8.0% 6.0% 5.6% 4.0% 2.0% 1.8% 1.8% 1.2% 1.2% 0.0% Family Emergency Internal Medicine Medicine Medicine General Pediatrics OB/GYN Psychiatry Surgery The three largest PA primary care/core specialties are Family Medicine, Emergency Medicine, and Internal Medicine, which is consistent with the top three specialties in the 2016-2017 renewal cycle. 13 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Table 5: Practice Setting Distribution Practice Setting Hospital-Clinic Multi-Specialty Physician Group Solo Physician Practice Hospital-University Physician Practice Management Org Community Health Center College or University Nursing Home or LTC Facility HMO Home Health Agency Other Total Number 1,125 648 571 536 82 71 30 15 13 2 717 3,810 Percent 29.5% 17.0% 15.0% 14.1% 2.2% 1.9% 0.8% 0.4% 0.3% 0.1% 18.8% 100.0% 14 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Table 6: PA Primary Care/Core Specialty by Practice Setting Core Specialty and Percent College or University Family Medicine Percent Emergency Medicine Percent Internal Medicine Percent General Surgery Percent 13 72.2% 1 5.6% 3 16.7% 0 0.0% Pediatrics 0 Percent 0.0% OB/GYN 1 Percent 5.6% Psychiatry 0 Percent Grand Total Percent 0.0% 18 1.4% Community Health Center 35 64.8% 2 3.7% 11 20.4% 0 0.0% 1 1.9% 3 5.6% 2 3.7% 54 4.3% HMO 0 0.0% 3 42.9% 1 14.3% 0 0.0% 1 14.3% 2 28.6% 0 0.0% 7 0.6% Home Health Agency 0 0.0% 1 100.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 0 0.0% 1 0.1% Hospital -Clinic 60 17.5% 179 52.2% 41 12.0% 24 7.0% 16 4.7% 10 2.9% 13 3.8% 343 27.0% HospitalUniversity 6 5.6% 78 72.9% 13 12.1% 5 4.7% 4 3.7% 0 0.0% 1 0.9% 107 8.4% MultiSpecialty Physician Group 67 40.9% 17 10.4% 30 18.3% 29 17.7% 14 8.5% 4 2.4% 3 1.8% 164 12.9% Nursing Home or LTC Facility 2 33.3% 0 0.0% 3 50.0% 0 0.0% 0 0.0% 0 0.0% 1 16.7% 6 0.5% Physician Practice Management Org Solo Physician Practice Other Grand Total 20 134 91 428 45.5% 10 22.7% 11 25.0% 2 4.5% 52.3% 12 4.7% 59 23.0% 4 1.6% 33.8% 94 34.9% 42 15.6% 6 2.2% 33.7% 397 31.3% 214 16.9% 70 5.5% 1 20 13 70 2.3% 7.8% 4.8% 5.5% 0 15 11 46 0.0% 5.9% 4.1% 3.6% 0 12 12 44 0.0% 44 3.5% 4.7% 256 20.2% 4.5% 269 21.2% 3.5% 1269 100.0% The largest percentage of PAs in Emergency Medicine, General Surgery, and Psychiatry work in a hospital/clinic setting. The largest percentage of Family Medicine, Internal Medicine, OB/GYN, and Pediatrics PAs work in a solo physician practice. 15 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Table 7: Georgia Physician Assistants by County County Georgia Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Carroll Catoosa Charlton PCSA Total PAs 2018 Population Rate per 100,000 Rank - 3,810 91 2 88 2 90 0 76 1 47 4 10 0 27 6 17 14 87 0 85 4 46 106 63 1 93 0 81 3 52 6 53 21 50 3 37 3 76 4 96 13 55 1 19 20 1 4 95 1 10,519,475 18,507 8,297 11,185 3,092 44,823 18,988 80,809 106,408 16,787 19,252 153,095 12,838 18,897 15,513 38,109 77,296 22,423 24,193 6,352 53,677 10,836 118,121 67,420 12,968 36.16 - 10.81 96 24.11 46 0.00 126 32.34 33 8.92 106 0.00 126 7.42 109 13.16 84 0.00 126 20.78 53 69.24 8 7.79 107 0.00 126 19.34 58 15.74 75 27.17 37 13.38 82 12.40 88 62.97 12 24.22 44 9.23 104 16.93 68 5.93 114 7.71 108 County PCSA Total PAs 2018 Population Rate per 100,000 Rank Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert 52 203 43 2 18 1 15 43 27 85 76 0 39 30 83 2 21 286 88 15 78 6 31 41 80 1 41 51 46 0 65 4 1 0 11 4 73 23 23 356 62 3 66 1 76 48 20 17 71 5 82 1 52 8 29 0 289,195 10,684 24,790 254,149 127,330 2,887 289,615 6,648 756,865 43,093 45,592 154,291 17,162 145,864 12,318 22,601 16,226 25,083 26,575 756,558 20,705 13,706 91,243 145,331 10,247 4,000 62,190 19,120 70.19 7 18.72 61 4.03 120 16.92 69 66.76 9 0.00 126 10.36 99 30.08 35 37.79 24 34.81 29 13.16 83 26.57 38 5.83 115 34.96 28 0.00 126 17.70 65 0.00 126 15.95 73 86.55 1 47.06 18 14.49 78 7.30 110 52.61 14 11.70 92 48.79 16 25.00 43 12.86 85 0.00 126 16 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey County Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis PCSA Total PAs 2018 Population Rate per 100,000 Rank 57 6 56 2 4 3 40 72 18 62 13 89 9 4 22 874 3 3 32 0 93 36 16 17 74 3 34 3 25 224 10 9 11 152 33 1 19 4 43 0 28 0 42 0 38 76 67 25 86 1 27 2 36 7 89 0 22,612 10,721 25,964 113,459 97,927 236,612 23,023 1,050,114 30,816 2,995 85,219 57,685 24,748 17,698 927,781 45,388 202,148 8,348 29,533 34,475 26,099 11,879 230,220 155,469 9,398 70,422 14,040 15,029 26.53 39 18.65 62 11.55 93 63.46 10 63.31 11 37.61 25 17.37 66 83.23 3 9.74 103 0.00 126 42.24 20 29.47 36 12.12 89 16.95 67 24.14 45 19.83 56 75.19 6 11.98 90 13.54 80 0.00 126 0.00 126 0.00 126 33.01 31 16.08 72 10.64 98 2.84 124 49.86 15 0.00 126 County Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion McDuffie McIntosh Meriwether Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee PCSA Total PAs 2018 Population Rate per 100,000 Rank 49 6 54 3 48 1 46 0 44 3 84 2 60 12 76 4 52 20 31 0 92 0 82 35 12 7 66 2 27 1 43 0 32 4 93 1 42 0 72 0 76 8 45 3 58 2 27 1 2 2 43 85 36 12 27 19 15,430 8,683 9,708 28,616 19,000 10,340 47,325 29,764 61,497 7,915 18,998 116,321 32,955 13,143 29,650 8,351 21,531 14,340 21,068 5,686 22,192 27,520 9,193 18,853 39,921 194,160 109,541 39,272 38.89 23 34.55 30 10.30 100 0.00 126 15.79 74 19.34 57 25.36 41 13.44 81 32.52 32 0.00 126 0.00 126 30.09 34 21.24 52 15.22 76 3.37 122 0.00 126 18.58 63 6.97 112 0.00 126 0.00 126 36.05 27 10.90 95 21.76 51 5.30 117 5.01 119 43.78 19 10.95 94 48.38 17 17 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey County Oglethorpe Paulding Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Rockdale Schley Screven Seminole Spalding Stephens Stewart Sumter Talbot Taliaferro Tattnall Taylor Telfair Terrell Thomas PCSA Total PAs 2018 Population Rate per 100,000 Rank 27 1 21 23 46 0 14 8 94 1 37 2 18 1 64 0 35 2 70 0 7 2 70 1 31 160 24 23 68 0 51 1 72 0 37 15 8 1 69 1 68 5 43 0 30 0 56 6 46 0 61 3 76 0 75 37 15,054 164,044 27,297 31,980 19,389 18,634 42,470 11,069 21,809 2,279 16,867 6,833 201,554 90,594 5,236 13,938 8,315 66,100 26,035 6,199 29,733 6,272 1,608 25,391 8,039 15,876 8,611 44,448 6.64 113 14.02 79 0.00 126 25.02 42 5.16 118 10.73 97 2.35 125 0.00 126 9.17 105 0.00 126 11.86 91 14.63 77 79.38 4 25.39 40 0.00 126 7.17 111 0.00 126 22.69 50 3.84 121 16.13 71 16.82 70 0.00 126 0.00 126 23.63 48 0.00 126 18.90 60 0.00 126 83.24 2 County Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth PCSA Total PAs 2018 Population Rate per 100,000 Rank 79 32 58 11 6 5 60 0 42 13 79 1 46 0 5 9 44 6 1 7 26 5 94 21 32 1 48 2 92 6 69 0 59 1 11 1 2 25 64 0 30 2 46 0 77 0 40,571 26,887 11,852 6,809 70,034 7,912 8,188 24,001 26,215 69,410 93,503 35,680 5,251 20,386 29,808 2,611 7,879 29,970 104,062 8,812 9,876 9,036 20,299 78.87 5 40.91 22 42.19 21 0.00 126 18.56 64 12.64 87 0.00 126 37.50 26 22.89 49 10.09 101 5.35 116 58.86 13 19.04 59 9.81 102 20.13 55 0.00 126 12.69 86 3.34 123 24.02 47 0.00 126 20.25 54 0.00 126 0.00 126 18 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Map 1: PAs per 100,000 Population, by County Rate of Physician Assistants Per 100,000 0 0-10 10-20 20-30 30-84 Number of Counties 34 24 46 20 35 There were 34 counties with no physician assistants. This represents a population of 432,000. For the state of Georgia, the average number of physician assistants per 100,000 people is 36.16. 19 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey Map 2: PAs per 100,000 Population, by MSA Status Rate of Physician Assistants Per 100,000 0 0-10 10-20 20-30 30-84 Non-MSA Number of Counties 15 8 23 7 21 85 The color is null (white) for non-MSA counties. There were 15 counties in MSAs with no physician assistants. This represents a population of 254,207. 20 Georgia Board of Health Care Workforce 2017-2018 Physician Assistant Licensure Survey The 2017-2018 Physician Assistant Licensure Survey document can be viewed and downloaded on the internet at gbpw.georgia.gov. The Georgia Board of Health Care Workforce welcomes comments and suggestions for future editions of this report. Please send comments to leanna.greenwood@dch.ga.gov. 21