Physician Assistant/Associate Urology Workforce: A National Analysis

Introduction/Background: The urology workforce is shifting in terms of the number of physicians per capita, age, gender, and availability. To meet this growing need, physician assistants/associates (PAs) and nurse practitioners (NPs) are part of this workforce backfilling effort. However, limited studies have been conducted on the demographic and employment attributes of PAs practicing in urology. Thus, using a national dataset, this study aims to compare the attributes of PAs in the urology workforce compared with PAs in all other surgical and medical disciplines. Methods: We analyzed the practice of PAs in urology using data from the 2022 National Commission on Certification of PAs (NCCPA). This study drew on responses from 117,748 board-certified PAs who reported their medical and surgical specialty. Our analysis involved descriptive and inferential statistics, comparing the demographic and practice attributes of PAs in urology (n = 1199) with PAs in all other medical disciplines (n = 116,549). Results: In 2022, 1199 (1.0%) PAs were reported to be clinically active in urology. Among PAs in urology, 68.1% self-identified as female, with a median age of 39 [IQR: 32-48]. Compared to PAs in other medical disciplines, PAs in urology resided in urban locations (94.5% vs. 92.5%, p = 0.002). They were also more likely to practice in office-based settings (53.6% vs. 37.0%), work over 40 h weekly (37.9% vs. 29.3%), and partake in telemedicine (52.0% vs. 40.1%; all p < 0.001). No statistical differences were found among PAs in urology versus PAs in all other medical fields related to job satisfaction (p = 0.763), symptoms of burnout (p = 0.124), and retirement plans in the next 5 years (p = 0.442). Conclusions: Given the predicted shortfalls of urologists and their changing demographic composition, this study has important implications for practice in the urology workforce. Our findings can inform workforce planning, recruitment strategies, and organizational policies to support the expansion of PAs in urology and help address shortages in this discipline.