Bridging the Gap: Examining Physician Assistant Practice Patterns to Address Kentucky's Health Care Workforce

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; Z = 6.76; P < 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.