Bridging the gap
California programs fill growing need for physician assistants and nursing professionals
Miriam Raftery
Job opportunities
“There is definitely a demand for both physician assistants (PAs) and family nurse practitioners (FNPs),” says Michael Denis, a student enrolled in a PA program at the University of California, Davis. “With the current nationwide situation with health care, there’s a huge need to fill the gap with these mid-level providers.”
Both PAs and FNPs practice under supervision of a physician. The first PA program was founded at Duke University to create civilian jobs for military corpsmen and medics returning from Vietnam. In 2007, 245 million patient visits were made to PAs, according to the American Association of Physician Assistants (AAPA). The U.S. Bureau of Labor Statistics has ranked physician assistant as the fourth fastest growing profession nationally.
“PAs come from traditional or nontraditional medical backgrounds,” Denis notes. “Often they are paramedics, military or foreign medical graduates, whereas the nurse practitioners are the four-year, Bachelor of Science degree nurses who come from a nursing background. However, a lot of the protocols we are allowed to practice under are very similar.” Average salaries nationally are around $75,000 a year for PAs and around $77,000 for nurse practitioners, though certain specialties and locations command higher wages, he adds.
California also faces a shortage of nurses—a gap new training programs seek to fill. According to a May 2007 report from the California Legislative Analyst’s Office, the state is short 4,696 registered nurses (RNs)—a shortage that is expected to double by 2014. The gap is caused by population growth, an increasing number of older Californians, and nurses nearing retirement age.
According to the University of California, San Francisco’s Center for California Health Workforce Studies, the number of nursing school graduates in California has fortunately increased nearly 70 percent over the last five years, reaching a projected number of over 10,000 new RN graduates per year; new programs have also emerged to further ease the nursing shortage. The ratio of RNs per general population in California is much smaller versus the national ratio (about 650 full-time RNs per population of 100,000, versus 825) but as of 2006 California RNs typically earned a higher hourly wage ($36.12) than the national average ($28.71).
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“We anticipate starting enrollment in about 2009,” says Ann Bonham, executive associate dean. “The focus initially will be on master’s and Ph.D.s. Then we will roll out a bachelor’s in nursing program approximately two years following that.”
The program aims to educate nursing students to practice in an increasingly complex health care system including not only hospital settings, but also community clinics, public health service, government agencies and other emerging health care environments.
“The Institute of Medicine came out with a report that said between 45,000 and 95,000 medical errors occur annually,” Bonham observes. “This is an amazing statistic. Who are better prepared to help improve patient safety than nursing professionals? They are putting their hands on the patients and families more than anybody else, figuratively speaking.”
The new school’s nursing curriculum will have four anchors. “One is inter-professional education,” Bonham explains. “That means nursing students and medical students are educating shoulder to shoulder, so they are seeing the same cases together. They are really learning how to communicate early in their careers, so these communication skills will go with them throughout the educational process.”
Other program anchors include:
• patient-centered technologies (including teletechnology, such as electronic medical records, in research and patient care);
• scientific rigor (enabling graduates to utilize best practices based on evidence, not instinct);
• preparation in leadership, management and communication skills.
Master’s degrees will be conferred following a two- to three-year program. Ph.D program length will vary depending on the scope of specific research projects.
“Another important thing is to provide qualified nurse educators,” Bonham says. “When we think about the nursing shortage in California and across the nation, one of the barriers is having sufficient faculty. The mean age is over 50 and many are retiring, so we have to think about new professoriate. We believe a key contribution of the Betty Irene Moore School of Nursing is to provide those outstanding nurse educators, as well as the practicing nurses.”
Touro University in Vallejo offers programs for nursing, physician assistants and other health care professions. Recently, Touro’s Vallejo campus became the first college in the nation to offer a joint master’s degree in both public health and physician assistant. The program has two tracks: community health and global health.
In January 2007, students in Touro’s double master program traveled to Ethiopia, where they worked at a hospital with a goal toward improving the health of people worldwide. Students helped conduct field research on malaria and evaluated the effectiveness of a tuberculosis treatment program.
Ryan Garson, a Touro student who participated in the Ethiopia project, plans to focus on pediatrics after graduating in 2008. He concludes, “This was definitely a worthwhile experience that gave me a global perspective on the delivery of health care from a public health viewpoint.”
As the baby boomer generation enters retirement age and demand increases for affordable and accessible healthcare services, career opportunities for students in nursing and physician assistant programs should remain strong for the foreseeable future.
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