By BECKY GILLETTE
Mississippi ranks as having the worst physician shortage in the country. One way to help meet that gap is the use of “physician extenders” like advanced practice registered nurses (APRNs) and physician assistants (PA).
Mississippi was the last state in the country to allow PAs to practice. The state’s first training program was launched at Mississippi College (MC) in Clinton in 2011. Six classes graduated between 2013 and 2018 for a total of 182. There are currently three cohorts of 30 students undergoing training for a total of 90.
Dr. Gary H. Nowell, Jackson, has been an internal medicine clinical preceptor for PA students since the beginning of the MC PA program.
“In my experience, I have found the students to be extremely bright and motivated,” Nowell said. “The PA curriculum closely mimics medical school training with 15 months of classroom training followed by 15 months of clinical training such that at graduation and upon passing the licensing test, a PA is at a similar level of a medical intern. The remainder of their training is completed by the physician(s) who they will work alongside in a particular specialty.”
Nowell said the PAs that he has worked with have been exceptionally capable of providing excellent medical care with appropriate oversight and have been very well accepted by patients and staff in his practice.
“There is a progressively increasing number of PA-C’s (PA-Certified) now employed in the St. Dominic Medical Associates, LLC, St. Dominic medical staff subspecialties, and MEA (Mississippi Emergency Agency) Clinics,” Nowell said. “They have been a welcome addition to the medical care team.”
Dr. Daniel P. Edney, an internist with Medical Associates of Vicksburg, said he and his associates serve as clinical preceptors for the program and find the students very well-educated.
“PAs and APRNs are helping to relieve some of the burdens we as physicians face daily and, when involved in appropriate collaborative relationships with physicians, they do help to meet critical health care needs in Mississippi in a safe manner,” Edney said. “Our clinic finds great value in using the physician led team-based approach using both PAs and APRNs to assist us in managing our practices. Without our midlevel providers, we would not be able to manage our very busy practices, which include helping us in the nursing homes, a long-term acute care unit, an acute care hospital, as well as our clinic practices. “
Edney said PA-Cs are very bright and hard working with a strong desire to learn and assume the challenges involved in assisting physicians with clinical care.
Another physician who thinks highly of PA-Cs is Dr. Lee Nicols, General Surgical Associates, Jackson.
“We have three PA-Cs with our group and anticipate hiring another one at the start of the year,” Nicols said. “They play a significant role in the health care and management of our patients. We have found the PA-Cs to be extremely well-trained. The coursework for physician assistant training is very rigorous, comprising over 2,000 hours of training.”
Nichols said PA-Cs have improved their group’s documentation, which has reduced errors and increased reimbursement. They have also allowed the physicians to be more available as surgeons and have more provider time with the patients pre and post operatively.
Job prospects are excellent for PA graduates, said Steven Martin, program director and department chairman for the MC Department of Physician Assistant Studies.
“Education is the key though,” Martin said. “While PAs are a household word in all other states in the U.S., because Mississippi was the last state to allow licensure of PAs, we’re not yet as well known. That is changing rapidly, however. When physicians see the depth of our training and recognize how much we can add to their practice, they increasingly want to work with a PA.”
Martin said it is difficult to know the average salary of a PA in Mississippi because there are so few PAs in Mississippi compared to other states. In the American Academy of Physician Assistants 2019 Salary Survey, the 75th percentile for PA salaries in Mississippi is $106,000, not including bonuses or other forms of compensation.
Of the 182 PA graduates from MC, 82 have stayed in Mississippi. About half of the students enrolled in the MC program are from out of state.
PAs are particularly needed in rural areas.
“It is difficult to get medical providers to go to rural areas,” Martin said. “Many of our students are from rural areas and often return there. Student loan repayment opportunities also entice physicians, PAs, and NPs as well. Our program mission is to prepare PAs to provide primary health care services in medically underserved areas of Mississippi and surrounding states.”
Most PA-Cs, however, are working in higher population areas. Martin said that is because there are more jobs available in urban and suburban areas and it is harder to recruit medical providers to rural areas.
The shortage of primary care providers, in particular, is well-documented both in Mississippi and nationally. Martin said PAs are well-trained to meet this need.
Almost all PAs are trained with a strong primary care foundation. They then may go on to enter a specialty.
“There are PAs in the White House, stationed abroad with the State Department and military, and, of course, all of across the nation,” Martin said. “The U.S. military, the National Health Service Corps, the U.S. Public Health Service, the U.S. Bureau of Prisons, and many others offer scholarships and loan repayment after graduation.”
Martin said PAs are educated in the medical model designed to complement physician training.
“Students at our program are assigned to faculty-mentored learning teams,” he said. “Problem-based learning, team-based learning, lectures, objective structured clinical experiences, lab exercises, and supervised clinical experiences supported by technologic innovation and service are just a few strategies used to achieve this mission,” Martin said. “The program encourages scholarship, is responsive to changing health-care and societal needs, facilitates personal and professional growth, and promotes life-long learning.”
The seeds of the PA program at MC began in 2007 when Dr. Lee Royce, then president of Mississippi College, and Dr. Stan Baldwin, dean of the School of Science and Mathematics, identified the need to better address the health-care needs of Mississippi.
“They both new knew PAs could help, having come to Mississippi from other states where PAs were much more commonplace,” Martin said. “Dr. Robert Philpot was hired as the program’s new director and department chair. The program attained appropriate accreditation and enrolled its first class in 2011.”
Martin said in addition to training, their students are very involved in Mississippi communities. They volunteer through service learning as a part of their curriculum at medical clinics in Jackson and Vicksburg and at other outreaches such as Stew Pot in Jackson.
“We also prepare them for medical service and outreach both here in the U.S. and internationally and many of our students do their clinical rotations around the world,” he said.
The Department of Physician Assistant Studies is currently accepting applications for the May 2020 session. For more information about the application process, call (601) 925-7371 or visit the website www.mc.edu/academics/departments/pa/.
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