Physician Assistant Doctorate

Miller, Anthony; Coplan, Bettie

doi:10.1097/jpa.0000000000000147

Cited by 18 publications

(28 citation statements)

References 11 publications

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“…Neither collegiate years nor entry‐level degree were predictive of PT imaging authority. This is consistent with previous research with reports educational rigour, in itself, does not lead to professional autonomy (Miller & Coplan, ).…”

Section: Discussionsupporting

confidence: 93%

“…This suggests the overall educational rigour of USA PT programs is at least on par with other member nations that allow PTs to order imaging. Neither collegiate years nor entry-level degree were predictive of PT imaging authority.This is consistent with previous research with reports educational rigour, in itself, does not lead to professional autonomy(Miller & Coplan, 2017).Although lower healthcare expenditures per capita was a predictor of musculoskeletal imaging authority, it cannot indicate causation within the limits of our study. A multitude of factors influence a nation's healthcare expenditures(Dieleman et al, 2016; J. L Johansen, 2017)…”

supporting

confidence: 93%

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Physical therapy musculoskeletal imaging authority: A survey of the World Confederation for Physical Therapy Nations

Mabry

Boyles

Brismée

et al. 2019

Physiotherapy Res Intl

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Objectives Medical evidence largely supports PTs in expanded roles, however, healthcare policy within the United States (USA) typically restricts PTs from ordering musculoskeletal (MSK) imaging. It is unknown how MSK imaging policy in the USA compares to other World Confederation for Physical Therapy (WCPT) member nations. The primary objective of our study was to investigate the authority of PTs to order MSK imaging. A secondary objective was to identify factors associated with the authority for PTs to order MSK imaging. Methods 111 WCPT member nations were surveyed over a 2‐month period on the authority of PTs ordering MSK imaging within their nation. A secondary analysis utilizing a step‐wise binary regression compared member nation demographic statistics to MSK imaging authority. Results 81 member nations responded to the survey. 31 (38.3%) of member nations reported having some level of PT MSK imaging authority while 50 (61.7%) did not. Member nations with lower per capita healthcare costs were significantly more likely to allow PTs to order MSK imaging (p = 0.02). Those with direct access authority were 7.4 times more likely to authorize PTs to order MSK imaging (p < 0.01). Entry‐level clinical degree and years of entry‐level collegiate credit were not associated with imaging authority. Conclusion This is the first study to report MSK imaging policy within the WCPT member nations. While many nations within the WCPT allow PTs to order MSK imaging, the majority of nations still restrict PTs from such practice. Lower per capita healthcare costs and direct access authority were significant predictors of MSK imaging authority, however, causation cannot be established within the confines of this study. Future studies should consider issues such as restrictive policy origin (i.e. governmental vs. institutional), insurance reimbursement (i.e. private vs. public sector policy), and limitations on imaging modality

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Section: Discussionsupporting

confidence: 93%

supporting

confidence: 93%

Physical therapy musculoskeletal imaging authority: A survey of the World Confederation for Physical Therapy Nations

Mabry

Boyles

Brismée

et al. 2019

Physiotherapy Res Intl

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“…The debate on PA doctoral education was initially addressed at the 2009 PA Clinical Doctorate Summit conducted by the Physician Assistant Education Association (PAEA) and the American Academy of PAs (AAPA). The purpose of the summit was to address the question of whether a clinical doctorate was the appropriate entry-level degree for the profession and subsequently endorsed the master's degree as the entry-level and terminal degree for the profession [5,6,7].Post-professional doctorates such as the doctor of medical science (DMSc) were supported as an educational option for PAs as long as they were not PAspeci c [8]. While the PA profession has remained consistent in not endorsing a PA entry-level doctorate, there has been renewed interest in the PA doctoral education debate and recently PAEA commissioned research to investigate the feasibility of an entry-level doctoral degree for PAs [9].…”

Section: Introductionmentioning

confidence: 99%

“…PAs have traditionally practiced team-based care under the supervision of a physician. A concern for some PAs is that a PA entry-level doctoral degree could signal abandoning team-based practice in favor of greater autonomy and disrupt the traditional symbiotic relationship between PAs and physicians [7]. In addition, since the PA scope of practice is not typically a function of formal educational level, many question if additional doctoral level training would enhance the clinical competency of PAs.…”

Section: Introductionmentioning

confidence: 99%

A Physician Assistant Entry-Level Doctoral Degree: More Harm Than Good?

Kulo

Fleming

Gordes

et al. 2021

Preprint

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Background: As most health professions in the United States have adopted clinical or practice doctorates, there has been an ongoing debate on whether physician assistants (PAs) should transition from a master’s to a doctorate as the terminal degree. The authors examined perceived risks, benefits and impact of transitioning to an entry-level PA doctoral degree. Methods: A multi-prong, mixed-methods approach was used that included a literature review and collecting quantitative and qualitative data. Bivariate analysis and binomial logistic regression analysis were performed to evaluate relationships between perceptions/perspectives on an entry-level PA doctoral degree and the anticipated impact of it causing more harm than good to the PA profession. For the semi-structured interviews (38 interprofessional stakeholders), deductive content analysis was used to analyze the qualitative data. Results: Six hundred and thirty six PA clinicians and PA students (46%) completed the survey. Most respondents (n = 457, 72%) disagreed that an entry-level PA doctoral degree should be required. More than half of the respondents (n = 341, 54%) agreed that it should be offered but not required and 380 respondents (60%) agreed that an entry-level doctoral degree would cause more harm than good. Race, educational attainment, occupation, and length of practice as a PA were significantly associated with having a perception of causing more harm. There was strong positive association between the perception of a doctoral degree causing more harm with expectations of having a negative impact on the availability of clinical training sites (OR = 4.39, p <.05). Based on the analysis of qualitative data, the most commonly cited perceived risks were increased cost for education, decreased diversity in the profession, and negative impact on the PA/physician relationship. Conclusions: The perceived benefits and risks of an entry-level PA doctoral degree are strongly influenced by the lens of the stakeholder. While the majority of PAs and students appear to be not in favor, the proportion of those in favor is not insignificant and their views should not be ignored in future discussions. Addressing concerns with key stakeholders could help the PA profession to transition to a doctoral degree with minimal adverse impact.

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“…This has not been without contention, however, with some in these fields voicing concerns about training burden and the clinical relevance of doctoral-level work. 29,30 The prospect of increased educational requirements for DTs has faced similar backlash. 31 Yet as the Minnesota model has grown to encompass the plurality of states with DT legislation in place, it is likely that future DT training programs will develop curricular offerings aligned with these requirements in order to maximize their graduates' ability to practice.…”

Section: The Future Of Dental Therapymentioning

confidence: 99%

Dental therapy in the United States: Are developments at the state level a reason for optimism or a cause for concern?

Simon

Donoff

Friedland

2020

J Public Health Dent

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Access to dental care continues to be a challenge for millions of vulnerable Americans. In more than 50 nations worldwide, dental therapists (DTs), midlevel providers who deliver a limited scope of dental care under the supervision of a dentist, have helped increase access to needed care. Since 2003, when the Alaska Native Tribal Health System introduced DTs as part of the Federally authorized Alaska Community Health Aide Program, a total of 13 states have adopted the role. However, as of April 2020, there are fewer than 150 DTs in practice throughout the country, and educational and licensing requirements as well as scope of practice vary between each state. Such heterogeneity makes the training and recruitment of future DTs a challenge. This article summarizes the current state of the DT workforce in the United States and discusses the possible future of the profession as other states contemplate adopting the model in the face of ongoing oral health disparities.

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Physician Assistant Doctorate

Cited by 18 publications

References 11 publications

Physical therapy musculoskeletal imaging authority: A survey of the World Confederation for Physical Therapy Nations

Physical therapy musculoskeletal imaging authority: A survey of the World Confederation for Physical Therapy Nations

A Physician Assistant Entry-Level Doctoral Degree: More Harm Than Good?

Dental therapy in the United States: Are developments at the state level a reason for optimism or a cause for concern?

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