Date of Award

Fall 10-18-2017

Degree Type

Dissertation

Degree Name

PhD Higher Education Leadership, Management, Policy

Department

Education Leadership, Management and Policy

Advisor

Rong Chen, Ph.D.

Committee Member

Denise Rizzolo, Ph.D.

Committee Member

Robert Kelchen, Ph.D.

Keywords

specialty choice, physician assistant, primary care, job choice

Abstract

Current trends and data analysis show that there is a shortage of primary care providers throughout the United States. Physician assistants (PAs) who are mid-level practitioners, nationally certified, and state licensed to practice medicine, play an important role in healthcare delivery; however, the percentage of PAs practicing in primary care has dramatically decreased in the past 15 years. An important question to consider is what drives the decision-making process of job choice for PAs? The purpose of this dissertation was to identify potential modifiable factors that influence PA first job choice following graduation from a PA program in a national sample and to determine if they have a relationship to the choosing of primary care. Specifically, this study utilized a conceptual framework to explore the following: what role do individual factors (demographics; student debt; and personal values) have relative to “program” factors (including faculty and preceptor influence; and mentoring) vs. “external” factors (job availability, income potential) in shaping job choice?

Using a national sample from The 2016 End of Program Survey from the Physician Assistant Education Association, out of the 3038 subjects, 269 (8.9%) accepted a job in primary care medicine, 847 (27.9%) accepted a specialty job and 1922 (63.3%) did not accept a job at the time they were given the survey. The multinomial logistic regression model comparing no job accepted versus primary care job choice revealed marital status and racial/ethnic differences in first job choice. Additionally, financial factors including both educational debt and income potential, were found to be significant predictors. For the second multinomial logistic regression model comparing specialty job versus primary care job choice, the results demonstrate civil status differences in first job choice, financial factors including both educational debt (strong) and income potential (both moderate and strong), and a program factor (moderate clinical rotation experience).

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