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The number of physician assistants in California jumped by 22 percent between 2012 and 2017, but despite the healthy growth in clinicians, research shows the state remains on track to experience a shortfall in primary-care providers in 2025.
"Like other states, California is seeing an increase in demand and need for health care services," said Dawn Morton-Rias, president and chief executive officer of the National Commission on Certification of Physician Assistants. "Many areas, especially rural and some urban ones, are experiencing a physician shortage. PAs are stepping in to fill gaps in care in every clinical setting."
Physician assistants are certified to provide basic medical care, and they can work autonomously in primary care or specialties as long as a physician is available when needed.
While California is second only to the state of New York in its total number of physician assistants, the Golden State is 45th when it comes to the concentration of PAs per 100,000 residents, according to research from the national certification commission. Less populous states such as Alaska, South Dakota and Pennsylvania have much higher ratios of PAs for every 100,000 people.
In Alaska, for instance, there are roughly 78 physician assistants per 100,000 residents, compared with with 24 per 100,000 in California, the commission reported in a statistical profile released earlier this week.
The University of California, San Francisco, reported last year that California is expected to have 78,000 to 103,000 primary-care clinicians by 2030, and physician assistants and nurse practitioners will make up half of the total. But the state will need at least 4,100 additional primary-care providers to meet the needs of its population.
“California faces a looming shortage of primary care clinicians in the coming decades,” said Janet Coffman, one of four authors of the UCSF report and associate professor of health policy in the university's Department of Family and Community Medicine. “If we continue along our current path, more and more Californians will need to visit the emergency room for conditions like asthma, ear infections or flu because they lack a primary care provider.”
To meet the need, UCSF researchers said, health care providers and civic leaders in the state will have to recruit primary-care doctors from other states, expand residency programs, improve retention, ensure that graduation rates grow by 3-7 percent annually, and ensure that state laws allow PAs and nurse practitioners to operate at their maximum capacity.