Bibliographic record
Abstract
UNLABELLED: Physician assistants (PAs) in American medicine are aging. After 30 years of having PAs enter the US health care system, it seems an appropriate time to examine where they are in their careers. This study describes the phenomenon of a rising number of elder PAs in the ranks of the nation's health providers and their patterns of practice. METHOD: A subpopulation cohort of practicing PAs 60 years and older was compared to all PAs. Age range, gender, practice setting, specialty, and other demographic variables were analyzed using established methods. Differences between elder PAs and all other PAs and services provided by the two groups were examined. RESULTS: Elder PAs constituted about 1.6% of full-time PAs in practice in 1998. Average age of elder PAs is 64 years (range, 60 years to 74 years) compared to 41 years (range, 21 years to 60 years) for all full-time practicing PAs. Analysis of several variables--gender, ethnicity, geographic distribution, number of patients seen in a week, and hours worked in a week--revealed few differences between the cohorts. On average, older PAs were in practice longer than all PAs (18.3 years and 9.2 years, respectively), had been with their current employer for 7.7 years, and worked one job. Elder PAs had an associate degree at twice the rate of all PAs, but three times as many of them had a doctorate. Elder PAs are more likely to be taking care of older patients, working in a rural area, and remaining in a rural area longer than PAs overall. INTERPRETATION: America's corps of PAs continues to work into and beyond the usual retirement age for most workers, and is caring for a greater percentage of older persons than all PAs are. Most elder PAs practice in family or general medicine and prefer to practice in a rural area. These practice preferences mirror results of previous studies of the practices of elder physicians in the United States and Canada. The aging of PAs has important implications for clinical practice and health workforce planning. If PAs were encouraged to take early retirement, more elderly patients would be shifted to younger providers--with the potential to affect delivery of primary care services in rural communities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".