Physician & Physician Assistant Workforce Capacity Report
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GOVERNMENT OF THE DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH BOARD OF MEDICINE PHYSICIAN & PHYSICIAN ASSISTANT WORKFORCE CAPACITY REPORT 3.0 A Summary of Findings from the Physician and Physician Assistant 2014 Workforce Survey in the District of Columbia September 2015 www.doh.dc.gov/bomed GOVERNMENT OF THE DISTRICT OF COLUMBIA MURIEL BOWSER, MAYOR D.C. Board of Medicine Physician & Physician Assistant Workforce Capacity Report Mission Statement “To protect and enhance the health, safety, and well-being of District of Columbia residents by promoting evidence-based best practices in health regulation, high standards of quality care and implementing policies that prevent adverse events.” 2 D.C. Board of Medicine Physician & Physician Assistant Workforce Capacity Report ACKNOWLEDGEMENTS Healthcare Workforce Workgroup Members: • Rikin S. Mehta, PharmD, JD, LLM – Senior Deputy Director • Janis M. Orlowski, MD, MACP – Chairperson, Board of Medicine • Andrea A. Anderson, MD – Physician Member, Board of Medicine • Jacqueline A. Watson, DO, MBA – Department of Health Chief of Staff • Rita A. Habib, PharmD, MPH – Health Policy Fellow, Health Regulation and Licensing Administration • Rowena Samala – Supervisory Statistician- CPPE • Marvin Romero – Health Licensing Specialist • Aisha Nixon, MA – Health Licensing Specialist • Deniz Soyer, MBA – Data Analyst – Health Care Finance • Eva Stern, GISP – GIS Analyst and Training Specialist – OCTO • Aaron Young, PhD – Assistant Vice President, Research and Data Integration- FSMB D.C. Department of Health Staff: • Sheila Ford-Murphy – Executive Assistant to the Senior Deputy Director, Health Regulation and Licensing Administration • Yonatan Berhe D.C. Board of Medicine Members: • Andrea A. Anderson, MD • Kelly Ann Colden, MD, MPH • Thomas J. Dawson, III, Esq. • Anitra Denson, MD, MPH • Vikisha Fripp, MD • Treazure R. Johnson, Esq. • Robyn Macsata, MD • Lawrence A. Manning, MD • Janis M. Orlowski, MD, MACP • Marc Rankin, MD • Jeffrey Smith, MD • Terrence Straub 3 D.C. Board of Medicine Physician & Physician Assistant Workforce Capacity Report TABLE OF CONTENTS I. Key Acronyms .................................................................................................................. 7 II. Key Definitions................................................................................................................. 8 III. Executive Summary ....................................................................................................... 11 IV. Introduction .................................................................................................................. 15 V. Methods and Survey Response Rate .............................................................................. 16 VI. Physician Workforce ...................................................................................................... 17 a. Comparison of 2010 vs. 2012 vs. 2014 ..................................................................................... 17 b. Comparison to National Physician Workforce ......................................................................... 26 c. 2014 Physician Workforce Survey ........................................................................................... 31 Demographics Non-Clinical Activities Clinical/Patient Care Hours Practice Specialty Board Certification and Eligibility Workforce Reduction and Retirement d. Primary Care Physicians ......................................................................................................... 49 Demographics Clinical Practice Setting and Location Workforce Reduction and Retirement Extended Hours and Weekend Hours Hospital Admitting Privileges and Affiliations e. Specialty Care Physicians ........................................................................................................ 70 Demographics Clinical Practice Setting and Location Workforce Reduction and Retirement Extended Hours and Weekend Hours Hospital Admitting Privileges and Affiliations f. Access to Care and Participating Providers............................................................................... 79 D.C. Managed Care (D.C. Healthcare Alliance) Medicaid Medicare g. Health Professional Shortage Areas ........................................................................................ 91 h. Special Topics ........................................................................................................................ 99 Continuing Medical Education Electronic Medical Records Social Media Advanced Practice Clinicians Collaborative Practice Agreements Pain Management Medical Marijuana Postgraduate Physicians Age-Based Competency Screening 4 D.C. Board of Medicine Physician & Physician Assistant Workforce Capacity Report VII. Physician Assistant Workforce ...................................................................................... 116 a. Comparison of 2010 vs. 2012 vs. 2014 ................................................................................... 116 b. Comparison to National Physician Assistant Workforce ......................................................... 122 c. 2014 Physician Assistant Workforce Survey ........................................................................... 124 Demographics Non-Clinical Activities Clinical/Patient Care Hours Practice Specialty Medicare, Medicaid, and D.C. Managed Care (D.C. Healthcare Alliance) Workforce Reduction and Retirement d. Primary Care Physician Assistants ......................................................................................... 138 Demographics Clinical Practice Setting and Location Workforce Reduction and Retirement Extended Care Hours and Weekend Hours e. Specialty Care Physician Assistants ....................................................................................... 152 Demographics Clinical Practice Setting and Location Workforce Reduction and Retirement Extended Care Hours and Weekend Hours f. Access to Care and Participating Providers............................................................................. 158 g. Health Professional Shortage Areas ...................................................................................... 160 h. Special Topics ...................................................................................................................... 161 Electronic Medical Records Social Media Pain Management Age-Based Competency Screening VIII. Postgraduate Physicians in Training ............................................................................. 169 IX. Additional Healthcare Professionals in the District ......................................................... 170 X. Limitations ..................................................................................................................... 171 XI. Summary ....................................................................................................................... 173 XII. Appendices ................................................................................................................... 176 5 D.C. Board of Medicine Physician & Physician Assistant Workforce Capacity Report 6 D.C. Board of Medicine Physician & Physician Assistant Workforce Capacity Report I. KEY ACRONYMS AMA American Medical Association AAMC Association of American Medical Colleges AAPA American Academy of Physician Assistants FSMB Federation of State Medical Boards GIS Geographic Information System HRSA Health Resources and Services Administration HPSA Health Professional Shortage Area MUA Medically Underserved Area MUP Medically Underserved Population 7 D.C. Board of Medicine Physician & Physician Assistant Workforce Capacity Report II. KEY DEFINITIONS Actively Licensed Physician or Physician Assistant: Actively licensed physicians or physician assistants are defined as those who hold active licenses in the District. Actively Practicing Physician or Physician Assistant: Actively practicing physicians or physician assistants are defined as those who reported that they were involved in clinical practice in the District for equal to or greater than twenty hours per week. Board Certified: Designation attained when a physician has passed an examination and met the standards of a professional organization representing a particular medical specialty. Physicians are eligible to take the exam after completing postgraduate training in the area and may be board certified in more than one specialty. Board Eligible: Designation attained when a physician has completed a residency in a certain specialty or subspecialty and is eligible to take the board exam for certification but has either not taken or has not passed the test. Census Tracts: Census tracts are small, relatively permanent statistical subdivisions of a county or equivalent entity that are updated by local participants prior to each decennial census as part of the Census Bureau’s Participant Statistical Areas Program. The Census Bureau delineates census tracts in situations where no local participant existed or where state, local, or tribal governments declined to participate. The primary purpose of census tracts is to provide a stable set of geographic units for the presentation of statistical data. Census tract boundaries are delineated with the intention of being maintained over a long period of time so that statistical comparisons can be made from census to census. D.C. Healthcare Alliance: D.C. Healthcare Alliance is a program offering health coverage to low-income families.