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When experts and business leaders shared the latest news and insights on the future of healthcare at the October 2022 Providence Business News summit in Warwick, Rhode Island, Â鶹¹ÙÍø was consulted to address the healthcare workforce shortage as well as accessibility and equity in health care. Thomas Meehan, Ph.D., shared his perspective as the director for Â鶹¹ÙÍø’s Physician Assistant Studies program, which had been the first program of its kind in Rhode Island when founded. Under Meehan’s direction, Â鶹¹ÙÍø’s Center for Physician Assistant Studies strives to create innovative curricula focused on hands-on learning with real-world clinical examples and interprofessional opportunities.

>>Read More: Â鶹¹ÙÍø Launches Accelerated Second Degree Nursing Program<<

Meehan joined Chief of Staff Melissa Husband of Neighborhood Health Plan of Rhode Island; Senior Medical Director for Enterprise Virtual Care Sri Adusumalli, M.D., of CVS Health and SVP & General Manager Corey McCarty of CCA Health RI for this panel discussion before a packed audience. Here is a taste of the moderator’s questions and Meehan’s responses.

_{Â鶹¹ÙÍø Physician Assistant Studies Director Thomas Meehan, far right, participating on PBN's Fall 2022 Healthcare Summit panel}

The Healthcare Workforce Shortage

PBN: The healthcare field has been hit particularly hard by the ongoing workforce shortage. What is being done by practitioners, insurers and universities to address this issue, including removing barriers for folks with low incomes and people of color?

Meehan: Â鶹¹ÙÍø & Wales University is known for its history in culinary and hospitality, but in 2013 Â鶹¹ÙÍø ventured into healthcare and has done well identifying workforce needs and bringing them forward. This month, as its latest commitment to healthcare education, Â鶹¹ÙÍø announced the launch of a new accelerated nursing program that will begin next fall. This ABSN is designed for people who have already earned a bachelor’s degree and are looking for a career change to nursing. Students can complete this fast-track program and receive full nursing qualification in just 16 months.

Â鶹¹ÙÍø is reaching students as early as high school through its collaboration with Brown University’s career pathway programming, and we host healthcare education events every year. Â鶹¹ÙÍø’s Physician Assistant (PA) Studies program is one of the only programs in the country with its own cadaver dissection lab. We’re trying to meet healthcare needs with experiential education.

Medicine is tough, but we have conversation to address how they’re doing and how Â鶹¹ÙÍø is doing, as well as how capable the students are. A culture of support avoids attrition rate.
- Â鶹¹ÙÍø Physician Assistant Studies Program Director Thomas Meehan

In his response to the same question, McCarty noted that CCA Health RI is hoping to expand its higher education partnerships to Â鶹¹ÙÍø, finding ways to think and collaborate differently on how to expose people to community health.

_{A packed room listens intently and composes audience questions during the Fall 2022 PBN Healthcare Summit}

When Husband of Neighborhood Health Plan of Rhode Island noted that barriers that are concentrated in communities of color include affordable childcare and higher education, Meehan added that affordability is a concern for Â鶹¹ÙÍø as well. He noted that the Physician Assistant Studies degree requires six years of school — four years as an undergraduate plus two years as a graduate student. Although there are scholarships available, that is still out of reach for some individuals and their families.

To help with this, Â鶹¹ÙÍø has been looking to partner with institutions such as CCRI to work on transfer paths that can provide marginalized populations with a chance for initial schooling, and then work on identifying ways to expand that education to 4- and 6-year programs.

PBN: On the concept of brain drain: is there a problem keeping graduates of healthcare degrees such as Â鶹¹ÙÍø’s PA program in the state?

Meehan: In 2013 when Â鶹¹ÙÍø launched the PA program, there were only 300 certified PAs in the State of Rhode Island; now there are 549 PAs. The biggest increase in Â鶹¹ÙÍø’s PA enrollment was between 2017-2021, and today 50% of our graduates do stay here for their first job. Long-term, about 75% of our PA program graduates remain in New England area, and we don’t anticipate a major change to that trend.

There is good news for PAs: as they do their clinical experience to learn the field of medicine, they’re close to graduation and often get a job from those clinical sites. In fact, Â鶹¹ÙÍø PA students often get around five offers. They tend to take the ones where they have been part of the clinical culture already and know they want to stick around.

_{Meehan being asked about healthcare trends and issues at the PBN Healthcare Summit}

PBN: How is the general workforce shortage in the industry affecting the long-term need for more physician assistants and registered nurses in the state?

Meehan: Rhode Island has so many healthcare opportunities. There are 150 physician assistant and nurse practitioner job openings available right now. There is a clear need for healthcare practitioners, and primary care providers are stressed to their limits. The biggest barrier for Â鶹¹ÙÍø or any other healthcare education program is the need for clinical training sites for those practitioners.

The PA industry has been growing every year, at least 20% each year. It’s natural that physicians, physician assistants and nurse practitioners go where the money is. Often the highest-paid positions are in specialties rather than primary care.

The Future of Primary Care

PBN: How has virtual care evolved since COVID, and what is the outlook for its future? How could this further affect the role of primary care doctors, who we already are seeing being replaced with physician assistants or nurse practitioners?

Meehan: From an education standpoint, we immediately pivoted to telemedicine as part of our teaching; in particular, behavioral health went to virtual care clinically. When it comes to replacing primary care providers, think of it as a team led by the primary care provider. With a half-dozen PAs working under him or her, that doctor can get out and see more patients.

We teach limits at Â鶹¹ÙÍø. Our physician assistants come out of the program knowing when ask for help and how to realize what situations might be above their knowledge and skills. In good practices, PAs work with all patients and the primary care physician is there to work with the more complicated patients. Primary care is more about preventative medicine and looking at the patient as a whole, and PAs and NPs do a great job with that care.

Healthcare Equity

PBN: How are providers and insurers addressing clear inequities in the system?

Meehan: Â鶹¹ÙÍø is teaching the specialists to recognize if people have access to quality food and how to help them think about preventative medicine. We teach students about nutrition and dietetics, including a two-semester series course on food deserts and how to give patients access to healthy recipes. Healthy foods impact patient care down the road. Although a majority of PAs go into specialty care, they are still able to recognize primary care needs and help patients get those needs taken care of.

_{One Â鶹¹ÙÍø: Director of Institutional & Advancement Marketing Clara Schwager and Meehan at the summit}

Healthcare Education

PBN, reading an audience question: Recent data shows a decline in nursing programs across the U.S. and higher attrition rates, with COVID being a factor. How do we inspire and prepare high school students for healthcare programs?

Meehan: Â鶹¹ÙÍø chose to provide an advanced bachelor’s of nursing program for students who already have a bachelor’s degree because those students have already proved their ability to succeed. Even people from different professions can succeed in the ABSN program. The key is providing better support once students are in the program and having a structure in place to address deficiencies. When students encounter imposter syndrome, being told by Â鶹¹ÙÍø that “you belong here” and “you can do this” helps student get through.

Medicine is tough, but we have conversation to address how they’re doing and how Â鶹¹ÙÍø is doing, as well as how capable the students are. A culture of support avoids attrition rate. Â鶹¹ÙÍø’s PA program attrition is only 3% because when we bring students in, we make sure they’re successful.

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