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Exploring the science of healthcare delivery

Bushardt, Reamer L. PharmD, PA-C, DFAAPA

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Journal of the American Academy of Physician Assistants: October 2019 - Volume 32 - Issue 10 - p 8
doi: 10.1097/01.JAA.0000580560.94840.0d
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JAAPA is pleased to introduce a new department this month—the Science of Healthcare Delivery. The department offers critical reviews with commentary on timely topics focused on the delivery of healthcare, such as models of care, provider well-being and teamwork, patient safety, quality and value, social determinants of health, policy, economics, and more. Led by JAAPA's research editors, Richard W. Dehn, MPA, PA-C, DFAAPA, and Christine Everett, PhD, PA-C, MPH, each article will pose a relevant health services or policy question, critically review the issue, detail recommendations, and assess the effect for the PA profession. I invite you to read the inaugural Science of Healthcare Delivery article, “Predicted shortages of physicians might even disappear if we fully account for PAs and NPs” on page 51 of this issue.

There are several reasons why diving into critical reviews of policy and practice issues is particularly important for JAAPA and the PA profession. Let me highlight a couple.

First, the US healthcare system remains in a state of flux as we edge closer to a presidential election year. The path to value-based care in the United States has been bumpy and numerous lawsuits still aim to dismantle the Affordable Care Act. Like many of you, I have tuned in to watch the recent presidential primary debates. Healthcare and health financing clearly are a centerpiece of contentious debate. Interestingly, this year there are more polarizing opinions expressed within political parties than in the last election. In parallel, state PA chapters and regional grassroots advocacy efforts are underway to optimize legislation and the practice environment for PAs. What do PAs need to know to make informed decisions about practice, reimbursement issues, and advocacy efforts?

Secondly, PAs continue to diversify across specialties and practice within a broad array of healthcare delivery systems. In its most recent statistical report by specialty, the National Commission on Certification of Physician Assistants notes that most certified PAs practiced in family medicine or general practice (19.2%) followed by emergency medicine (13%) and orthopedic surgery (10.8%). Further, more than one in five practiced in a wide variety of surgical subspecialties, including cardiothoracic, colorectal, gynecology and obstetrics, gynecologic oncology, neurosurgery, ophthalmology, oral/maxillofacial, otorhinolaryngology, pediatric, plastic, urologic, and vascular surgery. How can PAs provide leadership at the practice level in shaping high-quality, safe, affordable person- and population-centered care?

The Science of Healthcare Delivery will seek to answer these questions and more, offering PAs concise, evidence-based appraisals of policy and practice issues facing the US healthcare system, our practice, and the communities we serve. JAAPA continues to shape content that supports PAs in all aspects of their careers, including clinical content, policy and practice briefs, original research, opinions, and award-winning essays that delve into the humanistic aspects of care. The editorial board hopes this new department will provide insights that are valuable to you, and we invite submissions from JAAPA readers that have important perspectives to share. To learn more about the department or submit your work, visit

JAAPA also is retiring two departments (Citations and What's New In...) to make way for new content that better meets the evolving needs of PAs. I want to thank the long-standing editors of these departments for their vision, tireless efforts, and commitment to the PA profession. Additionally, the editorial board welcomes two new editors to the board after evaluating dozens of highly qualified applicants. Perri Morgan, PhD, PA-C, joins JAAPA as policy editor and brings to the role many years of experience as a primary care PA, educator, health services researcher, policy expert, and distinguished PA scholar. Tricia Marriott, PA-C, MPAS, DFAAPA, joins JAAPA as PA practice editor with a strong background and expertise in clinical leadership, surgical practice, workforce innovation, health law, and organizational development. I remain proud of the significant effect PAs have each day on improving access to high-quality, affordable care for Americans as well as individuals all over the world through PA-led humanitarian efforts. JAAPA is grateful for the opportunity to help chronicle and inform the PA journey through timely and relevant clinical articles, research, and commentaries while walking hand-in-hand with PAs by publishing reflective essays and humanities pieces that capture the heart of our profession.

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