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Examining higher education’s role in health care – educating personnel for allied health services – special report: health sciences

To meet health industry needs for thousands of physical therapists, occupational therapists and other trained health professionals, colleges and universities have revamped their course offerings. Even so, they turn down more students than they accept.

“Schools are being swamped with applicants,” says Dr. Judy Barr, President of the Association of Schools of Allied Health Professions (ASAHP). Howard University, the first historically Black college or university (HBCU) to establish a College of Allied Health, fits in that category.

“We had sixty-five qualified students applying for thirty-two spaces in physical therapy,” says Dr. Gene Gary-Williams, dean of Howard’s College of Allied Health Sciences. “We had to turn them down. If we had more resources and facilities, we could be twice as large as we are now.”

At Florida A&M University (FAMU), 500 applicants vied for sixty slots in last year’s physical therapy program. Because of increased demand, FAMU had just increased its physical therapy program student population from last year’s class of forty-five. According to Dr. Jacqueline B. Beck, dean of the School of Allied Health Sciences at FAMU, “When we recruit, everyone wants to be a physical therapist.”

The National Commission on Allied Health claims that allied health professionals are the largest component of the health care workforce.

More than 250 jobs are listed under allied health–ranging from physician assistants and dietitians to physical, respiratory and occupational therapists–providing more care to consumers than doctors and nurses. And the high demand for these programs is causing many community colleges to add on physical therapy (PT), physician assistant (PA) and occupational therapy (OT) programs.

Barr says, “Programs for physician assistants are doubling in numbers, in terms of new programs. Institutions see the demand for them. There was also significant growth in programs for occupational therapy.”

A Lack of Programs, Faculty

But for most HBCU’s, adding new majors is harder because of the funding these programs require. Fewer than ten HBCUs have allied health schools or offer allied health courses in other departments.

Dr. Elaine Williams, president of the National Society of Allied Health (NSAH), believes that the reason is, “These programs are expensive to operate–which is why there are few at HBCUs. You have to have a strong clinical component, which increases the cost of training, because students have to be trained before they go into clinical settings…. The [schools’] clinical settings have to be similar [to hospitals, HMOs, clinics, etc.] so the students will have the expertise they need to do well [in their internships].”

Williams says that at Los Angeles’s Charles Drew University, where she is the interim dean of allied health, many programs are funded by grants and not dependent on tuition only. “Tuition would be prohibitive for minority students if the programs were tuition-based only,” she suggests.

As president of NSAH, a group of African Americans in allied health, Williams says that in addition to funding, the society is also concerned that so few African Americans are seeking careers in allied health at all. Fewer than 4 percent of allied health professionals are African American.

“Physical therapy and occupational therapy are less representative with minorities. We plan to implement them at Drew,” says Williams. Beck said increasing the number of African Americans in allied health is a major concern of hers as well. “We’ve got to get them in the programs. In physical therapy, 1.7 percent of students nationally are African American.”

She also criticized those who say they cannot find qualified minority students with strong backgrounds in math and science, a prerequisite for the programs. “You can get African-American students and you don’t have to get them as special students. You can do it…. In the early years, it was hard. But we’ve changed that by recruitment and we keep them once they get in,” Beck says.

According to figures released this year by the American Medical Association (AMA), of the 42,000 degrees given in all accredited allied health programs in the 1994/95 academic year, fewer than 3,600 were awarded to African Americans. The program with the largest number of degrees granted to African Americans was the medical assistant (MA) program which had nearly 1,200 Black graduates. The duties MAs perform range from receiving patients and preparing medical records to CPR and assisting doctors in examinations. Most graduates of the program receive two-year associate degrees or one-year certificates.

AMA reports that “more medical assistants are employed by practicing physicians than any other type of allied health personnel.” Although job opportunities in this field are said to be unlimited, the salaries are low, averaging only $16,500 last year.

The second highest number of allied health degrees granted to African Americans in allied health was in the areas of respiratory therapy (RT) and respiratory therapy technicians (RTT). In these high-demand programs, 400 and 330 degrees were granted, respectively. Although these therapists are important links in monitoring and evaluating illnesses associated with the heart and lungs, salaries for RTs averaged $23,000 and $19,800 for RTTs.

Other areas where many African Americans are getting degrees include health information technicians, medical technicians (two-and four-year degrees), and surgical technicians.

The three areas that had no African American graduates were anesthesiologist assistant, medical illustrator and orthotist/ prosthetist. Starting salary averages for these positions are $65,000, $25,000, and $45,000 respectively.

Recruiting qualified faculty is another major problem in this field for higher education. Faculty salaries have not increased significantly in recent years and most advanced-degree graduates prefer :private industry over academia.

“These people are in high demand and they make a lot of money in private industry…. We can’t pay what industry pays,” says Beck, who adds that the majority of her faculty at FAMU are Ph.D.s, which she prefers. However, because of the shortage of doctoral candidates, she concedes that FAMU also accepts faculty with master’s and work experience.

Barr says, “[The] bottleneck is lack of faculty, [mainly because there are] few doctoral programs in allied health fields.” A report issued by the National Commission on tallied Health this year, recommends, “State boards of higher education and foundations should stimulate the flow of resources to public and private institutions for the establishment of faculty development…in allied health.”

The report also criticizes higher education for being slow in responding to changes in the way health care is being delivered and recommends that a more flexible curricula could “enhance the ability of educational institutions to respond to the work-force needs of emerging health care delivery systems.”

With health care being increasingly moved from hospital settings to managed-care facilities and community-based centers, institutions say they realize their curricula has to change as well.

Says Beck: “Over the last three years, [FAMU has] integrated managed-care theory and application into our courses. We’ve increased our emphasis as managed care increases and [we] are still looking at its effect now and in the future.”

Because managed-care facilities are for-profit operations, Beck hopes that administrators at these centers will continue their commitment to supervising interns. And with more patients receiving health care at home, Beck says FAMU is also “doing more in-home health care than in the past. I’d like to see us do more because the need is so great.”

Howard University also has a three-year grant to look at settings outside of the hospital where students can be assigned for their internships. “We will be looking at ways to expose students to nontraditional settings,” Gary-Williams said.

Varied Competency Requirements

There are also discussions taking place between higher education institutions and managed-care officials about the level of training students need for competency. Dr. James M. Pekarthy, assistant provost for Health Education and Research at the State University of New York (SUNY), describes it as a “major debate between academia and managed care about what are the best levels for health professions. Some say a B.A. (degree) serves patients best. Managed care says prove it to us.”

Nationally, many schools are offering more associate degrees in various areas. These graduates command lower salaries. There is speculation that managed care will in the future push for more associate degree programs because, as Pekarthy says, “Associate degree programs have a major role in health care…. Managed care wants to know who can deliver the best care at the least cost.”

However, some professional associates are recommending graduate degrees for various fields. Ten years ago, the American Physical Therapy Association (APTA) recommended a master’s degree for these professionals and, gradually, schools have started to comply. Last fall, Howard added the master’s degree for physical therapy. “APTA decided that was the way to go and most are moving to master’s degrees for physical therapy because it has moved to a more in-depth practice,” explains Gary-Williams.

Physical therapists, who treat accident victims or people who suffer from illnesses such as a stroke, are in the highest demand among the allied health careers. There are more than 90,000 physical therapists in practice, treating more than a million people daily, according to APTA. The U.S. Labor Department lists physical therapy as the fastest growing health care Occupation in the country, with an 88 percent growth rate projected through 2005.

However, most PTs are not practicing in hospitals — 70 percent work in nursing homes and private offices, or in community, industrial, sports, and rehabilitation centers. Because they are in such high demand, physical therapists are well paid, with salaries that average approximately $55,000 and climb as high as six figures.

SUNY, which grants the most health sciences degrees to African Americans, reports that the two-year physical therapist assistants’ (PTA) program is also popular with students. PTAs work under the supervision of a physical therapist and earn an average of $30,000. All physical therapists must pass a national licensing exam, but just over half of all states require PTAs to be licensed.

The career that is second in demand in the job market, but equally popular with students, is occupational therapy. These nationally certified allied health professionals are “mostly involved in rehabilitation efforts that enable people to do daily tasks and movements, such as getting out of bed, taking a shower, using a computer” says Pekarthy.

Although they are in high demand, occupational therapists are not commanding salaries equal to physical therapists. The average OT salary is $38,000. Many schools also offer the two-year Occupational Therapists Assistants (OTA) program, which Pekarthy says is as popular at SUNY as OT and PT. OTA graduates must take a national licensing exam and their average salary is $25,000.

Gary-Williams says OT is evolving from being “white female oriented. Now we have large numbers of African American males who chose the program as a first choice and not just because they couldn’t get in another program.”

Gary-Williams says that at Howard, OT is third in demand with students, with the second most popular major being the physician assistant program. PA programs were established in the 1960s to train :professionals to assist physicians at a time when there was a shortage of primary-care doctors. They go through two-thirds of the training of doctors and are qualified to perform 80 percent of the duties of physicians. They can also write prescriptions in thirty-eight states, the District of Columbia and Guam.

Officials at Charles Drew University in Los Angeles say 500 students applied for forty-five slots last year. Howard University had 85 students competing for 40 PA openings. Nationally, there are more than 30,000 practicing PAs, with a projected employment growth rate of 36 percent through 2005, according to the Department of Labor. In addition, PAs receive an average of seven job offers when they graduate and their salaries range from $60,000 to more than $100,000.

PAs must he recertified every six years and must be supervised by a licensed doctor. Mississippi is the only state that does not have licensure requirements for PAs. Because of the lack of in-depth data, it is difficult to predict how changes in the allied health field will affect curricula. However, if the needs of health care delivery are to be met in the future, the NCAH report recommends collaboration between higher learning institutions, accrediting bodies, employers, and consumers.

The report also calls for increasing the number of minorities working in the field so that the system can better serve this country’s diverse population.

COPYRIGHT 1996 Cox, Matthews & Associates

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