10 hours ago

Courtesy Venice Family Clinic

Carrie Kowalski, a physician assistant at the Venice Family Clinic in Venice, California, checks "Tarzan", one of the homeless patients she seeks out to care for.

Editor's note: This storyis part of NBC'sseries "Quest for Care" exploring the shortage of health care providers as the Affordable Care Act rolls out.

Ben Olmedo traveled from Afghanistan to Alaska to find the gaps he wanted to fill. Wisconsin-born Carrie Kowalski found her niche in Venice Beach, Calif. And Vicki Chan-Padgett found her space full of needy women and children in Las Vegas 30 years after she first trained as an Air Force medic.

The three physician assistants are already helping to fill the many holes in the U.S. health care system, providing tests, counseling and other basic care when a doctor is unavailable. They expect to get busier as health care reform starts making it easier for people to pay for medical care.

The three are deployed at the very edges of the U.S. health care system, where its already hard to find physicians. Groups such as the Association of American Medical Colleges project a shortage of 90,000 medical doctors by 2020 as the population increases and ages -- and as more people gain the ability to pay for treatment through new insurance marketplaces and expanded Medicaid programs.

Physician assistants trained in medicine and able to provide care with minimal supervision by a physician are already seeking expanded roles to help fill the gap.

Some of our patients wait six months or more to get specialist care, says Kowalski, who just graduated from her physician assistant program at the University of Southern California in May. The Venice Family Clinic sends Kowalski in a van to scour the streets of the southern California city, finding the homeless and near-homeless who need help.

Kowalski and her team provide basic care, tending to injuries, testing and counseling for HIV, and trying to persuade patients to come in for more comprehensive care. As the changes mandated by the 2010 Affordable Care Act take hold, Kowalski expects her job to get busier because California has embraced Obamacare wholeheartedly, expanding its Medicaid program and setting up its own exchanges where people can buy health insurance.

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Physician assistants fill in at the fringes of health care