About the PA Profession

Please see the AAPA for the most up-to-date information on the PA profession.

General

Physician assistants (PAs) are health professionals licensed to practice medicine with physician supervision, providing patient services ranging from primary medicine to very specialized surgical care.

Educated in medical programs, PAs are qualified to perform 80 to 85% of the duties most commonly done by primary care physicians. PAs perform physical examinations, diagnose and treat illnesses, order and interpret lab tests, counsel on preventive health, suture wounds, set fractures, and assist in surgical operations. In 46 states, the District of Columbia, and Guam, PAs have prescriptive privileges.

Currently there are approximately 30,000 physician assistants in the United States. In some rural areas, where physicians are in short supply, PAs serve as the only providers of health care, conferring with their supervising physicians and other medical professionals as needed or required by law.

Practice Settings

PAs practice in almost all health care settings and in nearly every medical and surgical specialty. They have also served on the White House medical staff.

14.2 percent of all PAs practice in rural communities with fewer than 10,000 people; a third practice in towns with fewer than 50,000 people. The majority of all PAs provide primary care services, with 40% in family medicine. Three percent of all PAs are in general surgery, and 16% in surgical sub-specialties. Approximately 70% of all PAs practice in outpatient settings (clinics, HMOs, medical offices), and 30% practice in inpatient settings (hospitals).

Many hospitals, faced with a shortage of physician residents, employ physician assistants as house staff in medical and surgical departments.

PA distribution more closely matches the population than other primary care providers according to the Seventh Report on the Status of Health Personnel in the United States , published by the Department of Health and Human Services in 1990. The report noted that, were it not for physician assistants, many areas would have little or no access to quality health care.

Education

There are 123 specially designed physician assistant programs located at medical colleges and universities, teaching hospitals, and through the Armed Forces. Due to the close working relationship PAs have with physicians, PA education was designed to complement that of physician education. The programs are accredited by one national, independent accrediting agency for allied health.

The typical PA student in 1995 had a bachelor's degree and over 4 years of health care experience prior to admission to the PA program. PA programs generally require applicants to have at least two years of college education and previous experience in health care. On average, PA education is usually 24 months in length and is approximately two-thirds that of medical students (108 weeks compared to 153). Physician assistants take some of their classes with medical students.

The first phase of PA education is in the classroom, providing students with an in-depth understanding of medical sciences. Additional subjects include differential diagnosis, medical ethics, and pharmacology. The second year is spent in clinical rotations. Each year, PA programs graduate approximately 2,500 men and women.

Practice Credentials

Nearly all states require PAs to pass a national certifying examination as a requirement for state licensure. The exam, open only to graduates of accredited PA programs, is given each year by the National Commission on Certification of Physician Assistants (NCCPA), an independent organization established to assure the competency of PAs.

To maintain certification, PAs must complete 100 hours of continuing medical education every two years and take a recertification exam every six years. Only those with current certification can use the credentials Physician Assistant-Certified or PA-C.

The median salary range for clinically practicing physician assistants nationwide is $60,000 to $65,000. 49% of all practicing physician assistants are women.

All PAs must, by law or regulation, have a supervising physician. It is not necessary, however, for the physician and PA always to be located in the same building or even the same town. Most state laws allow the supervising physician to be away from the practice or working in another town when the PA is seeing patients.

Quality of Care

A study by the Congressional Office of Technology Assessment concluded that within the limits of their expertise, PAs provide care that is equivalent in quality to the care provided by physicians. Studies conducted by the Rand Corporation and other researchers found that PAs save as much as 20% of the personnel costs of medical care, can perform 80% of the routine functions of a primary care physician's practice, and are widely accepted by patients. A 1994 Gallup poll shows that a significant majority of Americans endorse the use of PAs as health care providers.

Case law reveals that physician assistants have been involved in very few malpractice cases. The majority of PAs are insured either by a rider on their employer's malpractice policy or by their own personal malpractice insurance.

Historical Background

The physician assistant concept originated in the mid-1960s. Physicians and educators recognized there was a shortage and uneven distribution of primary care physicians. To combat these problems, the physician assistant profession was developed. The first physician assistants graduated from Duke University in 1967. They were former Navy corpsmen who wanted to use their medical skills in civilian life.

Growth of the PA Profession

Demand for PA services is rapidly increasing. The Department of Labor projects the number of physician assistant jobs will grow by 23% from 1994 through the year 2005, greater than the national average for all professions.

Factors that have contributed to this growth include increased recognition of the quality of care that PAs provide and Medicare/Medicaid reimbursement for PA services.