Physician assistants are health professionals licensed to practice medicine with physician supervision. As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and write prescriptions. Within the physician/PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. The clinical role of physician assistants includes primary and specialty care in medical and surgical practice settings in rural and urban areas. Physician assistant practice is centered on patient care and may include educational, research, and administrative activities.*
Services performed by physician assistants include, but are not limited to the following:
- Evaluation – initially approaching a patient of any age group in any setting to elicit a detailed and accurate history, perform an appropriate physical examination, delineate problems, and record and present the data.
- Monitoring – assisting the physician in conducting rounds in acute and long-term inpatient care settings, developing and implementing patient management plans, recording progress notes and assisting in the provision of continuity of care in office-based and other ambulatory care settings.
- Diagnostics – performing and/or interpreting, at least to the point of recognizing deviations from the norm, common laboratory, radiologic, cardiographic and other routine diagnostic procedures used to identify pathophysiologic processes.
- Therapeutics – performing routine procedures such as injections, immunizations, suturing and wound care, managing simple conditions produced by infection or trauma, participating in the management of more complex illness and injury, and taking initiative in performing evaluation and therapeutic procedures in response to life-threatening situations.
- Counseling – instructing and counseling patients regarding compliance with prescribed therapeutic regimens, normal growth and development, family planning, situational adjustment reactions and health maintenance.
- Referral – facilitating the referral of patients to the community’s health and social service agencies when appropriate.
Because of the close working relationship the PAs have with physicians, PAs are educated in the medical model designed to complement physician training. Upon graduation from an accredited physician assistant educational program, physician assistants take a national certification examination developed by the National Commission on Certification of Physician Assistants (NCCPA) in conjunction with the National Board of Medical Examiners. To maintain their national certification, PAs must log 100 hours of continuing medical education every two years and sit for a recertification every 10 years. Graduation from an accredited physician assistant program and passage of the national certifying exam are required for state licensure.*
*Information provided by American Academy of Physician Assistants (AAPA)
In the mid-1960s, physicians and educators recognized there was a shortage and uneven distribution of primary care physicians. To expand the delivery of quality medical care, Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of PAs in 1965. He selected Navy corpsmen who received considerable medical training during their military service and during the war in Vietnam but who had no comparable civilian employment. He based the curriculum of the PA program in part on his knowledge of the fast-track training of doctors during World War II.*
Since its inception, the PA concept has experienced tremendous growth, both in the expansion of physician assistant educational programs and in the increase in the number of PAs nationwide. Since the establishment of the first PA educational program at Duke University in 1965, the number of PA educational programs has mushroomed to over 170 accredited programs today.
As a direct result of the increase in PA educational programs, the number of PA graduates has grown dramatically since 1965. The number of new graduates in 2007 was approximately 4,600. The national professional organization for physician assistants (AAPA) used a variety of scenarios regarding the number of PAs that will graduate in each of the next 14 years. AAPA projects that in the year 2020 there will be between 136,936 and 172,632 people eligible to practice as PAs and between 109,603 and 141,713 clinically practicing PAs.
2008 AAPA Census report
|Specialty||Percentage of Practicing PAs|
|Internal Medicine (General & Subspecialty)||15.6%|
|Pediatrics (General & Subspecialty)||4.3%|
|Surgery (General and Subspecialty)||25.1%|
The United States Bureau of Labor Statistics (BLS) projects that the number of PA jobs will increase by 30 percent between 2014 and 2024 (compared to the 7 percent projected increase in all jobs during the same time period)*. The PA profession was ranked #5 for the “Best 100 Jobs” in 2016 and #4 for best in healthcare by U.S. News & World Report.**
Keeping pace with the growth in PA practitioners, the level of income earned by PAs has also shown impressive increases. Results of the 2008 AAPA Physician Assistant Census Survey indicate that the mean total income from primary employers of PAs who work at least 32 hours per week for their primary employer is $89,987. The comparable mean for PAs who have been in clinical practice for less than one year is $76,232.*
*Information from the US Bureau of Labor Statistics (www.bls.gov/ooh/healthcare/physician-assistants)
*Information taken from the AAPA website.