Physician assistants (PAs) practice medicine under the supervision of physicians and surgeons. They should not be confused with medical assistants, who perform routine clinical and clerical tasks. PAs are formally trained to provide diagnostic, therapeutic, and preventive healthcare services, as delegated by a physician. Working as members of a healthcare team, they take medical histories, examine and treat patients, order and interpret laboratory tests and x rays, and make diagnoses. They also treat minor injuries by suturing, splinting, and casting. PAs record progress notes, instruct and counsel patients, and order or carry out therapy. Physician assistants also may prescribe certain medications. In some establishments, a PA is responsible for managerial duties, such as ordering medical supplies or equipment and supervising medical technicians and assistants.
Physician assistants work under the supervision of a physician. However, PAs may be the principal care providers in rural or inner-city clinics where a physician is present for only 1 or 2 days each week. In such cases, the PA confers with the supervising physician and other medical professionals as needed and as required by law. PAs also may make house calls or go to hospitals and nursing care facilities to check on patients, after which they report back to the physician.
The duties of physician assistants are determined by the supervising physician and by State law. Aspiring PAs should investigate the laws and regulations in the States in which they wish to practice.
Many PAs work in primary care specialties, such as general internal medicine, pediatrics, and family medicine. Other specialty areas include general and thoracic surgery, emergency medicine, orthopedics, and geriatrics. PAs specializing in surgery provide preoperative and postoperative care and may work as first or second assistants during major surgery.
Work Environment
Physician assistants held about 129,400 jobs in 2020. The largest employers of physician assistants were as follows:
- Offices of physicians - 53%
- Hospitals; state, local, and private - 26%
- Outpatient care centers - 8%
- Educational services; state, local, and private - 5%
- Government - 2%
Working with patients can be both physically and emotionally demanding. Physician assistants spend much of their time on their feet, making rounds and evaluating patients. Physician assistants who work in operating rooms often stand for extended periods.
Work Schedules
Most physician assistants work full time. Some work more than 40 hours per week. Physician assistants may work nights, weekends, or holidays. They may also be on call, meaning that they must be ready to respond to a work request with little notice.
Education & Training Required
Physician assistant educational programs usually take at least 2 years to complete for full-time students. Most programs are at schools of allied health, academic health centers, medical schools, or 4-year colleges; a few are at community colleges, are part of the military, or are at hospitals. Many accredited PA programs have clinical teaching affiliations with medical schools.
In 2008, 142 education programs for physician assistants were accredited or provisionally accredited by the Accreditation Review Commission on Education for the Physician Assistant. Eighty percent, or 113, of these programs offered the option of a master's degree, 21 of them offered a bachelor's degree, 3 awarded associate degrees, and 5 awarded a certificate.
Most applicants to PA educational programs already have a college degree and some health-related work experience; however, admissions requirements vary from program to program. Many PAs have prior experience as registered nurses, emergency medical technicians, and paramedics.
PA education includes classroom and laboratory instruction in subjects like biochemistry, pathology, human anatomy, physiology, clinical pharmacology, clinical medicine, physical diagnosis, and medical ethics. PA programs also include supervised clinical training in several areas, including family medicine, internal medicine, surgery, prenatal care and gynecology, geriatrics, emergency medicine, and pediatrics. Sometimes, PA students serve in one or more of these areas under the supervision of a physician who is seeking to hire a PA. The rotation may lead to permanent employment in one of the areas where the student works.
Certifications Needed
All States and the District of Columbia have legislation governing the practice of physician assistants. All jurisdictions require physician assistants to pass the Physician Assistant National Certifying Examination, administered by the National Commission on Certification of Physician Assistants (NCCPA) and open only to graduates of accredited PA education programs. Only those who have successfully completed the examination may use the credential “Physician Assistant-Certified.” To remain certified, PAs must complete 100 hours of continuing medical education every 2 years. Every 6 years, they must pass a recertification examination or complete an alternative program combining learning experiences and a take-home examination.
Other Skills Required
Physician assistants must have a desire to serve patients and be self-motivated. PAs also must have a good bedside manner, emotional stability, and the ability to make decisions in emergencies. Physician assistants should have an enthusiasm for lifelong learning, because their eligibility to practice depends on continuing education.
How to Advance
Some PAs pursue additional education in a specialty. PA postgraduate educational programs are available in areas such as internal medicine, rural primary care, emergency medicine, surgery, pediatrics, neonatology, and occupational medicine. Candidates must be graduates of an accredited program and be certified by the NCCPA.
As they attain greater clinical knowledge and experience, PAs can earn new responsibilities and higher wages. However, by the very nature of the profession, clinically practicing PAs always are supervised by physicians.
Job Outlook
Employment of physician assistants is projected to grow 31 percent from 2020 to 2030, much faster than the average for all occupations.
About 12,200 openings for physician assistants are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment
Demand for healthcare services will increase because of the growing and aging population. Growth of the population means more need for healthcare services generally, and members of the large baby boom generation will require more medical care as they age. An increase in the number of patients with chronic diseases, such as diabetes, will also increase healthcare demand and, in turn, drive the need for healthcare providers including physician assistants who often provide preventive care and treat the sick. Furthermore, increases in incomes may improve access to healthcare services, and advances in medical technology will continue to increase the number and types of treatments available.
Physician assistants can provide many of the same services as physicians. PAs are expected to continue to have a growing role in providing healthcare services because they can be trained more quickly than physicians. Team-based healthcare provision models will continue to evolve and become more commonly used. Physician assistants will have growing roles in all areas of medicine as states expand allowable procedures and autonomy, and as insurance companies expand their coverage of physician assistant services.
Earnings
The median annual wage for physician assistants was $121,530 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $77,940, and the highest 10 percent earned more than $164,620.
In May 2021, the median annual wages for physician assistants in the top industries in which they worked were as follows:
- Outpatient care centers - $128,430
- Hospitals; state, local, and private - $127,240
- Offices of physicians - $121,010
- Government - $106,910
- Educational services; state, local, and private - $101,040
Most physician assistants work full time. Some work more than 40 hours per week. Physician assistants may work nights, weekends, or holidays. They may also be on call, meaning that they must be ready to respond to a work request with little notice.
