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. Although PAs usually work in a comfortable, well-lighted environment, those in surgery often stand for long periods. At times, the job requires a considerable amount of walking.
PA’s work schedules may vary according to the practice setting and often depend on the hours of the supervising physician. The workweek of hospital-based PAs may include weekends, nights, or early morning hospital rounds to visit patients. These workers also may be on call. PAs in clinics usually work about a 40-hour week. Physician assistants are formally trained to provide diagnostic, therapeutic, and preventive healthcare services, under the supervision of a physician.
Requirements for admission to training programs vary; most applicants have a college degree and some health-related work experience. All States require physician assistants to complete an accredited, formal education program and pass a national exam to obtain a license.
Education and training. 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 2013, 181 education programs for physician assistants were accredited or provisionally accredited by the Accreditation Review Commission on Education for the Physician Assistant. The majority of these programs offer a Master’s Degree.
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.
Licensure. 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 10 years they must pass a recertification examination.
Other qualifications. 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.
Advancement. 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.
Physician assistants held about 86,700 jobs in 2012. The number of jobs is greater than the number of practicing PAs because some hold two or more jobs. For example, some PAs work with a supervising physician but also work in another healthcare facility. According to the American Academy of Physician Assistants, about 15 percent of actively practicing PAs worked in more than one clinical job concurrently in 2008.
More than 53 percent of jobs for PAs were in the offices of physicians. About 24 percent were in general medical and surgical hospitals, public or private. The rest were mostly in outpatient care centers, including health maintenance organizations; the Federal Government; and public or private colleges, universities, and professional schools. Very few were self-employed.
Employment is expected to grow by 38 percent from 2012 to 2022,much faster than the average for all occupations. Job opportunities for PAs should be good, particularly in rural and inner-city healthcare facilities.
Employment change. Employment of physician assistants is expected to grow by 39 percent from 2008 to 2018, much faster than the average for all occupations. Projected rapid job growth reflects the expansion of healthcare industries and an emphasis on cost containment, which results in increasing use of PAs by healthcare establishments.
Physicians and institutions are expected to employ more PAs to provide primary care and to assist with medical and surgical procedures because PAs are cost-effective and productive members of the healthcare team. Physician assistants can relieve physicians of routine duties and procedures. Healthcare providers will use more physician assistants as States continue to expand PAs’ scope of practice by allowing them to perform more procedures.
Besides working in traditional office-based settings, PAs should find a growing number of jobs in institutional settings such as hospitals, academic medical centers, public clinics, and prisons.
Job prospects. Job opportunities for PAs should be good, particularly in rural and inner-city clinics because those settings have difficulty attracting physicians. Job openings will result both from employment growth and from the need to replace physician assistants who retire or leave the occupation permanently. Opportunities will be best in States that allow PAs a wider scope of practice.
The median annual wage of physician assistants was $90,930 in May 2012. The middle 50% of physician assistants earned between $68,210 and $97,070. The lowest 10 percent earned less than $62,430, and the top 10 percent earned more that $124,770.
According to the American Academy of Physician Assistants’ 2008 Census Report, median income for physician assistants in full-time clinical practice was $85,710 in 2008; median income for first-year graduates was $74,470. Income varies by specialty, practice setting, geographical location, and years of experience. Employers often pay for their employees’ professional liability insurance, registration fees with the Drug Enforcement Administration, State licensing fees, and credentialing fees.
The above wage data information is from the United States Department of Labor, Bureau of Labor Statistics, unless otherwise noted.
For more information on a career as a Physician Assistant, including a list of accredited programs, contact: