At first, the physician assistant role was created to support primary care physician practices, but PAs now have taken on more responsibilities. In 2018 there were 98,625 physician assistants who were clinically active and responded to a survey about medical specialties.
Some estimate the total number of practicing PAs is much higher as the number who are certified grows each year. In 2015 there were nearly 7,776 who were certified, as compared to 10,000 certified in 2018.
You are practicing in one of the most in-demand medical professions.
It has increased in opportunities and pay since the beginning of the profession in 1971 when the Air Force began training their first class of “Towner’s Boys.” They were named after Lt. General Alonzo Towner, then USAF Surgeon General, who started the program.
Today, you have the opportunity to grow your career and specialize as the profession enjoys a projected growth of 31% through 2028, higher than the average of any other occupation. With this growth comes unique opportunities to serve clients in a variety of medical specialties and subspecialties.
Physician Assistants Have a Choice of Specialties
PAs practice in a wide variety of specialties ranging from family practice and pediatrics to surgical subspecialties, including plastic and reconstructive surgery, vascular surgery, transplant surgery and trauma surgery.
Over the past 10 years the number of PAs practicing in different specialties has remained relatively stable, with shifts of just a few percentage points. Family practice and general medicine remains the most popular choice for certification, pulling 19.2% of active PAs.
This is followed closely by 18.5% who are practicing in surgical subspecialties. The largest change came between 1996 and 2007 when the percentage of PAs in family practice and general medicine dropped from 54% of all active PAs to 24.9% in 2007.
This change may be in part due to the salary differences between family medicine and specialties and the number of specialties available.
In one study, researchers determined financial incentives likely influenced specialty choice in the top five paying positions, but there was little relationship between salary and specialty preference in the remaining choices.
Top 10 Physician Assistant Salary by Specialty
There are several factors that affect salaries for physician assistant specialties. Factors over which you may have some influence include:
- Experience
- Choice of specialty
- Facility
- Geographical area
While it is prudent to be mindful of finances, it’s also important to consider the patient population and your ability to move from one specialty to another later in your career. One of the benefits of practicing as a PA is the flexibility it offers throughout your career.
According to the American Academy of PAs, this flexibility is unique to physician assistants. In one study published in 2010, over four decades of data showed 49% of PAs reported having practiced in two different specialties.
Since physician assistants are educated as generalists, they have greater lateral mobility than a nurse practitioner might. NPs are limited by their education in a specific patient population, such as pediatrics or adult and geriatric nurse practitioner (AGNP).
As you consider your first or second types of physician assistants in the medical field, remember you have the option to change later. Here’s a list of some of the highest paying PA specialties from the 2018 National Commission on Certification of Physician Assistants annual report and the number of practicing PAs in those specialties.
Dermatology
There were 3,940 practicing physician assistants in this specialty in 2018. Dermatology is the highest paying PA specialty. On average they earned $126,084 each year. The median (midpoint) salary was $115,000. These professionals evaluate, diagnose and treat skin conditions, medically and surgically.
Most specialize through training in collaboration with a practicing board-certified or -eligible dermatologist. Additional continuing medical education hours are required to maintain your practice. You also have the option to lecture at University PA programs and offer student rotations.
Critical Care
PAs practicing in critical care bring home an average $122,957 PA salary, and midpoint of $115,000. There are 1,502 PAs practicing in critical care, representing 1.5% of the total physician assistant field.
As value-based healthcare progresses, PAs in critical care units are expected to engage in comprehensive care of patients in the ICU. While the physician is legally responsible, the critical care PA provides support and management over a 24-hour period. They communicate with the physician at least twice daily and during unexpected patient care events.
Emergency Medicine
Emergency medicine PAs average salary is $123,006, with a median salary of $115,000. This is the third most popular specialty, behind family practice and surgical subspecialties. There were 12,860 practicing in 2018, representing 13% of the total number of active PAs.
The demand for PAs in emergency medicine continues to rise to support busy emergency rooms. In addition to completing a history and physical, ordering diagnostic tests and prescribing treatments, PAs in emergency medicine close lacerations, perform lumbar punctures, thoracentesis and arterial punctures. They practice under supervision of physician but often work independently.
General Surgery
PAs practicing in general surgery average $112,396 salary and a midpoint of $105,000. Nearly 3% of all PAs practice in general surgery, representing 2,890 in 2018. Under physician supervision, general surgery PAs do patient rounds, write discharge summaries and anticipate and correct post-operative issues.
In the surgical suite, PAs may perform a wide range of abdominal surgeries. They may also handle orthopedic, urologic and thoracic procedures. General surgery PAs may also evaluate and begin treatment on trauma victims.
Hospital Medicine
Physician assistants practicing hospital medicine earn an average of $111,426 each year and a midpoint of $105,000. There were 3,436 practicing hospital medicine PAs in 2018, representing 3.5% of the field.
Hospital medicine PAs collaborate daily with physicians and members of the patient care team. This is a generalist position in a hospital setting, where you may be asked to work in the emergency department or inpatient units. In some cases the hospital employs the hospital medicine PA and other times a medical practice engages a PA for hospital support.
Pathology
Physician assistants specializing in pathology earn an average $111,000 a year and a median PA salary of $115,000. Although a lucrative career choice, the NCCPA records only 6 working in 2018. Their scope of practice includes tissue sampling, imaging and postmortem examinations.
Radiology
There were 675 PAs practicing in radiology who earned an average $110,556 in 2018 and a mean salary of $105,000. In this PA specialty practice, you perform different invasive and noninvasive procedures, imaging and scans.
Physician assistants may also work in the field of interventional radiology, which is sometimes described as the “surgery of the new millennium.” The speciality uses real time images to deliver immediate, targeted treatments using a minimally invasive approach to reduce pain and recovery time.
Pain Management
PAs practicing in pain management earn an average salary of $109,273 and a median salary of $105,000. Pain management may be one of the more complex aspects of nonsurgical care. The treatment of chronic, nonterminal pain requires an understanding of the underlying condition, while considering the patient’s lifestyle.
The American Pain Society estimates the cost of treating chronic pain has reached $635 billion annually. Nearly one third of Americans will experience chronic pain in their lifetime that causes disability or limits the ability to work.
Addiction Medicine
In 2018, there were 296 PAs practicing in addiction medicine, who earned an average salary of $108,685 and a median salary of $105,000. PAs may work in recovery centers or physician offices, assisting with patient assessments, testing and treatment plans. The ability of PAs to prescribe buprenorphine for addiction treatment has increased the value of the PA in the field.
After completing a 24-hour training course, PAs may apply for a waiver to prescribe buprenorphine to treat addiction. The waiver is regulated by the Substance Abuse and Mental Health Services Administration. You can apply online for the waiver and increase your patient load to 100 after practicing for one year.
Occupational Medicine
There are 1,415 PAs practicing in occupational medicine earning an average salary of $107,897 annually and a median salary of $105,000. Occupational medicine PAs work in the workplace to deliver physical, mental and emotional healthcare.
They offer the ability of large employers to do annual physical examinations, exercise stress tests and treatment of work related injuries on the premises. This reduces the employers overall costs and insurance costs to the employee.
Lowest Paying PA Specialties
As you look through the highest paying PA specialities, it’s worth considering some of the lowest paying ones as well. According to the Bureau of Labor Statistics (BLS), the median wage earned by an individual with an advanced degree, like a PA, is $81,068.
The median wage is lower than the median wage earned by any of the specialties tracked by the NCCPA. Although finances are important, enjoying what you do is crucial to be successful. Getting up every day to a job you hate may be one of the more draining experiences in life.
One distinguished Hungarian psychologist wrote that being able to enjoy the work you do is one of the main factors to feeling focused and creative. Beginning the day with a negative mindset makes it difficult to complete your work and increases your risk of burnout.
The median salary for the lowest paying PA specialties, $95,000 a year, is higher than the median salary reported by the BLS. Some of those specialities include:
Obstetrics and Gynecology
There are 1,156 PAs in OB GYN earning an average salary of $96,244 and a median salary of $95,000. Specialists in this field may work in an obstetrics office, or be hired by general medicine or family practice. They provide family planning, address gynecological complaints and do annual examinations.
Pediatrics
PAs who practice in pediatrics earn an average salary of $92,194 and a median salary of $95,000. There are 1,921 in active pediatric practice who offer well and sick child care. They diagnose and treat illnesses, do annual physical exams and may assist in surgeries.
Adolescent Medicine
Adolescent medicine is a growing field where the average salary earned is $90,588 and the median salary is $95,000. There are less than 200 PAs who practice in adolescent medicine, which is a subspecialty of pediatrics.
This is a challenging career choice during which you address mental, emotional, developmental and physical health. In many cases, the approach is family centered where you and the parents work collaboratively to achieve the best outcome for the adolescent.
The Best PA Specialties
It may be next to impossible to identify one or two best specialities that fit the unique talents and needs of each PA.
However, by evaluating your options and remembering you have the opportunity to make lateral moves throughout your career, you may find there is more than one best PA job waiting for you.
