Have you considered a professional career as a physician assistant, but you’re not quite sure what that looks like?
Practicing as a physician assistant is fun, exciting, and challenging. You may have guessed PAs work with physicians and patients, but we are also charged with finding creative solutions to problems and helping our patients learn to live healthier lives.
The profession began in the 1960s, growing out of a need for greater access to medical care. Today physician assistants are an integral part of providing primary and specialty care throughout the country.
In January 2020, U.S. News & World Report ranked physician assistants as the No. 3 best job, including an important update to the profile description.
The past profile stated: “PAs are required by law to practice under the supervision of a physician or surgeon.” However, the update states: “in most states, PAs must collaborate with a licensed physician or surgeon to practice.”
David Mittman, president and chair of the American Academy of Physician Assistants (AAPA) Board of Directors, spoke to U.S. News and World Report, underscoring the decision to become a PA as a solid career choice that would help ensure the country could meet patient needs.
Mittman was quoted in the presentation saying: “Because we are highly trained, collaborative and versatile, we are a ready solution to some of the most pressing health care challenges of today, like access to medical care and provider shortages in underserved and rural areas.”
What Is a Physician Assistant?
Physician assistants are integral members of the healthcare services team and we practice in collaboration with physicians and other advanced practice healthcare professionals.
There are currently more than 140,000 physician assistants practicing throughout the United States and the District of Columbia. You can find a PA in nearly every medical setting and specialty, and though we collaborate with a physician, we often serve as the principal healthcare provider.
A physician assistant’s education is rigorous; it’s modeled after medical school curriculum, providing a comprehensive view of all aspects of care. This strong foundation in general medicine enables you to provide “whole patient care,” even while practicing in a specialty environment.
For instance, a PA practicing in obstetrics may notice a skin condition and can choose to treat the skin condition or refer the patient to a dermatology practice. PAs are highly-trusted by patients. A 2014 Harris Poll found 93% of patients surveyed regarded PAs as trusted providers, and 91% believed they improved the quality of healthcare.
History of the Physician Assistant Profession
In the mid-1960s medical providers and educators recognized a growing shortage of primary care physicians. To help address the deficit, Duke University Medical Center put together the first class of physician assistants.
The curriculum was modeled after fast-track training used to educate doctors during World War II. The first class consisted of 4 Navy Hospital corpsmen who were selected based on the substantial medical training they acquired during their military service. They graduated on October 6, 1967, and the rest—as they say—is history.
The program was an early success and was adopted at the federal level in the 1970s. Over the coming decades, advancement of the profession moved quickly as the field reached significant milestones.
1970 – Kaiser Permanente became the first HMO to hire physician assistants.
1971 – The American Medical Association recognized the profession.
1982 – The annual conference had 2,500 in attendance.
1988 – Duke University awarded the first master’s degree for PA education.
1992 – The Department of Labor projected a job increase of 36% by 2005.
1993 – DEA allowed registration of PA allowed to prescribe controlled substances.
2000 – Mississippi was the last of 50 states to approve PA practice.
2005 – PA-type programs were developed in the U.K.
2009 – PA Professional – the first official publication of the AAPA was released.
2015 – The U.K. National Health Service announced an expansion program to recruit PAs from the U.S.
2017 – The Ministry of Health in Ireland announced they would back the development of a PA career.
The development of physician assistants grew out of a need for medical professionals, and that need continues to expand. Today PAs practice around the world, where they’re recognized for their expertise and skill. Choosing this career, you can be assured there will be a continued need for your talents and knowledge.
Educational Requirements for a PA
Admission into one of the 250 U.S. PA programs is highly competitive, so you may want to investigate your options and prerequisite education as early as your freshman year in college whilst seeking a bachelor’s degree.
For the most part, physician assistant programs require two years of basic and behavioral sciences coursework, including prerequisites in chemistry, physiology, biology, microbiology, and anatomy. Some programs require you’ve held hands-on patient care positions in the past, like a registered nurse (RN), medical assistant (MA), EMT or paramedic.
You’ll notice once you’ve been admitted to a program, it closely resembles a condensed version of medical school, including class and clinical education with inpatient clinical rotations. The average U.S. PA program takes nearly 27 continuous months to finish.
Once you graduate, you’re eligible to be certified. The certification test is called the Physician Assistant National Certifying Exam, which you may have seen abbreviated as PANCE. It’s administered through the National Commission on Certification of Physician Assistants (NCCPA).
After you complete your education and pass the certification exam, you can add the title Physician Assistant-Certified, or PA-C, after your name.
A Physician Assistant In Practice
Since your education as a physician assistant is general medical training, the field is considered as one of the most versatile.
Medical Fields Where PAs Practice
Nearly 49% of PAs report providing care in more than one specialty during their career. General medicine/family practice, emergency medicine and surgical subspecialties had the highest percentage of practicing PA-Cs in 2018.
Interestingly those practicing in primary care also had the lowest percentage of changing specialties. By far, the greatest number of physician assistants practice in hospitals or office-based private practices. Together, these practice settings represent 80% of where all PA-Cs work.
In a 2018 statistical analysis performed by the NCCPA, it most PAs prefer to practice in hospitals and private practice, while 3.1% reported working in community health centers. The study also found that less than 1% of PAs practiced in hospice settings.
A Physician Assistant’s Daily Duties
We provide many different services to our patients and the medical professionals we collaborate with.
Some of your duties will include recording patient history and performing physical exams; ordering, performing, and interpreting diagnostic testing, such as labs, x-ray, and EKGs; and analyzing information, making diagnoses, and prescribing treatment plans including medication, physical therapy, and palliative care.
PAs also do rounds at the hospital, assist in surgery, and perform certain procedures.
Prevention is another significant part of patient care. During patient visits, we often counsel and educate our patients on preventive measures they may take to reduce the burden of chronic disease.
Education and counsel to help patients make healthy lifestyle choices is an important part of any physician assistant’s practice.
The number of hours worked and patients seen will also vary by specialty. The average across all PA specialties is 73 patients over the course of a 40-hour work week. And while this is the average, there are some outliers.
For instance, PAs working in cardiothoracic and vascular surgery report seeing an average of 29 patients in 46.2 hours each week.
On the other hand, dermatology PAs see an average of 118 patients in 36.9 hours each week. In our experience, the range of patients in a specialty like GI or cardiology is typically around 14 – 18 patients per day, to 40 on a busy urgent care day.
What Does a PA Do: 6 Things You May Not Know
As in any healthcare setting, no day is like the day before, and a day in the life of a physician assistant is not different. While our duties involve many of those listed above, here are some things you may not know about physician assistants:
- PAs can order advanced imaging studies, such as CT and MRI scans. We can also perform procedures such as setting fractures, serial casting, and cardiac procedures.
- There’s a difference between a physician’s assistant and physician assistant. The first is typically an assistant who is cross-trained in administration and clinical duties. The second is a fully-qualified and fully-certified medical professional.
- Salaries for PAs are close to the highest in the medical industry, in some areas close to an MDs salary. Salaries are dependent on geographical location, specialty, and experience.
- Physician assistants must pass a recertification test every 10 years.
- Many PAs in major specialties have residency-type rotations, and the scope of practice is nearly identical to the scope of most physician practices.
- A physician assistant can prescribe narcotics after receiving a separate DEA registration.
PA vs Medical Assistant vs Nurse Practitioner: What’s the Difference?
Medical assistants work with physicians in outpatient and ambulatory care settings. A medical assistant performs a variety of duties that may differ from office to office. On the whole, administrative tasks include medical records, scheduling, and arranging hospital admissions.
Clinically, their responsibilities include preparing patients for examination, drawing blood, taking EKGs, and assisting the physician during exams.
Nurse practitioners more closely resemble PAs. According to the AAPA, “At the practice level, there are likely more similarities than differences between PAs and NPs.”
The two primary differences are in their education and practice focus. PAs are educated in general medicine, while nurse practitioners are educated with a population focus, such as pediatrics, geriatrics, or women’s health.
The second difference is in the philosophy of care, or practice focus. While an NP is patient-centered with a focus on health promotion and disease prevention, a PA is disease-centered practicing in the same medical model as physicians.
PAs place an expressed emphasis on the pathological aspects of health. Both PAs and NPs require certification and licensure to practice medicine.
Future Job Outlook for Physician Assistants
The Bureau of Labor Statistics recorded the median annual PA salary in 2018 as $108,610. That year, there were 118,800 U.S. jobs for PAs, with an estimated growth of 31% from 2018 to 2028 , which the BLS states is “much faster than average.”
The high demand and need for PAs to fill the shortage of physicians is driving the creation of new programs to educate advanced-practice professionals. A physician assistant is also attractive from a financial standpoint as they are able to cost-effectively provide appropriate healthcare to a growing population burdened with chronic disease.
Choosing a career as a physician assistant gives you the opportunity to diagnose and treat challenging patients, and expand the availability of medical care to the community.
Your daily experiences will never be dull, and you’ll be well compensated for your time, talent, and skills.