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Physician assistants, often considered primary care professionals, are entering more specialty fields including surgery and emergency medicine amid a nationwide doctor shortage, according to a new report.
More than 70% of physician assistants now work in “non-primary care specialties,” according to the National Commission on Certification of Physician Assistants in its annual profile of the PA profession.
“A key reason for the growth in specialties such as surgery and emergency medicine is that’s where there’s a real need, often due to physician shortages in those areas,” says Dawn Morton-Rias, a physician assistant and chief executive of the commission (NCCPA).
There are now more than 108,000 PAs across the country and they are increasingly taking on a greater role given doctor shortages in certain areas. The Association of American Medical Colleges earlier this year projected a shortage of 61,000 to 94,700 physicians by 2025.
A physician assistant is nationally certified by the commission and must be licensed in the states where they practice. Most have a two-year master’s degree, often from a program that runs about two years and includes three years of healthcare training, according to the American Academy of Physician Assistants. They work in doctor’s offices, hospitals, surgery centers and other locations, and their work includes diagnosing illnesses, writing prescriptions and counseling patients on preventive care.
An increasing number of states are granting physician assistants more autonomy to increase access to patients amid the doctor shortage, which has been exacerbated by an influx of millions of new patients seeking care now that they have health insurance under the Affordable Care Act. Physician assistants are also escalating their lobbying efforts to change state scope-of-practice laws so they can gain more direct access to patients.
In some cases, states are removing bureaucratic barriers that in the past led to redundant tasks or slowed the ability of patients to get the care they needed. Earlier this year, for example, New Jersey joined nearly 30 other states to get rid of the countersignature requirement as states across the country lift hurdles and allow PAs and nurse practitioners more direct access to patients. The New Jersey legislation also removed a rule that required the PA to have a “continuing or intermittent presence” with a collaborating physician while working in a hospital or other inpatient setting.
Physician assistants are increasingly an integral part of value-based care models proliferating across the country like accountable care organizations (ACOs) and patient-centered medical homes that contract with insurers, Medicare and Medicaid programs. Major insurers like
“One part of the value equation is cost, and PAs are cost-effective providers of high quality care,” Morton-Rias said. “While the PA salary is competitive, it is much less than a physician, particularly in the surgical specialties.”
The association’s PA profile shows median salary of PAs in primary care is about $95,000, though some specialties are making between $100,000 and $120,000. Meanwhile, the Medical Group Management Association’s annual survey this year showed primary care physician compensation surpassing $250,000.
