Yes, rigorously trained and licensed physician assistants (PAs) practice medicine under the supervision of or in collaboration with physicians whose expertise helps shape the PAs’ scope of practice based on their qualifications.
As PAs consistently demonstrate their ability to enhance patient outcomes, they are gaining well-deserved recognition and autonomy, expanding their roles in healthcare systems nationwide.
PAs, NPs, MDs: What’s the Difference?
PAs and NPs (nurse practitioners) emerged in the 1960s as a response to the urgent need for more healthcare providers in the face of medical doctor (MD) shortages and increasing healthcare demands. The expansion of Medicare and Medicaid through the Social Security Amendments of 1965 increased access to and heavily contributed to an increased demand for healthcare. The development of PAs and NPs has significantly improved patient access to care and enhanced the capacity to meet the population’s evolving needs.
The table below shows some significant distinctions among PAs, NPs, and MDs.
Table: Years of study, wages, and professional authority of PAs, NPs, and MDs
As you can see, PAs and NPs have similarities regarding how long it takes to become qualified and average pay, but they differ significantly from MDs in both these areas.
Aren’t PAs about the Same as NPs?
PAs and NPs are sometimes called “Advanced Practice Providers” (APPs). Both require graduate studies and provide essential healthcare services, but they differ in their undergraduate educational backgrounds, patient care approaches, and autonomy levels.
Educational Pathways and Autonomy: Differences
PAs enter the field in their graduate programs after a broad spectrum of undergraduate studies. Approximately 30 percent of PAs come from a nursing background, and 70 percent from many other diverse fields. PA training programs follow a model similar to medical school, focusing on disease pathology and treatment.
These statistics highlight that while PAs have diverse educational paths, many have prior experience working as registered nurses (RNs) before transitioning to the PA role. This background can provide valuable clinical skills and patient care experience that are beneficial in their PA training and practice.
Meanwhile, NPs study nursing and become RNs in their undergraduate programs, then pursue advanced nursing degrees. Nursing emphasizes a holistic, patient-centered approach. NPs are trained to provide comprehensive care, orientation on disease prevention, and health education, and they can practice independently in many states.
Both diagnose illnesses, create and oversee treatment plans, prescribe medications, and serve as healthcare providers, but nurse practitioners enjoy more professional autonomy.
How Much Autonomy Do PAs Have?
While no state allows PAs to practice entirely independently without any form of supervision, several states provide varying degrees of autonomy that enable PAs to operate with greater independence. This autonomy usually involves determining the PA’s scope of practice in an agreement directly with their supervising physician.
These agreements vary and have diverse names, including delegation, supervision, or collaborative agreements. Common issues contemplated in such contracts are scope of practice, prescriptive authority, and level of supervision.
Prescriptive Authority
Regarding prescriptive authority, PAs can generally prescribe medications in collaboration with supervising physicians. However, specific states prohibit PAs from prescribing Schedule II controlled substances, defined by the Controlled Substances Act as drugs with some medically acceptable uses but with a high potential for abuse and/or addiction.
Scope of Practice
The agreement clearly outlines the medical services and procedures that the PA is authorized to perform based on the PA’s training, experience, and the supervising physician’s practice area. Establishing a well-defined scope helps ensure that the PA operates within their competency and the legal framework set by state regulations.
Level of Supervision
The agreement specifies the level of supervision, which can vary substantially depending on the state. For example, the agreement specifies whether the supervising physician must be physically present or available via telecommunication or whether the PA can operate more autonomously after demonstrating sufficient experience.
PAs: Assistants or Associates?
The American Academy of Physician Associates (AAPA)—previously the American Academy of Physician Assistants—is still in the developing stages of efforts to phase out the title “physician assistant” and replace it with “physician associate” to clarify the PA role in the public’s eyes. However, no government entity at any level—federal or state—has signed off on the change, which means PAs cannot yet use the title “physician associate.”
What Is the Role of a PA?
PAs are licensed clinicians who practice medicine in various specialties and settings. Their roles in healthcare teams encompass various aspects of patient care, from evaluation and diagnosis to education and monitoring. Here are some of the primary duties and functions of PAs:
- Conducting Patient Evaluations and Diagnoses: PAs gather medical histories, assess health conditions, and diagnose medical conditions by conducting thorough patient interviews, physical examinations, and diagnostic testing.
- Developing and Implementing Treatment Plans: PAs develop and implement patient care plans, which may include prescribing medications (with authorization in some cases), ordering further tests, and recommending lifestyle changes.
- Performing Minor Surgical Procedures: PAs perform joint injections, suture wounds, and drain abscesses, and if they specialize in surgery, they may work alongside surgeons.
- Providing Patient Education: They counsel patients about their health conditions, treatment options, and preventive care, helping patients understand and manage their health effectively.
- Monitoring Patient Progress: PAs track and document patient progress, adjusting treatment plans based on patient responses and outcomes as necessary.
- Conducting Clinical Documentation: Documenting comprehensive patient histories, including medical, surgical, and family histories, as well as social factors that may affect health, is a standard PA duty.
- Performing Research and Administration Tasks: Some PAs may also be involved in medical research, healthcare administration, and education, contributing to the profession’s advancement and healthcare delivery.
PAs are highly trained healthcare professionals who provide essential services across a broad spectrum of medical care. Their ability to diagnose, treat, and manage patient care enhances healthcare access and efficiency, making PAs crucial components of the modern healthcare system.
PA Specialties
The National Commission on Certification of Physician Assistants (NCCPA), the PA certifying organization for the U.S., lists the following as the most common PA specialties.
- Primary Care: 23.7%
- Family Medicine/General Practice: 17.7%
- Emergency Medicine: 11.8%
- Orthopedic Surgery: 10.8%
- Internal Medicine/General Practice: 4.3%
- Dermatology: 4.1%
- Cardiothoracic & Vascular Surgery: 3.3%
PAs can specialize in these and other fields through on-the-job experience, postgraduate training, certification, continuing education, and collaboration with specialists.
How Much Do Physician Assistants Make?
An annual PA salary starts under $86,280 and goes up to over $170,790. The average PA salary is $130,490, which, according to DATAUSA, is slightly more than the average pay of aerospace engineers and physicists.
Physician assistant pay varies by specialty and setting. The top-paying settings are outpatient care centers, specialty hospitals, and general medical-surgical hospitals.
How Much Does a PA Make in the Highest-Paying Specialties?
As stated in Becker’s Hospital Review, the highest-paying PA specialties are the following:
- Cardiothoracic and vascular surgery: $143,807
- Dermatology: $136,749
- Critical care medicine: $134,027
- Neurosurgery: $131,883
- Emergency medicine: $130,689
The physician assistant salary for these highest-paying specialties indicates the career advancement opportunities available to PAs who can take on the challenges of additional training and greater responsibilities.
How Can I Become a Physician Assistant?
After high school, an aspiring PA must complete a bachelor’s degree, which can be in any field, although 38 percent choose health-related disciplines. The PA training itself requires the following:
- A master’s degree from an accredited PA program, typically a Master of Science in Physician Assistant Studies
- At least 2,000 hours of extensive supervised clinical practice, which is part of the PA master’s program
- Certification from the Physician Assistant National Certifying Examination (PANCE)
Once you have completed the PA program, passed the PANCE exam, and obtained certification, you become a certified and licensed physician assistant, ready to practice.
What Is the Job Outlook for Physician Assistants?
The AAMC (Association of American Medical Colleges) forecasts a shortage of 37,800 to 124,000 MDs by 2034, including critical shortfalls in primary and specialty care. Meanwhile, BLS projects a 27 percent leap in physician assistant jobs from 2022 to 2032.
These PAs are stepping up to work with MDs, nurses, and the allied healthcare workforce to meet the country’s growing medical needs. However, finding PA assistant jobs can still be challenging.
Nursa can help in the job hunt. Learn about PRN allied health jobs and how to find them.
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