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Physician Assistants Career Information

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• Significant Points
• Nature of the Work
• Working Conditions
• Employment
• Training, Qualifications, Adv.

• Job Outlook
• Earnings
• Related Occupations
• Sources of Additional Information

Significant Points

·     The typical physician assistant program lasts about 2 years and usually requires at least 2 years of college and some healthcare experience for admission.

·     Earnings are high and job opportunities should be good.

Nature of the Work

Physician assistants (PAs) provide healthcare services under the supervision of physicians. 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 the healthcare team, they take medical histories, examine and treat patients, order and interpret laboratory tests and x rays, make diagnoses, and prescribe medications. They also treat minor injuries by suturing, splinting, and casting. PAs record progress notes, instruct and counsel patients, and order or carry out therapy. In 47 States and the District of Columbia, physician assistants may prescribe medications. PAs also may have managerial duties. Some order medical and laboratory supplies and equipment and may supervise 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 or as required by law. PAs also may make house calls or go to hospitals and nursing homes to check on patients and 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 areas such as general internal medicine, pediatrics, and family medicine. Others work in specialty areas, such as general and thoracic surgery, emergency medicine, orthopedics, and geriatrics. PAs specializing in surgery provide pre- and postoperative care, and may work as first or second assistants during major surgery.

Working Conditions

Although PAs usually work in a comfortable, well-lighted environment, those in surgery often stand for long periods, and others do considerable walking. Schedules vary according to practice setting, and often depend on the hours of the supervising physician. The workweek of PAs in physicians' offices may include weekends, night hours, or early morning hospital rounds to visit patients. These workers also may be on call. PAs in clinics usually work a 40-hour week.

Employment

Physician assistants held about 62,000 jobs in 2009. 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 practice, clinic, or hospital. According to the American Academy of Physician Assistants, about 15 percent of actively practicing PAs worked in more than one clinical job concurrently in 2009.

More than half of jobs for PAs were in the offices of physicians. About a quarter were in 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. A few were self-employed.

Training, Qualifications, Adv.

All States require that new PAs complete an accredited, formal education program. As of July 2001, there were 129 accredited or provisionally accredited educational programs for physician assistants; 64 of these programs offered a master's degree. The rest offered either a bachelor's degree or an associate degree. Most PA graduates have at least a bachelor's degree.

Admission requirements vary, but many programs require 2 years of college and some work experience in the healthcare field. Students should take courses in biology, English, chemistry, math, psychology, and social sciences. More than two-thirds of all applicants hold a bachelor's or master's degree. Many applicants are former emergency medical technicians, other allied health professionals, or nurses.

PA programs usually last at least 2 years. Most programs are in schools of allied health, academic health centers, medical schools, or 4-year colleges; a few are in community colleges, the military, or hospitals. Many accredited PA programs have clinical teaching affiliations with medical schools.

PA education includes classroom instruction in biochemistry, pathology, human anatomy, physiology, microbiology, clinical pharmacology, clinical medicine, geriatric and home healthcare, disease prevention, and medical ethics. Students obtain supervised clinical training in several areas, including primary care medicine, inpatient medicine, surgery, obstetrics and gynecology, geriatrics, emergency medicine, psychiatry, and pediatrics. Sometimes, PA students serve one or more of these "rotations" under the supervision of a physician who is seeking to hire a PA. These rotations often lead to permanent employment.

All States and the District of Columbia have legislation governing the qualifications or practice of physician assistants. All jurisdictions require physician assistants to pass the Physician Assistants National Certifying Examination, administered by the National Commission on Certification of Physician Assistants (NCCPA)—open to graduates of accredited PA educational programs. Only those successfully completing the examination may use the credential "Physician Assistant-Certified (PA-C)." In order to remain certified, PAs must complete 100 hours of continuing medical education every 2 years. Every 6 years, they must pass a recertification examination or complete an alternate program combining learning experiences and a take-home examination.

Some PA's pursue additional education in a specialty area such as surgery, neonatology, or emergency medicine. PA postgraduate residency training 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.

Physician assistants need leadership skills, self-confidence, and emotional stability. They must be willing to continue studying throughout their career to keep up with medical advances.

As they attain greater clinical knowledge and experience, PAs can advance to added responsibilities and higher earnings. However, by the very nature of the profession, clinically practicing PAs always are supervised by physicians.

Job Outlook

Employment opportunities are expected to be good for physician assistants, particularly in areas or settings that have difficulty attracting physicians, such as rural and inner city clinics. Employment of PAs is expected to grow much faster than the average for all occupations through the year 2010 due to anticipated expansion of the health services industry and an emphasis on cost containment.

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. Telemedicine—using technology to facilitate interactive consultations between physicians and physician assistants—also will expand the use of physician assistants.

Besides the traditional office-based setting, PAs should find a growing number of jobs in institutional settings such as hospitals, academic medical centers, public clinics, and prisons. Additional PAs may be needed to augment medical staffing in inpatient teaching hospital settings if the number of physician residents is reduced. In addition, State-imposed legal limitations on the numbers of hours worked by physician residents are increasingly common and encourage hospitals to use PAs to supply some physician resident services. Opportunities will be best in States that allow PAs a wider scope of practice.

Earnings

Median annual earnings of physician assistants were $69,410 in May 2009. The middle 50 percent earned between $57,110 and $83,560. The lowest 10 percent earned less than $37,320, and the highest 10 percent earned more than $94,880. Median annual earnings of physician assistants in 2009 were $70,310 in general medical and surgical hospitals and $69,210 in offices of physicians.

According to the American Academy of Physician Assistants, median income for physician assistants in full-time clinical practice in 2009 was $74,264; median income for first-year graduates was $64,536. Income varies by specialty, practice setting, geographical location, and years of experience. Employers often pay for their employees' liability insurance, registration fees with the Drug Enforcement Administration, State licensing fees, and credentialing fees.

Related Occupations

Other health workers who provide direct patient care that requires a similar level of skill and training include occupational therapists, physical therapists, and speech-language pathologists and audiologists.

Sources of Additional Information

For information on a career as a physician assistant, including a list of accredited programs, contact:

• American Academy of Physician Assistants Information Center, 950 North Washington St., Alexandria, VA 22314-1552. Internet: http://www.aapa.org

For eligibility requirements and a description of the Physician Assistant National Certifying Examination, contact:

• National Commission on Certification of Physician Assistants, Inc., 12000 Findley Rd., Suite 200, Duluth, GA 30097. Internet: http://www.nccpa.net