Medical Studies Nonphysician Clinicians

Physician Assistant Data

The concept of the Physician Assistant gained its inspiration from 17th century Europe where feldshers were used in the 17th century Russian Army. In the 1960s, China employed over 1.3 million “barefoot doctors” to improve delivery of health care, especially in rural areas. Not until the mid 1960s did the U.S. begin to use Physician Assistants to deliever medical care due to a shortage of primary care doctors.

In the United States, Physician Asssitants (PAs) must be associated with a physician and must practice in an interdependent role. The partner physician, however, does not need to be physically present during a PA examination of a patient. PAs routinely deal with uncomplicated sprains, strains, hypertension, bronchitis, depression, allergies, asthma, gynecological problems, family planning and trauma. Approximately 55% of all physician assistants practice in primary care.

In order to become a Physician Assistant, the average PA spends 25 months studying an intensive core curriculum. In 2001, there were 130 training programs in universities, medical schools, colleges, and the armed forces. PAs learn the broad topics related to primary care and rotate through the major specialties. Nurse practitioners, on the other hand, traditionally are trained in one specialty (pediatrics, women’s health, etc.).
The following are some summary data for Physician Assistant which comes from the American Academy of Physician Assistants 2005 Census.
Number of Physician Assistants by Disorder in 2005

BY PRIMARY EMPLOYER

Single-specialty physician group 30.6%
Other hospital 14.9%
Solo physician practice 13.5%
Multi-specialty physician group 12.3%
University hospital 7.5%
Community health center 6.1%
Self-employed 3.1%
HMO 2.3%
Other 9.7%

BY GENERAL SPECIALTY PRACTICED

Family medicine 28.4%
Surgical subspecialties 21.9%
Other 10.5%
Internal medicine subspecialties 10.3%
Emergency medicine 9.7%
General internal medicine 7.6%
General surgery 2.8%
General pediatrics 2.5%
Obstetrics & gynecology 2.4%
Occupational medicine 2.3%
Pediatric subspecialties 1.5%

ANNUAL INCOME (Full-time workers only)

Mean $81,129
10th percentile $60,184
25th percentile $67,128
Median $77,402
75th percentile $90,402
90th percentile $106,705

AAPA 2005 Census

Mittman, Cawley, Fenn; (2002) “Physician Assistants in the United States,”British Medical Journal, Vol 325, 31 August 2002.

5 Comments

  1. A little correction. PAs don’t have to practice with doctors. It’s true, there are clinics that are ran independantly by PAs and NP. They must seek Doctors advice though if the scope of practice is out of their reach.

  2. It is correct that PAs do not have to practice with doctors, however I believe in some states that a physician must register that they will “supervise” the PA. The “supervision” does not have to be even in the same facility, however. The American Academy of Physicians Assistants has an abridged version of state licensing laws which detail the rules: http://www.aapa.org/gandp/statelaw.html

  3. hi, i have been a PA for 7 years in orthopedics, and i’m currently renegotiating my yearly income with my physician boss. a lot of my value comes in non-billable forms (saving the doc time, taking the extra load off o him in clinic, etc). any ideas on how to “calculate” my value to the practice other than looking at what i bring in through reimbursement?

  4. Beyond how much salary a PA generates, compensation is broken down to the economic value and benefits a PA provides to clinical practice, patient satisfaction, and a PA’s participation and leadership role in improving the practice.

    The most driving cause for PAs to be knowledgeable this information is that medicine is moving in the direction of compensation structures that are based on determining the value that you bring to your practice in terms of direct economics and participation in committee activities and patient satisfaction.

    This is a huge shift that I am not sure the average PA is ready for. Most practicing PAs continue to believe you just get paid a base salary and don’t have to worry about the rest of it.

    The compensation that should be considered is how effective the PA is in his or her practice. One way to determine this is by examining all services the PA provides the patients in clinical practice, and then approximate the amount the of compensation value of a PA.

    Typically, in terms of how much money did you bill, what did you collect, and how much it costs to have you here. What I tend to do is say, OK, let’s look at what PAs do. Because some of PAs duties in clinical practice is directly billable. In other words it’s billable services PAs provide that could be billed separately, but in some cases it is bundled together.

    More PAs can increase their compensation in practice is to understand coding, know what to charge for your services, become familiar with major payer rules, and acquire production/cost data.

    The cost-effectiveness of PAs should be considered. From a productivity standpoint, there are two ways this can be determined: by the money a PA generates and by the number of patient services a practicing PA provides.

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