When Eugene Stead founded the physician assistant (PA) profession and graduated his first class of PAs in 1967, the new mid-level providers only worked in primary care settings. Today, their roles are evolving to help bridge existing healthcare gaps due to a growing physician shortage.
“We’re seeing PAs enter hospital leadership roles and become more involved with research, education, and pharmaceutical companies. There’s so much that’s open to you as a PA,” says Physician Assistant Program Director Ashley Iacone, MSPAS, PA-C.
PAs are graduate-level healthcare providers who function with autonomy in patient interactions. While many programs train them to be generalist providers, they may choose to enter fields such as dermatology, pediatrics, surgery, and subspecialty areas.
“There is such a need right now to see patients,” says Medical Director Earl Jackman, DO, noting how people have difficulty making primary care appointments or scheduling non-emergency procedures. “There’s a shortage anticipated of 50,000 primary care doctors that’s going to go into the next decade, so this is a wonderful time to become a PA and provide care for patients who need it.”
Iacone believes fewer people are attending medical school today because of time and cost. While PA students typically undergo a 27-month or three-year program with optional residencies and fellowships, those attending medical school must complete a four-year program with a three- to seven-year mandatory residency. PAs have lateral mobility that allows them to start in one area of medicine and switch to another specialty down the road — unlike MDs and DOs, who are committed to a specific field throughout their career.
PA roles are still evolving. The profession recently expanded abroad, and other countries are implementing educational programs similar to America’s curriculum.
“In the future, I see the use of PAs expanding in every aspect of healthcare,” Iacone says.
Iacone notes that the quality of care that a patient receives from a PA versus a physician should be fairly equal since both are healthcare providers trained in medical best practices and are equipped to care for sick patients. She notes that patient care is a collaborative approach and physicians and PAs should work together for the benefit of patient care. Physicians have a wealth of experience and serve as a valuable knowledge resource to PAs, enhancing the collaboration between the two professions.
Approximately a quarter of all medical visits are conducted by PAs and nurse practitioners (NP) — not physicians, according to a Harvard Medical School study. Researchers found that patient and PA/NP interactions grew from 14 percent in 2013 to 25 percent in 2019, and that PAs are expanding their roles in behavioral health. Advanced practice providers are now providing evidence-based treatments to those with anxiety disorders and mental health conditions since there are not enough psychiatrists to treat all those in need.
With a PA’s ability to take on new positions, states are widening their range of practice laws for the profession.
“We are fortunate that Rhode Island is a very PA-friendly state. In fact, it is more friendly for PAs than it is for physicians,” Jackman says, adding that the insurance reimbursement codes pay physicians very little compared to other markets.
Today, according to the American Academy of PAs, there are approximately 168,300 licensed PAs in the United States who interact with more than 500 million patients per year. U.S. News & World Report also ranked the profession as fourth in the 2023 Best 100 Jobs List. At Bryant, 94 percent of graduates are employed within three months with an average starting salary of $110,000. The university also offers a PA and NP leadership in healthcare certificate that helps individuals develop leadership skills for their current position or future supervisory role.
“The curriculum is rigorous for the PA student,” Jackman says, noting that students must complete 2,000 hours of clinical rotations and pass the Physician Assistant National Certification Exam. “But our PAs are well trained, well prepared, and provide a wonderful service.”