The role that physician assistants (PAs) play in the American healthcare system is changing and expanding along with their numbers. There are now slightly more than one hundred PAs for every one thousand doctors in the United States, and they are expanding their presence into more non-primary care specialties. The National Commission on Certification of Physician Assistants (NCCPA) has released the first practice specialty report using data from over ninety percent of PAs in America that breaks down this shift and what it means for patient access to healthcare.

It’s important when looking at the role PAs are taking in healthcare to understand why they are being welcomed into highly specialized fields. Like physicians, they are educated in the medical model and licensed by state medical boards. They also maintain certification by completing substantial continuing medical education and passing a rigorous exam every 10 years.

While the total number of Certified PAs is now just over one hundred for every one thousand doctors, the ratio of PAs to physicians is much higher in specific fields: dermatology (275 per 1,000), emergency medicine (291 per 1,000), and surgical subspecialties (374 per 1,000). Furthermore, the NCCPA report found that thirty percent of PAs’ patients were Medicare patients. Twenty percent were Medicaid patients, and ten percent of their patients were people who could not pay; PAs working in emergency medicine provided the highest amount of uncompensated care.

Across the board, PAs work forty-one hours per week on average and thirty-five percent of them record the highest call hours in surgical subspecialties. More than eighty percent of PAs also perform key services for many patients including ordering, performing, and interpreting lab tests, x-rays, and EKGs. Many are able to balance these rigorous schedules and numerous tasks with the vigor of youth—the median age for all PAs is only thirty-eight. With such a young demographic, few PAs are intending to leave practice soon, and their influence will likely only continue to grow.

The increasing contribution that Certified PAs are making to the equity of healthcare provision is revealed in the high numbers of their patients who utilize Medicare or Medicaid. Even the substantial amount of patients who receive uncompensated care highlights the expanded access made possible by their efforts. As more and more PAs move into specialized fields and provide greater numbers of services, they will continue to earn the trust of physicians. Expect to see them play even larger roles in healthcare in the near future.

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