Medical Professionals - Physician Assistants

The map shows the distribution of physician assistants (PAs) per 100,000 population in 1999. The national average was 10.4.

Duke University created the first PA training program in 1965 to take advantage of the skills of medics returned from Vietnam. By 1991 there were about 20,000 PAs in clinical practice, a number that had more than doubled to about 42,708 by the beginning of 2002. According to the American Academy of Physician Assistants, there were 10,000 students enrolled in 132 accredited PA programs in 2002.

Students accepted for PA training typically hold a bachelor's degree and have some experience in a healthcare setting. Training programs are usually associated with a medical school and last a little over 2 years. Once dominated by men, the profession is now about 55% female, according to Medline. By law PAs must be supervised by a physician, and they perform many of the tasks once performed only by physicians, such as history taking, physical exams, diagnosis, and writing prescriptions. Starting salary is about $60,000.

Some doctors complain that PAs are being used by cost-conscious HMOs to replace physicians. J.D. Kleinke predicts the day will come when the managed care system will turn the practice of medicine from an art to a science and doctors will spend less time acting as clinicians and more time serving as managers of large numbers of PAs and other para- professionals. The result of changes like this, says Kleinke, "is paradoxical: those most bedeviled by managed care (physicians) may come to embody its essence but, one hopes, not its reputation for mean-spiritedness."

Sources: Chart: National Center for Health Workforce Information and Analysis, State Health Workforce Profiles; Primary Source: American Academy of Physician Assistants; http://bhpr.hrsa.gov/healthworkforce/profiles/default.htm. American Academy of Physician Assistants, http://www.aapa.org/glance.html. J. D. Kleinke, "The Industrialization of Health Care," Pulse — Report Vol. 278, pp. 1456-1457, Nov. 5, 1997, http://www.ama-assn.org/sci-pubs/msjama/articles/vol_278/no_17/pu145601.htm. "Physician Assistant profession," MedlinePlus Health Information, http://www.nlm.nih.gov/medlineplus/ency/article/001935.htm. Information retrieved September 30, 2002.