The PA profession began at Duke University in 1967 with the first graduating class of Physician Assistants. Today there are more than 79,000 PAs from 154+ accredited programs. Graduates of the first program went into primary care or surgical positions, and that focus persisted for the next twenty years. Since the early 1990s, there has been rapid expansion in the areas in which PAs practice with a shift from primary medicine to specialty areas, and even subspecialty areas within tertiary medical centers.
Likewise, a similar shift has been occurring over the past decade in the settings in which PAs practice, creating a number of jobs in areas outside the traditional clinic-based settings, including: institutional settings such as hospitals, academic medical centers, federally qualified health clinics, and in the US prison system. PAs are now being used in teaching capacities both in the expanding numbers of PA programs as well as assisting academic medical staff in medical schools and academic inpatient hospital settings. Medical resident rules limiting the number of hours physician residents are permitted to work has produced a new need for PAs as hospitalists in direct patient care.
PAs provide high quality, cost effective healthcare and are productive members of the health care team. Physicians and hospitals/clinics are expected to employ more PAs to provide primary care and to assist with medical and surgical procedures. Telemedicine—technology used to allow consultations between PAs in rural or remote settings and physician supervisors—will expand the use of physician assistants.
Over the years the scope of practice for PAs has progressively broadened, allowing PAs to fully utilize the skills gained from their rigorous training. Prescriptive privileges, now allowed in all states, have improved PAs abilities to contribute more effectively in patient care. Residents who have recently graduated from medical school now gain experience working on teams that include PAs as both students and certified clinicians, so that past confusion about a PA's scope of practice is rapidly diminishing. Job prospects, therefore, have increased in all specialty and subspecialty areas.
Job opportunities for PAs are predicted to be excellent, particularly in rural and inner-city clinics, settings in which there is difficulty attracting physicians. Job openings will result both from employment growth and from the need to replace physician assistants who retire or leave the occupation permanently. Opportunities will be best in states that allow PAs a wider scope of practice.
Job Demand Forecast
According to the U.S. Department of Labor, Bureau of Labor Statistic, employment of physician assistants is expected to grow by 39 percent from 2008 to 2018, much faster than the average for all occupations.
CNNMoney.com ranks PA as the second best job in America and projects it to be the third hottest (fastest growing) occupation over the next decade. The most recent Money magazine article states that with the continuing shortage of physicians willing to work in primary care medicine and in remote and underserved areas of the country, the PA profession has proven to be virtually recession-proof. This is proving true as unemployment rates in the country continue to rise while job prospects for PAs continue to improve. A shortage of physicians projected to be as high as 13% over the next ten years, coupled with an aging population with higher than ever before life expectancy, will result in abounding opportunities for physician assistants. Finally, with the expected increases in insured patients due to the Healthcare Reform Bill, there will be even more demand for primary care practitioners, a role in which Physician Assistants excel!