A physician assistant (PA) is a licensed medical professional who diagnoses illnesses, develops treatment plans, and prescribes medications, working alongside physicians as part of a healthcare team. There are roughly 145,700 PAs employed across the United States, practicing in nearly every medical specialty from family medicine to surgery. While they don’t attend medical school, PAs complete rigorous graduate-level training that qualifies them to handle a wide range of patient care responsibilities.
What PAs Actually Do
PAs perform many of the same clinical tasks as physicians. They conduct physical exams, order and interpret lab tests and imaging, diagnose conditions, prescribe medications (including controlled substances in most states), assist in surgery, and manage ongoing treatment for chronic diseases. In 47 states, the specific scope of what a PA can do is determined collaboratively with the physician or physician group at their practice site, meaning a PA working in orthopedics will handle different cases than one working in dermatology.
Prescriptive authority varies by state. PAs can prescribe controlled medications in 44 states, though some states place limits on quantity or refills. In Arizona, for example, certain prescriptions are capped at a 30-day supply with no refills unless a physician gives written consent. Kentucky restricts PAs from prescribing certain categories of drugs entirely. In Texas, a single physician can delegate prescribing authority to no more than seven PAs.
Education and Training Requirements
Becoming a PA requires completing a master’s degree program, typically lasting about 27 months. Before even applying, candidates need substantial hands-on healthcare experience. Programs like the one at UC Davis require a minimum of 1,000 hours of direct patient care, though competitive applicants often log significantly more. Working in medical records or other roles without patient contact doesn’t count.
PA programs follow a medical school model compressed into a shorter timeframe. The first year focuses on classroom instruction covering anatomy, pharmacology, and clinical medicine. The second year is spent in clinical rotations across multiple specialties, including internal medicine, surgery, pediatrics, emergency medicine, and women’s health. This broad training is intentional: PAs are educated as generalists so they can work in virtually any area of medicine.
After graduating, PAs must pass the Physician Assistant National Certifying Exam (PANCE) to earn their certification. Maintaining that certification requires logging at least 100 continuing medical education credits every two years and paying a maintenance fee. Over the course of a 10-year certification cycle, PAs complete five of these two-year cycles. They also periodically take a recertification exam to demonstrate ongoing competency.
Where PAs Work
The majority of PAs work in physician offices, which employ about 80,600 PAs, or roughly 52% of the workforce. Hospitals account for the next largest share at 26%, followed by outpatient care centers at 8%. Smaller numbers work in government agencies, universities, and specialty hospitals. Within these settings, PAs practice across a wide range of specialties, from primary care and emergency medicine to cardiology, orthopedics, and surgical subspecialties.
In practice, your experience seeing a PA can look very similar to seeing a physician. In a primary care clinic, a PA might be the provider who manages your blood pressure medication, evaluates a new rash, or refers you to a specialist. In a surgical setting, a PA often assists during procedures and handles pre-operative and post-operative care. In emergency departments, PAs evaluate and treat patients independently for many common complaints, consulting with the attending physician for more complex cases.
How PAs Relate to Physicians
The traditional model requires PAs to practice under physician supervision, though what “supervision” means varies widely. It doesn’t necessarily mean a doctor is in the room or even in the building. In many states, supervision can be fulfilled through periodic chart reviews, phone availability, or written protocols. Delaware, for instance, requires that when a PA treats patients in a setting where the supervising physician isn’t routinely present, the physician must ensure that the methods of oversight are adequate for appropriate patient care.
This model is shifting. The American Academy of Physician Associates (AAPA) advocates for what it calls “Optimal Team Practice,” a framework that would eliminate the legal requirement for a specific supervisory relationship between a PA and physician. Under this model, PAs would practice to the full extent of their education and training while remaining fully responsible for the care they provide. Several states have moved toward this less restrictive approach, while others, along with the American Medical Association, maintain that physician oversight is essential.
The Title Is Changing
The profession is in the middle of a gradual name change. In 2021, the AAPA’s governing body voted to adopt “physician associate” as the official professional title, replacing “physician assistant.” The reasoning is that “associate” more accurately reflects the collaborative role PAs play on healthcare teams, while “assistant” can imply a more limited, subordinate function.
The AAPA has already changed its own legal name to the American Academy of Physician Associates, and five state chapters have followed. However, the transition is far from complete. PAs are strongly advised by legal counsel not to use “physician associate” in clinical settings until the state where they practice formally adopts the new title through legislation. Using the term prematurely could create regulatory problems, disciplinary actions, or malpractice issues. For now, the legal title in clinical practice remains “physician assistant” or “PA” in most of the country.
Salary and Job Growth
PA is one of the faster-growing healthcare professions. The Bureau of Labor Statistics projects employment growth well above the average for all occupations over the coming decade, driven by an aging population, expanding insurance coverage, and persistent physician shortages, particularly in primary care and rural areas. The combination of strong demand and a relatively limited number of PA program graduates each year keeps the job market competitive for employers rather than candidates.