Physician Assistants Enter More Specialty Fields as the Doctor Shortage Worsens

The annual summary of the PA profession by the National Commission on Certification of Physician Assistants (NCCPA) revealed a new trend in the workforce.

While PAs are often considered providers for primary care, large numbers of them are moving into specialty fields such as emergency medicine and surgery. In fact, more than 70% of PAs now work in areas other than primary care.

Dawn Morton-Rias, an NP and Chief Executive of the NCCPA, told Forbes that a key reason for the growth of PAs working in specialties such as emergency medicine and surgery is often the result of shortages of physicians in those areas.

The Association of American Medical Colleges projected a shortage of at least 61,000 physicians by 2025. A number of states are responding to this critical shortage by providing greater autonomy to PAs.

Part of the reason for this shortage is the influx of millions of new patients who gained insurance coverage under the ACA. Also, PAs increased their lobbying efforts to get more direct access to patients by changing scope-of-practice laws at the state level.

For instance, New Jersey eliminated the countersignature requirement earlier this year, joining nearly 30 other states that have done so. In addition, its legislature removed an onerous rule that required PAs who work in a hospital or other inpatient setting to have “continuing or intermittent presence” with a collaborating physician.

PAs are becoming an integral part of accountable care organizations (ACOs) and other patient-centered medical care entities that contract with Medicare and Medicaid programs and insurers. Insurers such as Blue Cross and Blue Shield, UnitedHealthGroup, Anthem, and Aetna increasingly sign contracts with ACOs. This trend accompanies the shift away from fee-for-service medicine.

Morton-Rias stated that PAs provide high quality care at a lower cost that that of physicians. While PAs in some specialties earn between $100,000 and $120,000, the salary for PCPs surpassed $250,000 in 2016.


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