Growth of the Physician Assistant Profession in Healthcare

Physician Assistants (also known as Physician Associates or PAs) are increasingly being utilized around the world in many capacities. Now ‘present on four continents’,¹ this group of professionals are working to fill the gaps created by physician shortages and the changing healthcare needs of patients and their families.

While some PAs are ‘employed as a substitute for traditional physician services’¹, others are hired as a complement to physician care. An international review of literature conducted in 2021 found that the PA professional practices in nearly every hospital department as well as general practice and many specialty clinics globally. The biggest difference related to scope of practice tends to be the ability to prescribe medications and the amount of autonomy in performing procedures needed by patients.

The review of literature’s aim was to compare the quality of care provided by PAs to the care provided by traditional physicians.  As outcomes are generally the best indicator of quality care, the study included ‘patient outcomes, process of care, accessibility of care, and costs of care’.¹ Ultimately, the international study concluded that the PA care was either comparable to or exceeded traditional physician care, and that ‘both labor and resource costs were lower when the PA delivered the care than when the physician delivered the care’.¹

‘According to the National Commission on Certification of Physician Assistants’ 2018 Statistical Profile of Certified Physician Assistants, a detailed portrait of the profession by the numbers, the top ten specialties for PAs (in the USA) are:

1. Family medicine/general practice: 19.2 percent.
2. Surgical subspecialties: 18.5 percent.
3. Emergency medicine: 13.0 percent.
4. Internal medicine subspecialties: 9.4 percent.
5. Internal medicine general practice: 4.7 percent.
6. Dermatology: 4.0 percent.
7. Hospital medicine: 3.5 percent.
8. General surgery: 2.9 percent.
9. Pediatrics: 1.9 percent.
10. Obstetrics/gynecology: 1.5 percent.

In 2015, the National Procedures Institute predicted that radiology, surgery, mental health, emergency medicine, and urgent care would soon be the most popular PA specialties.’⁴

Although specialty skills may be learned according to individual job duties, some more common skills are performed by Pas. These include: suturing, punch biopsy, fishhook removal, needle decompression, chest tube insertion, knee and shoulder injection and aspiration, splinting, intraosseous line insertion, central line placement, and lumbar puncture.²

There are currently over 132,000 PAs practicing in general and specialty medicine, training in more than 350 programs around the world. The following diagram is taken from ‘a global census of Physician Assistants and Physician Associates’³ and shows the number of practicing PAs and training programs by country:

As many healthcare training programs are increasing their focus on disparities in care and cultural competence, ‘accreditation standards include mandatory elements regarding cultural competency training of PA students.’⁵ Sherer et. Al (2018) conducted a study to determine ‘PA students’ perceived levels of preparedness to treat patients of culturally diverse backgrounds.’⁵ When looking at the study conclusions, 39% of students felt well prepared, 46% felt moderately prepared, and 15% of students felt unprepared to care of diverse populations.⁵

‘Overall, findings showed that PA students rated their attitudes, awareness, and abilities about cultural competence as significantly greater than their knowledge, skills, and encounters. Specific areas of identified weaknesses in cultural competency education included: knowledge regarding the cultural context of care, skills associated with managing cross-cultural clinical challenges, and encounters related to coping with aggressiveness and bias. Further analysis indicated that second-year students and non-Caucasian students reported higher personal ratings for levels of cultural competence.’⁵

Limbs & Things is proud that many PA programs have relied on us to enhance their training programs. With more than 20 products in the Physician Assistant range, our products meet the challenges of procedural training as well as caring for diverse populations encountered by many students without extensive healthcare backgrounds. If you would like to speak to someone about the PA range of products, don’t hesitate to contact us.

1 The cost-effectiveness of physician assistants/associates: A systematic review of international evidence

2 AAPA website

3 A Global Census of Physician Assistants and Physician Associates. JAAPA: Official journal of the AAPA. December 2020.33(12):43-45.DOI: 10.1097/01.JAA.0000721668.29693.36

4 Specialties for PAs: What’s the cost to Primary Care?

5 Physician assistant students’ perceptions of cultural competence in providing care to diverse populations