Most PAs Now Working in Specialties Outside of Primary Care
October 13th, 2016
JOHNS CREEK, GA – More than 70% of certified physician assistants in the United States now work outside of primary care specialties, according to a new report.
The report developed by the National Commission on Certification of Physician Assistants represents data from more than 93% of the 108,500 certified physician assistants (PAs) in the United States.
The 2015 Statistical Report of Certified Physician Assistants by Specialty points out that there now are 103 certified PAs for every 1,000 physicians in the U.S. Some specialties have especially high ratios, including:
- surgical subspecialties, with 374 PAs for every 1,000 physicians,
- emergency medicine, with 291 PAs per 1,000 physicians, and
- dermatology, with 275 PAs per 1,000 physicians.
The median percentage of patients treated by certified PAs in all specialties includes 30% Medicare patients. PAs in cardiothoracic and vascular surgery treat the most Medicare patients — 50% — followed by oncology and urology — both 40%.
That is 20% for Medicaid patients with clinicians in general pediatrics having the highest percentage, 55. Psychiatry at 40% and obstetrics and gynecology at 35% also have high rates.
In addition, PAs, on average, have 10% of patients who do not pay. That is most common in emergency medicine, where 15% of the care provided by PAs is uncompensated, according to the report.
“The numbers of patients where the payer is Medicare or Medicaid, or where the PA is uncompensated, shows once again how certified PAs contribute greatly to healthcare equity,” said Dawn Morton-Rias, EdD, PA-C, president and CEO of NCCPA. “Also, the high percentage of certified PAs employed in surgical subspecialties demonstrates the high degree of trust and confidence that surgeons have in them, relying on certified PAs to perform procedures, provide pre-op and post-op care, and serve as first and second assist to the surgeon in the operating room.”
Across all specialties, certified PAs work an average of 41 hours a week, and more than 35% also take calls, with the highest call hours in the surgical subspecialties. In fact, more than 49% of cardiothoracic and vascular surgery PAs work more than 10 hours a week on call and have an average workweek of 47 hours.
The scope of practice is broad for most PAs, with more than 80% ordering, performing, and interpreting lab tests, X-rays, EKGs, and other diagnostic studies, the NCCPA pointed out. In addition, more than 81% prescribe medication; and nearly that percentage, 78%, counsel and educate patients and families.
While many physicians are reaching retirement age, the report noted, PAs tend to be young with a median age of 38. Only 0.6% plan to retire this year, according to the study.