Physician Assistants/Associates (PAs) are outstanding professionals who can do many things, but there are some things we cannot do (nor do we want to ?).
In this blog post, I will outline what a PA is and what we are not. So, if you are curious about PAs or want to know what we can and cannot do, read on!
What Physician Assistants Are
Physician assistants are professionals who diagnose, treat, and help prevent illnesses.
Physician assistants do work with varying levels of collaboration or supervision depending on state law. While traditional models involved physician supervision, legislative changes in recent years have modified these requirements in many states, with some states transitioning to collaboration models and others removing supervision requirements entirely for experienced PAs.
Physician assistants are trained to provide primary care in the office, hospital, school, or clinic setting.
In the United States, physician assistants are called PAs (this is more than just an acronym), and we are also called physician associates - depending on who you ask!
Physician assistants are medical providers who have duties that may include taking medical histories and physical examinations; ordering x-rays and other tests; interpreting test results; diagnosing diseases; counseling patients on general health issues such as nutrition, exercise, or stress management; writing prescriptions for medications or surgical procedures when qualified to do so by experience or training; prescribing medication when authorized by law to do so in the course of their job duties; performing physical therapy if qualified to do so by training or experience.
Physician assistants can assist surgeons during surgery.
PAs can prescribe medications in all 50 states.
Physician assistants are educated in a master’s or doctorate program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).
PAs are part of a healthcare team that includes physicians, nurses, and other medical professionals who work together to provide high-quality care for their patients.
Physician assistants practice within a scope determined by state law, their education, training, and experience. This scope may vary depending on the setting in which they work and the state's specific regulations regarding PA practice.
Certified physician assistants are PAs who have passed a national certification exam, the Physician Assistant National Certifying Exam (PANCE), and have been certified. PAs who are certified receive the designation of PA-C.
Physician assistants can be licensed but not certified - they need to pass their certification exam to be certified. PAs can work without certification but will face few options.
PAs are lifelong learners, and maintaining certification requires one hundred continuing medical education (CME) credits every two years, recertification examinations, and the Physician Assistant National Recertification Exam (PANRE/PANRE-LA) every ten years. PA certification maintenance mirrors the physician certification maintenance process.
PAs must complete training at an accredited institution to be licensed as a PA.
Physician assistants and PA-like medical workers (nonphysician clinicians) that function under the supervision of a doctor are working all around the world in various capacities and go by different names.
Physician assistants are eligible for certification as Medicare and Medicaid providers.
Physician assistants are well compensated and have one of the best jobs in America.
PAs are able to change specialties throughout our careers, and we do not need to acquire a new certification to do so.
Although PAs pass a National Certifying Exam, we must satisfy requirements dictated by the state where we wish to practice and apply, pay additional fees, and submit documentation to obtain (and maintain) state licensure.
What Physician Assistants Are Not
Physician assistants are not medical doctors, nor do we want to be.
Physician assistants are not physician's assistants. Ever!
PAs are not mid-level providers, physician extenders, or non-physician providers. These phrases are not only hurtful to PAs but also out of date and should be avoided.
While physician assistants can do many things, they cannot perform all the duties of a medical doctor. For example, physician assistants can assist in surgery, but we cannot perform surgery.
Physician assistants do not become PAs as stepping stones on their path to becoming medical doctors.
PAs are not unhappy being called physician assistants unless they have a fragile ego, in which case they should have become doctors.
Though we share similar duties in certain situations, physician assistants are not the same as nurse practitioners.
PAs are not advanced practice providers or advanced practice clinicians: Grouping PAs with other providers should be avoided. These terms are problematic, as they are imprecise and applied inconsistently.
PAs are not required to choose a specialty area of practice during (or after) PA school.
Physician assistants are not required to complete a residency program to practice in a given specialty.
Physician assistants are not anyone's bosses. We are part of a team working in collaboration with other medical professionals to provide the best possible care for our patients.
Physician assistants are not required to pass the certification exam on the first try. You get up to six attempts over six years and up to three attempts in a given year.
What PAs Are and Are Not
As you can see, being a physician assistant is a complex topic.
PAs are not medical doctors, assistants to doctors, or just nurse practitioners with different titles. We are physician assistants/associates (PAs) who have chosen to specialize in the practice of medicine. Depending on state regulations, we may work in collaborative relationships with physicians, with varying degrees of autonomy based on our experience, training, and state law.
We have a strong focus on the practical application of medical knowledge and are committed to providing the very best care to people from all backgrounds in the communities we serve.
The fact that so much confusion surrounds the role of physician assistants is a reflection of the growing demand for affordable, accessible medical care. No doubt, the future of health care lies in the hands of capable PAs, and it is up to us to navigate this role with intelligence, humility, and tenacity.
If you have any questions about being a physician assistant, the Physician Assistant National Recertification Examination, or anything else related to physician assistants, please feel free to ask in the comments below.
The Future of Physician Assistants/Associates
The PA profession is rapidly evolving, with significant legislative changes expanding our autonomy in many states. Currently, six states have removed supervision and collaboration requirements for experienced PAs, allowing them to practice independently based on their training and experience. Additionally, nearly half of all states have transitioned from supervision models to collaboration models, recognizing the expertise and capabilities of PA professionals.
As healthcare demand continues to grow, PAs remain a critical part of the solution for accessible and affordable medical care. Understanding our role—both in terms of what we can do and how the profession is changing—is essential for aspiring PAs and the general public alike.
If you have any questions about becoming a PA, the PANCE, or the PA profession in general, drop them in the comments below!
Additional Reading:
You may also like -
Why Choose PA Over NP? Here’s the Perfect Answer
A common PA school interview question that stumps many well-intentioned PA school interviewees is "Why did you choose PA over NP?"
This is a classic question that you must be prepared to answer.
Do you have an answer?
How to […]- Infographic: PA VS MD Understanding the DifferencesPA VS MD Comparison: GPA, MCAT, GRE scores, prerequisite coursework, clinical experience, years of training and time in school, job duties, cost of education, average salary, job satisfaction, divorce and burnout rates all compiled into […]
- Torn Between PA or MD? Here’s How You Decide!Are you struggling to decide between PA or MD, NP or PA, pre-nursing or biochem, a new job vs. your comfy job, CNA vs. MA, or scribe vs. EMT?
One day you favor option A and the next day you flounder back to option B or worse, you start […]
CASPA Personal Statement Help
We offer comprehensive, start-to-finish personal statement assistance or help to perfect a draft you already have. We have services to fit every budget.
Schedule a Live Recorded PA School Video Interview
We offer 60-minute mock PA school interviews with post-interview feedback and advice. Includes a recorded video of your interview that you can watch, download, or share with family and friends. There is no better way to prepare!
Schedule an InterviewPre-PA Consulting and Advising
Our pre-PA coaching service consists of a 1-hour phone consultation focused on addressing your specific questions or concerns about becoming a PA and applying to PA school.
Hi. I am not seeing my normal dermatologist for my annual checkup. I am seeing a PA-C. I’ve only seen my dermatologist 2 times and both times, I have had a recurring skin issue frozen off.
Can a PA-C freeze things off your body?
Thank you for such an informative webpage!!!
Yes, a PA-C (Physician Assistant-Certified) is fully trained to perform procedures like freezing off skin lesions, such as warts or other skin growths, using cryotherapy. PAs in dermatology can handle a wide range of skin issues, often under the supervision of a dermatologist. You’ll be in good hands!
Thank you so much for your kind words about the webpage, and I’m glad you found it helpful! Let me know if you have any more questions.
Best,
Stephen
Over the years I have had the misfortune to deal with several PA’s. The first one diagnosed melanoma as a simple rash. The second prescribed a medication for angina that had a black box warning regarding certain drug interactions. The PA never bother to check if that warning applied to me, which it did. And as it turned out I did not have angina. Third, post spinal surgery I was in extreme pain. Having undergone twp previous spinal surgeries I knew this pain was different. The PA said it was normal. Fortunately, I raised enough of an issue that the nurse contacted the doctor. Turns out I had a severe infection and was rushed back into surgery. I spent months on IV antibiotics. There is more but I think you get the point.
it is my experience that PA’s are DEADLY dangerous. I refuse to be seen by a PA for anthing more than my vital signs.
Dear Chevy,
Thank you for sharing your experiences. I’m truly sorry to hear about the challenges you’ve faced in your medical care, and I can understand why those situations have caused you to feel this way. Medical errors are deeply concerning, and it’s heartbreaking when they result in complications or harm. As a PA, my goal is always to provide the best care possible, but I also recognize that the experiences you’ve had were far from that.
It’s important that every healthcare provider, whether a PA, nurse, NP, or physician, takes the time to thoroughly assess, diagnose, and follow up on any concerns. I’m glad that your persistence in the last situation led to a timely intervention, but I sincerely wish it hadn’t come to that. I respect your decision to advocate for yourself and choose the type of care you’re comfortable with—that’s something I always encourage patients to do.
I also believe that when healthcare teams collaborate effectively and communicate clearly, it leads to safer and better outcomes. PAs, when practicing effectively, can be a valuable part of that team. I hope that in the future, your experiences with medical care are positive and that you feel confident in the professionals supporting your health.
If you ever have any questions or concerns, I would be happy to offer any insights I can.
Wishing you the best in your health journey.
Warm regards,
Stephen Pasquini, PA-C
Dear Chevy. I am a medical doctor. 4 years of college, 4 years of medical school and 3 years of a medical residency. PA’s have NOWHERE near the amount of training, yet have to hook on to a licensed physician to do their job. They LOVE being called Dr and do not explain to the patient they are not physicians in my experience. Get the title without putting in the work? I don’t think so. I would NEVER put my license at risk by hiring one. Your story I have seen repeated over and over again
A patient of mine was away and went to an urgent care, seen by “Dr” so and so who was a PA. Made a major mistake and almost caused my patient his life. I educate my patients to stay clear. Want to be a doc? GO TO MEDICAL SCHOOL
Hi there,
Thank you for sharing your perspective. I completely understand that PAs and physicians undergo different paths of training, and I respect the rigorous journey of becoming a doctor. That said, PAs work closely with physicians and provide excellent care within their scope of practice. A PA’s role is never to replace a doctor but to collaborate as part of a healthcare team. Clear communication is crucial, and PAs should always ensure patients understand their role in care.
I appreciate the conversation, and I value your input.
Best,
Stephen Pasquini
You sound like a great person to work with. Don’t sound arrogant or egotistical at all. Are you sure you wouldn’t hire one or the fact that no one would want to work with you (notice I said “with” and not “for”). If you truly think doctors don’t make mistakes, unfortunately sir you (or ma’am) are WRONG. Yes, it’s true that PAs are not as highly trained in the beginning of their careers, but I would honestly trust a PA with 10 years of experience over an MD or DO with 2 years. Get over yourself.
P.S. I agree with you that PAs who do not have a doctorate level education should not refer to themselves as “doctor”, however some of them do actually decide to further in education for other reasons. As long as they make the distinction of PA vs. MD/DO to their patients, then they are just as worthy. You don’t own the title.
If a PA is working under a supervising physician and that physician would like all patients that need a referral to a surgeon (mohs in this case) to go to the in-office Mohs surgeon, can the supervising physician insist that the PA refer their patients to the in-office surgeon as opposed to referring that patient to a different surgeon that is out of the office?
Hi Tracy!
This is an important question that touches on some key ethical and legal considerations for PAs. While PAs do work under the supervision of physicians, they are also healthcare providers in their own right, with a responsibility to prioritize patient welfare and autonomy.
From an ethical standpoint, PAs should always strive to make referrals based on what they believe is best for the patient. This includes considering factors like the patient’s preferences, insurance coverage, geographical convenience, and the expertise and track record of the surgeon. If a PA believes that an out-of-office surgeon would provide better care for a particular patient, they have an ethical obligation to recommend that option.
However, there are also practical and legal considerations at play. PAs typically work as part of a healthcare team and are expected to collaborate with their supervising physicians. If a supervising physician has a strong preference for in-office referrals, the PA should have an open discussion with them about their concerns and advocate for the patient’s best interests.
In some cases, the PA’s employment contract or the practice’s policies may dictate certain referral practices. PAs should familiarize themselves with these policies and seek clarification if needed.
Ultimately, if a PA feels that they are being pressured to make referrals that they don’t believe are in the best interest of their patients, they may need to escalate the issue to a higher level (e.g., the practice’s medical director or ethics committee) or consider whether the practice is a good fit for them long-term.
It’s a complex issue without a one-size-fits-all answer. The key is for PAs to stay focused on patient welfare, communicate openly with their supervising physicians and colleagues, and advocate for what they believe is right.
If you’re grappling with a specific situation related to this issue, I would recommend consulting with your state’s PA association or a healthcare attorney for guidance on your rights and obligations.
I hope this helps provide some general guidance! Let me know if you have any other questions.
Best,
Stephen
Article is very outdated now.
MT, AZ, WY, ND, and UT all allow for independent practice (typically with over 4000 of employment) of PAs. A slew of others have collaborative agreements removing some of the restrictions.
Can a PA revoke/cancel a prescription written by an MD other than an MD in his/her practice? The prescribing MD is the patients individual PCP and NOT in any way related to the practice which the PA is employed by?
A Physician Assistant (PA) generally does not have the authority to revoke or cancel a prescription written by a medical doctor (MD), especially if the MD is not affiliated with their practice. Prescriptions are typically associated with the provider who wrote them, so only that provider (or someone with direct authority over that provider) could make changes to it.
The primary role of a PA in this situation might be to advise the patient to contact their PCP regarding the medication, or, with the patient’s consent, to reach out to the prescribing MD themselves to express any concerns. If the PA believes the medication is inappropriate or harmful, they could also recommend the patient to discontinue the medication while awaiting further advice from the prescribing MD.
However, policies can vary by region and practice, and it’s always important to follow the legal and ethical guidelines established by relevant professional and regulatory bodies.
– Stephen
There are still many PAs practicing who have a bachelor’s degree, rather than a graduate degree, from an accredited program. The majority of programs did not begin awarding a graduate degree until well into the 2000s when the Master’s degree became the accepted entry level degree.
What difference does this make? It’s a moot point. Bachelor’s degreee, Master’s degree….whatever. The training is the same. One isn’t any better than the other.
“Physician assistants can be licensed but not certified – they need to pass their certification exam to be certified.”
This is inaccurate. ALL states require certification by NCCPA for their initial license. Several do not require maintenance of certification for continued licensure.
May i suggest that it’s important to switch to “PA education”, rather than “PA training”. It’s a subtle but important distinction between level of professionalism knowledge versus technical skills acquisition.
If many CTS (cardiothoracic surgical) PAs perform vein or artery harvesting for CABGs. Many CT surgeons are not even in the OR during this process. Is this still considered assisting in surgery or actually performing a surgical procedure?
In this instance, I would say that the PA is doing both: assisting in surgery and performing a surgical procedure!
Stephen