The Physician Assistant Profession: Current Status and Future Trends

Abstract

N the almost two decades since their inception, physician assistants (PAs) have made important contributions to J T 2 advances in American health care. In doing so, the notion that highly trained mid-level practitioners could assume a large number of medical tasks traditionally L e A performed only by physicians has gained widespread acceptance. Introduced amid the extensive shortage of primary care providers, PAs have, in large measure, fulfilled the promises inherent in their creation. They practice predominantly in primary care settings, are well accepted by patients and supervisory physicians, and have proven themselves to be productive and highly competent clinicians (1). Despite these accomplishments, issues regarding PAs still remain. Uneven state medical practice laws governing PAs, and the lack of third-party reimbursement for their services, are but two of several policy barriers restricting the realization of the full potential of PAs to extend medical care services and to reduce health care costs. The purposes of this paper are to explore these and other issues facing the PA profession, and to review some of the more important aspects of the development of the PA concept in the United States. Our analysis considers the current status of the PA profession, the extent of PA involvement in health care delivery, some present trends in PA utilization, and what lessons two decades of experience with PAs hold for U.S. health manpower policy-makers. Also discussed are current trends in health manpower supply and demand, and issues regarding how health providers practice and are reimbursed. Consideration of these issues may shed light on the future prospects for PAs in health care delivery, and aid policymakers in determining new and expanded directions for these practitioners.