What has NOT changed?

PAs continue to provide high-quality, cost-effective care. Their mission to increase patient access to care continues to this day. Although more PAs are entering specialties, these specialties are experiencing provider shortages or exceptional wait times.7 PAs are still dedicated to the team approach to medicine. That means fully using all team members at the top of their training and license. Even if PAs gain more legislative practice autonomy, the educational model of knowing our limits and consulting or referring to a physician or specialist are ingrained in PA daily practice. The great name debate has not changed. From physician assistant to physician associate, the discussion continues.

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Another thing that has not changed is the importance of having an organized professional organization advocating on behalf of all PAs. PAs could take a lesson from the strong and powerful nursing and nurse practitioner organizations, fundraising accomplishments, lobbying efforts, and legislative victories. PAs cannot depend on physicians or physician organizations to understand or defend us. In my experience, many of the leaders of physician organizations are the least educated about the PA profession and often have an ax to grind. Therefore, having a strong, well-funded, professional organization with a unified voice is important. In 1998, 89% of clinically practicing PAs were members of the AAPA,1 but that percentage has decreased throughout the past 20 years.8 This trend is alarming and weakens the national voice for our profession. State PA organizations play a vital role in the protection of state-by-state PA scope of practice. Therefore, despite the downward trend of PA professional members, the importance of PA society membership has not diminished.

What will the next 20 years bring?

No one knows what the PA profession will look like in 20 years. It is exciting for me to see PAs blazing trails as practice owners or providers practicing at the top of their license and skill set. It makes me proud to see PAs breaking into fields such as hospital administration, government, and the pharmaceutical industry. 

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Over the next 20 years, I hope many more physicians, nurses, hospital administrators, and patients have learned and fully understand the vital role that PAs play in the delivery of health care. As we progress as a profession, we need to be able to adapt to the changes in health care. Although PAs provide outstanding direct patient care, we need more PAs in leadership roles at the head of the table to have a full voice in our future. 


  1. American Academy of Physician Assistants. Milestones in PA history. 2010. Available at: https://www.aapa.org/wp-content/uploads/2017/01/History_Milestones.pdf
  2. American Academy of Physician Assistants. Infographic: What is a PA? 2017. Available at: https://www.aapa.org/wp-content/uploads/2018/03/What-is-a-PA-Infographic-Legal-Size_3.22_FINAL.pdf
  3. Accreditation Review Commission on Education for the Physician Assistant. Accredited Programs. 2018. Available at: http://www.arc-pa.org/accreditation/accredited-programs/
  4. Forbes. The ten most promising jobs of 2015. Available at: https://www.forbes.com/forbes/welcome/?toURL=https%3A//www.forbes.com/pictures/mkl45eigdf/1-physician-assistant/&refURL=https%3A//www.google.com/&referrer=https%3A//www.google.com/
  5. US News & World Report. Best jobs in health care. 2017. Available at: https://money.usnews.com/careers/best-jobs/physician-assistant/salary
  6. Quella A, Brock DM, Hooker RS. Physician assistant wages and employment, 2000-2025. JAAPA. 2015;28:56-63. 
  7. American Academy of Physician Assistants. 2017 AAPA Salary Report. 
  8. American Academy of Physician Assistants. Optimal team practice. 2017. Available at: www.aapa.org/advocacy-central/optimal-team-practice/ 
  9. American Academy of Physician Assistants. 2016 AAPA Salary Report.