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Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

The data for this first annual Physician Assistant Compensation Report were collected early in 2020, before the onset of the SARS-CoV-2 pandemic in the United States. Although some physician assistants (PAs) have been busier than ever, others have experienced reduced clinical hours or even practice closures while the priority has been on controlling the pandemic. Pay cuts, furloughs, and layoffs have affected many PAs who aren't involved in day-to-day care of patients with COVID-19. These events are likely to have a substantial impact on PA income for some time to come.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Medscape invited practicing licensed PAs from the United States to participate in an online survey about their earnings for the year 2019. The following slides report the findings from the entire sample of 5455 PAs who responded to the survey, 4645 of whom worked full-time. Which specialties pay PAs the most? Do PAs who get incentive or productivity pay really earn more? Who earns the least—men or women—and do we know why? Do you earn more with a master's? Does it pay to get a CAQ? In which part of the country do PAs earn the most and least? The answers to these and many more questions can be found here.

If you'd like to comment on any of the findings in this report, go to slide 23.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

We asked respondents to report their total earnings from their employment as PAs as well as, where applicable, their earnings from each individual income stream: base pay, productivity or incentive pay, annual bonuses, and overtime pay.

Full-time PAs earned an average of $118,000 (median, $116,000). Some differences were seen between mean and median pay for the income streams. Medians were: base pay ($110,000), productivity or incentive pay ($8000), annual bonuses ($3000), and overtime pay ($1000).

As expected, income increases with age. PAs aged 45 and older earned about 10% more than younger PAs.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

More than half of full-time PAs reported that their total income increased from 2018 to 2019, and 5% reported earning less in 2019.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Our data suggest that the PA profession is highly composed of specialists. The most frequently reported field of practice was family medicine (18%) although another 8% reported working in internal medicine, so collectively, about one fourth of PAs are adult primary care providers. About 75% of PAs specialize in a field other than primary care. The second most common specialty is emergency medicine (15%), followed by surgery (10%) and orthopedics (8%).

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

The range of PA practice is broad, in spite of being trained as generalists. PAs now work in practically every medical and surgical specialty. This slide shows the specialties reported by 1% of our respondents or less. Another 7% of respondents chose "other," which aggregates many subspecialty, administrative, and other positions that don't fall neatly into another category.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Only practice specialties with at least 100 full-time PA respondents are shown. Critical care PAs reported the highest annual earnings, followed by emergency medicine and surgery.

Insight into the specialization trend among PAs comes from Randy Danielsen, PhD, PA, director of the A. T. Still University's Doctor of Medical Science Program. "The PA role began more than 50 years ago as an extension of the primary care physician. That changed when specialty physicians started seeing the value of hiring their own PAs. The specialization of PAs is at an all-time high, and PAs tend to gravitate, like physicians, toward the higher-paying specialties." Added Danielsen, critical care and emergency medicine are the fastest-growing specialties among PAs, probably because they are highly procedure-based.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

PAs are largely divided between being employed by a medical group (53%) or a hospital system (39%), with very few being independent contractors or practice owners. Women are more likely to practice in medical offices (52%) compared with men (43%). Overall, 7% of PAs were employed by state or federal governments (data not shown).

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

These data support some well-known facts about high- and low-paying positions in healthcare. PAs based in hospital critical care units ranked highest on earnings, whereas those employed in academic and long-term care settings ranked lowest.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

A PA's wages can be either an annual salary or an hourly rate of pay. Base wages can be supplemented with one or more of the following: productivity or incentive pay, annual bonuses, or overtime pay. Among full-time PAs, those who received productivity/incentive pay earned the most, whether their base pay was salaried or hourly. Without incentive/productivity pay, however, those paid an hourly rate earned 6% more than salaried PAs.

Danielsen expects the trend toward incentive-based compensation for PAs to continue. "There is likely to be more emphasis on incentive/productivity because PAs (like physicians) are more likely to be employees (rather than practice owners) and their salaries (and reimbursement) will be tied to productivity."

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Most PAs (85%) reported working full-time; 12% work part-time and 2% work per diem ("as needed"). The hourly rates of pay for full-time and part-time or per diem PAs were similar. Full-time PAs earned an average of $65 per hour, and part-time PAs earned $64 per hour. The average hourly rate of pay was significantly higher for full-time PAs who were age 45 and older ($69) compared with younger PAs ($63).

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Among PAs in our survey, 67% reported as female and 32% as male. Sex-related differences in pay are found throughout healthcare, and PAs are no exception, despite the predominance of women. Men earned more than women in annual gross income and base pay (10%), productivity/incentive pay (23%), annual bonuses (25%), and overtime pay (67%). Among PAs paid hourly, men were paid an hourly rate of $68 compared with $63 for women, a difference of 8%.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

PAs have the option of earning a certificate of added qualification (CAQ) in one of seven specialties: cardiovascular & thoracic surgery, emergency medicine, hospital medicine, nephrology, orthopedic surgery, pediatrics, and psychiatry. But does doing so result in higher income? PAs who reported holding a CAQ had slightly but not significantly higher total annual incomes (mean, $119,000 vs $117,000).

CAQ attainment was relatively modest overall considering the high degree of specialization among PAs: Only about 1 in 5 PAs holds a CAQ. Danielsen suggests that some PAs may be resistant to the specialization credential because it could limit the mobility of the profession. If fully accepted or even required by employers or payers, it could prove more difficult for PAs to change specialties.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

A question often asked is, "Will having a higher degree increase my income?" The answer, from our data, is a qualified yes. The highest incomes were associated with having a doctorate, but counterintuitively, those with a master's degree earned less than those with only a bachelor's degree. The reason for this appears to be the stronger effect of age and years of experience on income, compared with the effect of education alone. Usually, age and highest educational degree are closely related. But here, PAs aged 45 and younger were more likely to hold master's degrees (75%), as were PAs with 5 years of experience or less (45%). Thus, the younger-skewing master's degree group earned less overall than the older, bachelor's-only group. Another factor was gender. Women were more likely to hold master's degrees, but because women overall earn less than men, the master's group reported lower-than-expected incomes.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

The findings here were more predictable: More experience means more money. Those who have worked as PAs for 21 years or longer had the highest incomes, and early-career PAs with less than 5 years in practice earned the least.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Geographically, PAs working in the Pacific region earned the most, followed by those in the New England and West South Central regions. Earnings in the East South Central region are the lowest. Reported earnings in the Pacific region are significantly higher than in all other regions except New England. These trends were evident for both mean and median annual incomes.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Urban and suburban work settings predominate among PAs; combined, they represent 80% of the PA workforce. An anticipated finding in our survey is that PAs working in urban settings have the highest incomes.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

About 88% of full-time PAs hold positions that offer or require overtime. We asked PAs whether they receive pay for hours worked beyond their scheduled hours. Nearly 60% of PAs who work overtime are not paid for these hours; however, 8% are able to take time off to compensate for unpaid hours worked. Overtime pay is more common among PAs who are paid by the hour vs salaried PAs, and 76% of hourly paid PAs are eligible for paid overtime. Men are more likely than women to report being paid for overtime (45% vs 35%).

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Most PAs report that they do not take evening, night, or weekend call. Among those who do take call, more than half are not paid for call time. Men report taking call more often than women (39% vs 32%) and are more likely to be paid for this activity (19% vs 14%).

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Nearly 90% of PAs report receiving health insurance, paid time off, and professional liability coverage. Other fairly frequently used benefits were contributions to retirement savings and reimbursement for professional continuing education.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

About three quarters of PAs feel fairly compensated. The addition of productivity/incentive pay to annual compensation increased PA satisfaction with their earnings. PAs who feel fairly compensated earn an average of $115,000, which is significantly more than those who do not feel fairly compensated ($106,000). Men were more likely to express fairness with compensation (78%) compared with women (73%). Very early-career PAs (working less than 1 year) reported higher satisfaction with pay than more experienced PAs.

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

Medscape Physician Assistant Compensation Report 2020

Laura A. Stokowski; Mary McBride; Daniela Bastida; Emily Berry | May 15, 2020 | Contributor Information

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