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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021
| Contributor Information
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
If you're one of the more than 140,000 physician assistants (PAs) practicing in the United States today, you can expect to have some company in the coming years. Due in part to factors like an aging population and physician shortfalls, the PA profession is projected to grow by 31% by the decade's end.
What can those entering this growing field expect? To find out, Medscape surveyed licensed PAs practicing in the United States about their satisfaction with their careers. (For information on the financial aspects of being a PA, be sure to read the Medscape Physician Assistant Compensation Report 2021.)
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
We collected responses from 5826 PAs, of whom 4859 practiced full-time. Our survey was conducted between November 2020 and February 2021, a period that saw both the peak of hospitalizations and deaths due to COVID-19 in the United States and the arrival of the vaccines that would eventually help combat it. Several survey questions directly addressed respondents' experiences during the pandemic, but first we wanted to understand more about what they consider the main rewards and disadvantages of being a PA.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
PAs continue to derive the most professional satisfaction from helping people and making a difference in people's lives. For the second year in a row, this was the most popular answer among survey respondents (41% in this and last year's survey alike). A higher percentage of female vs male PAs reported this as the most rewarding aspect of their job (43% vs 37%).
According to Randy Danielsen, PhD, PA, director of A.T. Still University's Doctor of Medical Science Program, the popularity of this answer makes perfect sense when considering the profession's historical roots.
"PAs have always been the on-the-ground clinician that showed a direct connection with their patients," he said. "If you think about it, the PA profession was created on the shoulders of those Army medics and Air Force and Navy corpsmen from Vietnam who were known as 'doc' and cared about their patients in the face of battle."
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
The aspect of their role that PAs considered least rewarding also remained consistent with last year's survey, with a fifth of respondents citing the paperwork and electronic health record requirements (down slightly from 23% in 2020). There was an increase in the number of PAs citing administration (15% to 18%) as the least satisfying aspect of their job.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
Over half of PAs responding to this year's survey practice independently with a physician on site, whereas approximately a quarter practice under direct supervision by a physician. PAs in urban work settings more often practice under direct supervision by a physician (33%) than do PAs in all other environments, with rural PAs (17%) being least often under direct supervision.
Two thirds of PAs have their charts reviewed by a collaborating physician. This is more common for PAs in rural settings (75%) than it is for their peers in suburban (66%) and urban (65%) settings.
PA supervision requirements, which vary on a state-by-state level, continue to be a source of controversy "from both within the profession and externally," said Danielsen. "Physician groups have insisted on the supervision of PAs. While PAs can offer comprehensive care to patients, some argue (and lobby against) independent practice. Some physicians even perceive the increasing number of PAs as a threat to their profession."
Of note, the American Medical Association (AMA) opposes legislative efforts or proposed regulations that would authorize PAs "to make independent medical judgment regarding such decisions as the drug of choice for an individual patient."
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
The vocal opposition of their physician colleagues does not appear to have dampened the enthusiasm among PAs for autonomous or independent practice, which was supported by nearly two thirds of this year's survey respondents.
The American Academy of PAs (AAPA) instituted a policy in 2017 permitting state chapters to seek changes to "eliminate the legal requirement for PAs to have a specific relationship with a particular collaborating physician in order to practice."
Although Danielsen described most state laws as still being "very prescriptive" in this area, he noted that progress toward reaching the AAPA's goal has been made in places like Michigan and Utah.
"To accomplish this in all states," said Danielsen, "the profession will need to have a concentrated effort to change antiquated statutes and policies that will better reflect the current state of PA practice."
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
As COVID-19 roiled the nation and patient volumes surged, granting PAs more autonomy suddenly turned from an ongoing debate to a critical necessity. Several states took the step of temporarily waiving or suspending PA supervision requirements. Nearly 9 in 10 of those surveyed support making pandemic-related expansions to the scope of PA practice permanent.
Although the support among PAs appears resounding, it is also being met with vociferous opposition. In July 2020, the AMA and several other medical associations wrote a letter to the Centers for Medicare & Medicaid Services asking that these rules not be left in effect after the end of the public health emergency.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
The ongoing struggle to redefine the laws governing how they practice doesn't appear to have decreased the satisfaction PAs take in their chosen profession.
The vast majority of respondents — and the same exact percentage as last year — said they were happy with their decision to become a PA. And time on the job didn't diminish that enthusiasm either, as PAs working at least 10 years were more likely to say they were glad they became a PA compared with their less-experienced counterparts (95% vs 89%).
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
But this doesn't mean that the same percentage would pursue a career as a PA if given the chance to start all over again. In fact, 18% said they would not choose to do so. Of those, 7% each said they would either pursue a career outside of healthcare entirely or go to medical school instead.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
Like all healthcare workers, the professional and personal lives of PAs were dominated by the specter of the ongoing pandemic. This year's survey sought to measure the toll of this in the form of several questions directly related to COVID-19.
The majority of PAs had a clear window into the ravages of COVID-19, with three quarters reporting that they treated a patient with the disease.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
In doing so, they found themselves vulnerable to infection themselves, with 45% of PAs citing not having adequate PPE at some point during the pandemic.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
Rates of COVID-19 were significantly higher amongst frontline healthcare workers than the general population in the United States.
About 1 in 10 PAs have tested positive for COVID-19. Among these respondents, approximately three quarters were symptomatic but not hospitalized. Only 3% required hospitalization.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
A fifth of PAs were required to switch to a different work setting during the pandemic, and 10% volunteered to do so for all or part of the time. Although the majority of these PAs have since returned to their previous work setting, for roughly a quarter of respondents, that change has since been made permanent.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
The majority of PAs had no change regarding their specialty due to COVID-19. Among those who switched to a different specialty, most have since returned to their original specialty.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
Just over half of PAs have had no change to their hours worked due to the pandemic, with 25% reporting that their time on the job increased.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
Two thirds of PAs have used telehealth since the pandemic began. PAs in suburban (68%) and rural (71%) areas were more likely to use telehealth than PAs in urban areas (62%).
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
Most respondents said that the pandemic either had no effect on their satisfaction with being a PA (67%) or increased it (9%). Approximately a quarter of PAs did associate the pandemic with a decrease in satisfaction, which was a more common response among those who say they currently feel very burned out.
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
It's not surprising that COVID-19 had a clear correlation with levels of burnout. Only 13% of respondents classified themselves as being "very burned out/burned out" prior to the pandemic, but that rate increased by more than 2.5-fold to 34% when asked if they felt this way after the outbreak of COVID-19.
Danielsen said, "Anecdotally, many PAs (and other clinicians) report posttraumatic symptoms such as nightmares or unwanted memories of the trauma, avoidance of situations that bring back memories of the trauma, heightened reactions, anxiety, or depressed mood."
He advised his PA colleagues dealing with burnout "to not ignore and compartmentalize their feelings and seek counseling early."
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
Among the abundant stressors of working during a pandemic, the primary concern for PAs was transmitting the infection to a family member (44%), followed by concerns of loss of income (13%) and fear of becoming infected oneself (12%). What doesn't appear to have been a notable concern was being asked to work overtime, which was cited by just 3% of respondents.
"The value of PA work during the COVID-19 pandemic was exceptional and above board, particularly those who were on the front lines (ie, critical care, emergency center, and urgent care)," Danielsen noted. "Even in spite of furloughs and laying off of other PAs, many PAs volunteered to move to the front lines to add their efforts to fighting this terrible pandemic."
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Medscape Physician Assistant Career Satisfaction Report 2021
John Watson; Mary McBride; Daniela Bastida; Emily Berry | July 21, 2021 | Contributor Information
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John Watson
Freelance writer
Disclosure: John Watson has disclosed no relevant financial relationships.
Mary McBride
Associate Director, Market Research
Medscape
Daniela Bastida
Research Analyst
Medscape
Emily Berry
Editor
Medscape
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