P2 Mobile Logo

Search form


Certified Physician Assistants: 10 Myths vs. Facts

Certified Physician Assistants: 10 Myths vs. Facts

  • Certified Physician Assistants: 10 Myths vs. Facts
  • 1. Myth: PAs are educated like NPs.
  • Fact: PAs are educated in the medical model versus the nursing model.
  • 2. Myth: PAs are held to lower standards than physicians.
  • Fact: In practice, PAs are held to the same standards of care as their physician partners. Just as importantly, PAs are certified and maintain certification in a manner similar to physicians.
  • 3. Myth: PAs want to be independent from physicians.
  • Fact: PAs want significant autonomy but not independence.
  • 4. Myth: It costs too much to employ PAs due to the supervision requirements.
  • Fact: PAs reduce the overall cost to the practice while increasing access to high quality care.
  • 5. Myth: PAs see only patients that a physician delegates on any given day.
  • Fact: PAs often have their own patient panel.
  • 6. Myth: Hiring a PA is a big legal risk.
  • Fact: PA-physician teams experience a lower rate of malpractice suits vs. physicians overall.
  • 7. Myth: The physician has to be onsite or see every patient.
  • Fact: Physicians do not have to be onsite.
  • 8. Myth: Each physician can only supervise one PA.
  • Fact: State laws vary on this, and in about a dozen states there is no ratio limit at all.
  • 9. Myth: More PAs practice in specialties because that is how they are educated and trained.
  • Fact: PAs are educated in general medicine, and certified and recertified as generalists.
  • 10. Myth: Patients only want to see physicians.
  • Fact: 94 percent of patients are willing to be seen by a PA.

As a certified physician assistant (PA-C) who has practiced over 20 years, I am often surprised by the many fallacies that exist, even among physicians, about who physician assistants are, what we can do, where we practice and how we can improve practice operations and profitability.

There are many myths about PAs — the most prevalent being that PAs are the same as nurse practitioners (NPs). Read on to understand fact versus fiction regarding this and other PA myths.

For more on the Medical Economics article regarding malpractice suits, click here.

James Cannon, PA-C, DHA, MBA, DFAAPA, is the past chair of the National Commission on Certification of Physician Assistants. He also holds a Certificate of Added Qualifications (CAQ) in psychiatry. He can be contacted at jcannon@nccpa.net.

Physicians Practice


It's been experience that patients want to see the practictioner that offers them the better outcome result md or pa. Many prefer the PA because they get more verbal reassurance and time allotted for education.

Eric Johnson,PA
EDJ Consults

eric @

Hi James, this is a wonderful article! I think you hit on many of the key points and misconceptions that even we as PAs are not necessarily prepared to demystify properly. Would you mind if I republished your article on my website at www.thepalife.com? I would, of course, give you full author credits and link back to the original article here? I think many of my readers would benefit from this information as well.

Stephen Pasquini PA-C

Stephen @


If you e-mail me at keith.martin@ubm.com, I can provide details on reprinting James' article.

Keith L. Martin
Physicians Practice

Keith @

Thanks! Great article!

Tricia @

Great article James. I have been practicing as a PA for 10 years now. I am extremely surprised about the lack of awareness that still exists among the public, physicians and patients regarding our profession. Your article is an excellent learning tool and I plan to share it with my future PA students, colleagues, patients and friends.


Patricia Brims PA-C, P.C.

Tricia @

Absolutely spot on and awesome! You said everything I have been trying to say to people who asked about PAs since I started practicing as PA in Internal medicine 22 years ago! BRAVO!!

Tricia @

GREAT Blog James!!! Very well-written and accurate.

James @

Complex issue, that perhaps may be solved the way Alexander solved the Gordian knot.
Are PAs 154% of a nurse or 66% of an MD?
2000 hours of training is a bit above the hours of lectures in first year in a Law school, 1500 hr, close to the 2000 hours, divided into two years of curriculum, for learning machining and foundry at a worker's level.

The win-win economical strategy is obvious: PA salaries are lower, insurance costs are lower, so costs for medical care insurance companies are lower, probably patients would refrain from putting a malpractice suit because they accepted a care that is not exactly a medical care, the issue of the severity of cases going to a PA compared to the severity of cases going to a physician remains obscure to me, be it only for the lack of an universal definition of 'severity' or 'complexity' of diseases.

The issue sounds a bit similar to the way clinical psicologists (if it's clinical it's not: 'logos', it's: 'iatros'), a fuzzy image is running aorund the world, that for mild mental health problems, the psychologist is good, and psychiatrists are just for the very serious ones, this added to the propaganda that psychopharmacology destroys personality, obvioulsy based in the fact that only physicians can prescribe drugs, as others can't handle it, they say it's no good, in this special case, basic elements in the therapy agreement, such as informing the patient of the risks and benefits in the therapy proposed, the way diagnosis was reached, and the possible alternatives to the therapy proposal may be often missing.

Does PA care induce secondary extra costs, economical and personal, in solving problems missed in first visits, or taken too long to refer to a physician or to an upper level?

The subject deserves an specially focused data gathering, and many, specially potential patients or customers of PAs, and medical associations, would like knowing about this.

If it were not for pharmacists requesting making: 'follow-up of chronic diseases' in the pharmacy shop, I'd look at PAs in a more kind way, but this road map may lead in the end as some training in diseases being part of the priesthood and teacher's training, and then taking care of physical diseases, not only about sins, this is a never ending story.

Why and when was the PA figure first introduced?
We know nursery field of work was initially from delegation of technical procedures formerly conducted by physicians, and physicians have or had some duties in supervising nurses' tasks, but the way the PA was started sounds more as a bite tan as a delegation, self-taught curricula are dangerous.

I was tempted sending the politicians who considered care in pharmacy shops, after checking they have no life threatening disorder, and no emergency exists, to receive care from the boys and girls in the pharmacy desks, but this will be considered a retaliation.

What does, and what a PA knows, remains to me an enigma wrapped in a mistery.

The better is enemy of the good, and I like also 'protecting my turf'.

Jose @

Thanks for the reply....

Lot's of questions for which answers exist for many but I will offer a few thoughts in response...

First, comparing the academic physician training with PA training using the Carnige method would be 155 weeks versus 105 weeks, respectively. A physician graduate their academic program and in most cases today, enters residency. The PA graduates and moves into practice with physcian precepting/supervision/collaboration. I would not attempt to compare the PA to a nurse or botanist. The reference to the 2,000 hours was for the clincial phase which is a hybrid of the physician clerkships and early residency years. The didactic phase is also between 1,500 and 2,000 hours. The entire PA enducational and certifcation exeprience is accredited with ironically physician involvement. Do the other professions share this attribute? I would encourage that you check out the content blueprint at the NCCPA (www.nccpa.net)

Malpractice rates from the evidence has nothing to do with the logic of "not being medical care" or "patient choice" to be seen by a PA but related to better outcomes i.e less unfavorable. Care rendered by physicians and PAs together over all allow for more time with patients or greater profit for the practice. I like the more time with patients. If PAs do not provide medical care what do we call it? The enity bills for PAs using physician service or medical codes. I might suggest in certain settings a PA could be a "bio-similar" or subtitute and in others, a compliment. I work in psychiatry with a wonderful attending physician. I do initial evaluations, initaite medications, adjust medications, and undertake discharges. As a psychiatric certified and post graduate trained PA, I enhance access to care and I am not a psychiatrist. My attending, oversees the collective practice and we talk frequently about the care of patients. In this setting, a specialty, a PA can have autonomy but less. Overtime, however and with physciain directed (formal and informal) clincal training this autonmy can increase.
As for outcomes, more data is emerging with respect to PA care and outcomes. What I think is more likely especially with the movement to "global" services, are difficulty in finding isolated outcomes.

PAs are not connected to pharmacist just as physicians are no longer trained a drugest or compounders. No one can be everything in medicine today. One may want to pause for a moment on the phramacist or drugest role in the context of the world. Many of the medications patients get are from the pharmacist and in many developed countries they have better health statistics than us here in the US. Personally, I agree that a psychologist or pharmacist should not prescribe. Organized medicine may however not have a choice in the decision in the end.
As far as what PAs know, I again would suggest a look at our practice blueprint for the initial, re-certifying, and certificates of added qualifications this is an evidenced based model that defines what PAs know and what they can do.
I apprecaite your concerns. In the end who knows what will determine our collective fate.

James @

Spot-on Cannon. You covered the entire landscape. I'm e-mailing you with another topic perhaps could be done someday.

C. Scott, PA, Retired

Charles @

Well done, James! Great info!

Randy D. Danielsen, PhD, PA-C

James @

Excellent presentation of what our profession is and is not! Thanks! Karen Dybus, PA-C, MS

Karen @

Thank you Karen for the feedback

James @

Add new comment

Loading comments...

By clicking Accept, you agree to become a member of the UBM Medica Community.