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New Physician Assistant Definition Reflects Evolving Profession


The scope of practice of new PA graduates today is quite different than it was decades ago.

Over the course of many years, the responsibilities of PAs have evolved and broadened significantly. PAs practice in every setting - inpatient and out - and in every specialty and subspecialty with their physician partners and other team members.

In the 34 years that I have been a PA, change has been incremental and slow. But the reality and scope of practice of those PAs who are entering the profession today looks decidedly different than it did when I graduated back in 1981.

This evolution recently led the American Academy of Physician Assistants (AAPA) House of Delegates to redevelop a formal definition of the PA that more accurately depicts the current state of physician–PA teams

The following definition was adopted by the AAPA House of Delegates during the AAPA annual conference in Boston:

“PAs are health professionals licensed or, in the case of those employed by the federal government, credentialed to practice medicine in association with designated collaborating physicians. PAs are qualified by graduation from an accredited PA educational program and/or certification by the National Commission on Certification of Physician Assistants ... Within the physician-PA relationship, PAs provide patient-centered medical care services as a member of a healthcare team. PAs practice with defined levels of autonomy and exercise independent medical decision making within their scope of practice.”

While I can understand how some physicians unfamiliar with PAs may see this as an “expansion” of scope of practice, this updated definition does not change how PAs and physicians interact. What it represents is a true reflection of the current reality and evolution of the PA practice since 1967.

In my personal experience, this definition is spot-on accurate. I work very closely with the physician with whom I practice, but I also exercise a significant level of autonomy in medical decision making. This type of relationship and level of independence has become increasingly standard in today’s healthcare system.

I’ve written a lot about the symbiotic relationship that physicians and PAs have working together in teams. The relationship is founded on trust and the mutual respect of the skills, training, and ability of each member of the team.

The medical team functions best when each member practices and contributes to his fullest potential and ability. All you have to do is to observe the physician–PA teams around you to understand how PAs contribute to and understand the concept of team practice. We are acculturated to team practice from day one of our training and live it every day.

The timing was right for the AAPA to bring the role and definition of PAs back into alignment with the state of physician–PA team practice. The demand for healthcare providers in America is growing at an extraordinary rate, primarily because of the Affordable Care Act, a rapidly aging patient population, and a significant portion of providers nearing or at retirement age.

The value of PAs has been recognized as states seek to increase and improve the ways that PAs practice medicine. In 2013, 42 states and the District of Columbia made positive regulatory changes affecting PA practice. This year, already 26 states and the District of Columbia have continued the trend.

I can attest to that in my own relationship with the physician with whom I practice. We work very closely together, but I exercise a significant level of autonomy in medical decision making - both in an inpatient and outpatient setting.

Thankfully, there are 181 PA programs in the United States graduating a total of more than 6,500 PAs each year. The United States recently surpassed a major milestone of 100,000 practicing PAs, and each of them is highly trained and expertly skilled to provide the highest quality of care to their patients. 

This blog was provided in partnership with the American Academy of Physician Assistants.



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