Mirroring Physician Trend, PAs in Primary Care Decline

Primary care has made great use of physician assistants since the profession's inception in the 1960s, but mirroring the trend among physicians, the percentage of PAs choosing primary care has dropped drastically over the last 15 years.

Primary care has made great use of physician assistants (PAs) since the profession’s inception in the 1960s. However, a new study in the Annals of Family Medicine revealed that the the careers of PAs is mirroring a trend among physicians — the percentage of PAs choosing primary care has dropped drastically in just 15 years.

Of the 18,000 PAs who participated in the 2009 American Academy of Physician Assistants’ Annual Census Survey, one-third (31%) reported working in primary care. This number is drastically down from 50.8% in 1996.

“PA practice trends mirror the practice trends of physicians,” authors Bettie Coplan, MPAS, PA-C, James Cawley, MPH, PA-C, and James Stoehr, PhD, wrote. “Consequently, actions that increase the number of primary care physicians are also likely to increase the percentage of primary care PAs.”

According to the survey results, female, Hispanic and older PAs were more likely to work in primary care. The percentage of primary care PAs from 2004 to 2008 graduates increased by 0.9% each year, but nearly half of all PAs change specialties during their careers.

The results from the 2004 to 2008 graduates could be good news, though it’s too early to tell. Although the fact that so many PAs change specialties, primary care has the most staying power, with more than half (53%) staying in family practice.

“We cannot predict the practice patterns of new graduates, but historically, the net decrease in the number of PAs in family medicine correlates with smaller percentages of new graduates choosing family practice,” the authors wrote. “The slight upward trend of new graduate selection of primary care may therefore reflect some stabilization in the percentage of primary care PAs.”