Physician Associate / Assistant (PA) vs Doctor

Your mother or father probably wants you to become a doctor for two main reasons: it’s one of the highest-paid professions in the country, and it has a tangible and positive impact on society. Those are very real benefits, but they come at a steep cost. Doctors spend over a decade in school and in training, and can rack up over a quarter-million dollars in debt in the process.

The country desperately needs more medical professionals, but it simply can’t train them fast enough to meet the growing needs of an aging Baby Boomer generation. That’s why the U.S. Bureau of Labor Statistics (BLS) predicts an average rate of growth (7 percent) for doctors but a blistering rate of growth (31 percent) for physician associates between 2018 and 2028. But what are the real differences between these two professions?

Physician associates (f.k.a. physician assistants) perform many of the same tasks doctors do, too. They conduct physical examinations, perform and interpret medical tests, and develop treatment plans for their patients. In many cases they are dependent upon a supervising physician, but their skill set is both broad and deep enough to handle many of the needs of an aging population.

Physician associates do not occupy a generalist role, either; PAs can specialize in nearly as many areas as medical doctors can. At the same time, physician associates spend less time in school, spend less money on their education, and still manage to have personal relationships with their patients (and, yes, a high salary as well).

Each profession has its own separate requirements for education, licensure, continuing education, and practice authority. To get a breakdown of the small but crucial differences (and similarities) between a physician associate and a doctor, check out our side-by-side comparison chart below.

Side-by-Side Comparison: Physician Associate / Assistant vs Doctor

Physician Associate (PA)Doctor (MD)
EducationPhysician associates need to earn a bachelor’s degree, followed by a master’s degree (MPAS, MHS, or MMSc) from a PA school. Medical doctors need a bachelor’s degree as well as a medical degree (MD or DO).
Timeline to PracticeIn addition to a four-year bachelor’s degree and a two- to three-year master’s degree, physician associates need three years of healthcare experience. While it’s possible that some requirements will overlap, the general timeline to practice is seven to ten years. In addition to a four-year bachelor’s degree and a four-year medical degree, physicians need to complete an additional three to seven years of training through residencies and fellowships, making the general timeline to practice between 11 and 15 years.
Typical DutiesA physician associate’s typical duties will vary based upon their specialization and work environment, but may include:

• Performing physical examinations
• Designing treatment plans
• Assisting in surgery
• Taking medical histories
• Ordering and interpreting medical tests
• Performing clinical research
A doctor’s typical duties will vary based upon their specialization and work environment, but may include:

• Performing physical examinations
• Designing treatment plans
• Administering medications
• Diagnosing illnesses
• Ordering and interpreting medical tests
• Addressing patient concerns
Can Prescribe Medications? Physician associates are allowed to prescribe medications in all 50 states, but the scope of their prescriptive authority can vary from state to state and from practice to practice.

As of February 2020, a physician associate’s prescriptive authority is determined by the supervising physician in 47 states. Furthermore, seven states place regulatory restrictions on a physician associate’s prescriptive authority, often as it relates to Schedule II substances.
Doctors (both MDs and DOs) can prescribe medications in all 50 states and Washington DC.
Common Practice SettingsAccording to the Bureau of Labor Statistics (BLS 2019), the three most common practice settings for physician associates are:

• Physician offices
• Hospitals
• Outpatient care centers
According to the American Medical Association (AMA), four of the most common practice settings for doctors are:

• Private practices
• Group practices
• Hospitals or healthcare systems
• Academic institutions
Licensing and CertificationPhysician associates need to be certified as well as state-licensed in order to practice.

Certification is achieved by passing the 300-question Physician Assistant National Certifying Exam (PANCE), which is administered by the National Commission on Certification of Physician Assistants (NCCPA).

Each individual state has its own eligibility requirements for physician associates. More information can be found on the
American Academy of PAs (AAPA) website.
Doctors (both DOs and MDs) need to be licensed by a state licensing board. Requirements will vary from state to state. The Federation of State Medical Boards (FSMB) provides each state’s requirements for initial licensure.

• DOs must pass the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA)
• MDs must pass the United States Medical Licensing Examination (USMLE)
• Specialty boards (for specializations) require recertification on a regular basis
Continuing Education Requirements Physician associates will need to complete 100 hours of continuing medical education (CME) every two years in order to maintain their certification and licensure. They also need to pass the Physician Assistant National Recertification Exam (PANRE) every ten years.While the state requirements for a doctor’s Continuing Medical Education (CME) or Continuing Education and Improvement (CEI) vary based on location and specialization, they generally include:

• Earning 20 to 50 hours of CME credits every one to two years
• Renewing one’s medical license every one to three years
• Completing additional continuing education hours based on one’s specialization
Specializations Physician associates can choose from a wide variety of specializations, which include:

• Dermatology
• Emergency Medicine
• Family Medicine
• Hospital Medicine
• Internal Medicine
• Pathology
• Pediatrics
• Obstetrics and Gynecology
• Surgery
Doctors can choose from a wide variety of specializations which include:

• Anesthesiology
• Cardiology
• Dermatology
• Emergency Medicine
• Family Medicine
• Gastroenterology
• Obstetrics and Gynecology
• Oncology
• Pediatrics
• Radiology
• Surgery
Salary According to the BLS (2019), there are an estimated 114,710 physician associates in the US, with an average salary of $108,430 per year. To break that down further:

• The 10th percentile makes $69,120 per year
• The median (50th percentile) makes $108,610 per year
• The 90th percentile makes $151,850 per year

Do note that salary estimates will vary further based on a physician associate’s specialization and geographical setting.
According to the BLS (2019), there are an estimated 389,180 physicians and surgeons in the US, with an average salary of $203,880 per year. To break that down further:

• The 10th percentile makes $60,280 per year
• The median (50th percentile) makes $200,890 per year
• The 90th percentile makes over $205,000 per year

Do note that the BLS doesn’t record all salary data over $205,000 per year, but many doctors, especially in the 90th percentile, make much more than this. The average wage for anesthesiologists, for example, is $267,020 per year.
Career Outlook According to BLS data, the need for physician associates is set to grow 31 percent between 2018 and 2028, a rate that’s over quadruple the national average for all professions.

A growing and aging population requires increased care, and physician associates are able to provide the generalist services needed in a shorter time than medical doctors.

Job prospects are particularly bright for physician associates who are looking to practice in rural and low-income areas. And as states continue to expand the number of services physician associates are allowed to perform, the job outlook for PAs remains extremely strong all across the country.
According to BLS data, the need for physicians and surgeons is set to grow 7 percent between 2018 and 2028, matching the average rate of growth for all professions.

The career outlook for physicians remains high, however, as graduates of domestic medical schools are almost always matched to residencies immediately after graduating.


Job prospects are particularly bright for doctors who are looking to practice in rural and low-income areas, and for doctors who specialize in treating the needs of the aging Baby Boomer generation.
Professional Associations and Resources • American Academy of Physician Associates
• Accreditation Review Commission on Education for the Physician Assistant
• National Commission on Certification of Physician Assistants
Journal of the American Academy of Physician Assistants
• American Medical Association
• American College of Surgeons
• American College of Physicians
• American Academy of Family Physicians
• American Osteopathic Association
• Association of American Physicians and Surgeons
• Association of American Physicians
• Federation of State Medical Boards of the United States
• National Board of Medical Examiners
• National Institutes of Health
Matt Zbrog

Matt Zbrog

Writer

Matt is a writer and researcher from Southern California. He’s been living abroad since 2016. Long spells in Eastern Europe, Southeast Asia, and Latin America have made the global mindset a core tenet of his perspective. From conceptual art in Los Angeles, to NGO work on the front lines of Eastern Ukraine, to counterculture protests in the Southern Caucasus, Matt’s writing subjects are all over the map, and so is he.

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