PAs Continue to Grow in Reach, Importance

By J. Toby Gray, PA-C, CEO of AP Health



I became a PA in 1998 because it was a profession that was not only growing in numbers, but also in importance. I saw it as a great way for me to make a more impactful contribution to the delivery of quality healthcare. Over the last 20-plus years, the PAs role in the care delivery has grown across all medical specialties.

Before I was a PA, I was an athletic trainer. I loved being in healthcare, but I wanted more responsibility and autonomy. While PAs had been around as a profession for more than 30 years, they were becoming a more prominent part of the care team in more and more specialties. It was the perfect role for me.

Back then (and to some degree today), PAs were largely trained for internal medicine. I wanted to do orthopedic surgery, which meant on-the-job training with the orthopedic surgeons. I enjoyed the learning experience and taking on more responsibility in the OR as I earned the surgeons’ trust. I got a lot of satisfaction as our surgeries became more efficient and we grew to truly collaborate on decisions during procedures. My hope is that PA education will continue to evolve to provide specialty-specific training. Schools are adapting beyond their traditional primary care focus by providing clinical exposure to various specialties, but more needs to be done to prepare PAs for the duties they will perform after graduation.

The PA profession has grown dramatically in size and scope. When I became a PA, there were about 110 accredited programs and 41,000 PAs in the U.S. As of last year, there were more than 250 accredited programs and nearly 150,000 practicing PAs. More important has been the PA growth in nearly every medical specialty. At the beginning of the profession, PAs practiced mostly in a primary care setting. Now, PAs are more evenly distributed across specialties, with the number practicing in surgical subspecialties exceeding those in primary care.

At AP Health, our advanced practitioners – many of whom are PAs – are an integral part of the care team and a proven resource for the delivery of high-quality, cost-effective care. Our highly skilled professionals take on an increasingly important role in the OR, which lowers operating costs and increases efficiency.

The scope of duties that PAs are allowed to perform is regulated at the state level. However, the trend over the years has been to give PAs more freedom to work more independently, without physician supervision. The challenges of COVID-19 have accelerated that trend. The pandemic exacerbated the physician shortage, and PAs stepped in to deliver more care. Florida, home to many of AP Health’s practitioners, passed a law earlier this year to modernize regulations, granting PAs more powers to provide care independently.

I am pleased that there is a growing recognition of the vital role of the PA by regulators, physicians and the patients they serve. The change in the definition of PA from “physician assistant” to “physician associate” is just one more recognition of the growing and critical role the PA plays in the delivery of quality care in America.