Introduction
The American Academy of Physician Assistants (AAPA) was founded in 1968 and is the only national organization representing physician assistants (PAs) in all medical specialties. The Academy educates the general public about the PA profession, assures competency of PAs through active involvement in the accreditation of PA programs, provides continuing education, and conducts PA-related research. The Academy works to promote quality, cost-effective health care, and the professional and personal growth of PAs.
Each year since 1990, the AAPA has conducted a census survey of its members. Beginning in 1996, the census survey was expanded to include those PAs who were not members of AAPA. While the survey instrument and the data collection process have undergone some revisions since the inception of the census, the general approach and data elements have remained much the same.
The data collection effort for the 1999 AAPA Physician Assistant Census was conducted between March 1 and September 30, 1999. Survey forms were mailed to all individuals, both AAPA members and non-members, who were believed to be eligible to practice as PAs in the United States as of March 1, 1999, and for whom address information was available. In total, forms were mailed to 38,112 people - accounting for 92 percent of the 41,421 individuals eligible to practice as PAs as of the census expiration date. Completed surveys were received from 18,030 people or 43 percent of all individuals eligible to practice as PAs. Of the 22,733 members as of September 1, 1999, 13,861 (61%) completed surveys; of the 18,688 non-members, 4,169 (22%) completed surveys. The tables in this document represent the responses received from those PAs. It should be noted that the number of usable responses for each item does vary, and the percentages displayed in all tables may not sum to 100 due to rounding.
To facilitate locating specific items of interest, an index of the subjects addressed by the tables is provided in addition to a list of tables.
Highlights of National Statistics
Section I. General Information about Respondents
Sex: The proportion of female respondents to this year's census is 54 percent.
Ethnicity: White PAs comprise 88 percent of the respondents.
Age: The mean age of census respondents is 41.4 years; the median is 42.
Education: Approximately 67 percent of the PAs responding had received at least a bachelor's degree before enrolling in a PA program. More than half (54%) of the PAs responding received a bachelor's degree from PA school; 11 percent received a master's level PA degree. At present, 62 percent of respondents hold bachelor's degrees, 25 percent hold master's degrees, and 3 percent hold doctorate degrees.
Section II. Information about Respondents in Clinical Practice
Practice Status: The vast majority of census respondents (88%) are in clinical practice.
Years In Clinical Practice: The mean number of years in clinical practice is 9.5; the median is 7 years. The mean number of years respondents have worked in their current position is 4.7; the median is 3 years.
Number of Clinical PA Jobs: Approximately one-fifth (19%) of the respondents in clinical practice work more than one clinical PA job concurrently.
Geographic Distribution: The states in which the largest numbers of clinically practicing respondents are employed include: New York (11%), California (8%), Texas (7%), North Carolina (6%), Pennsylvania (5%), and Florida (5%).
Section III. Information about Respondents in Clinical Practice at Primary Job
Employer Type: More than one-third (37%) of the respondents are employed by a single or multi-specialty physician group practice. More than one-fourth (26%) of the respondents are employed by hospitals.
Public Service: About 13 percent of the respondents work for a government agency; the Department of Veterans Affairs is the single largest government employer of PAs accounting for 3 percent of all respondents.
Work Setting: The predominant work setting for more than one-third (38%) of all respondents is a hospital, another third (35%) work predominantly in solo or group practice offices, and about 12 percent of respondents work predominately in some type of Federally Qualified Health Center or Community Health Facility.
Type of Community Served: PAs practice medicine in communities ranging from the most rural to the inner city. Nearly one-third (31%) of respondents work in areas that they believe have fewer than 50,000 people.
Primary Specialty of Practice: While PAs practice in at least 60 specialty fields, more than half of this year's respondents (52%) report that their primary specialty is one of the primary care fields: family/general practice medicine (38%), general internal medicine (9%), general pediatrics (3%), and obstetrics/gynecology (2%). Other prevalent areas of practice for PAs include general surgery/surgical subspecialties (20%), emergency medicine (10%), and the subspecialties of internal medicine (7%).
Functions Performed: PAs can perform a variety of functions for their primary employer. One-fourth (25%) of respondents assist in surgery; almost half (45%) perform invasive procedures.
Other Responsibilities: Eleven percent of respondents report supervising other PAs, and almost one-fourth (23%) report supervising other clinical staff.
Preceptor Status: Approximately 38 percent of respondents indicate that they precept PA students; 28 percent precept students of other health professions.
Patient Ages: PAs are seeing patients of all ages, from newborns to the elderly. More than half (57%) of respondents treat patients 0-3 years of age, while 74 percent of respondents treat patients who are 85 years old or older.
Section IV. Information about Respondents in Clinical Practice Who Work at Least 32 Hours per Week at Primary Job
Hours Worked: Eighty-eight percent of clinically practicing respondents work full-time for their primary clinical employer. The mean number of hours these respondents work in a typical week is 44.7; the median is 42 hours. (Full-time is defined as working 32 or more hours per week at the primary clinical job.)
Patient Visits/Encounters: Due to the variety of work settings and specialty fields in which PAs practice, the types of patients PAs treat are quite varied. More than 90 percent of census respondents who work full-time see outpatients in their primary job; the mean number of patient visits provided per week by PAs who see outpatients exclusively is 100.2. Twenty-eight percent of respondents who work full-time see inpatients in their primary job; the mean number of patient encounters provided per week by respondents who see inpatients exclusively is 60. Eight percent of full-time PAs see nursing home patients in their primary job, and 5 percent of respondents see other types of patients.
Taking Call: More than one-third (36%) of full-time respondents report taking call for their primary employer. The mean hours on call per month for those PAs who take some call but are not always on call is 104.
Base Pay: Eighty percent of respondents report receiving their base pay in the form of a salary; 19 percent indicate that they receive an hourly wage.
Compensation: Respondents report receiving several different forms of compensation from their primary employer. Common forms of compensation include on-call pay (10%) and overtime pay (16%). Twenty-six percent of respondents report receiving an incentive based on productivity or performance. More than one-third (38%) of these who receive an incentive based on productivity/performance report that the incentive is based on revenue that the PA generates.
CME Funding: Eighty-six percent of respondents report having CME funds available to them from their primary employer. For those PAs who reported the amount of CME funds available to them, the mean was $1,393; the median was $1,500.
Source of Funds for Expenses: More than ninety-five percent of respondents report having their employer pay 100% of their professional liability insurance. Approximately three-fifths of respondents also report having their employer pay 100% of their AAPA dues (64%), state license fees (65%), NCCPA fees (60%), AAPA Annual Conference registration fees (59%), and DEA registration fees (75%).
Annual Income: The median total annual income from primary employer for respondents who work at least 32 hours per week for their primary employer and who are not employed by the military or self-employed is $64,780; the mean is $68,164. The comparable figures for respondents who graduated in or after 1998 are $57,113 and $57,982, respectively.
