Physician Assistant Income:
Changes in Total Inflation-Adjusted Income from Primary Employer
1997-1998, 1998-1999, 1999-2000, 2000-2001

Overview

A question that many practicing PAs want answered is: "How much should I be earning?"  Summary statistics, such as the mean total income for all PAs during a single year, are not particularly useful when answering this question because they do not provide any context or basis for comparison. Moreover, such summary statistics do not account for any of the many factors that determine income.  To be useful, even a simple analysis must recognize the effects of such factors as:

  1. Inflation


  2. What the PA does (specialty)


  3. How long the PA has worked as a PA (experience)


  4. The geographical area in which the PA works (labor market)


  5. The employer's assessments of how well the PA performs his/her job and the PA's aptitude or talent

In this report we address the question of how much a PA should earn in the context of the relative change in inflation-adjusted income over time.  Moreover, to be able to account for the individual differences in performance and talent, we measured the change that was actually reported by the individuals who participated in consecutive census surveys (i.e., 1997 & 1998, 1998 & 1999, 1999 & 2000, and 2000 & 2001).  Specifically, we examined summary measures of the relative change in total inflation-adjusted income for the four pairs of surveys for the individual members of groups defined with respect to meaningful combinations of factors.  The groups that we examined fall into two broad categories: PAs who did not change their type of job and PAs who changed their type of job.

Methodology

The income data analyzed for this report were collected on the 1997, 1998, 1999, 2000 and 2001 AAPA Physician Assistant Census surveys.  Preliminary to performing any analyses, we adjusted the income data for inflation.  The inflation figures used are shown in the table below.  These figures reflect the Bureau of Labor Statistics' measurements of the Consumer Price Index for a 12-month period ending in September of 1998, 1999, 2000 and 2001.

   1997-1998  1998-1999  1999-2000   2000-2001

Inflation Rate

1.2% 2.6% 3.5% 2.6%

Before performing any analyses, we also removed the following types of respondents:

In addition, prior to examining the income data, we considered the comparability of the PAs who responded in consecutive years and those who responded in either of the two years with regard to a select set of personal and practice characteristics. The personal characteristics examined included age, race, and sex; the practice characteristics examined included specialty, employer type, and hours worked per week.  We did not observe a consistent pattern of statistically significant differences (p ³ .01) between the groups of PAs who participated in consecutive surveys and the groups of PAs who responded to only one survey with respect to age, sex, or hours worked.  However, we did consistently observe statistically significant differences for several other variables.  Generally speaking these differences suggested that the groups of PAs who responded to both surveys included

  1. approximately four percent more white PAs (e.g., 91% v. 87%)


  2. approximately four percent more PAs employed by group practice (e.g., 41% v. 37%)


  3. approximately three percent more PAs working in a solo specialty group practice (e.g., 17% v. 14%)

While these differences are statistically significant, they are relatively small and not likely to substantially affect income levels. Consequently, we proceeded to calculate the change in total inflation-adjusted income from the primary employer reported by each PA who responded to two consecutive surveys for each of the four distinct time periods: 1997-1998, 1998-1999, 1999-2000, and 2000-2001. We posit that there is little risk in generalizing these findings to all of the PAs who were in practice at the time periods considered.

Our first examination focused on data for PAs who did not change their type of job, defined by specialty, employer type, or geographic area of their work setting. In particular, we examined the contributions of the two most important factors of PA income: specialty and years of experience.  Our second set of analyses focused on PAs who changed their type of job in terms of specialty, employer type, or both, but did not change the geographic area of their work setting.

Results

As shown in Table 1, the mean percent change in total income adjusted for inflation for each of the four time periods is positive for those PAs who did not  change specialty, employer type, or geographic area of their work setting.

Table 1.   Mean Percent Change in Total Inflation-Adjusted Income for PAs Who Did Not Change Specialty, Employer Type, or Geographic Area, 1997-1998, 1998-1999, 1999-2000, and 2000-2001
 
1997-1998
1998-1999
1999-2000
2000-2001
Respondents
4171
4097
3992
3751

Percent Change

2%
4%
1%
3%

Specialty

As shown in Table 2, the mean percent changes in total inflation-adjusted income for the groups of PAs who work in different specialties, but did not change specialty, employer type, or geographic location for the observed time period provide a somewhat inconsistent picture.  For example, the changes experienced by the PAs in emergency medicine were slightly less than the mean in 1997-98, slightly more than the mean in 1998-99, equal to the mean in 1999-00, and slightly less than the mean in 2000-01.  However, most changes in inflation-adjusted income experienced by the PAs in all specialties were within one percentage point of the mean for the associated time period.

Table 2.   Mean Percent Change in Total Inflation-Adjusted Income from Primary Employer for PAs Who Did Not Change Specialty, Employer Type, or Geographic Area by General Field of Primary Specialty, 1997-1998, 1998-1999, 1999-2000, and 2000-2001
  Respondents 1997-98 Respondents 1998-99 Respondents 1999-00 Respondents 2000-01
Total
3239
2.0%
3223
4.0%
3342
1.0%
3751
3.0%
 
Family/General Medicine
1113
2%
1145
5%
1230
0%
1307
3%
General Internal Medicine
283
2%
283
4%
262
-1%
297
3%
Emergency Medicine
265
0%
261
5%
255
1%
270
2%
General Pediatrics
80
1%
88
4%
89
-2%
84
5%
General Surgery
121
2%
103
5%
100
1%
113
1%
Internal Medicine Subspecialties
247
2%
259
5%
270
1%
337
2%
Pediatric Subspecialties
54
1%
47
3%
50
0%
66
1%
Surgical Subspecialties
707
2%
732
4%
690
1%
801
4%
Ob/Gyn
89
-1%
76
5%
72
-1%
94
2%
Industrial/Occupational Medicine
85
3%
57
3%
105
0%
128
1%
Other
195
2%
172
4%
219
1%
254
4%

Experience

As shown in Table 3, of the PAs who did not change specialty, employer type, or geographic area, those with more years of experience were associated with relatively smaller changes in income for each time period.     

Table 3. Mean Percent Change in Total Inflation-Adjusted Income from Primary Employer for PAs Who Did Not Change Specialty, Employer Type, or Geographic Area by Years in Clinical Practice as a PA for 1997-1998, 1998-1999, 1999-2000, and 2000-2001
  Respondents 1997-98 Respondents 1998-99 Respondents 1999-00 Respondents 2000-01

Total

4501
2.0%
4338
4.0%
4250
1.0%
4700
3%

1 To 3 Years

511
4.0%
604
6.0%
473
2.0%
819
5.0%

4 To 6 Years

809
3.0%
839
5.0%
1027
2.0%
981
4.0%

7 To 9 Years

509
1.0%
474
4.0%
582
1.0%
507
2.0%

10 To 14 Years

843
1.0%
673
4.0%
469
0%
605
2.0%

15 Years Or Greater

1829
1.0%
1748
4.0%
1699
0%
1788
2.0%

Changing Type of Specialty and/or Type of Employer

Since data about specialty and employer type both involve too many classifications to examine all possible types of changes, we created two new variables for analyzing the effects of changing employers and/or changing specialty on total inflation-adjusted income.  One variable represented transitions regarding primary care[1] specialties and the other represented transitions regarding hospital employment.  The primary care variable allowed us to classify PAs into the following four categories for each time period:

  1. Those who continued to work in a primary care specialty


  2. Those who continued to work in a non-primary care specialty


  3. Those who changed from a primary care specialty to a non-primary care specialty


  4. Those who changed from a non-primary care specialty to a primary care specialty

The hospital employment variable allowed us to classify PAs into the following four categories for each time period:

  1. Those who continued to work for a hospital


  2. Those who continued to work for a non-hospital each time period


  3. Those who changed from a hospital to a non-hospital each time period


  4. Those who changed from a non-hospital to a hospital each time period

The following eight tables present the mean percent change in total inflation-adjusted income in regards to years of experience, primary care transitions and hospital employment transitions for each time period. As too few PAs in each cohort changed geographic location of their work setting, the tables represent only PAs who stayed in the same general geographic area.  For this purpose, we defined location in terms of Metropolitan Statistical Areas (MSA) as designated by the US Census Bureau.  This classification represents whether or not the PA worked in an urban area (MSA) or in a rural area (non-MSA).

Mean Percent Change in Total Inflation-Adjusted Income from Primary Employer for PAs who Remained in the Same Specialty by Years of Experience, Hospital Employment, and Location (MSA/Non-MSA), 1997-1998
  Stayed in Hospital Stayed in Non-Hospital Changed from Hospital to Non-Hospital Changed from Non-Hospital to Hospital Total
 
N
% Change
N
% Change
N
% Change
N
% Change
N
% Change

Total
1240
2%
3386
1%
269
3%
172
2%
5067
2%

Stayed in Primary Care

328
3%
2029
1%
170
2%
70
2%
2597
2%
Stayed in MSA
1 to 3 Years
29
6%
207
3%
14
5%
3
*
253
4%
4 to 6 Years
49
7%
282
2%
18
8%
9
3%
358
3%
7 to 9 Years
28
0%
148
2%
8
2%
5
-2%
189
2%
10 to 14 Years
44
2%
233
0%
12
-2%
9
18%
298
1%
15 Years Or Greater
97
2%
529
0%
31
4%
12
-1%
669
0%
Stayed in Non-MSA
1 to 3 Years
8
9%
83
5%
7
6%
4
*
102
5%
4 to 6 Years
14
9%
112
1%
18
0%
5
9%
149
2%
7 to 9 Years
8
-2%
60
2%
10
-2%
2
*
80
1%
10 to 14 Years
13
-1%
91
2%
10
-2%
4
*
118
1%
15 Years or Greater
37
3%
273
1%
41
-1%
17
-2%
368
1%
Stayed in Non-PC
912
2%
1357
1%
99
5%
102
2%
2470
2%
Stayed in MSA
1 to 3 Years
85
3%
99
4%
5
11%
5
6%
194
4%
4 to 6 Years
126
3%
203
3%
11
9%
21
0%
361
3%
7 to 9 Years
101
3%
154
1%
12
7%
13
1%
280
2%
10 to 14 Years
183
2%
250
1%
21
5%
14
-5%
468
1%
15 Years Or Greater
315
1%
448
1%
32
3%
34
4%
829
1%
Stayed in Non-MSA
1 to 3 Years
5
-2%
21
3%
.
2
*
28
2%
4 to 6 Years
12
-3%
33
3%
3
*
2
*
50
2%
7 to 9 Years
9
-5%
16
1%
3
*
.
28
0%
10 to 14 Years
17
4%
43
0%
4
*
4
*
68
3%
15 Years or Greater
51
0%
84
0%
8
-1%
7
-7%
150
0%
*Figures not reported for categories with less than 5 respondents

Mean Percent Change in Total Inflation-Adjusted Income from Primary Employer for PAs who Remained in the Same Specialty by Years of Experience, Hospital Employment, and Location (MSA/Non-MSA), 1998-1999

  Stayed in Hospital Stayed in Non-Hospital Changed from Hospital to Non-Hospital Changed from Non-Hospital to Hospital Total
 
N
% Change
N
% Change
N
% Change
N
% Change
N
% Change

Total
1132
5%
3349
4%
178
8%
176
4%
4835
5%

Stayed in Primary Care

317
5%
2044
5%
83
10%
82
4%
2526
5%
Stayed in MSA
1 to 3 Years
36
12%
230
7%
9
14%
7
2%
282
8%
4 to 6 Years
55
7%
309
4%
18
9%
9
-2%
391
4%
7 to 9 Years
27
3%
136
4%
5
9%
5
4%
173
4%
10 to 14 Years
34
3%
202
4%
5
3%
4
*
245
3%
15 Years Or Greater
88
4%
510
4%
14
26%
20
4%
632
4%
Stayed in Non-MSA
1 to 3 Years
13
5%
96
8%
5
8%
3
*
117
8%
4 to 6 Years
15
3%
142
7%
6
-3%
10
2%
173
6%
7 to 9 Years
8
-2%
57
5%
2
*
1
*
68
4%
10 to 14 Years
10
4%
73
2%
4
*
6
6%
93
2%
15 Years or Greater
29
3%
279
6%
15
5%
16
7%
339
5%
Stayed in Non-PC
815
5%
1305
4%
95
7%
94
4%
2309
5%
Stayed in MSA
1 to 3 Years
99
8%
135
6%
18
11%
17
7%
269
7%
4 to 6 Years
110
6%
183
5%
16
7%