Publishing Award

Alison C. Essary, DHSc, MHPE, PA-C

Ask a typical patient how much he or she thinks their primary care doctor makes in annual salary and the response will likely be along the lines of, “A lot.” Ask the same question about a primary care PA and the response might be something to the effect of, “Not as much as the physician.”

The patient is generally correct. But by taking a comprehensive look at training costs and salary potential of each profession over a lifetime, the net earnings gap between physicians and PAs—specifically those who are female—is surprisingly narrow.

A team of PAs and PhDs at Arizona State University recently determined that gap to be approximately $250,000 more in lifetime earnings for the female physician than the female PA. Though the difference is seemingly significant, the findings show that the PA still nets a very healthy income by comparison.

Study Aims to Highlight Career Opportunities

Results from the study were published in the 2016 paper, “Women, Family Medicine, and Career Choice: an Opportunity Cost Analysis,” which has earned AAPA’s 2017 Publishing Award.

The ultimate goal of the study was to help shine a light on the career opportunities for women in family medicine, said the paper’s lead author, Alison Essary, DHSc, MHPE, PA-C, director of strategic academic initiatives for the College of Health Solutions at Arizona State University, and clinical associate professor and associate director for its School for the Science of Health Care Delivery.

“There were periods when it seemed a little overwhelming, and we began to wonder if it was going to be worth it in the end,” Essary said of the study, which took nearly a year and a half to complete. “But because the majority of PAs are women, it’s very important to show the real value for those who work in this specialty, in addition to the value they bring to their patients.”

The study shows the “net present value” (NPV or total earnings minus training costs) for a female primary care physician to be slightly more than $2 million by the end of her career, compared to about $1,750,000 for a female primary care PA.

Both Good Investments

A primary care physician’s NPV is certainly higher, “but both are very good investments, and $1.75 million is impressive, particularly given the length of training” Essary said.

The paper begins by highlighting the progression of women healthcare providers. Essary specifically notes the need for more female providers in rural and underserved settings because of the unique qualities they bring to any practice.

One of the more attractive features of becoming a PA is career mobility and the added value of that versatility, notes one of the paper’s co-authors Bettie Coplan, MPAS, PA-C, clinical associate professor in the School for the Science of Health Care Delivery at Arizona State University.

“That ability to switch specialties is a big advantage that PAs have over physicians,” Coplan said. “We looked at a wide variety of scenarios of a PA changing specialties, and our results showed that in many of those cases, the impact was so great that becoming a PA might still be the better investment for some providers.”

Neither Essary nor Coplan was especially surprised to find that the physicians in the study made more over time. However, both were intrigued by how close the total values were, and they knew their findings would be of value to any woman thinking about a career in healthcare.

“Primary care is where it all began for the PA profession,” Essary said. “So it would be a hidden benefit of this study if we were able to inspire more PAs to return to their family-medicine roots.”

AAPA 2017 Award Recipients