Areas of Practice Guide

The Areas of Practice Guide is a collection of tools and resources from AAPA and its partners to help PAs make the most of their careers, whether they are just starting out or are seeking to make a career transition.

Read more about PA career flexibility and changing specialties.

Use the drop-down menu to navigate among specialties and career tracks.

More Areas of Practice Coming Soon! Urgent Care, Internal Medicine, Dermatology, Hospital Medicine, and Education.

Overview

Administration Overview

As administrators, PAs are on the front lines of leading a changing healthcare landscape as well as contributing to a more collaborative, team-based system. PAs in Administration utilize leadership and management competencies above and beyond their clinical skill set to positively impact patient care. They are aspiring or current experts in the business of medicine, clinical quality, compliance, staffing, and revenue cycle management.

In the 2018 AAPA Salary Survey, 1.2% of PAs reported that their primary role was administrator or manager. According to the 2018 PA and NP Workplace Experiences National Summary Report from CHLM, 17% of PAs and NPs surveyed reported they were in a formal leadership role at their place of employment and 27% were in an informal leadership role. The 2020 AAPA Salary Survey did not break out administration as a role but included PAs in administration as respondents who are not in clinical practice.

Prior to COVID-19, 13.8% of PAs in administration reported practicing telemedicine at least some amount of time. More information on how this has changed during the pandemic is coming soon.

Compensation

Median compensation in 2019 among PAs in administration was $140,000. This includes all forms of base compensation, including base salary, annualized hourly wage, and base compensation based on productivity. It does not include bonus. Among PAs in administration, 52.1% received a bonus, and of PAs who reported receiving one, the median bonus was $10,000.

For customized information on compensation by state, specialty, work setting, and years of experience, in addition to benefits, please check out the interactive AAPA Salary Report.

Emergency Medicine Overview

According to the 2020 AAPA Salary Report, 9.3% of PAs practice in emergency medicine, making it the third most popular specialty for PAs.

According to the 2020 AAPA Salary Report, PAs who practice emergency medicine as their major specialty area earned more than PAs in other major specialty areas ($124,100) although some surgical subspecialties are paid far more than emergency medicine.

Prior to COVID-19, 18.8% of PAs in emergency medicine reported practicing telemedicine at least some amount of time. More information on how this has changed during the pandemic is coming soon.

Compensation

Median compensation in 2019 among PAs in emergency medicine was $124,100. This includes all forms of base compensation, including base salary, annualized hourly wage, and base compensation based on productivity. It does not include bonus. Among PAs in emergency medicine, 54.9% received a bonus, and of PAs who reported receiving one, the median bonus was $8,000.

For customized information on compensation by state, specialty, work setting, and years of experience, in addition to benefits, please check out the interactive AAPA Salary Report.

Family Medicine Overview

According to the 2020 AAPA Salary Report, 14.1% of PAs practice in family medicine, making it the most popular specialty for PAs.

While family medicine is the most popular specialty for PAs, primary care (defined as family medicine, general internal medicine, and general pediatrics) is the lowest-paid major specialty area ($105,000) according to the 2020 AAPA Salary Report. The median compensation for PAs in all specialties in 2019 was $111,000.

Prior to COVID-19, 11.9% of PAs in family medicine reported practicing telemedicine at least some amount of time. More information on how this has changed during the pandemic is coming soon.

Compensation

Median compensation in 2019 among PAs in family medicine was $105,000. This includes all forms of base compensation, including base salary, annualized hourly wage, and base compensation based on productivity. It does not include bonus. Among PAs in family medicine, 53% received a bonus, and of PAs who reported receiving one, the median bonus was $7,000.

For customized information on compensation by state, specialty, work setting, and years of experience, in addition to benefits, please check out the interactive AAPA Salary Report.

Rewards & Challenges

The rewards of practicing family medicine include providing comprehensive care to the same patients over time, developing relationships with patients and their families, addressing a wide range of conditions, emphasizing prevention, providing continuity of care, maintaining skills and learning new ones, teaching and sharing knowledge, and learning and growing.

The many and deep rewards of family medicine must be balanced against the challenges, which include workload and time pressures; overhead and income inequities; difficulty accessing specialists, procedures, tests, and other resources; paperwork, telephone calls, and forms; maintaining and acquiring skills and knowledge; patients’ expectations; and liability fears.

Despite the challenges, over the 50-plus years of the profession, family medicine has always been – and still remains – the most frequently chosen specialty among PAs.

Orthopaedic Surgery Overview

According to the 2020 AAPA Salary Report, 11.1% of PAs practice in orthopaedic surgery, making it the second most popular specialty for PAs, behind family medicine. PAs in orthopaedic surgery provide medical care, including procedures such as joint injections and fracture care; assist in surgery; cover call; round on hospital inpatients, and provide musculoskeletal care in emergency departments and urgent care centers.

Orthopaedic surgery is by far the largest surgical specialty for PAs. According to the 2020 AAPA Salary Report, 11.1% of PAs practice in orthopaedic surgery. Whether practicing with highly specialized or general orthopaedic surgeons, PAs provide a range of evaluation and management medical services and procedures, including joint and trigger point injections, wound debridement and closure, tendon repair, and fracture management. Many assist in surgery. In the hospital, PAs conduct rounds, write orders, take calls for inpatient consults and the emergency department, help formulate and implement therapeutic treatment plans, and perform discharge duties.

Prior to COVID-19, 3.6% of PAs in orthopaedic surgery reported practicing telemedicine at least some amount of time. More information on how this has changed during the pandemic is coming soon.

Compensation

Median compensation in 2019 among PAs in orthopaedic surgery was $112,500. This includes all forms of base compensation, including base salary, annualized hourly wage, and base compensation based on productivity. It does not include bonus. Among PAs in orthopaedic surgery, 58.5% received a bonus, and of PAs who reported receiving one, the median bonus was $8,000.

For customized information on compensation by state, specialty, work setting, and years of experience, in addition to benefits, please check out the interactive AAPA Salary Report.

Education and CME

Education and CME

2021 Executive Leadership Tuesdays

2021 Executive Leadership Tuesdays is a series of 5 webinars that will provide timely information to help you stay up-to-speed on the ever-changing healthcare environment and improve your healthcare leadership competencies. Experience the interactive webinars from the comfort of your home while engaging with expert faculty.

Evaluation and Management Services in 2021

A new code structure for new and established outpatient E/M services is in effect beginning January 1, 2021. The new structure relies on medical decision-making or time for proper code selection. This activity explores the… more

Degree Pathways

Is your goal to earn an advanced healthcare degree or certificate? This program offers a soft entrance into pursuing an academic degree/certificate by completing pre-requisite coursework specific to PA and NP practice.

Virtual Care Now! Design Thinking for Transformative Care

This activity explores the fundamental concepts and terminology in the practice of virtual medicine, as well as key insights differentiating successful practices and programs from the rest of the field. Plus, this activity serves as… more

Building Your Leadership Skills to Take a Seat at the Table

This course covers various leadership pathways. The goal is to provide learning opportunities in building leadership skills and teams as well as speak to diversity challenges. Leadership models must be flexible but sustainable. This course… more

The AAPA Healthcare Leadership and Management on Demand 2019

With AAPA’s Healthcare Leadership and Management on Demand 2019, earn 6 AAPA Category 1 CME credits as you explore topics like the top three PA leadership strategies, managing successful teams, and more.

Reimbursement & Regulatory Policies for PAs and NPs

PAs and NPs have always been at the forefront of the healthcare delivery by increasing patient access to care, improving care coordination and driving quality outcomes. This tutorial will help PAs and NPs better understand… more

PA/NP Workforce: Trends & Impact

This course will encourage the learner to identify the four main areas where PAs and NPs can have an impact on an organization’s strategy. Those four categories include Patients, Finance, Providers and Risk. The course… more

Evaluating Your PA/NP Workforce: 6 Essential Elements

This course examines the six essential elements to evaluating an organization’s PA/NP workforce. Identifying how the growth of the PA/NP professions is attributable to several national trends as well as unraveling potential artificial barriers to… more

EHRs: Regulations, Opportunities & Risks for Clinicians and Healthcare Leaders

Health information technology and electronic health records (EHRs) are increasingly important to healthcare delivery and practice management. This activity will review the significance and potential benefits of EHRs to patients, clinicians, and healthcare leaders.

Critical Factors of Clinical Leadership for APPs

Using tested leadership models, this course offers vital skills for PAs and NPs to flourish as healthcare leaders, both in direct patient care and leading healthcare teams. The three topics of power/influence, followership, and leading… more

Becoming the Self-Aware Self-Advocate

Contracts, negotiations, promotions or job changes, your professional life isn’t just about patient care. In this course, we will guide you through how to find your voice in salary and position negotiations, navigate the waters… more

Building Leadership Opportunities at Your Institution

This session aims to address the answers to four primary questions you should ask when thinking about building leadership opportunities at your institution. Why build them? How are they defined? What is the building process?… more

Incorporating PAs and NPs into Organizational Strategy for Maximum Impact

This webinar outlines how best to incorporate PAs and NPs into your organizational strategy.

Leadership on Demand

Access recorded leadership sessions from AAPA’s live events and webinars. Choose sessions and bundles from the popular Executive Leadership Conference, AAPA Conference, and more.

AAPA Primary Care RAP Podcast

The lively pulse of Primary Care (with a PA spin) in an entertaining, monthly podcast.

We Are Family (Medicine) on Demand 2021

Family Medicine on Demand 2021 includes recorded sessions from the 2021 We Are Family (Medicine) virtual conference. This video-based CME activity offers up to 36.0 AAPA Category 1 CME credits from ocular pathology, to infectious… more

Telemedicine CME Series

These activities explore the fundamental concepts and terminology in the practice of virtual medicine, provide a comprehensive overview of the CMS telehealth guideline updates, highlight a detailed outline of the documentation and coding requirements for… more

PAIN COACH—Pain Assessments and INterventions to Consider in Older Adult Care for Healthcare Providers

By listening to these podcasts, you can learn how to reduce serious adverse outcomes resulting from inappropriate prescribing, misuse, and abuse of opioid analgesics, while managing chronic pain in older adults.

Satellite Symposium 2020: Focus on Flu with an Eye on Treatment

Although the impact of influenza varies, it places a substantial burden on the health of people in the United States each year. PAs, NPs, primary care physicians, and other healthcare professionals can identify and help… more

Smiles for Life: A National Oral Health Curriculum

Smiles for Life is the nation’s only comprehensive oral health curriculum. It is designed to enhance the role of primary care clinicians in the promotion of oral health for all age groups through interactive online… more

Primary Care Obesity Management Certificate Program

AAPA has collaborated with the world’s leading organization on obesity management, The Obesity Society, and an award-winning educational partner, Integrated Learning Partners, to develop the 2020-2021 Obesity Management in Primary Care Certificate Program designed for PAs and NPs.

2021 Musculoskeletal Galaxy: Virtual

The Musculoskeletal Galaxy is going virtual in 2021! Learn critical orthopaedic topics from expert faculty at this popular conference! This course is designed to offer PAs and NPs a well-rounded foundation on the essential orthopaedic topics. It’s the perfect course if you are new to orthopaedics, or if you are a family practice, emergency medicine, or urgent care provider who sees musculoskeletal conditions in your daily practice. Registration is now open!

Building Pathways in Pain Management: Advancing the Future of Chronic Pain Management

Chronic pain is an under-recognized and under-resourced public health problem with devastating impact. In the United States, chronic pain represents more years lost to disability than cancer, heart attacks, and diabetes combined. Chronic low back… more

PAOS On Demand

Physician Assistants in Orthopaedic Surgery (PAOS) on Demand includes topics on shoulders, hips, knees, spine, osteoporosis, MRI, surgical techniques and more, all on demand. This is the perfect course for advanced knowledge on the diagnosis and management of many musculoskeletal conditions.

Galaxy on Demand

Galaxy on Demand offers up to 21.5 AAPA Category 1 CME credits, from musculoskeletal infections to orthopaedic rehabilitation techniques and more, all on demand. This is the perfect course if you are new to orthopaedics or want to transition into it.

AAPA Emergency Medicine Self-Assessment

Get quick feedback on your Emergency Medicine knowledge with test questions – organized by organ system and task dimension and accessible from any device or computer. Reinforce your know-how with a detailed assessment report and extensive resource of correct answers and explanations.

Clinical Dialogue: Current Evidence and Controversies in COVID-19: Discussion on Best Practices Amid Changing Evidence

With the current COVID-19 pandemic, clinicians are placed in a difficult position of staying abreast of the ever-changing landscape of complexities that this virus presents. To support PAs’ understanding of COVID-19, this activity provides an… more

Rapid Response: The Approach to the Acutely Ill Patient

PAs are faced with acutely ill patients on a regular basis whether working in the ED, inpatient, or outpatient settings. The ability to evaluate and make immediate management decisions is crucial. This session develops a… more

Empathetics Bundle

Gain knowledge on how to improve the patient and clinician experience and earn up 4 AAPA Category 1 CME credits. Empathetics self-paced online courses are based on extensive and novel clinical research conducted at Massachusetts… more

Emerging Drugs of Misuse and their Public Health Implications

This activity covers some emerging drugs of misuse and their public health implications. Substance use, misuse, and abuse has become a leading public health topic in the U.S. The American Public Health Association estimates that… more

Resources

Resources

Productivity Articles

Learn about PA productivity and value, and explore ways to measure PA contribution.

Reimbursement

Read the latest news and resources on reimbursement, compiled by the AAPA advocacy team.

Business Ownership and Independent Contracting

Decide whether ownership or working for yourself is right for you.

Essential Nutrition Concepts

If you’d like to offer more in-depth nutritional counseling to your patients, start with this free, AAPA-approved curriculum developed in partnership with The France Foundation and supported by Abbott Nutrition. Learn evidence-based guidance from PAs with nutrition expertise on topics like assessing a patient’s nutritional status, offering nutritional counseling, and developing a nutrition plan.

Obesity Leadership Edge

Overweight and obesity compose a chronic disease of epidemic proportions that presents on a continuum, likely affecting nearly two out of every three patients treated by PAs. The effective treatment of overweight and obesity requires an efficient and timely process of screening, diagnosis, evaluation of complications, staging, and clear algorithmic management.

Diabetes Leadership Edge

According to the CDC, more than 34 million Americans have diabetes and another 88 million have pre-diabetes. The progressive nature of diabetes and its relationship to other serious conditions like cardiovascular disease and kidney disease make it a priority for PAs and other providers. AAPA’s Diabetes Leadership Edge curriculum will help you stay up to date on diabetes care.

PAs and Team Practice

A summary of PAs in team-oriented care models.

PAs and Practice Ownership

A summary of opportunities and challenges for PAs interested in practice ownership.

Evaluating and Certifying Health Status

Issue brief on PAs and their ability to certify the health status of individuals.

PAs and Buprenorphine in Opioid Treatment Programs

A summary of rules regarding buprenorphine in opioid treatment as they relate to PAs.

PA Prescribing

An AAPA Issue Brief describing all aspects of prescribing by PAs, including prescribing controlled medications.

Chart Cosignature: What Is Best for Patient Care?

Issue brief regarding how chart cosignature is being re-evaluated now.

PA Training and Skills to Work with Survivors of Sexual Violence

Sexual violence affects every demographic and every community, making this a serious public health concern. PAs can improve their ability to treat all survivors of sexual violence through continuing education and in adjusting practice habits to ask patients at every visit about their sexual health and safety.

Insights into the Primary Care PA Experience During COVID-19: 6 Months In

The results from the August 2020 PA Practice Survey illustrate the status of primary care PAs six months into the COVID-19 pandemic.

PAs in Orthopaedic Surgery

AAPA Issue Brief on PAs in Orthopaedic Surgery.

PAs and OPAs: The Distinctions

Issue brief on physician assistants (PAs) in orthopaedics and “orthopaedic physician’s assistants” (OPAs).

PA Prescribing

An AAPA Issue Brief describing all aspects of prescribing by PAs, including prescribing controlled medications.

Chart Cosignature: What Is Best for Patient Care?

Issue brief regarding how chart cosignature is being re-evaluated now.

PAs in Emergency Medicine

Issue brief on PAs in Emergency Medicine.

EMTALA and PAs

A summary of PA roles and responsibilities related to the Emergency Medical Treatment and Labor Act, including medical screening exams, certifying false labor, emergency department call, and transferring patients.

Evaluating and Certifying Health Status

Issue brief on PAs and their ability to certify the health status of individuals.

PAs and Buprenorphine in Opioid Treatment Programs

A summary of rules regarding buprenorphine in opioid treatment as they relate to PAs.

PA Prescribing

An AAPA Issue Brief describing all aspects of prescribing by PAs, including prescribing controlled medications.

Chart Cosignature: What Is Best for Patient Care?

Issue brief regarding how chart cosignature is being re-evaluated now.

PA Training and Skills to Work with Survivors of Sexual Violence

Sexual violence affects every demographic and every community, making this a serious public health concern. PAs can improve their ability to treat all survivors of sexual violence through continuing education and in adjusting practice habits to ask patients at every visit about their sexual health and safety.

Articles

Articles

Q&A with PA Leader Clair Kuriakose

Clair Kuriakose, MBA, PA-C, is a high achiever. She sets goals for herself, achieves them, and then strategically lays out her next steps. She finished PA school, got her MBA and Lean Six Sigma certification, and now leads advanced practice providers at Stanford Health Care.

Two PAs talking

Quantifying PA Productivity Can be Challenging

Measuring productivity in healthcare is important to determine contribution to care, revenue generation, and job performance; however, accurate measurement of a health professional’s productivity can be challenging. PAs are acutely affected when productivity measurements are quantified by financial contribution alone.

The winners of the CHLM Employer of Excellence award

Learn About Best APP Models From These Employers

How do you recruit and retain the best PA talent at your workplace? Among those with excellent hiring potential are PA employers that have advanced practice provider (APP) structures formed to offer management and leadership opportunities for PAs and NPs.

Josanne Pagel headshot

Long-Time PA Leader Josanne Pagel Shares Motivations and Career Journey

Josanne Pagel, MPAS, PA-C, DFAAPA, AAPA past president, recently shared her thoughts about her career journey with AAPA’s Andrea Lowe, MHA, PA-C. Pagel reflects on everything from her days in the Peace Corps to her current role at the Cleveland Clinic.

PA pointing at a computer in front of another PA

3 Ways PAs Can Advance Their Careers Through Leadership

For PAs looking to grow in their careers, there are also many opportunities to become a true leader in your field — either directly or through thought leadership. Here are three ways to advance in your career and become a leader.

PAs, sitting at a table, having a discussion

Experts Discuss Impacts of PA/NP Onboarding on Organizational Finances

The American College of Healthcare Executives recently hosted a webinar – How PA/NP Onboarding Impacts Organizational Finances – to share best recruitment, onboarding, retention, and financial practices with participants. Here is a recap of key takeaways.

Three PAs walking down a hallway

Help Your Employer Recognize the Power of the PA Workforce

Not all PAs are lucky enough to work at an organization that fully recognizes all the ways in which PAs contribute to the healthcare continuum. You can help your employer recognize the power of the PA workforce and fully utilize advanced practice providers (APPs), including PAs, across their organizations.

CHLM/ACHE Leadership Institute image

Grow Your Hospital Career with FACHE Credential

For PAs interested in transitioning from clinical leader to executive within a hospital or healthcare organization, consider the American College of Healthcare Executives (ACHE) and Center for Healthcare Leadership and Management (CHLM) Leadership Institute.

The winners of the CHLM Employer of Excellence award

How to Build an APP Leadership Career Pathway in Your Organization

What do Employers of Excellence have in common? Pathways for APPs to excel, including formal leadership training, a structured career pathway, and APP councils. These help to create positive environments that seek input and opportunities for improvement.

PAs walking and talking

Survey Uncovers Ways Employers Can Enhance the PA Workplace

CHLM’s 2018 PA and NP Workplace Experiences National Summary Report offers insight to help employers enhance the working environment for PAs and NPs, focusing on recruitment and retention, onboarding, clinical utilization, leadership structure, billing and reimbursement, and productivity reporting.

PA sitting at her desk, smiling

Looking for a Non-Clinical Role? Consider Medical or Clinical Science Liaison

PAs who serve as medical and clinical science liaisons play a unique role in pharmaceutical and other medical organizations. They use their clinical skills to interpret clinical trials, medications’ chemical composition, safety matters, and help to educate clinicians.

Two PAs talking

Bianca Belcher: 4 Things to Know About Becoming a Leader

Executive Director of Clinical Integration, Bianca Belcher, MPH, PA-C, talks about how she has transitioned from clinician to a senior leadership role. Her advice to future leaders: Get involved, communicate effectively, work hard, see the big picture, and network.

DeTroye laughing while accepting her EOE award alongside two others

How to Find Your Voice at the Leadership Table

Looking for ways to ensure that your voice is heard at the leadership table? Alisha T. DeTroye, MMS, PA-C, DFAAPA, director of PA Services at Wake Forest Baptist Health and president-elect of North Carolina Academy of PAs, shares her tips.

PA Krisi Gindlesperger’s Path to Leadership

How a PA climbed the leadership ladder, learned the business of medicine, and became a major player in the industry – Krisi Gindlesperger’s inspiring PA career path. Learn more about CHLM’s programs for PA leaders.

PAs in Administration: Higher Salaries and Job Satisfaction

PAs in management and administration tend to be paid more, have access to leadership training and an identified career path, and are more satisfied with their employers.

Early-Career PAs Share Leadership Advice

At AAPA’s 2018 Leadership and Advocacy Summit, four PA panelists spoke passionately about the value of leadership for young PAs and the need to make leadership an early-career priority.

From PA to President: David Claeys’s Career Trajectory

David Claeys, PA-C, served in many different hospital roles before his October 2017 appointment as president of Beaumont Health, Dearborn, a 632-bed hospital.

PAs in Administration

For Sheri A. Shebairo, MBA, PA-C, getting to the bottom of an issue has been a driving force throughout her professional life. Her first career was as a television news reporter in New York, but she always knew she wanted to have a more personal impact on the lives of others.

JAAPA Articles on Administration

Read articles on administration in JAAPA, the peer-reviewed clinical journal of AAPA, published for more than 25 years.

Kris Pyles-Sweet, MS, PA-C; Travis Randolph, PA-C; Emily WhiteHorse, Ph.D., PA-C; Melissa Ricker, PA-C

Insider Tips on Popular PA Specialties

PAs know that career flexibility is a built-in benefit of the profession. But it can be overwhelming to think about transitioning specialties. Do you have enough experience? What’s the best way to get your foot in the door? Four experts share their insights.

Horses on the street in Wheeler County

Frontier Medicine: One County, One PA

Amanda Roy, PA-C, is the only healthcare provider for all of Wheeler County, Oregon. She discusses what she finds rewarding about frontier medicine, the significance of precepting in her career, and what it means to her that her patients trust her so much.

Rural field

Country Living: Working as a PA in Rural Healthcare

Things are different in the country, and healthcare is no exception. PAs who leave the big city to work in the country are in for a unique and rewarding experience. Here’s what a few PAs had to say about working in a rural setting.

Sharmila Sewell performing a medication reconciliation in her patient's home

PAs Help Close Gaps in Care Through House Calls

As an in-home healthcare provider, Sarah Kaplan, PA-C, is among a rapidly growing number of medical professionals who are revitalizing the once-common practice of bringing urgent and primary care services directly into the homes of their patients.

Brittany Hager and Kathryn LaFleur smiling

A Primary Care PA Answers Your Most Pressing Questions

Kasey Brundidge, a primary care PA, sets the record straight on PA students’ most pressing practice questions. Here, she addresses the wide range of medical knowledge needed, patient volume, burnout, salary, and schedule questions.

A Day in the Life of a PA in Primary Care

I’ve been working in family medicine for two years now. Some things we do every day may seem routine, but there is nothing ordinary about how we care for our patients. Here is a recent day at my practice.

JAAPA Articles on Family Medicine

Read articles on family medicine in JAAPA, the peer-reviewed clinical journal of AAPA, published for more than 25 years.

Kris Pyles-Sweet, MS, PA-C; Travis Randolph, PA-C; Emily WhiteHorse, Ph.D., PA-C; Melissa Ricker, PA-C

Insider Tips on Popular PA Specialties

PAs know that career flexibility is a built-in benefit of the profession. But it can be overwhelming to think about transitioning specialties. Do you have enough experience? What’s the best way to get your foot in the door? Four experts share their insights.

Alyssa Zantello

PAs on the Front Lines: Alyssa Zantello Helps New York City During COVID-19

As the COVID-19 surge began in the U.S., Alyssa Zantello, PA-C, who practices orthopaedics in Michigan, found she couldn’t sit at home and do nothing. Forty eight hours after a conversation with her mentor, she was on a plane to New York City.

A Career in Orthopaedics: Why I Love the Specialty

Almas Abbas, PA-C, grew up playing sports – and getting injured. Her on-field experiences inspired an early interest in how the body works and how best to treat herself, and eventually led to a career as a PA in orthopaedics.

Dana Urban with her classmates

PA Inspires Patient to Follow in her Footsteps

Dana Urban has known she’s wanted to be a PA since she was 12 years old. In 2005, she met Amanda Asaro, MPAS, PA-C, who was part of her healthcare team. Asaro’s compassion, kindness, and care made a lasting impact on her patient.

Dan Acevedo pointing at a patient's x-ray

A Week in the Life of a PA in Orthopaedics

Daniel Acevedo, a PA in orthopaedics at OrthoVirginia in Lynchburg, Virginia, sees a lot in a typical week: five to seven surgeries, hospital consultations, hip fracture clinics, post-op patients, outpatient procedures at an ambulatory surgery center, and more.

A Day in the Life of a PA in Orthopaedic Surgery

I enjoy being a physician assistant because my work is challenging, yet very rewarding. I am able to practice medicine within a multidisciplinary team where I consult with my supervising physicians daily. Here’s what a recent day was like for me.

JAAPA Articles on Orthopaedic Surgery

Read articles on orthpaedic surgery in in JAAPA, the peer-reviewed clinical journal of AAPA, published for more than 25 years.

D.C. PA Helps Create Better PPE for Airway Procedures

When COVID-19 hit Washington, D.C., emergency medicine PA Amy Keim observed that the plastic drapes being used to decrease aerosolized particles during airway procedures weren’t cutting it. So she set out to make something better: the Airway Procedure Tent.

Katherine Thompson

How PAs Can Provide Compassionate Care to Survivors of Interpersonal Violence

AAPA enlisted Katherine Thompson, PA-C, a practicing PA in emergency medicine and urgent care for four years, to respond to Huddle’s Ask Me on interpersonal violence (IPV) and forensic medicine. Read her advice on how healthcare providers can identify and manage IPV survivors.

Nicole Dettmann

2020 PA of the Year Has Volunteered in Bolivia for More Than 20 Years

Nicole Dettmann, DSc, MPH, PA-C, is AAPA’s 2020 PA of the Year. Dettmann works in the emergency department at Newton Wellesley in Massachusetts and has volunteered with the Foundación de Salud del Rio Beni in Bolivia for more than 20 years.

Johnnie Gilpen in 1996 stationed in Tunisia

How a Helicopter Crew Chief and Bioterrorism Expert Ended Up a PA

Johnnie Gilpen, PA-C, had a long and varied career by the time he was accepted to the University of Oklahoma Health Sciences Center PA program in 2017. His unique career path led him to where he is today: an emergency medicine PA and an involved leader.

PA Jiselle Del Cid examining a patient

PAs Respond in El Paso Shooting Aftermath

Two PAs with Envision Physician Services responded within minutes to the shooting at a Walmart store in El Paso, Texas. “It was like a war zone…The moment all of them came in, it’s like a gear in my head turned.”

Vituity Emergency Medicine PA Fellows

A Day or Night in the Life of an Emergency Medicine Fellow

Stephen Lewia, PA-C, has spent the past few months as a Vituity Emergency Medicine PA Fellow at Arrowhead Medical Center in Colton, California. He shares his insights about the experience and about balancing life with being a new PA.

Dave Sander with a couple members of his DMAT and a Customs and Border Protection Special Unit officer talking to a local in Puerto Rico

How PAs Can Use Their Skills in Disaster Medicine

Interested in using your skills to help communities in need after a disaster? Four PAs offer their best advice for getting involved, from participating in trainings and minimizing harm to being patient throughout the process.

Erin Stutz headshot

A Day in the Life of a PA in a Medical ICU

Erin Stutz, PA-C, works in pulmonary critical care in the medical ICU at the University of Rochester Medical Center (URMC). She shares what her days are like, and why the upcoming Adult Hospital Medicine Boot Camp is worth your time.

Hospital ER PA and MD Make Three Changes to Improve Teamwork

PA and MD will talk at CHLM’s Executive Leadership Conference about the three changes they have made in the ER to collaborate as a team to better serve patients.

How to Help Provide Emergency Disaster Services

Most PAs don’t hesitate to use their skills and training to help others in need. Have you wondered how to help people before, during, and after natural disasters? Here are some things you need to know.

What You Always Wanted to Know About EMPAs, But Were Afraid to Ask

In this article written for the American College of Osteopathic Emergency Physicians, the Society of Emergency Medicine Physician Assistants (SEMPA) provides a brief history of emergency medicine PAs (EMPA), gives a primer on PA training and discusses EMPA onboarding and utilization.

JAAPA Articles on Emergency Medicine

Read articles on emergency medicine in JAAPA, the peer-reviewed clinical journal of AAPA, published for more than 25 years.

Networking and Jobs

Networking and Jobs

Job Opportunities in Administration

Search for current jobs on PA JobSource. Filter by location, job function, experience level and more.

Job Opportunities in Family Medicine

Search for current jobs on PA JobSource. Filter by location, job function, experience level and more.

Job Opportunities in Emergency Medicine

Search for current jobs on PA JobSource. Filter by location, job function, experience level and more.

Job Opportunities in Orthopaedic Surgery

Search for current jobs on PA JobSource. Filter by location, job function, experience level and more.

Connect with PAs in Administration on Huddle

Find PAs and PA students by location, specialty, PA program and more using the advanced search function on Huddle, AAPA’s members-only community.

Mentor Match Volunteers: Mentors Needed!

Explore Mentor Match in Huddle and find a PA student or new PA who could use your professional and valuable advice.

AAPA Conference 2021

Unite with your peers at AAPA 2021 and remember the reason you became a PA. Registration is now open!

Connect with Family Medicine PAs on Huddle

Find PAs and PA students by location, specialty, PA program and more using the advanced search function on Huddle, AAPA’s members-only community.

Mentor Match Volunteers: Mentors Needed!

Explore Mentor Match in Huddle and find a PA student or new PA who could use your professional and valuable advice.

AAPA Conference 2021

Unite with your peers at AAPA 2021 and remember the reason you became a PA. Registration is now open!

Connect with Orthopaedic Surgery PAs on Huddle

Find PAs and PA students by location, specialty, PA program and more using the advanced search function on Huddle, AAPA’s members-only community.

Mentor Match Volunteers: Mentors Needed!

Explore Mentor Match in Huddle and find a PA student or new PA who could use your professional and valuable advice.

AAPA Conference 2021

Unite with your peers at AAPA 2021 and remember the reason you became a PA. Registration is now open!

Connect with Emergency Medicine PAs on Huddle

Find PAs and PA students by location, specialty, PA program and more using the advanced search function on Huddle, AAPA’s members-only community.

Mentor Match Volunteers: Mentors Needed!

Explore Mentor Match in Huddle and find a PA student or new PA who could use your professional and valuable advice.

AAPA Conference 2021

Unite with your peers at AAPA 2021 and remember the reason you became a PA. Registration is now open!

Words from the Field

Words from the Field

 

Making the Transition From a Clinical to an Administrative Role

I transitioned to an administrative role in our large healthcare system two years ago. I have a standard MHS, not an MHA or MBA. The transition was challenging. There was a steep learning curve, but I survived because of the unrelenting work ethic and leadership skills that are inherent to the PA profession. These characteristics make us natural choices for leadership and administrative positions.

 

Before the Degree, Think About Your Goals

If you are considering an additional degree, the type of degree you seek should depend on your planned trajectory. If you are trying to prepare yourself for an administrative position but do not have a particular focus in mind, an MBA or MHA would suffice. If your role will be in education (fellowship/residency director, CME coordinator, curriculum development, etc.), a D.Ed. may be more applicable.

 

Begin as a Volunteer

If you have any interest in healthcare administration, I strongly suggest that you volunteer for your state PA organization and then run for a board position. You’ll learn a lot about not only the business of medicine but the legislation and regulation of it. As a bonus, you will make some good friends in powerful positions!

 

Choose Your Field of Interest in Administration

What you do in the realm of “administration” can vary depending on your interest. There are administrative opportunities for clinicians with an interest in public health. I moved into a public health clinical consultant role and later a public health advisor role with the federal government. I was able to do this with my PA degree, although I am currently completing a doctoral degree in health sciences. My work largely involves health policy and programming for underserved populations. I lead a number of health focused programs (diabetes, oral health, adult immunizations, etc.) for my office and the department. There are opportunities if you are flexible.

 

Doors Are Opening for PAs

10 years ago, it was not easy for me to get into a leadership role as a PA. PAs didn’t have a formal leadership track back then. A lot has changed in the last 10 years, and healthcare has really evolved; the sheer number of PAs nationally (along with other advanced practice roles) has grown, and an increased number of leadership roles are becoming role agnostic. I am excited to see the doors open and look forward to seeing many more PA leaders make a meaningful impact in healthcare and healthcare delivery.

 

Building Long-Term Relationships

There is a lot of paperwork, emails, and phone calls but the reward of building a long-term relationship with your clients is worth it. It helps to remind myself to think about how I would want my family treated.

 

A Challenging and Highly Complex Specialty

Family Medicine is, in my not-so-humble opinion, one of the most difficult specialties in medicine. This “womb to tomb” care, encompassing knowledge of a wide range of acute and chronic conditions in all organ systems, along with behavioral medicine, preventive medicine, and care coordination of complex geriatric, post-transplant, mental health, and oncology patients, is also one of the most rewarding. Nearly every patient requires skilled motivational interviewing to achieve a health behavior change, and the therapeutic relationships that develop over time offer tremendous professional satisfaction.

Becoming comfortable with uncertainty, knowing when to apply the tincture of time, shared decision-making, and leveraging your resources are essential skills to learn early-on. It took me nearly 3 years of full-time experience being supervised by teaching family physicians and PAs to feel confident that I could independently determine the next best step for any patient who walked in the door, even when I had no idea what the diagnosis was. Differentials are endless; the one you didn’t consider will be the one you miss, with uncommon presentations of the common as the norm. The variety of conditions seen, unpredictability of each day, and constant challenge of chief complaints that don’t match chief concerns work to keep me on my toes and looking forward to tackling every shift. After 20 years of practice and teaching family medicine, I continue to value and utilize physician collaboration in delivering effective primary care to my own panel of patients.

 

Wearing Multiple Hats

Family practice clinicians must be part psychiatrist, social worker, pediatrician, gynecologist, geriatrician, dermatologist, orthopedic, pain management provider, ENT, urgent care, gastroenterologist, minor surgeons, insurance prior authorization paperwork specialist, and after hours emergency medication refiller, just to name a few.

The reward is the continuity of care and if you are lucky, you’ll see that 2-week-old baby into adulthood knowing you were part of keeping her healthy, along with her siblings and parents.

 

This Specialty Surprised Me

I never imagined going into primary care. It just didn’t seem as exciting as being in a specialty. I took the job in primary care due to good benefits and compensation straight out of school and thought I could get a good base knowledge of family practice and get a job elsewhere when it became available. In primary care, I am able to keep up on the latest changes in diabetes, hypertension, and other chronic illnesses that almost all specialties need to be aware of. Twelve years later, here I am, still doing primary care, and I couldn’t be happier. I feel that in primary care the sky is the limit.

 

Expect a Little of Everything

EM is a field that is general in scope. You have to know a little bit (or more) of every specialty. You perform a lot of procedures, it is fast paced, and can be high stress. It’s tough to prepare for and requires a lot of self-directed study while managing a full case load.

 

Before You Transition to Emergency Medicine

I loved EM from the start and my experience with pre-hospital care really paid off. I have worked everything from a Trauma Center to a Solo ER in a tiny rural hospital. How much responsibility you have will depend on the protocol and how experienced and comfortable the supervisors/hospitals are with PAs/NPs, as well as their particular needs. It would benefit you to speak with potential site staff prior to accepting a position, as well as shadowing.

It is best to get a couple years of IM or FP prior to taking an ER position. It provides the comfort of introducing yourself to the patient as their provider, and helps you develop a sense of what a sick patient really looks like. You will need both adult and peds experience for EM. You would also benefit from experience with orthopedics and surgery, but your clinical rotations might provide sufficiently for this. You should be skilled in reading X-rays, and have a speaking knowledge of CTs and US. Even if you don’t manage the complicated cases, the ability to convey to the specialist exactly what is wrong with your patient is critical.

 

Why I Chose an Emergency Medicine Fellowship

Before starting PA school, I practiced as a Nationally Registered Paramedic for ten years. Needless to say, Emergency Medicine (EM) was my specialty of choice very early in my PA journey. When applying for jobs during my clinical year, I began looking into formal postgraduate training as an alternative to a traditional first job.

I chose a fellowship for several reasons. First, I knew that I learn best in an academic setting. I wanted to learn EM through both hands-on and didactic education. To enable opportunities to acquire the broad knowledge needed to practice Emergency Medicine, EM fellowships commonly include non-EM rotations and training and I personally saw value in the variety of experiences I would gain while in an EM fellowship. Lastly, and to me most importantly, I wanted my professional development to take precedence over productivity. While many have found professional development though non-fellowship opportunities, I decided to seek them in a fellowship.

 

Solving the Medical Puzzles

I personally enjoy the problem-solving aspect of rapid responses. Sometimes, the issues are simple. For example, we’ll have a patient who has flash pulmonary edema and needs IV Lasix and BiPAP. At other times, the patients have extensive medical problems with multiple organ systems affected. We’ll bring on any additional teams we need to consult with, and then we collaborate on the decisions. I really enjoy strategizing options, talking with the patient and their family, and then sharing the information with my team. It’s one of the parts of my job I find most satisfying.

 

Practice Makes Perfect

Surgery is one of the areas where direct personal experience is the best teacher. All of the textbooks in the world are not going to be as valuable as actually being confronted with fractures. I always joked that I learned orthopedics one fracture at a time while working in the ER and UC.

It is important to work with a surgeon who is a good teacher and realizes that you are a new grad or new to the specialty. He or she must make themselves immediately available to you as you go down to the ER to do a consult. Having an opportunity to review imaging and discuss a treatment plan with your surgeon before you go down to the ER will help you show the ER attendings and staff that you are competent and prepared.

Figure out the most common Dxs that your practice sees and consults on, and study these. Know how your surgeon treats various fractures (they don’t always follow the “book”). Be prepared to take a long time to feel confident and competent. Surgery is a complex business and it takes a long time for anyone to see enough case variety to get comfortable.

 

How to Push the Envelope

I’ve been the first PA in a few roles, and, admittedly, pushed the envelope. I was the first surgical PA in a small hospital (had been working in the ER for a while and they wanted to try PAs in the OR). One way to push the envelope is to go to recovery with the patient and offer to write the note or orders for the surgeon. Make rounds on them the next day. Learn what the surgeon looks for and how they handle it.

 

Character Traits of Successful PAs in Orthopaedics

One of the most important character traits in orthopaedics is being adaptable. You should be able to adapt on the go with scheduling changes (OR cases canceled or cases go longer than expected), and handling complicated patients with multiple comorbidities. Efficiency is another key in orthopaedics. It is important to be very thorough but yet concise. Most ortho clinics have a high volume of patients with only 10-15 minute visit slots for each patient. I also think that humility should be one of the main components of a physician assistant regardless of the medical specialty. Never get to the point where you refuse to admit when you are wrong. This is true when treating patients and dealing with colleagues.

 

Looking for Variety? Try Orthopaedics

Orthopaedics is one of the most popular specialties for PAs – with good reason! One of the best things about being a PA in orthopaedics is that there is so much variation in what your job could entail. I have worked for hospital-owned, military, and private practices, and operated out of both hospital operating rooms and ambulatory surgery centers. My routine includes a rewarding mix of inpatient and outpatient clinics, and surgery. I often work with several surgeons in a week, which means that I may be doing arthroscopies one day and total joint replacements the next.

 

The Reward of Seeing It Through

For me, continuity of care is exceptionally satisfying. I love that I see a patient in the emergency department who has suffered an orthopaedic trauma, then shepherd them through the process of surgical management and postoperative care on the wards, and finally, see them back in the office. I am glad that, at each step of their journey, they are seeing a familiar face.

External Resources

External Resources

American College of Healthcare Executives

The American College of Healthcare Executives (ACHE) is a membership association focused on advancing leaders in the field of healthcare management. PAs interested in a career in administration are encouraged to take advantage of the educational offerings that are available through the AAPA/ACHE Leadership Learning Collaborative and to consider pursuing ACHE’s FACHE credential.

Society of Hospital Medicine

Some PAs who work as administrators in a hospital setting choose to belong to both AAPA and the Society of Hospital Medicine (SHM). SHM provides hospital medicine-specific opportunities, including education, professional development, networking, advocacy, and leadership development.

American Association of Healthcare Administrative Management

The American Association of Healthcare Administrative Management (AAHAM) is a professional organization dedicated to healthcare administrative management. PAs working in healthcare administration may benefit from the information, education, and advocacy that AAHAM provides in the areas of reimbursement, admitting and registration, data management, medical records, and patient relations.

Healthcare Information and Management Systems Society

The Healthcare Information and Management Systems Society (HIMSS) serves the global health information and technology community and is uniquely positioned to provide guidance on best practices in health information and technology.

PubMed Articles on Healthcare Administration

PubMed® comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books.

Constituent Organization – Society of PAs in Family Medicine

The Society of PAs in Family Medicine (SPAFM) is an AAPA Constituent Organization that supports AAPA’s knowledge base in family medicine practice issues. SPAFM works to ensure the professional growth, excellence, and recognition of PAs in family medicine and to support their efforts to enable them to improve the quality, accessibility, and cost-effectiveness of patient-centered health care.

Association of Family Practice PAs/NPs

The mission of the Association of Family Practice PAs & NPs is to foster the educational and professional interests of family practice clinicians by promoting clinical and academic excellence and providing a forum for assembling and distributing information important to the profession.

MDLinx – Family Medicine

MDLinx scans, sorts, summarizes, and disseminates new literature in family medicine in a digestible form.

PubMed Articles on Family Medicine

PubMed® comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books.

Constituent Organization – Society of PAs in Emergency Medicine

The Society of PAs in Emergency Medicine (SEMPA) is an AAPA Constituent Organization that supports AAPA’s knowledge base in emergency medicine practice issues. SEMPA strives to advance, protect, and promote the role of PAs in emergency medicine through education, advocacy, collaboration and research.

Implementation of a Physician Assistant Emergency Medicine Residency Within a Physician Residency

Physician assistants (PA) are an important part of emergency department healthcare delivery and are increasingly seeking specialty-specific postgraduate training. This 2020 paper published in the Western Journal of Emergency Medicine presents the outcomes of a pilot program that embedded PA postgraduate training within the existing educational infrastructure of an EM residency program.

Physician Assistants in Emergency Medicine: The Impact of Their Role

This 2010 paper published in the Academic Emergency Medicine journal examines relevant literature published between 1970 and 2009 to assess the role of PAs in patient treatment and the management of emergency services.

MDLink – Emergency Medicine

MDLinx scans, sorts, summarizes, and disseminates new literature in emergency medicine in a digestible form.

PubMed Articles on Emergency Medicine

PubMed® comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books.

Constituent Organization – Society of PAs in Orthopaedic Surgery

The Society of PAs in Orthopaedic Surgery (PAOS) is an AAPA Constituent Organization that supports AAPA’s knowledge base in orthopaedic surgery practice issues. PAOS creates high quality educational programs and a forum for networking, information dissemination, and job placement for PAs in orthopaedics.

American Association of Surgical Physician Assistants

The American Association of Surgical Physician Assistants (AASPA) is a support organization for surgical PAs in all operative settings and specialties who seek to better their careers, their professions, and the quality of patient care.

MDLink – Orthopedics

MDLinx scans, sorts, summarizes, and disseminates new literature in orthopedics in a digestible form.

Blog by Physician Assistants in Orthopaedic Surgery

PAs working in Orthopaedic Surgery may be interested in following this Healio.com blog written by Sam Dyer, PA-C, MHS, and other contributors.

PubMed Articles on Orthopaedic Surgery

PubMed® comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books.

Featured Career Resources

Advance Your Career

As a PA, you can take your career anywhere you want. Advance your career with leadership opportunities, recognition programs, volunteering and mentoring relationships, and more from AAPA.

Leadership Development promo pic

Find a New Job

Find tools to support a job search, from preparing your resume or interviewing tips, to searching jobs on PA JobSource in your desired area or specialty.

Advocacy promo pic

Mastering Telemedicine

Explore the latest CME and training opportunities, policy news, and expert advice to help you effectively practice telemedicine.

Telemedicine promo pic

Career Central

Whether you’re a new grad or a seasoned PA (or somewhere in between), find helpful checklists and expert guidance to navigate daily challenges and plan for your future.

Explore Here