Areas of
Practice Guide

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 2023 AAPA Salary Survey, 1.6% of PAs reported that their primary role was administrator or manager, 12.1% of PAs reported they were in a formal leadership role at their place of employment, and 18.9% of PAs reported they were in an informal leadership role at their place of employment.

Compensation

Median compensation in 2022 among PAs in administration was $164,191. 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, 58.2% received a bonus, and of PAs who reported receiving one, the median bonus was $11,000.

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

Hematology and Oncology Overview

According to the 2023 AAPA Salary Report, 2.4% of PAs practice in hematology & oncology. PAs working in hematology & oncology provide a full range of services in the treatment of blood illnesses, specifically cancers.

Compensation

The median compensation in 2023 among PAs in hematology & oncology was $122,000. 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 hematology & oncology, 52.3% received a bonus, and of PAs who reported receiving one, the median bonus was $5,000.

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.

Practice

PAs provide a broad range of medical services to hematology & oncology patients. According to data from the National Commission on Certification of PAs, PAs working in oncology diagnose, treat, and manage acute and chronic illness; conduct physical examinations and obtain medical histories; order, perform, and interpret diagnostic tests; provide care coordination; practice telemedicine; perform procedures; and provide other essential services. PAs in hematology & oncology often access and manage intraventricular catheter systems, administer and supervise cellular therapy, prescribe and manage chemotherapeutic agents via all therapeutic routes, perform fine-needle aspiration, interpret pathology reports, perform lumbar punctures, manage and remove indwelling venous access catheters, supervise apheresis and plasmapheresis, and other essential components of blood cancer treatment.

PAs working in hematology & oncology work in both hospital and outpatient settings and are often employed full time.

Cardiothoracic Surgery Overview

According to the 2023 AAPA Salary Report, 2.2% of PAs practice in cardiothoracic surgery. PAs working in this surgical subspecialty provide a full range of services in the preoperative, intraoperative, and postoperative care of patients undergoing cardiovascular and thoracic surgeries.

Compensation

The median compensation in 2022 among PAs in cardiothoracic surgery was $148,000. 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 cardiothoracic surgery, 49.8% received a bonus, and of PAs who reported receiving one, the median bonus was $7,500.

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.

Practice

PAs provide a broad range of medical and surgical services to cardiothoracic surgery patients. According to data from the National Commission on Certification of PAs, PAs working in this surgical subspecialty diagnose, treat, and manage acute and chronic illness; conduct physical examinations and obtain medical histories; order, perform, and interpret diagnostic tests; provide care coordination; practice telemedicine; perform procedures; and provide other essential services. As assistants in the operating room, cardiothoracic PAs often harvest saphenous vein and radial artery conduits using both endoscopic and open techniques, open and close median sternotomies, and perform other essential components of surgery.

PAs working in cardiothoracic surgery primarily work in a hospital setting but may see pre- and post-operative patients in a medical office or clinic. PAs in this surgical subspecialty are often employed full time and may work additional on-call hours.

Cardiology Overview

Cardiology is the largest internal medicine subspecialty for PAs, with 3.1% of PAs practicing in cardiology according to the 2023 AAPA Salary Report.

PAs in cardiology have an opportunity to work in a variety of settings and subspecialties and among diverse patient populations, levels of acuity, and disease severities. With the continued disparity between the supply of cardiovascular specialists and demand for cardiovascular care, as well as the autonomy PAs are afforded in providing cardiovascular care, the number of PAs working in cardiology and cardiovascular medicine is expected to increase.

Compensation

The median compensation in 2022 among PAs in cardiology was $118,000. 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 cardiology, 46.4% received a bonus, and of PAs who reported receiving one, the median bonus was $4,950.

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.

Practice

According to the 2016 National Commission on Certification of Physician Assistants (NCCPA) Statistical Profile of Certified Physician Assistants, the majority (67%) of PAs working in cardiology provide both inpatient and outpatient care and a minority perform only inpatient (11.5%) or outpatient (11.5%) services.

PAs provide a broad range of medical care to cardiology patients, with varied clinical duties depending on the subspecialty, patient population, and practice setting. According to a 2018 article in Cardiology magazine titled “The Evolution of the Physician Assistant Workforce in Cardiology” and the 7th edition of Ballweg’s Physician Assistant: A Guide to Clinical Practice, commonly performed outpatient duties include cardiology consultations, acute care visits, chronic disease management, medication management, disease prevention, and care coordination. Common inpatient duties include admission histories and physical examinations, cardiology consultations, hospital rounds, discharge management, pre- and post-procedure management, and cardiovascular procedures (e.g., cardioversions, insertion and removal of temporary pacemakers, and explant of percutaneous ventricular assist devices). PAs in cardiology also supervise and interpret exercise and pharmacologic stress tests, interpret electrocardiograms and ambulatory telemetry monitors, interrogate and program implantable cardiac electronic devices, participate in research and clinical trials, and manage disease-specific clinics (e.g., heart failure, adult congenital, resistant hypertension, lipid, and other clinics).

General Surgery Overview

According to the 2023 AAPA Salary Report, 2.6% of PAs practice in general surgery. PAs are medically and surgically trained and able to practice in all phases of perioperative care.

Compensation

The median compensation in 2023 among PAs in general surgery was $120,016. 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 general surgery, 44.3% received a bonus, and of PAs who reported receiving one, the median bonus was $5,000.

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.

Practice

PAs in general surgery practice in inpatient and outpatient settings. They are employed by private practices, hospitals, and health systems. Hospitals without residents hire PAs to act as house officers. Teaching hospitals hire them to work with residents and attending physicians. In academic institutions, PAs provide continuity of care on the surgical service and help to cover night and weekend call.

In hospitals and academic medical centers, PAs conduct rounds, write orders, take call for inpatient consults and the emergency department, first and second assist at surgery, manage care for postsurgical patients, cover intensive care and step-down units, help formulate and implement therapeutic treatment plans, provide patient education, admit patients, perform discharge duties, and serve as a resource for hospital staff. In the outpatient office setting, they provide initial consults; perform preoperative examinations and postoperative wound checks; remove sutures, staples, and drains; perform other routine office procedures; and educate patients about their care.

Under Medicare, PAs are authorized to perform and bill for minor surgical procedures and assistant-at-surgery services. Minor surgical procedures performed by PAs include most procedures that have a 0-,10-, or 30-day global period. Procedures associated with a 90-day global period are generally reserved for physicians; however, fracture care management with a 90-day global period is a notable exception that may be furnished and billed by PAs. Minor surgical procedures are not eligible for split (or shared) billing, and procedures performed by PAs should be submitted to Medicare under a PA’s name and NPI. Under Medicare, PA first assists are identified on claims by the modifier AS and are covered at 13.6% of a primary surgeon’s fee. PAs can provide the same range of first assist duties as physicians. Medicare restricts coverage for PAs, NPs, and physicians who first assist in teaching hospitals. TRICARE also authorizes PAs to first assist at surgery. Coverage, conditions, and reimbursement rates for first assisting under Medicaid and commercial payers will vary and must be ascertained from each payer with whom an institution contracts.

Critical Care Overview

According to the 2023 AAPA Salary Report, 2.2% of PAs practice in critical care. PAs serve a vital role in critical care management, with the majority of critical care units (CCUs) or intensive care units (ICUs) reporting PAs participate in direct patient care. PAs may work in general CCUs or patient/disease-specific units like a neonatal (NICU), pediatric (PICU), surgical (SICU), trauma, neurologic, or cardiac CCU.

Compensation

The median compensation in 2022 among PAs in critical care was $127,448. 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 critical care, 48.4% 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.

Practice

PAs are integral to all aspects of critical care management. According to a 2019 ICU Management and Practice paper titled “The role of the Physician Assistant in critical care”, PAs working in critical care participate in direct patient management and perform various procedures, including but not limited to intubation, thoracentesis, paracentesis, arterial and central venous cannulation, lumbar puncture, and bronchoscopy. PAs practicing in critical care may also perform cardiopulmonary resuscitation, coordinate comprehensive patient care plans, manage medications and hemodynamic support, and facilitate communication between practitioners and among patients and their caregivers.

PAs working in critical care may work 10- or 12-hour days, including weekends and evenings, but this may provide a more flexible schedule than traditional clinic hours. Critical care PAs must be able to manage acute, complex medical conditions often under high-stress situations. This specialty may be ideal for procedure-oriented PAs who thrive in fast-paced environments.

Education Overview

In the 2023 AAPA Salary Report, 2.1% of PAs reported that their primary role was educator. Two-thirds of PA program faculty continue to practice an average of 11.6 hours per week, according to the 2020 Physician Assistant Education Association (PAEA) Faculty & Directors Report.

Compensation

Two-thirds of PA program faculty continue to practice an average of 11.6 hours per week, according to the 2020 Physician Assistant Education Association (PAEA) Faculty & Directors Report.

The median compensation in 2022 among PAs in education was $117,000. 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 education, 23.7% received a bonus, and of PAs who reported receiving one, the median bonus was $3,727.Additional information about faculty compensation and university benefits is available PAEA’s Faculty & Directors Report.

Rewards and Challenges

PA educators train the nation’s future healthcare providers in the 267 accredited PA programs across the country, in both the didactic and clinical phases of the curriculum. PAs become educators for a variety of reasons. Some have a passion for teaching and always knew they would become an educator. Some are looking for new challenges including research and other scholarly work. Others say training the new generation of PAs is a way of giving back to the profession and benefitting society long into the future.

When asked how to prepare for a career change to education, PA program faculty and program directors offer the following advice:

• Gain as much exposure to academia as possible to inform your decision making. Learn about adult education theory, best teaching practices, and current theory in assessment.
• Try teaching as a preceptor, adjunct faculty, or guest lecturer to see if you like teaching before committing to full-time academia. Some PA programs offer training in clinical education to preceptors who are thinking of teaching didactic courses. Teaching in the didactic year offers prospective educators experience in the nuts and bolts of preparing and delivering a presentation to students, a crucial skill for PA educators.
• Serve as a guest lecturer to gain exposure to teaching without the administrative responsibilities of full-time faculty. Consider team teaching with an experienced faculty member.
• Most PAs find that taking education classes on curriculum design and implementation, or at least teaching adult learners, is critical in helping them with the transition from clinical practice to teaching.
• A master’s degree is almost always required – in fact, nearly 98% of faculty have one, according to PAEA’s Faculty & Directors report. Some PA programs hire faculty who are in the process of completing an advanced degree.
• Keep your NCCPA certification current. Often, but not always, it is a hiring requirement.
• Do not assume that you will work fewer hours. While there may be more flexibility than in a clinical job, education is not a 9-to-5 job. Faculty may have to be on campus from 9-to-5, but most work in the evenings and during the weekends, because days are filled with classroom time, program and university meetings, and student interactions. One of the most common challenges new faculty experience is how much work they have to do at home.
• Spend time in a PA department to get a feel for day-to-day expectations

Dermatology Overview

According to the 2023 AAPA Salary Report, 3.3% of PAs practice in dermatology.

Dermatology offers PAs the opportunity to evaluate, diagnose, and treat a wide variety of skin-related health conditions, both medically and surgically. Dermatology PAs also provide screening exams, preventive care, and education for patients and their families. Building on their broad medical training, most PAs learn the specifics of dermatology practice while they are working in the clinical setting. Most work autonomously within a dermatology office, much like a staff dermatologist, seeing a wide range of medical, surgical, and cosmetic patients.

After graduation, PAs receive additional postgraduate education in dermatology by attending professional dermatology meetings, tumor boards, dermatology grand rounds, and self-study courses.

Compensation

Median compensation in 2022 among PAs in dermatology was $124,800. 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 dermatology, 55.1% received a bonus, and among PAs who reported receiving one, the median bonus was $20,000.

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.

Practice

Some PAs in dermatology focus only on medical dermatology, while others concentrate on surgery or aesthetics. For many PAs in dermatology, their practice includes pediatric and adult medical dermatology, surgery, and aesthetics. In a private dermatology office, the day-to-day work includes reviewing lab and biopsy results, following up on prior authorizations for specific medications, visits with pharmaceutical sales reps, and a schedule chock-full of patient visits. Dermatology is a very procedure-based specialty that routinely includes biopsies, wide excisions, cryotherapy, and an array of other procedures in the office. Some PAs also perform aesthetic procedures such as dermal fillers, neuromodulators, lasers, micro-needling, and peels.

PAs who choose dermatology in most cases can be assured of a busy, but predictable, schedule with typical workday hours and no call.

Emergency Medicine Overview

According to the 2023 AAPA Salary Report, 7.4% of PAs practice in emergency medicine, making it the third most popular specialty for PAs.

PAs are found practicing in every aspect of emergency medicine – from fast-track care to trauma. They examine and evaluate patients, order and interpret lab tests, and diagnose and treat. PAs perform procedures in the ED — using point of care ultrasound, as needed.

According to the 2022 AAPA Salary Report, PAs who practice emergency medicine as their major specialty area earned more than PAs in most other major specialty areas, although PAs in some surgical subspecialties are paid far more than PAs emergency medicine.

Compensation

Median compensation in 2022 among PAs in emergency medicine was $130,000. 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 emergency medicine, 52.1% received a bonus, and of PAs who reported receiving one, the median bonus was $6,000.

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.

Practice

According to the National Center for Health Statistics, in 2019 PAs conducted 26,490,000 patient visits in EDs, up more than 8 million visits from 2017. In 2019, 43 percent (11 million) of those PA visits did not involve a physician.

The Society of Emergency Medicine Physician Assistants (SEMPA) reports on procedures performed by PAs in EDs. Multiple layer laceration repair was most frequently performed (at least once a week by 55.38% of respondents). Only 0.73% of respondents never perform multiple layer laceration repair. Slit lamp exams were frequent (at least once a week by 51.9%). At least one fourth of respondents frequently performed reduction of major joint dislocations, closed fracture reductions, procedural sedation, arthrocentesis and lumbar puncture.

PAs in emergency medicine serve in settings from the smallest rural emergency departments (EDs) in Critical Access Hospitals to the largest Level 1 trauma centers. In rural settings, a PA may be the only provider on call for the ED, and on an urban trauma team, they may be found in the thick of responses to multi-casualty events. PAs often are the backbone of fast-track care and observation units within EDs. Employers of PAs in emergency medicine range from small hospitals to the largest emergency medicine staffing companies.

Family Medicine Overview

According to the 2022 AAPA Salary Report, 13.1% of PAs practice in family medicine, making it the most popular specialty for PAs.

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.

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

Compensation

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 ($114,000) according to the 2023 AAPA Salary Report. The median compensation for PAs in all specialties in 2022 was $120,000.

Median compensation in 2022 among PAs in family medicine was $114,000. 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, 56.6% 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.

Practice

PAs in family medicine provide a broad range of medical care to patients of all ages. PAs take medical histories, perform physical examinations, order and interpret laboratory and diagnostic tests, diagnose and treat acute and chronic illnesses, develop and manage treatment plans, prescribe medications, provide patient education, and perform procedures.

According to the National Commission on Certification of Physician Assistants (NCCPA), just over half of the PAs in family medicine (51.1%) work in office-based private practices. Family Medicine PAs also practice in community health centers (11.4%), hospitals (7.9%), urgent cares (4.7%), and for the federal government (10.3%).

The following tables highlight how Family Medicine PAs responded to the AAPA PA practice survey.

Hospital Medicine Overview

According to the 2023 AAPA Salary Report, 2.8% of PAs practice in hospital medicine.

A hospital medicine service provides general medical care for hospitalized patients. The hospital medicine team coordinates care for inpatients. The hospitalist physicians or PAs may examine patients as they are admitted, ordering X-rays, diagnostic tests, and other lab work. They examine test results, order treatments and medical services, and prescribe medications. Many patients in the hospital have complicated cases. They could have multiple health conditions occurring at once, making the hospital medicine service essential to their recovery. Unlike specialists that work solely with one organ system or a certain patient demographic, the hospital medicine team sees it all.

Hospitalists help manage patients medically through the continuum of hospital care, often seeing patients in the emergency room, following them into the critical care unit, and arranging for discharge. Physicians who become hospitalists typically have taken specialty boards in internal medicine, family medicine, or pediatrics. PAs who choose hospital medicine tend to come from general internal medicine or an internal medicine subspecialty. The percent of hospital medicine services employing PAs has been on the rise. In 2007, about 30 percent of hospital medicine practices included PAs. By 2017, about 70 percent of hospitalist groups were hiring PAs.

Compensation

Median compensation in 2022 among PAs in hospital medicine was $120,000. 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 hospital medicine, 45.8% received a bonus, and of PAs who reported receiving one, the median bonus was $5,000.

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.

Practice

There are varied roles for PAs on hospital medicine services. On some services, a physician and PA split a panel of patients. Each cares for their share, including daily visits, progress notes, calling consults, discharges, discharge summaries, procedures, and billing. The physician follows up on patients seen by the PA, if needed. This system allows the team to see more patients and provides backup and redundancy for both team members when the patient acuity gets high. A variation on this model gives the PA a more independent role, with a hospitalist physician seeing a PA’s patients every third day.

Some PAs in hospital medicine manage observation units or lower acuity observation patients. In those cases, typically PAs provide all of the care, with a physician available for backup.

PAs often fill a vital role of hospitalist services by managing late afternoon and early evening admissions, getting patients onto the service and starting diagnostic work-ups and treatment plans. A hospitalist physician evaluates the patient the next day. This model is efficient for the physicians and hospital. The downside is possible job dissatisfaction for the PA, unless they rotate through this function and have other hospital medicine responsibilities.

Some critical access hospitals use PAs in a very independent role, staffing these hospitals at night. Smaller, rural hospitals with aging medical staff have learned to maximize the scope of practice of their PAs to remain viable and provide care for inpatients. The growing use of telemedicine offers another avenue for physician backup in this setting.

Internal Medicine Overview

According to the 2023 AAPA Salary Report, 4.6% of PAs practice in general internal medicine. Internal medicine is the diagnosis, treatment, and care of adults, ranging from healthy individuals to those with complex illnesses. PAs in internal medicine solve common and complex health issues. They provide long-term, comprehensive care in the office or the hospital, in all areas of medicine, including:

• Disease prevention
• Wellness and health promotion
• Women’s health
• Treatment involving the cardiac, pulmonary, gastrointestinal, neurologic, nervous systems, etc.
• Mental health
• Addiction

Compensation

Median compensation in 2022 among PAs in general internal medicine was $116,000. 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 general internal medicine, 52.8% received a bonus, and of PAs who reported receiving one, the median bonus was $6,000.

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.

Practice

Providers of general internal medicine handle a wide spectrum of illnesses affecting adults. They are experts in diagnosis, in the treatment of chronic illnesses, in health promotion, and in disease prevention. They are not limited to one type of medical problem or organ system. PAs in general internal medicine often treat patients with multiple conditions or diseases and those taking multiple medications; therefore, they must know about multiple disease processes and polypharmacology.

PAs in general internal medicine often serve as primary care providers. The main difference between internal medicine and family medicine is that internal medicine focuses on adults and the adult medicine subspecialties, while family practices care for patients across the lifespan, including adolescents, children, and newborns.

General internal medicine providers have a broad scope of practice. They typically:

• Treat internal disorders, such as hypertension, heart disease, diabetes, or problems of the lung, brain, kidney, or gastrointestinal tract.
• Prescribe or administer medication, therapy, and other specialized medical care to treat or prevent illness, disease, or injury.
• Explain procedures and discuss test results or prescribed treatments with patients.
• Manage and treat common health problems, such as infections, influenza or pneumonia, as well as serious, chronic, and complex illnesses, in adults.
• Analyze records, reports, test results, or examination information to diagnose medical condition of patient.

PAs who choose to practice in general internal medicine should enjoy caring for adults from young adulthood through geriatric years. They often will care for patients for many years, offering the opportunity to develop a strong personal connect with patients over the course of their lives. They should enjoy a wide variety of patients. Some days they may see a patient with a cold followed by someone with a cancer diagnosis. They may have conversations ranging from basic preventive care to multiple chronic issues or end-of-life preferences. General internal medicine providers perform some procedures, but usually do not perform surgery. General internal medicine practice tends to have typical workday hours (8-5).

Some internal medicine outpatient practices conduct inpatient rounds, but these days, most inpatients are cared for by hospitalists, providers in general internal medicine who practice solely in the inpatient setting.

Obstetrics and Gynecology Overview

According to the National Commission on Certification of Physician Assistants (NCCPA) 2021 statistical profile of certified physician assistants by specialty, about 55 percent of PAs in OBGYN practice in an office-based private practice and about 33 percent are hospital-based. The rest work in various other settings. In outpatient OBGYN, PAs evaluate and manage gynecological conditions and are safe, qualified providers of first trimester abortion care. PAs are on teams that evaluate and treat infertility. They also provide prenatal, intrapartum, and postpartum care. PAs provide patient education and counseling on family planning, breast self-examination, pre- and postnatal care, childbirth, lactation, sexual health, and other women’s health topics.

In addition to involvement in all clinical aspects of OBGYN care, PAs help to advance patient care and the profession by serving on boards and participating in committees convened by the American College of Obstetrics and Gynecology.

According to the 2023 AAPA Salary Report, 1.9% of PAs practice in obstetrics and gynecology (OBGYN).

Compensation

The median compensation in 2022 among PAs in obstetrics and gynecology was $114,816. 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 obstetrics and gynecology, 49.5% received a bonus, and of PAs who reported receiving one, the median bonus was $5,000.

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.

Practice

PAs practicing in OBGYN provide a broad range of services to patients including performing physical exams and obtaining medical histories; counseling and educating; ordering, performing, and interpreting diagnostic tests; prescribing medications for acute and chronic illnesses; diagnosing, managing, and treating acute illness; providing preventive care; providing care coordination, and more.

In hospital-based OBGYN practice, PAs perform histories and physicals, consultations, and daily rounds. They update and educate about courses of treatment and management plans. PAs write orders for admission, discharge, transfer, pre- and post-operative care, labs, and diagnostic tests. They arrange for studies or procedures, request consultations, and write discharge summaries and prescriptions. PAs perform amniotomies, place internal monitors, and interpret fetal monitor strips. They perform ultrasound, colposcopy, cryotherapy, IUD and Nexplanon insertion and removal, insemination, endometrial and vulvar biopsies, and loop excision electrocoagulation procedure (LEEP). Many PAs working in OBGYN first assist in surgery. PAs in labor and delivery monitor patients, perform pelvic exams to evaluate the course of labor, perform uncomplicated vaginal deliveries, and assist with operative vaginal deliveries and Cesarean-sections. PAs often share call for deliveries, particularly in rural areas where there may be few providers.

Orthopaedic Surgery Overview

According to the 2023 AAPA Salary Report, 9.7% 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. They also serve as care coordinators, communicating closely with patients and referring practices.

Compensation

Median compensation in 2022 among PAs in orthopaedic surgery was $120,000. 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 orthopaedic surgery, 61.6% received a bonus, and of PAs who reported receiving one, the median bonus was $7,750.

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.

Practice

Orthopaedic surgery is by far the largest surgical specialty for PAs. 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.

Psychiatry Overview

According to the 2023 AAPA Salary Report, 2.8% of PAs practice in psychiatry. These PAs are on the front lines working to address the growing demand for psychiatric and behavioral health services.

While PAs have practiced with psychiatrists for years, payment for mental health provided by PAs can be challenging with certain behavioral health payers. While Medicare includes PAs among the health professionals eligible to furnish outpatient diagnosis and treatment for mental disorders, certain commercial behavioral health companies may not recognize or reimburse PAs unless the PA has advanced training or a specific degree in a mental health specialty. However, both federal and state laws increasingly reflect the consensus of PA importance in meeting behavioral health needs. AAPA is working to secure further policy changes by third-party payers to enable more psychiatric practices and facilities to hire PAs.

Compensation

The median compensation in 2022 among PAs in psychiatry was $125,000. 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 psychiatry, 47.2% received a bonus, and of PAs who reported receiving one, the median bonus was $5,000.

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.

Practice

The 2020 JAAPA paper titled, “The role of PAs in providing mental health care,” outlines PAs practicing in psychiatry provide a broad range of services to patients including prescribing medications for acute and chronic illness; counseling and educating patients and families; diagnosing, treating, and managing acute illness; performing physical exams and obtaining medical histories; providing care coordination; and ordering, performing, and interpreting diagnostic tests. PAs in psychiatry care for patients with a wide range of conditions such as mood, anxiety, and obsessive-compulsive disorders and substance related and addictive disorders. Most also treat patients with personality, sleep, cognitive, and attention disorders.

Per the 2015 Acad Psychiatry paper titled “The Benefits of a Physician Assistant and/or Nurse Practitioner Psychiatric Post Graduate Training Program”, PAs provide inpatient and outpatient psychiatric and mental health services in every setting type from private office practices and community health centers to safety net hospitals and prisons. In some cases, PAs provide all evening and weekend psychiatric coverage, with a psychiatrist and internist available by phone.

Telemedicine Overview

The COVID-19 pandemic has permanently shifted the growth trajectory for telemedicine. In short, telemedicine is here to stay. Now, every PA and PA student must learn to adapt and incorporate these new and expanding clinical skills into their practice. While telemedicine can be a tool in a PA’s clinical toolbelt, it can also be a full-time career path. In recent years, many PAs have been able to add part-time telemedicine roles to supplement their income or shift into full-time dedicated telemedicine positions. This rapidly growing area of clinical practice represents an enormous opportunity for the PA profession and a new way to demonstrate its clinical excellence, flexibility, and capacity to lead in the changing healthcare landscape.

Compensation

According to the 2023 AAPA Salary Report, about half of all PAs (54.8%) used telemedicine in their clinical work within the last year. Primary care PAs (82.4%) were the most likely to report using telehealth or telemedicine, followed by PAs in internal medicine (59.9%) and those in other specialties (53.6%). Approximately two in five PAs in pediatric subspecialties (41.7%) reported using telehealth or telemedicine, which was similar to the number of PAs in surgical subspecialities (45.2%) incorporating telehealth services into their practice. PAs in emergency medicine had the lowest utilization of telehealth services (17.8%). These trends in telehealth use are similar proportionally to the 2022 Salary Report; however, the overall use of telehealth declined between 2021 and 2022 (61.4% versus 54.8%). This reduction in utilization may be indicative of post-COVID-19 pandemic trends. However, the use of telehealth is still more prevalent than it was pre- COVID-19 pandemic; in 2019, 9.6% of PAs reported using telehealth in their clinical practice.

While PA utilization of telemedicine has increased dramatically as a result of the pandemic, wide variation in use across specialties and evolving reimbursement models make it challenging to quantify its impact on PA compensation. As telemedicine practice patterns and reimbursement models stabilize, AAPA will continue to study how the use of telemedicine is impacting compensation for PAs who use telemedicine part time as well as those who are exclusively practicing via telemedicine.

Urgent Care Overview

According to the 2023 AAPA Salary Report, 6.5% of PAs practice in urgent care. Urgent care medicine is immediate outpatient medical care for acute and chronic illness and injury. The urgent care segment of the healthcare industry has been a growth market since it first appeared in the 1970s. According to Consumer Reports, the number of urgent care facilities increased from 6,400 in 2014 to 8,100 in 2018, with another 500 to 600 expected to open soon. Business analysts expect this delivery setting to continue to grow, as they are seen as a money-saver for patients and health insurers, and as the number of emergency departments declines.

Some of the benefits of working in urgent care include one-on-one patient opportunities, seeing a wide variety of conditions, lower stress and fewer hours than emergency room counterparts, no on-call duties, and it is a growing segment of the healthcare industry.

Compensation

Median compensation in 2022 among PAs in urgent care medicine was $124,900. 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 urgent care, 57.3% received a bonus, and of PAs who reported receiving one, the median bonus was $5,574.

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.

Practice

PAs in urgent care need an array of clinical skills and the ability to quicky identify patients who need more intensive emergency care. While urgent care providers may be the first to diagnose a patient with a chronic illness such as asthma or diabetes, those patients usually are referred to a primary care practice for management of the conditions. Urgent care centers are equipped to diagnose and treat urinary tract infections, respiratory infections, local allergic reactions, abscesses/boils, ear infections, simple lacerations, and suture removal. PAs in urgent care see more patients per week and spend significantly less time consulting with physicians than their counterparts in emergency medicine.

Urgent care most often is delivered in free-standing urgent care centers, although many emergency departments and some primary care offices offer urgent care. PAs are a good fit for urgent care centers with their generalist medical training. For-profit urgent care centers also find PAs attractive because they are less costly to employ than physicians. According to Becker’s Healthcare, the top-reported staffing model for an urgent care center is one physician, one PA, two medical assistants, one radiologic technician, one center manager, and two receptionists.