Physician assistants in primary care: trends and characteristics

Physician assistants (PAs) have made major contributions to the primary care workforce. Since the mid-1990s, however, the percentage of PAs working in primary care has declined. The purpose of this study was to identify demographic characteristics associated with PAs who practice in primary care.

We obtained data from the 2009 American Academy of Physician Assistants' Annual Census Survey and used univariate analyses, logistic regression analyses, and χ(2) trend tests to assess differences in demographics (eg, age, sex, race) between primary care and non-primary care PAs. Survey respondents had graduated from PA school between 1965 and 2008.

Of 72,433 PAs surveyed, 19,608 participated (27% of all PAs eligible to practice). Incomplete questionnaires were eliminated resulting in a final sample of 18,048. One-third of PAs reported working in primary care. Female, Hispanic, and older PAs were more likely to work in primary care practice. Trend tests showed a decline in the percentage of PAs working in primary care in the sample overall (average 0.3% decrease per year; P <.0001). In the cohort of 2004-2008 graduates, however, the percentage of primary care PAs increased slightly by an average of 0.9% per year (P = .02). Nonetheless, the low response rate of the census limits the ability to generalize these findings to the total population of PAs.

Demographics associated with an increased likelihood of primary care practice among PAs appear to be similar to those of medical students who choose primary care. Knowledge of these characteristics may help efforts to increase the number of primary care PAs.