HealthEd: What's in a Name? Why PAs Want to Evolve from Assistant to Associate

What's in a Name? Why PAs Want to Evolve from Assistant to Associate

Osmosis Team
Published on Oct 3, 2022. Updated on Feb 16, 2023.

In May 2021, the American Academy of Physician Associates (AAPA) voted to pass a resolution to change the official title of “Physician Assistant” to “Physician Associate” after years of research and debate. Here’s why they’re making the change.

A brief history of PAs

In the mid-1960s, physicians and educators were alarmed at a growing shortage of trained primary care physicians. At the Duke University Medical Center, Dr. Eugene Stead created a new program of study that would fast-track the training of medical professionals. He based it on a military program that was designed to produce qualified field medics quickly and called the new role a Physician Assistant. The first class of PAs graduated from Duke University’s PA program in October 1967 and included four Navy Hospital Corpsmen who Dr. Stead had selected for their previous military medical training. 

The new role quickly gained recognition across the United States as a remedy for the physician shortage, with the federal government and national medical community coming together to create accreditation standards for the position. The first national certification exam for PAs took place in 1973, and the position has had a valued role in healthcare since.

Why does a change in title matter?

Per a 1961 article in the Journal of the American Medical Association, the physician assistant role was originally conceived as “an advanced medical assistant with special training, intermediate between that of the technician and that of the doctor, who could not only handle many technical procedures but could also take some degree of medical responsibility.” Today, PAs work in every medical specialty, from emergency medicine to psychiatry, in settings that range from family medicine to staffing large hospitals.  

The role of a PA involves more than simply assisting physicians. They are licensed to examine, diagnose, prescribe and treat patients under their specialty. However, as the years have gone by, a number of PAs feel that their title does not accurately match their healthcare role. Often, they have to deal with patients who don’t understand what they do and question their authority and ability to diagnose illness or prescribe treatments.

The AAPA spent three years surveying PAs, patients, and doctors about the role as well as researching the idea of a title change. A large majority of respondents felt that the term “physician associate” more accurately represents the PA’s day-to-day life and their responsibilities in medical practice.

While a rose by any other name may smell as sweet, the title in this case reflects important perceptions and misunderstandings about a significant medical profession. As the physician shortage continues, the PA role will continue to grow in importance as well. Taking a moment to reflect on the importance of their role in healthcare is an important step in aligning everyone’s expectations and clarifying the importance of PAs contributions to healthcare.

What’s next?

The AAPA voted to change the title from physician assistant to physician associate in May 2021. Since then, they have worked with state and federal organizations to implement the change as well as engaging with branding firms to manage the shift.

To date, not all medical organizations have been supportive of the change. The American Medical Association released a statement in June of 2021 criticizing the change. Dr. Susan Bailey, former president of the AMA, wrote  “AAPA’s recent move to change the title ‘physician assistant’ to ‘physician associate’ will only serve to further confuse patients about who is providing their care.” The American Osteopathic Association has expressed concern that the title change reflects a larger agenda on the part of the AAPA to become independent practitioners, but the AAPA reiterates that the shift is about accurately reflecting the job.

Ultimately, each of these organizations is focused on providing access to safe and effective medical care. The AAPA continues to work with state and federal organizations, including licensing boards, medical associations, and the IRS to advance the title change, but it will likely take years to finalize. Doctors and patients will have time to adjust to the shift. And we will have taken a step forward in refining what the roles and responsibilities are in a constantly innovating healthcare landscape.