Three States Change Physician Assistant Title to Physician Associate as Healthcare Workforce Shortage Looms

In Oregon, New Hampshire and Maine, P.A. now means “physician associate,” and other states may follow this year. The seemingly simple semantic shift from “assistant” to “associate” represents a significant development in healthcare workforce management as the Association of Medical Colleges projected last March that the healthcare industry would be short up to 72,600 physicians in 2025 and up to 86,000 by 2036, creating unprecedented pressure on healthcare organizations to optimize their workforce strategies.

American Academy of Physician Associates Leads $22 Million Rebranding Initiative

The American Academy of Physician Associates (which changed its own name in 2021) has been driving this transformation following a majority vote of 198 to 68 by their House of Delegates. The consulting firm that studied a title change reportedly estimated the move would cost the AAPA at least $22 million over five years. AAPA last year spent 8% of its budget to lobby states on issues including title change, demonstrating the organization’s commitment to this workforce positioning strategy.

Growing PA Workforce Addresses 125,000 Provider Gap

The numbers underscore the profession’s expanding role in healthcare delivery. In 1980, there were about 29,000 active PAs in the US, but by 2021, there were 125,000+ in practice. More than 125,000 PAs were practicing last year in the U.S.; their median annual pay was $115,390. About a quarter of PAs work as primary care providers, filling gaps in patient access as doctors become more specialized.

“Physician associates have been a really important part of filling gaps in the healthcare workforce, particularly in rural areas and areas that are traditionally underserved,” according to healthcare industry analysts.

Patient Confusion and Physician Opposition Create Implementation Challenges

The rebranding effort faces significant resistance. Physicians themselves have been more ambivalent, with only 61% agreeing that “physician associate” would be a better match to the job description. The American Medical Association said AAPA’s name change would confuse patients and was “incompatible with state laws.”

The physicians group said it “strongly opposes” the new name, pointing out that there’s already confusion about “who is or is not a physician.” According to its research, about a quarter of patients already believe that PAs are physicians or aren’t sure. However, according to the AAPA, 71% of patients in a survey thought “physician associate” matches the PA job description.

Financial and Regulatory Implications for Healthcare Organizations

Healthcare organizations face complex implementation challenges beyond the title change. The transition to physician associate will take time, as legal documents, state laws, and institutional policies still reference “physician assistant.” States and organizations are slowly rolling out the change—Oregon, for example, was the first state to mandate the new title in law, followed by New Hampshire and Maine.

In some states, doctors are required to meet regularly with PAs, periodically visit them in person if they work at a different location and review sample patient charts on a recurring basis. States generally mandate less oversight for nurse practitioners, who perform jobs similar to those of PAs, making them more appealing to some employers. This creates cost differentials that healthcare CFOs must consider in workforce planning.

Not all PAs are crazy about the title change, either. Medscape found last year that 15% of PAs opposed the change, and 45% said they were neutral. Some PAs feel the time and money spent on lobbying, changing paperwork and rebranding graduate programs could be better spent elsewhere.

Future State Legislation and Workforce Planning

Michigan may soon follow Oregon’s lead. Other states including Michigan and South Carolina are considering similar measures. Healthcare organizations should prepare for a patchwork of state-specific regulations and title requirements that will complicate credentialing, billing, and compliance processes.

The title “associate” should not be employed in a clinical setting until the jurisdiction overseeing a PA’s licensure and practice formally adopts the title “physician associate.” It is crucial to heed the strong advice from AAPA’s legal counsel, Foley & Lardner LLP, which strongly discourages PAs from identifying themselves as “physician associates” at this time. It’s important not to appear ahead of legislatures and regulators at local or federal levels, as doing so could have adverse consequences for PAs, including regulatory challenges, disciplinary actions, and malpractice issues.

Healthcare organizations navigating workforce optimization and regulatory compliance can benefit from specialized guidance. Contact James Moore’s healthcare practice team to discuss how these developments may impact your organization.

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