As physician shortages intensify, the push to rename physician assistants as physician associates reflects a broader debate about scope of practice, clinical autonomy, and how health systems deploy advanced practice providers.
The American Academy of Physician Associates (AAPA) is determined to see the title of physician assistants (PAs) changed to physician associates across the country.
PA is the fastest growing job title in the country. The number of PAs is expected to grow by 20% through 2034, according to the U.S. Bureau of Labor Statistics.
So far, Maine, New Hampshire, and Oregon have adopted the title change from physician assistant to physician associate. The AAPA expects the name change to be made eventually nationwide, according to the organization's chief of public affairs and advocacy, Chantell Taylor.
"The name change is likely to be adopted widely across the country," Taylor says. "It may take some time as momentum builds and more states recognize the importance of the title change."
The term physician associate more accurately describes the role of PAs, Taylor explains.
"The term physician assistant is misleading because the relationship between a PA and a physician is merely transactional," Taylor says. "In most cases, a PA diagnoses, treats, and prescribes care, and a supervising physician signs off on charts and rarely sees the patient."
Adopting the term physician associate is an important modernization that can help legislators and regulators understand the scope of what a PA can do, according to Taylor.
"When you think about legislative priorities to modernize PA practice laws, it's challenging to advocate for PAs to practice independent of physician supervision when their title suggests they merely assist physicians," Taylor says. "Based on PA education, training, and experience, we know that they do far more than assist physicians."
The AAPA is moving on several fronts to secure the name change, including through the organization's state chapters, Taylor explains.
"We have several bills moving through state legislatures this year for adoption of the name change," Taylor says. "We are also working at the federal level to get recognition of the physician associate title, including working with the Centers for Medicare & Medicaid Services and the Department of Health and Human Services."
Debra Fournier, DNP, APRN, is the chief advanced practice provider officer at Dartmouth Health. Photo courtesy of Dartmouth Health.
Perspective from New Hampshire
New Hampshire is the most recent state to adopt the name change.
Particularly in primary care, the term physician assistant does not accurately describe the services PAs provide, according to Debra Fournier, DNP, APRN, chief advanced practice provider officer at Lebanon, New Hampshire-based Dartmouth Health.
"All 50 states allow PAs to be primary care providers," Fournier says. "Whether PAs practice independently of physicians varies by state, but when you think about what a PA primary care provider does, they do not function as an assistant to a physician. A PA functions as an associate of the primary care team."
Fournier says shifting to the term physician associate is a recognition of how PAs function rather than an attempt to increase their scope of practice.
"The name change to physician associate is not driving change in the way PAs practice," Fournier says. "The way PAs practice has already changed. In most states, PAs are practicing independently in a way that their education and skills support. The name change is really an effort to catch up to the way PAs are practicing."
PAs at Dartmouth Health have embraced the name change, according to Fournier.
"Our PAs are excited about this name change," Fournier says. "PAs feel it recognizes the practice they are engaged in and the work they do."
Chantell Taylor is chief of public affairs and advocacy at the American Academy of Physician Associates. Photo courtesy of the American Academy of Physician Associates.
American Medical Association Opposes Name Change
The American Medical Association (AMA), which is the country's largest physician organization, believes the PA name change is misguided.
"The title physician assistant has been used for decades and is widely recognized by patients and deeply embedded across hospital and health system policies, as well as state and federal laws and regulations," says David Aizuss, MD, chair of the AMA Board of Trustees. "Given that many patients already struggle to know who is—and is not—a physician, changing this title would only add confusion."
Aizuss calls the PA name change an AAPA "rebranding effort" aimed at advancing independent practice by PAs rather than improving patient understanding.
The name change could also raise costs in the healthcare system, with no benefit to patients or improvement in the quality of care, according to Aizuss.
"The AMA strongly supports physician-led healthcare teams that value the contributions of all health professionals while putting patient clarity, safety, and outcomes first because that’s what patients want and deserve," Aizuss says.
David Aizuss, MD, is chair of the American Medical Association Board of Trustees. Photo courtesy of the American Medical Association.
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
So far, three states have changed the physician assistant title to physician associate.
Advocates for the name change say physician associate is a more accurate description of how PAs practice medicine.
Adoption of the title physician associate will confuse patients, according to the American Medical Association.