How Has the Rise of the PA Position Affected Doctors?

The growing role of physician assistants (PAs) has sparked plenty of debate about cost, access, and care quality—but how has the rise of the PA position affected doctors? As PAs take on greater responsibilities, from primary care to specialized procedures, doctors are navigating both new opportunities and unexpected challenges. Whether it’s shifting workloads, evolving leadership dynamics, or even malpractice risks, the PA boom is changing the practice of medicine in ways that directly impact MDs and DOs.

In this article, we break down five key ways physicians are feeling the effects—and what these trends could mean for the future of the profession.

5 Ways New PA Positions Have Affected Doctors

1. More PAs substituting for doctors
2. PAs in primary care roles
3. More PAs in leadership positions
4. Facilities seeking to reduce high-cost roles
5. Doctors may see more cases of medical malpractice
   Your expertise deserves more—find it with Era Locums

1. More PAs Substituting for Doctors

Physician assistants (PAs) are taking on more responsibilities traditionally handled by doctors, including critical preventive care like cancer screenings. A study surveying 1,363 physicians found that a significant majority—73–79% of family physicians and 60–70% of internists—were open to PAs conducting these exams. In fact, nearly half (46%) reported that a PA or nurse practitioner had performed at least one type of cancer screening for their patients. Family physicians, in particular, were more likely than internists to delegate this task. This shift suggests that PAs are becoming integral to primary care teams, easing physician workloads while maintaining patient access to essential services.

For doctors, this trend can be a double-edged sword. On one hand, it frees them to focus on complex cases and administrative duties. On the other, it may lead to concerns about oversight, reimbursement models, or even the long-term role of physicians in routine care. As PAs continue to expand their scope, the medical field will need to balance efficiency with ensuring that doctor-led expertise remains central to patient care.

2. PAs in Primary Care Roles

With growing physician shortages, especially in primary care, PAs are stepping in to fill critical gaps. Research shows that PAs are increasingly deployed in family medicine and internal medicine settings, providing essential services like chronic disease management, routine exams, and preventive care. This trend is particularly vital in underserved areas where access to doctors is limited, helping ensure patients still receive timely and high-quality care.

For physicians, this expansion means greater support in overburdened practices, allowing them to focus on more complex cases or administrative demands. However, it also raises questions about long-term workforce dynamics—will reliance on PAs ease physician shortages or inadvertently reduce incentives to train more primary care doctors? While PAs are proving invaluable in maintaining patient access, the healthcare system must continue to evaluate how best to integrate their roles without compromising the physician-led model of care.

3. More PAs in Leadership Positions

As the healthcare landscape evolves, PAs are increasingly stepping into leadership roles—serving as clinic directors, hospital administrators, and even policy advisors. This shift reflects both their growing expertise and the industry’s recognition of their ability to improve workflows, reduce costs, and enhance patient care. For physicians, this means collaborating with PAs not just as extenders but as decision-makers shaping practice standards and organizational strategy.

While some doctors welcome this trend as a way to diversify leadership perspectives, others may worry about the blurring of traditional hierarchies. Will greater PA involvement in management lead to more efficient teams, or could it create tension over authority and scope of practice? One thing is clear: as PAs take on more leadership responsibilities, the dynamic between physicians and PAs will continue to transform—requiring clear communication, mutual respect, and adaptable roles in an ever-changing system.

4. Facilities Seeking to Reduce High-Cost Roles

Healthcare systems, facing rising financial pressures, are increasingly looking for ways to cut costs—and one strategy involves shifting responsibilities from higher-paid physicians to more cost-effective PAs and NPs. Research shows a subtle but notable trend: as PA employment rises in certain settings, physician employment sees a slight decline. While many factors influence staffing decisions, anecdotal reports suggest some facilities actively prioritize hiring PAs over physicians for roles where their scope of practice overlaps, particularly in primary care, urgent care, and hospitalist teams.

For doctors, this trend raises concerns about job security, compensation, and the long-term value placed on physician expertise. While PAs provide excellent care within their training, the financial incentive to replace physicians could lead to understaffing of MD/DO-led teams or increased workloads for remaining doctors overseeing midlevel providers. The challenge for healthcare leaders will be balancing cost efficiency with maintaining the depth of physician experience—ensuring that financial decisions don’t compromise patient care or overburden the system’s most highly trained clinicians.

Chart from Increased reliance on physician assistants: an access-quality tradeoff?

5. Doctors May Face Increased Medical Malpractice Risks

As PAs take on more independent responsibilities, physicians could find themselves exposed to higher malpractice liability—especially when supervising midlevel providers. Research indicates that PAs are involved in a disproportionate number of malpractice cases compared to physicians, relative to their numbers in the workforce. While most PA-provided care is safe and effective, the increased autonomy granted in many states means doctors may bear legal and professional risks for decisions made by PAs under their oversight—or even for those working independently within the same practice.

For physicians, this trend underscores the importance of clear supervision protocols, thorough documentation, and ongoing communication with PA colleagues. Some doctors may also face higher malpractice premiums as insurers adjust to the growing role of PAs in patient care. Moving forward, healthcare systems will need to balance expanded PA autonomy with robust safeguards—ensuring patient safety while protecting physicians from undue legal exposure.

Your Expertise Deserves More—Find It with Era Locums

At Era Locums, we understand that physicians deserve roles that honor their expertise—without sacrificing well-being. That’s why we go beyond just placing doctors in locum tenens jobs; we prioritize your needs, securing positions with competitive compensation, strong clinical support, and balanced workloads designed to reignite your passion for medicine. If you’re ready to practice on your terms, explore opportunities with Era Locums—where your skills are valued, and burnout doesn’t have to be part of the job description.

Apply now or browse open locum tenens opportunities tailored to your goals.