What Does a Physician Assistant Do?
From stitching a hand laceration to adjusting a diabetes regimen, this role carries real clinical decisions inside a formal agreement with a physician.
By Priya Nandakumar · Oct 06, 2026 · 8 min read
Physician assistants, known as PAs, practice medicine as part of a healthcare team. According to the U.S. Bureau of Labor Statistics (2025), the work typically includes obtaining medical histories, examining patients, ordering and interpreting diagnostic tests, diagnosing injuries and illnesses, providing treatment such as setting broken bones and stitching wounds, counseling patients, and prescribing medication.
It is a clinical job with a defined entry route: an accredited PA program, a national certifying exam, and a state license. This guide walks through what the day actually looks like, who tends to fit it, and the order of steps to get in.
A Day in the Life
The shape of the day depends heavily on setting. In a primary care office you may see twenty-plus patients; in an emergency department or a surgical service the rhythm is completely different. A common outpatient day runs roughly like this.
You arrive before the first appointment and open the electronic health record to pre-chart: skimming yesterday's lab results, imaging reports and specialist notes, flagging an abnormal A1C and an overdue mammogram. A short huddle with the medical assistant and front desk sorts out double-bookings and same-day add-ons.
Then you start rooming patients. For a sore throat you take the history of present illness, check vitals and pulse oximetry, use an otoscope and tongue depressor, listen with a stethoscope, and order a rapid strep test. For an ankle injury you perform the physical exam, apply the Ottawa ankle rules to decide whether an X-ray is warranted, read the images with the radiologist's report, and apply a fiberglass splint or walking boot. A hand laceration means lidocaine, irrigation, a suture tray and 4-0 or 5-0 nylon, then wound care instructions and a tetanus check.
Between rooms you document in SOAP format, select ICD-10 diagnosis codes and procedure codes, and send prescriptions through e-prescribing. You order a CBC, a basic metabolic panel or a lipid panel, interpret the results, and call patients back with findings. You spend real time on patient education: inhaler technique, insulin titration, what warning signs should send someone to the emergency department.
The day also includes referrals, prior authorization paperwork, phone triage of nurse messages, and a conversation with your supervising or collaborating physician about a complicated case. In hospital roles, substitute rounding, admission and discharge orders, procedure notes, and structured handoffs to the incoming team.
Who Thrives in This Career
- If you're good at asking follow-up questions and listening for what someone leaves out, you'll likely enjoy the history-taking part of this job, where the diagnosis often hinges on one detail in the history of present illness.
- If you're good at pattern recognition under time pressure, you'll likely enjoy the diagnostic part of this job — deciding whether an ankle needs an X-ray or a cough needs a chest film.
- If you're good with your hands, you'll likely enjoy the procedural part of this job: suturing lacerations, splinting fractures, draining abscesses and injecting joints.
- If you're good at explaining technical things in plain language, you'll likely enjoy the patient education part of this job, such as teaching insulin titration or inhaler technique.
- If you're good at keeping accurate written records, you'll likely enjoy — or at least tolerate — the charting part of this job: SOAP notes, ICD-10 coding and medication reconciliation.
- If you're good at taking direction and giving it, you'll likely enjoy the team part of this job, since PAs practice under an agreement with a supervising physician and coordinate daily with nurses and medical assistants (U.S. Bureau of Labor Statistics, 2025).
- If you're good at staying steady when a case turns serious, you'll likely enjoy the acute part of this job, where a routine visit becomes a transfer to the emergency department.
- If you're good at absorbing new material continuously, you'll likely enjoy the maintenance part of this job, because keeping the PA-C credential requires ongoing continuing medical education (U.S. Bureau of Labor Statistics, 2025).
Salary, Outlook, and Requirements
Pay for PAs is usually a salary, sometimes with productivity incentives, call pay, shift differentials for nights and weekends, and a continuing education allowance. It varies by state, metro area, specialty and employer type, so look up the current published figures rather than trusting a number quoted secondhand.
| Metric | Figure | Source/Year |
|---|---|---|
| Median annual pay | Published and updated annually — look up the current national median, and the state and industry breakdowns, in the Occupational Outlook Handbook | U.S. Bureau of Labor Statistics, 2025 |
| Typical entry-level education | Master's degree from an accredited physician assistant program | U.S. Bureau of Labor Statistics, 2025 |
| Projected employment growth, 2025–35 | A percentage change for the decade is published; check the handbook's job outlook tab for the current figure | U.S. Bureau of Labor Statistics, 2025 |
| Number of PA jobs | Current employment count published in the occupational profile | U.S. Bureau of Labor Statistics, 2025 |
| Average annual job openings over the decade | Projected openings figure published alongside the growth rate | U.S. Bureau of Labor Statistics, 2025 |
| Largest employing industries | Ranked by share of PA jobs in the occupational profile | U.S. Bureau of Labor Statistics, 2025 |
| Typical schedule | Most PAs work full time; schedules may include nights, weekends and holidays, and PAs may be on call | U.S. Bureau of Labor Statistics, 2025 |
| Preparation level | ONET assigns the occupation a Job Zone classification; see the ONET profile | National Center for O*NET Development, 2025 |
| Licensing exam | PANCE, administered by the National Commission on Certification of Physician Assistants; multiple-choice format, with an application fee published by NCCPA | NCCPA, undated |
State licensure is required in every state, and the specific requirements — including rules about the supervising physician agreement and prescriptive authority — are set state by state (U.S. Bureau of Labor Statistics, 2025). Check your state's medical or PA licensing board for the current rules.
How to Get Started
- Complete the prerequisite coursework. PA programs set their own required science courses — typically anatomy, physiology, microbiology, chemistry and statistics. Pull the prerequisite list from each program you are targeting before you register for classes, because they differ.
- Accumulate direct patient care hours. Most programs require them, and the usual routes are jobs with a defined credential: emergency medical technician (EMT), certified nursing assistant (CNA), medical assistant, phlebotomist, patient care technician, or scribe. Confirm with each program which titles count toward their hours.
- Apply to and complete an accredited physician assistant program. These programs combine classroom and laboratory instruction with supervised clinical rotations (U.S. Bureau of Labor Statistics, 2025). Most use a centralized online application service; each program's admissions page names the one it accepts and its deadline.
- Sit for and pass the PANCE. Eligibility to take the exam comes through graduating from an accredited PA program, and the exam is a multiple-choice test with an application fee set by the National Commission on Certification of Physician Assistants (NCCPA, undated). Passing earns the PA-C credential.
- Apply for a state license. Every state requires PAs to be licensed, and licensure generally depends on certification (U.S. Bureau of Labor Statistics, 2025). Apply through your state's licensing board and allow for processing time before your intended start date.
- Add the certifications employers ask for. Basic life support certification is commonly required for PA positions (U.S. Bureau of Labor Statistics, 2025); specialty roles often add advanced cardiac or pediatric life support.
- Secure a supervising physician agreement and maintain your credential. A documented agreement with a supervising physician is part of practice (U.S. Bureau of Labor Statistics, 2025), and maintaining PA-C status requires ongoing continuing education and periodic recertification (U.S. Bureau of Labor Statistics, 2025).
Frequently asked questions
What is the difference between a physician assistant and a nurse practitioner?
The two roles overlap heavily in clinical duties but come from different educational traditions. PA training follows a generalist medical model built around rotations across multiple specialties, while nurse practitioner training builds on a nursing license and usually a defined population focus, such as family or acute care. Scope of practice, supervision rules and prescribing authority for both are set by individual state law, so compare your own state's statutes.`
Can a physician assistant change medical specialties?
Yes, and that flexibility is one of the practical draws. Because the certifying exam and license are generalist rather than specialty-specific, a PA can move from, say, family medicine to orthopedics or emergency medicine without returning for a second degree. The transition usually involves on-the-job training, specialty certifications such as advanced life support, and a hiring manager willing to teach. Expect a learning curve of months.
Do you need to shadow a PA before applying to a program?
Many admissions committees ask for shadowing hours, and nearly all expect you to show in your essay and interview that you understand the role rather than defaulting to it as a medical school alternative. Contact clinics, urgent care centers and hospital volunteer offices directly, ask about observation policies and HIPAA paperwork, and keep a log of dates, hours and settings.
How demanding is the job physically and emotionally?
Expect long periods on your feet, repeated patient transfers in hospital settings, and exposure to infectious illness. Emotionally, you carry diagnostic uncertainty and deliver bad news. Surgical and emergency roles involve more standing and more irregular hours than outpatient primary care. If that matters to you, compare specific postings on shift length, call frequency and patient volume per day before accepting an offer.
Sources
- U.S. Bureau of Labor Statistics — Physician Assistants : Occupational Outlook Handbook (2025)
- National Center for O*NET Development — 29-1071.00 - Physician Assistants (2025)
Written by
Priya Nandakumar
Priya covers the texture of offices, remote teams, and the spaces in between — what makes a workplace bearable or unbearable long after the paycheck stops mattering. She likes stories where nobody is the villain.
