Doctoral-Prepared PAs: Built for the Workforce Crisis Healthcare Is Already In

Peter Yen, DMSc, MSHA, PA-C, LSSGB

Introduction

The United States healthcare workforce faces a persistent and widening gap between clinical demand and physician supply. This gap is driven by population aging, increasing chronic disease prevalence, geographic maldistribution of physicians, and accelerating workforce burnout and retirement. Labor projections demonstrate that physician supply growth alone will not meet future needs. In this context, physician associates represent a rapidly expanding and highly adaptable workforce. Doctoral preparation further strengthens this role by equipping PAs with advanced competencies in leadership, systems improvement, and evidence implementation that align directly with contemporary healthcare system demands.

Labor market realities define the gap

According to the U.S. Bureau of Labor Statistics, employment of physicians and surgeons is projected to grow approximately 3% from 2024 to 2034, a rate slower than the average for all occupations. Despite modest growth, the BLS projects approximately 23,600 physician openings per year during this period, primarily driven by retirement and workforce turnover rather than expansion (U.S. Bureau of Labor Statistics [BLS], 2025a).

In contrast, physician associate employment is projected to grow approximately 20% over the same decade, with an estimated 12,000 openings annually (BLS, 2025b). This differential reflects health system dependence on PAs to sustain and expand access to care amid physician shortages.

Shortage data reinforce this mismatch. The Health Resources and Services Administration estimates that nearly 75 million Americans reside in primary care Health Professional Shortage Areas, and more than 120 million live in mental health shortage areas (HRSA, 2024). Even if physician training pipelines expand, the distribution and replacement burden makes timely gap closure unrealistic.

Burnout reduces functional physician capacity

Workforce availability is further constrained by burnout. National survey data summarized in HRSA workforce reports show that approximately 49% of physicians reported burnout in 2023, with rates exceeding 60% in emergency medicine and remaining above 50% in primary care (HRSA, 2024). Burnout directly reduces clinical full time equivalent availability, increases turnover, and accelerates early retirement, effectively shrinking the active workforce even when headcount appears stable.

These labor dynamics establish that the healthcare gap is not only numerical, but operational. The system requires clinicians who can deliver care while simultaneously stabilizing workflows, improving reliability, and extending physician capacity.

What doctoral preparation adds beyond traditional PA education

Doctoral PA education is designed to address this structural gap. National analyses of PA doctoral programs demonstrate that nearly 100% require a capstone or scholarly project, and approximately 75% explicitly emphasize leadership, research, education, or systems improvement as core outcomes (Martin & Kayingo, 2025). These programs are overwhelmingly structured for working clinicians, enabling immediate application to real world care environments.

As of 2022, approximately 2.3% of board-certified PAs reported a doctoral degree as their highest level of education, a proportion that continues to grow annually (National Commission on Certification of Physician Assistants [NCCPA], 2023). This emerging cohort represents a strategically differentiated segment of the PA workforce.

Primary care and longitudinal disease management

Primary care absorbs the greatest pressure from shortages and burnout. Doctorally prepared PAs add measurable value by managing defined patient panels, leading chronic disease pathways, and implementing population health strategies. Evidence from health services research demonstrates that care delivered by PAs in team based primary care models achieves comparable quality outcomes without increasing total costs, even for complex patient populations (Morgan et al., 2019).

Doctoral preparation strengthens this contribution by adding formal training in quality improvement, data driven care management, and implementation science. These skills directly support access expansion and reduce downstream emergency department utilization and hospital admissions.

Emergency and acute care settings

Emergency medicine faces some of the highest burnout rates in healthcare, exceeding 60% in recent national surveys (HRSA, 2024). In these environments, staffing instability translates into throughput delays and access bottlenecks.

Doctorally trained PAs function as stabilizing anchors by leading protocol driven care zones, safety initiatives, and operational improvement projects while maintaining clinical practice. Systematic reviews demonstrate that PAs contribute effectively to acute and secondary care delivery without compromising patient outcomes when roles are clearly defined (Halter et al., 2018).

Inpatient and specialty services

Hospital based services experience persistent physician turnover and reliance on locum coverage. With approximately 23,600 physician openings projected annually, continuity is increasingly difficult to maintain (BLS, 2025a).

PAs already provide service line continuity in these settings. Doctoral preparation enhances this role by equipping PAs to lead quality initiatives targeting length of stay, readmissions, and guideline adherence. Peer reviewed reviews show that PA integration improves team capacity and operational performance when embedded within structured models of care (Cooper et al., 2025).

Surgical and procedural care

In surgical services, the limiting factor is surgeon availability rather than documentation capacity. PAs extend surgeon productivity by managing perioperative workflows and post-operative continuity. Doctoral training aligns closely with surgical service line needs by supporting outcomes tracking, enhanced recovery protocol implementation, and infection reduction initiatives.

This model preserves surgeon time for operative decision making while improving reliability across the perioperative continuum.

Post acute care and underserved settings

Transitions of care remain among the most failure prone points in healthcare delivery, particularly in rural and underserved communities. Given that tens of millions of Americans live in shortage areas, scalable clinician leaders are essential (HRSA, 2024).

Doctorally prepared PAs are well positioned to lead transition standardization, reduce avoidable readmissions, and sustain access in resource constrained settings. Evidence supports the PA workforce’s contribution in under resourced regions, particularly when PAs assume hybrid clinical and leadership roles (Bruza Augatis et al., 2024).

Why doctoral PA preparation fits the gap precisely

Doctoral preparation allows PAs to fill the healthcare gap not by substituting for physicians, but by amplifying physician effectiveness while stabilizing care delivery. This alignment is precise:

• Physician growth is slow, but PA growth is rapid and scalable.

• Burnout erodes physician capacity, while doctoral PAs absorb leadership and systems burdens.

• The shortage spans settings, and PAs function across the entire continuum.

• Health systems require clinicians who can both deliver care and lead improvement.

Doctorally prepared PAs meet these needs simultaneously. That dual capability is exactly what current labor statistics and workforce projections indicate the healthcare system lacks.

References

Bruza Augatis, M., Paciotti, B., & Hooker, R. S. (2024). Providing care in underresourced areas: Contributions of the physician associate workforce. Journal of Physician Assistant Education, 35(1), 12–19.

Cooper, N., McMurray, R., & Sibbald, B. (2025). Impact of physician assistants on quality of care: A rapid review. BMJ, 390, bmj 2025 086358.

Halter, M., Wheeler, C., Pelone, F., et al. (2018). Contribution of physician associates to secondary care: A systematic review. BMJ Open, 8(6), e019573.

Health Resources and Services Administration. (2024). State of the U.S. health care workforce, 2024. U.S. Department of Health and Human Services.

Martin, A. E. R., & Kayingo, G. (2025). Doctoral education for physician assistants and associates: Trends and characteristics in the United States. BMC Medical Education, 25(1), 2.

Morgan, P. A., Smith, V. A., Berkowitz, T. S. Z., Edelman, D., & Van Houtven, C. H. (2019). Impact of physicians, nurse practitioners, and physician assistants on utilization and costs for complex patients. Health Affairs, 38(6), 1028–1036.

National Commission on Certification of Physician Assistants. (2023). 2022 statistical profile of board certified physician associates.

U.S. Bureau of Labor Statistics. (2025a). Physicians and surgeons: Occupational outlook handbook.

U.S. Bureau of Labor Statistics. (2025b). Physician assistants: Occupational outlook handbook.