A Guide to Physician Assistant Programs

New Hampshire's scope of practice lags behind many other states. PAs in the Granite State have less autonomy and require more oversight than their colleagues elsewhere. Movement is afoot to change those rules, however. New Hampshire Senator Jean Shaheen pointed out that PAs should be allowed to treat substance abuse disorders. This would help combat the state's opioid epidemic. This working environment does not, however, slow down the dramatic expansion of the industry. Healthcare dominates New Hampshire's fastest-growing occupations, with physician assistants near the top of the pack. According to a 2018 report by the state's Economic and Labor Market Information Bureau, analysts expect the profession to grow by as much as 35% by 2026.

PAs earn a good living in New Hampshire, with mean hourly wages of $53 an hour, and they enjoy a great deal of buying power with a strong cost-of-living adjusted income. The state came in fourth in U.S. News and World Report's survey of best places to live, making it an attractive option for any physician assistant.

New Jersey ranks second only to Washington when it comes to wages for physician assistants, according to occupational reports from the Bureau of Labor Statistics. PAs earn a mean salary of $119,260. And there are a lot of them. The New York-New Jersey metropolitan area boasts the single highest concentration of PAs in the nation, with more than 7,000 on the job.

New Jersey physician assistants gained more autonomy in 2016, when Garden State legislators voted to allow them to practice without physicians in the exam room. The ability to work without direct supervision has become commonplace elsewhere, and the rule change brings New Jersey in line with many other states. New Jersey's cost of living ranks higher than most other places, especially in busy metro areas, but those high wages go a long way toward offsetting the relative value of the dollar.

Nevada sits just behind New Jersey for wages. In other words, its PAs earn more than almost every other state, coming in third in the nation. The mean salary for a physician assistant in the state reaches $119,210, or $57.31 dollars an hour, according to the Bureau of Labor Statistics. Nevada's own data proves even more bullish, averaging hourly wages at $59.70. Regardless, physician assistants do well in a state where the cost of living is moderate.

The job ranks among the fastest-growing occupations in one of the country's fastest-growing states. Nevada's economic analysts expect the profession to grow an explosive 65% by 2024, according to an in-demand job report from 2017. The demand has become so great that universities in Nevada now add PA programs to their degree offerings. PAs in the state enjoy a fair degree of autonomy and may prescribe some drugs. This does, however, cause some controversy given the growing opioid problem.

In 2014, the Oregon legislature passed laws radically changing -- and improving -- the ways PAs practice. Today, the state boasts one of the most favorable working environments in the country, and physician assistants earn licensure to practice in every area of medicine. While not the state with the highest pay in the country, Oregon fares well in salary surveys.

The mean hourly wage for a physician assistant sits at $54.43, which compares favorably to most places and stacks up well against a mid-level cost of living. The state's healthcare system still debates the best way to use physician assistants, according to a 2018 report in the Bulletin in Bend. They are working on it, and the jobs continue to grow.

Almost 10% of all physician assistants live and practice in New York. According to the Bureau of Labor Statistics' occupational employment statistics, the state boasts the highest employment of PAs, with more than 12,000 in practice. The Empire State as a whole boasts the third-highest concentration of jobs in the nation. The New York metro area itself features the single highest concentration of PAs in the U.S., with the Nassau-Suffolk County metro area not far behind in third place.

The scope of practice of New York physician assistants remains a step behind others across the country. PAs in the state must work under the continuous supervision of a doctor, although they do not always need to be in the same room. They can dispense drugs but only when delegated by the physician to do so. But the appeal of the Big Apple and the Empire State manages to transcend that, making it one of the most popular places to practice.

Idaho Falls ranks among the top-paying metropolitan areas for physician assistants in the country. The rest of the state does not do too bad either: last year Idaho ranked fifth state in the nation for concentration of PAs per capita. The rural areas in the southwest of the Gem State currently boast one of the highest concentrations of PAs in the nation, according to the Bureau of Labor Statistics.

Idaho remains a largely rural state, and, just as in many other places, it uses physician assistants and nurse practitioners to help with a shortage of doctors. According to a 2018 report in the Boise Spokesman Review, the state ranks 49th for doctors and residencies per capita. High demand for advanced medical care coupled with good wages make Idaho a great place for PAs.

In September of 2018, Ohio removed many restrictions on PAs. A new law passed easing the oversight necessary for the profession, streamlining the paperwork employers must file. The ruling creates a more favorable work environment in a state where the physician assistant profession is already booming. The Buckeye State's official website ranks the job as one of the highest paying, in-demand occupations in Ohio.

The mean salary for Ohio-based PAs sits at $104,000, somewhere in the middle of the Bureau of Labor Statistics rankings. The high end of the pay range, however, is $139,000, which places it in the 90th percentile. Wages like those give a physician assistant a great deal of purchasing power in a state where the value of the dollar is $1.12, according to USA Today's cost-of-living index. With the improving scope of practice, it makes Ohio an attractive location to make a life as a physician assistant.

The Denver metro area claims some of the highest numbers of PA jobs in the country, according to the Bureau of Labor Statistics (BLS). Almost 1,700 practice in the Denver-Aurora-Lakewood region, bringing in wages of more than $50 an hour. High concentrations of physician assistant jobs spread across the countryside in Colorado, too. The southwestern corner, designated as a nonmetropolitan area by BLS, ranks among the most concentrated PA job localities in the country.

Growth in PA jobs exploded in Colorado, which itself boasts one of the nation's fastest-growing economies. Physician assistants ranked 9th among hot jobs in a recent study, but with growth of 150%. According to the BLS, the average PA's mean salary reaches $104,000, which provides a good living in a state with a moderate cost of living. Recent rule changes introduced by the Colorado Medical Board -- which gave physician assistants greater autonomy -- improve the outlook for Rocky Mountain State PAs even further.

More and more millennials choose to become physician assistants rather than doctors in Delaware, according to a report in the Delaware News Journal. In one of the few states without a medical school, young people prefer the cost, length of study, and flexibility of a PA career. In May 2016, nearly 440 PAs worked in Delaware. Today, according to the president of the Delaware Academy of Physician Assistants, that number reaches closer to 600. PAs now outnumber the combined count of internists, obstetricians, psychiatrists, and surgeons in Delaware.

Delaware ranks among the more progressive states when it comes to scope of practice for PAs, according to the American Academy of Physician Assistants. Salary-wise, physician assistants do reasonably well in Delaware. They earn a mean annual wage of $104,000, which lands somewhere in the middle of the national pay range for PAs. With a mid-range cost of living, PAs in Delaware enjoy good purchasing power, as well.

Patients choose PAs over physicians in Massachusetts in huge numbers. According to the Health Care Cost Institute, visits to physician assistants and nurse practitioners grew by 285% between 2012 and 2016. This occured in part due to changes in insurance practices, which allow for PAs to provide services once restricted to doctors.

Moreover, the Boston-Cambridge metro area boasts one of the highest concentrations of PAs in the nation, according to the Bureau of Labor Statistics. Some 1,600 physician assistants find employment in the city, earning $51 an hour on average. This rate compares well with that of the rest of the nation, providing strong spending power in one of the country's most venerable regions.

California boasts the nation's second-highest concentration of physician assistants, with roughly 9,500 PAs working in the state. These figures make sense, considering that of the 10 top-paying metropolitan areas in the country for PAs, four exist in California. These areas include San Francisco, Santa Cruz, Yuba, and Redding. The Physician Assistant Life website also notes Riverside as one of the nation's best cities for physician assistants.

In Riverside, PAs earn a mean wage of $112,000, which bests the national mean of $104,000 by a large margin. Statewide, the scope of practice for PAs allows them to serve as primary care providers. Moreover, the demand for PAs continues to soar in California. According to a report in the Sacramento Bee, the state expects to employ between 78,000 and 103,000 primary care providers by 2030, with PAs and nurse practitioners accounting for half of them.

Hawaii enjoys a place in the top five states for physician assistant salaries. PAs earn a mean wage of $116,660 there, only trailing the states of Washington, New Jersey, Nevada, and North Dakota. Physician assistants practice with great respect in Hawaii, where they help offset doctor shortages in the islands' underserved areas. They enjoy a progressive scope of practice.

The Hawaii Physician Assistant Program (HPAP) aims to increase the number of PAs on the islands. A nonprofit community advisory committee, HPAP strives to improve access to primary care in Hawaii's rural corners. According to a recent study, Hawaii suffers from a dearth of doctors. HPAP views PAs as a solution to this shortage, as one physician can oversee four PAs in Hawaii. For that reason, the organization is working to establish PA training programs in the state. Officials in Hawaii know that if they can recruit physicians assistants they can easily retain them thanks to high wages and a high quality of life.

Baltimore boasts some of the highest numbers for PAs per capita in the country, according to the Bureau of Labor Statistics. The Greater Washington, D.C. area, which includes several Maryland communities, also ranks high for physician assistant employment density. The profession is among the fastest growing in in Baltimore, and state officials expect it to remain in high demand through 2024. According to the state's economic projections, the PA profession will likely expand by about 26% in coming years.

For a small state, Maryland already employs an unusually large number of PAs, at 2,700. The largest portion (27%) work in primary care, followed by 25% in surgery, 21% in specialty areas, 16% in emergency medicine, and 10% in internal medicine -- according to the Maryland Academy of Physician Assistants. Wages in the state sit in the mid-range for PAs, at $103,150. With good wages and plenty of jobs, Maryland looks to remain an inviting place for physician assistants.

With an annual mean wage of $138,000, the rural area of east central Illinois ranks among the highest-paying regions for physician assistants in the nation. The state also claims one of the highest concentrations of jobs in the Carbondale and Marion area, according to the Bureau of Labor Statistics.

In many respects, Illinois represents a great place to work for PAs. Statewide wages are strong, and the passage of recent legislation allows physicians to oversee more PAs than they could previously. Advocates of this legislation say the change both significantly improves patient coverage in rural parts of the state and creates more jobs for PAs -- as doctors can hire more help. Another new law grants PAs the ability to work as paramedics, again creating more jobs and more opportunities.

According to the American Academy of Physician Assistants, Rhode Island ranks among the few states in which physician assistants enjoy all of the benefits of modern PA practice. These include full prescription authority, a scope of practice determined at the practice site, adaptable supervision, chart co-signing, unlimited physician supervision, and licenses as a regulatory term. Only a few states provide working environments with these features.

These progressive working conditions draw many to the profession. According to a report in the Rhode Island Medical Journal, 20% of the 550 physician assistants in the state obtained their licenses after January 2017. Salaries in the Ocean State hold their own against others across the nation, with a mean of $103,530 -- and up to $147,350 on the high end. Those salaries compete well in a state with a moderate cost of living.