Physician assistants (PAs) work in a wide range of healthcare settings, but the best-paying jobs appear to be in hospitals, according to a new report. According to the 2018 Salary Report released by the American Academy of PAs (AAPA), PAs employed by hospitals have higher salaries, more leadership opportunities, and better benefits as compared to those who work in physician practices.

Established as a profession in 1967, PAs are allowed to work in every state, medical setting, and specialty area and are licensed to diagnose and treat illness and prescribe medication for patients. Data from the AAPA show that almost half (45.5%) of PAs are employed in outpatient offices and clinics, 38% work in hospitals, and the remainder in other settings.

The 2018 AAPA Salary Survey was conducted between February 2 and March 2 and sent to 78,244 PAs, and a total of 9,140 PAs responded to the survey. Both hospitals and physician practices offer competitive salaries, leadership opportunities, and good benefits to PAs, but the new report has demonstrated obvious differences between the two settings. For example, those employed in hospitals earned a median base salary of $107,000 in 2017, while PAs working in physician practices earned $101,000.

There is also more opportunity for career advancement in the hospital setting. PAs employed by hospitals were more likely to report a career ladder for PAs at their institution compared to those working in physician practices (27.7% vs. 11.0%). In addition, formal leadership positions were more likely held by PAs working in hospitals (57.5% vs. 28.2%), and they are also more likely to have completed formal leadership training (12.6% vs. 8.7%). Regarding benefits, hospitals tended to offer PAs more paid time off than physician practices (20.0 vs. 17.8 days of general paid time off and 8.4 vs. 5.0 days of sick paid time off).

Academic medical centers were the most common setting for PAs employed in hospitals and accounted for 46.4% of hospital-employed PAs. Community nonprofit hospitals accounted for 38.8% of hospital-employed PAs, and the remaining 15% reported being employed by other types of hospitals. 

The report also found that PA salaries, overall, increased by 2.9% from a median base salary of $102,000 in 2016 to $105,000 in 2017. Those employed part-time (24 hours per week) reported base salaries of $79,500, which extrapolates to 75% of a full-time (40 hours per week) median base salary of $105,000. In addition, PAs employed part-time who were paid on an hourly basis earned a median hourly wage of $56, compared to $60 an hour for full-time PAs.

Higher salaries tended to correlate with regions with a higher cost of living. For example, when cost-of-living differences are factored into the mix, the top five cost-of-living adjusted median base salaries for PAs are in Mississippi ($117,925), Iowa ($117,519), Oklahoma ($117,127), Texas ($115,546), and Indiana ($113,786). 

“PAs are critical members of a patient’s care team who practice in all medical settings and specialties across the country,” said Jonathan Sobel, PA-C, MBA, DFAAPA, FAPACVS, president and chair of the AAPA Board of Directors. “This valuable resource will help PAs plan for the future and navigate the ever-changing healthcare job market.”