9 Reasons To Become a Primary Care Physician Assistant

Posted By: Paul   |   Physician Assistant Specialties   |   10 Comments

primary care PAWhether you’re just looking into a career as a physician assistant, or you’re already in PA school, it’s never too early to start thinking about a specialty.  But what about the biggest specialty of all – Primary Care?  Primary Care has had a bit of a public relations problem for decades, but today we’re going to talk about why Primary Care is worth a second look.  It’s actually a group of specialties: Family Practice, General Internal Medicine, Pediatrics, and Obstetrics and Gynecology (OB/GYN).  These are broad areas.  And to be a primary care provider you need to know at least a little (and often a lot) about a lot of things.

Why You Should Take Another Look at Primary Care

If you wrote Primary Care off as not for you, you might want to take a second look.  There are some great reasons to go into this field – reasons that you might never have considered.

Job Security and Filling the Biggest Void

As a primary care PA, you will always have a job.  Plastic Surgery PAs can’t say that – when the economy dips they can get laid off.  But there is a huge shortage of primary care providers, and if you become one you will be seen as a little bit of a hero to your patients.  People naturally appreciate others who do what needs doing most.  And for it, your patients will go to great lengths to appreciate you; they will make sure you know that  your work makes a difference.


Get bored easily?  No problem.  Every day in Primary Care is different.  Not only will you serve all types of people, you will be called on to weigh in on all types of problems.  Illness, injuries, psychiatric problems, family planning, diet, exercise, medications, imaging, and advocacy for your patients will all be within your province.  You will get to do many different things.

“Is There a Physician Assistant in the House?”

We’ve all heard of flight attendants asking for medical assistance on planes.  This really happens, and it is rewarding and fun to be there when it does.  If you’re a dermatology or hand surgery PA, you won’t get called on very often to save the day when you’re out in public.  But as a Primary Care PA you can confidently step forward to help if ever there is a need.  If you are a hand surgery PA (and it isn’t about someone’s hand), believe me: you’re gonna want to hide in the lavatory.


Primary Care — because of its broad scope — requires you to use your intuition.  Often you will need to treat patients before you have a lot of data, such as when you have a patient with abdominal pain, or a child with a fever.  You will need to use instinct and “feel out” what you think is happening.  Is this patient BIG sick, or LITTLE sick?  Are they suffering from an infectious process, or an inflammatory one, or something else?  Can treatment wait, or is it urgent?  These questions require a provider who is comfortable making educated guesses and acting on them.  By contrast, surgical specialists collect as much data as possible, then try to go in with a plan, hoping to avoid surprises like the plague.


If you value your professional independence, Primary Care has a pleasant surprise in store for you.  As with all PA specialties you will work under the supervision of a physician.  But it pays to investigate just how closely.  Here you will mostly be flying solo, which is very important to some.  You will have your own patients, and you will be expected to make the decisions.  You may sometimes consult with your supervising physician, but you will usually be the one who decides when.  This is different from surgery, where as a PA you will have much clinical responsibility, but more of what you do will be with or at the direction of your supervising physician.


Particularly if you’re younger, this tends to get overlooked.  Do you want to get to know your patients?  Do you want to know them better each time you see them?  If so, Primary Care is the way to go.  It’s not uncommon for Primary Care PAs to work with the same patients for decades.  You may even treat one of your original patients’ children someday.  For some, this relationship building is stressful, uncomfortable, or unimportant.  These folks should probably consider something else.  But if you see the relationships with your patients as another nice perk of your job, your patients will love you, and you will have another reason to love what you do.


Besides treatment, in primary care you will be tasked with teaching your patients about their health.  In narrower specialties such as neurology or endocrinology this is harder and less realistic.  In primary care it’s not only possible — it’s essential. Helping diabetics understand how to maintain their blood sugar and helping depressed people to understand the importance of remaining socially engaged are just two examples.  Patients love to have things explained to them, and if you do it, they will love you for it.

Find Out What Happened

In primary care you will find out if what you did worked.  If there’s uncertainty, you will eventually find out what was “really going on,” and what happened in the end — because you will follow your patients.  By contrast, Emergency Room PAs often treat patients and never see them again.  This makes for many unfinished stories, and can leave you wondering how well you are helping your patients in the long run.  If you always want to know how things turn out, then you’re in luck in Primary Care.


Primary care is by its nature a social specialty.  There’s lots to do, so you will have more office staff than most.  You will also have different patients than most, and consult with more specialists than most.  Much of what you do will require teamwork, and you will be one of the team leaders, if not the team leader.  Some specialties that differ here?  Psychiatry — where privacy is so important — will have you interacting with fewer people, and Internal Medicine subspecialties like hepatology tend to be so narrow that you don’t need much staff and you see fewer patients in a day.

Financial Aid

Because Primary Care is in such demand, it’s the best place to find someone to help you pay off your student loan debt.  It’s not uncommon for Family Practice and OB/GYN clinics to hire you with an agreement to pay off a chunk of your PA school debt for staying for a predetermined length of time.  They do this to attract applicants, and it should attract you.  Once those loans are paid off, you have more options for your career than ever.


At first glance, Primary Care can seem “ordinary,” because it doesn’t have a high magnification focus on any one area.  But that means you will enjoy variety, challenge, and great responsibility in this specialty.  So take a closer look – the payoff could be a long and satisfying career.



  1. Hilary Webb January 30, 2014 at 11:33 pm - Reply

    Great post Paul!

    • Paul February 2, 2014 at 11:31 am - Reply

      Thanks, Hilary! We’ll keep them coming.

  2. The PA Coach January 31, 2014 at 6:48 am - Reply

    Great post Paul. Even after 14 yrs of clinical practice, I still enjoy Primary Care the most!

  3. Devin February 1, 2014 at 3:29 pm - Reply

    Thank you for this article. It clarified a lot of my questions about Physician Assistants in primary care. I really feel now that primary care is right for me and my interests.

    • Paul February 2, 2014 at 11:30 am - Reply

      That’s great, Devin! It’s a far more fun and rewarding specialty than most people realize!

  4. Henry February 6, 2014 at 1:23 pm - Reply

    Paul – thanks for the article. For many of those reasons you’ve listed above, I’ve been doing some research between NP’s and PA’s and I’m not sure which to pursue in order to become a great practitioner in the near future.

    At this point, I’ve already gotten a bachelors from a decent science university, worked at a pharmacy as a clerk & tech (& decided pharm is not for me), and am going back to community college to finish up NP/PA prereqs (there is overlap in some courses). I’m currently searching for shadowing/volunteer opportunities and have read your articles on that. What would you suggest as the next step?

    • Paul February 6, 2014 at 8:15 pm - Reply

      Shadow, shadow, shadow. This should make it clear to you whether NP of PA is for you. They primarily differ by curriculum, not function. But there are a few differences you should be aware of – NPs specialize in a more official way, so they have a harder time changing what they do. PAs specialize unofficially, so to change specialty basically means getting a new job; not so hard. NPs can practice solo; PAs always work under an MD. Ask those you intend to shadow about the differences and get clear on what will feel best to you.


  5. Anthony February 21, 2014 at 6:04 pm - Reply

    Great article Paul! I can say that I am happy to be going into Primary Care once I am done with PA school (Just accepted this year) I was lucky to receive a scholarship that is granted to those interested in primary care. I worked EMS for 12 years and look forward to the broad spectrum of patients I will see and work with them to get healthy! Thank you again for your commitment to this site!

  6. Jennifer September 6, 2014 at 7:42 pm - Reply

    I am interested in becoming a PA particular specializing in the field of OB/GYN. Any advice for me? I am a senior in high school

    • Paul September 7, 2014 at 12:15 pm - Reply

      My advice for you is twofold:

      1) get excellent grades.
      2) see number one above.

      Once you’ve completed your degree with excellent grades, you would do well to find it job or volunteer position working in an OB/GYN clinic or the labor and delivery Department of a hospital. But don’t worry about that at this point. Far and away the most important thing you can do is to get excellent grades in whatever courses you take leading to your bachelors degree.

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