PA salaries have been increasing significantly over the last few years, particularly for new graduates. PAEA data shows that between the graduating classes of 2006 and 2008, the average new graduate salary went from $68,886 to $76,410, a 9% rise. This is a remarkable increase in light of the fact that most of the class of 2008 graduates began their first position during or after the 2008 financial crisis that substantially decreased employment demand and salaries for many American workers. Anecdotally, PA faculty currently report that new graduates are being offered increasingly higher salaries for their first job, mostly in medical specialties and subspecialties.
While most of us in the profession view increasing salaries positively, rapidly increasing salaries do have consequences that might be considered negative. From my view as a PA educator, I recall when rapidly rising salaries occurred in the late 1980s and early 1990s, resulting in many PA educators returning to clinical practice. The increased demand for PAs that produced these sharp salary increases also stimulated the demand for the creation of many more PA programs, and these new programs were seeking new faculty at a time when many experienced PA educators were returning to clinical practice. The result was a challenging dilemma: how does the profession expand to meet a sharply increasing demand for PAs, accompanied by increasing salaries produced by the lack of supply of PAs, when those increasing salaries themselves have reduced the pool of experienced educators. In such a dynamic, can an increasing number of competent PAs be trained? Will the PA educator talent pool be stretched so thin as to result in a decrease in the quality of PA graduates? The same process is happening now.
Another consequence of rapidly increasing salaries is the impact on primary care. Primary care employers, mostly because our medical delivery system has assigned a low value to primary care services via low reimbursement rates, will likely not be able to match the increasing salaries. Most new PA jobs created over the last decade were in non-primary care areas, as illustrated last year in a paper by Morgan and Hooker, and it is likely the increased demand in these non-primary care settings that is driving PA salaries up. With increasing salaries in non-primary care specialties and stagnant pay in primary care, fewer PA can be expected to enter primary care.
Another consequence of rapidly increasing salaries is the attraction of new applicants to the profession for what some may consider the wrong reasons. For the most part, the PA profession has historically attracted smart and compassionate people, and the moderate salaries have likely dissuaded those motivated primarily by high salaries from becoming PAs. Will higher salaries attract more people motivated more by money than by altruism?
What are your thoughts on our sudden increase in salaries? Have you recently made a job change in response to this phenomenon? How do you think this trend will change the profession in the future?
Rick Dehn is a professor in the School of Health and Human Services and chair of the PA program at Northern Arizona University, Flagstaff.