September 30, 2022

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Leslie Clayton, a physician assistant in Minnesota, says a name change for her profession is long overdue. “We don’t assist,” she says. “We provide care as part of a team.”

Liam James Doyle for KHN


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Liam James Doyle for KHN


Leslie Clayton, a physician assistant in Minnesota, says a name change for her profession is long overdue. “We don’t assist,” she says. “We provide care as part of a team.”

Liam James Doyle for KHN

After 23 years as a physician assistant, Leslie Clayton remains rankled by one facet of her vocation: its title. Specifically, the word “assistant.”

Patients have asked if she’s heading to medical school or in the middle of it. The term confounded even her family, she says: It took years for her parents to understand she does more than take blood pressure and perform similar basic tasks.

“There is an assumption that there has to be some sort of direct, hands-on oversight for us to do our work, and that’s not been accurate for decades,” says Clayton, who practices at a clinic in Golden Valley, Minn. “We don’t assist. We provide care as part of a team.”

Seeking greater understanding for and appreciation of their profession, physician assistants are pushing to rebrand themselves as “physician associates.” Their national group formally replaced “assistant” with “associate” in its name in May, transforming into the American Academy of Physician Associates. The group hopes state legislatures and regulatory bodies will legally enshrine the name change in statutes and rules. The total cost of the campaign, which began in 2018, will reach nearly $22 million, according to a consulting firm hired by the association.

Doctors are pushing back

But rechristening the PA name has spiked the blood pressure of physicians, who complain that some patients will wrongly assume a “physician associate” is a junior doctor — much as an attorney who has not yet made partner is an associate. The head of the American Medical Association has warned that the change “will undoubtedly confuse patients and is clearly an attempt to advance their pursuit toward independent practice.” The American Osteopathic Association, another group that represents doctors, accused PAs and other nonphysician clinicians of trying “to obfuscate their credentials through title misappropriation.”

In medicine, seemingly innocuous title changes are inflamed by the unending turf wars between various levels of practitioners who jealously guard their professional prerogatives and the kind of care they are authorized to perform. Just this year, the National Conference of State Legislatures catalogued 280 bills introduced in statehouses to modify scope-of-practice laws that set the practice boundaries of nurses, physician assistants, pharmacists, paramedics, dental hygienists, optometrists and addiction counselors.

Lawmakers allowed North Carolina dental hygienists to administer local anesthetics; permitted Wyoming optometrists — who, unlike ophthalmologists, do not attend medical school — to use lasers and perform surgeries in certain circumstances; and authorized Arkansas certified nurse practitioners to practice independently. Meanwhile, the physicians’ lobby aggressively fights these kinds of proposals in state legislatures, accusing other

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