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Each year, the National Commission on Certification of Physician Assistants (NCCPA) fields a survey across the US physician associate (PA) workforce to gain a greater understanding of the underlying demographics, employment characteristics, and practice data for the field. While past NCCPA Statistical Profiles of Board-Certified PAs by State have highlighted growing burnout symptoms in the PA population and gender wage gaps, this year’s survey has identified a new trend involving workforce transitions, particularly in rural states.
Across the board, 5.8% of PAs in the US reported that they planned to retire within the next 5 years. Yet states like Wyoming (14.3%), Alaska (14.2%), Vermont (11.8%), and New Mexico (10.7%), all states with large rural populations, show a significantly larger proportion of would-be retirees. Importantly, those states do not have a corresponding growth in survey respondents who reported their workplace was actively recruiting new PAs.
“We see 10,000 or more newly certified PAs entering the workforce each year, and that number is only growing,” said Andrzej Kozikowski, PhD, senior director of research at the NCCPA. “But nearly one third of physicians in the country are approaching retirement age. And with data showing that specialties like primary care are declining across the PA profession, converging trends suggest healthcare organizations should take a closer look at future recruitment.”
About Medscape Insights
Medscape continually surveys physicians and other medical professionals about key practice challenges and current issues, creating high-impact analyses. For example, the Medscape Physician Assistant Job Market Report 2025 found that:
- Between 60% and 67% of PAs surveyed said the demand for PAs was high or very high.
- Respondents in our survey reported that the North, South, and Midwest were most in demand for PA jobs.
- Years of experience and a high number of CME hours in a specialty made PAs the most sought-after.
The Gradual Aging of a Profession
Michel Statler, DMSc, PA-C, retired in March 2024 after a long career both in clinical practice and PA education. She said once she qualified for Medicare, she decided to “dial things back a bit.” When asked about trends in PA retirement, Statler said she believes that any growing numbers of potential retirees, regardless of state, probably reflect “the overall age of the profession.”
“PA, as a profession, was first launched in the 1960s. If you think about those initial PAs, graduating in the late 1960s and through the 1970s, they are now all getting to an age that is consistent with retirement,” she added. “The aging of those first PAs is catching up with us a bit.”
Interestingly, Mirela Bruza, PhD, MS, PA-C, researcher with NCCPA, said that other research studies have shown that PAs, on the whole, tend to retire later than other types of healthcare providers, usually after 70. While that piece of data, along with the growing number of PA programs across the country, might initially suggest that newer PAs will simply fill the gaps left by those who do end up retiring, it may not be quite so simple.
“We’ve also seen that PAs that work in primary care, especially internal medicine and family medicine, are the ones reporting they are planning to retire,” said Bruza. “Looking across these different surveys, it seems like the trends are moving in a similar direction.”
Jeffrey Katz, PA-C, DFAAPA, who is technically retired but still works as needed at an urgent care center, said he can understand why PAs in primary care specialties may be more inclined to hang up their stethoscopes when they can — and why younger cohorts of PAs may not be interested in working in those areas.
“This kind of medicine is hard. You have to be available for your patients when they need you. Care coordination is dismal at best,” he added. “Salaries in primary care also tend to be lower than those in other specialties like surgery. It makes it harder to get people into these kinds of jobs.”
A Continued Need for Rural Providers
While the NCCPA’s Statistical Profile, for the most part, has shown relatively consistent plan-to-retire percentages over the past few years, there are some concerning increases in states with larger rural areas like Wyoming, Vermont, and Alaska. With the Commonwealth Fund estimating that 43 million Americans live in rural areas with primary care health professional shortages, filling the gaps left by retirements in these communities should be a priority.
“I’ve always thought that PAs were the answer to changing the healthcare system and improving access to care,” said Katz, who spent most of his career working in a rural health clinic in North Carolina. “But we need to find ways to incentivize PAs to work in these places.”
Increased pay would be a start, he said. Yet, as noted in the NCCPA’s recent study, median salaries tend to be lower in states with large rural areas regardless of specialty. That difference in pay, especially when you factor in the high cost of PA education and new obstacles to obtaining federal student loans for graduate study, may make backfilling PA positions even more of a challenge. Without equitable pay, newer PAs are more likely to gravitate toward higher-paying specialties, in higher-paying areas, to ensure they can pay off any student debt. That could leave an alarming lack of family medicine and primary care providers outside of cities and suburbs.
Understanding PA Retirement Data
Unfortunately, it’s difficult to know whether the country is truly facing a PA retirement wave, said Kozikowski. The NCCPA Statistical Profile only asks about intentions to retire — the organization can’t track who follows through with their plan. That can make it hard for employers to know when they should start considering succession plans or expanding their recruitment efforts in a proactive way.
“We often see in PAs, as well as other providers, that they don’t always fully retire but just decrease the number of hours they work as they get older,” said Kozikowski. Certainly, Katz falls into that category. He plans to continue working “as long as he can.”
Even with such unknowns, however, it’s clear that, with projected provider shortages, healthcare organizations need to act sooner rather than later to ensure they can recruit and retain enough PAs to support the highest-quality patient care. While the ever-evolving healthcare landscape already makes such planning difficult, understanding the latest trends regarding PA retirement and PA specialties provided by NCCPA’s latest Statistical Profile can help guide hospitals and practices as they work to expand healthcare access, regardless of location, as more PAs look at potential retirement.
“[The Statistical Profile] gives policymakers, educators, and healthcare leaders a clearer picture of where the PA workforce stands today and where attention is urgently needed,” said Dawn Morton-Rias, EdD, PA-C, ICE-CCP, NCCPA president and CEO. “The data show a profession that continues to expand its impact, while also confronting persistent disparities and a changing care environment.”
Disclosure information for Statler, Kozikowski, Katz, Bruza, and Morton-Rias was not available at the time of publication.
Kayt Sukel is a healthcare and science writer based outside Houston.
