In recent years, the physician associate (PA) profession has made notable advancements in the administrative medicine sector. Currently, over 200,000 PAs are practicing within the U.S. healthcare system, and their roles and scope of practice are continually evolving. The demand for PAs remains robust, a trend that industry experts anticipate will persist. And yet, while a specific statistic on the number or percentage of PAs in C-suite positions is not available, the evidence suggests that PAs are increasingly taking on leadership roles within healthcare organizations, some of which may fall into the category of C-suite or executive leadership positions.

Despite widespread acceptance and recognition slowly increasing within the medical community, the PA profession has faced many challenges since its inception & during its development. The integration of non-physician providers as key members of interprofessional healthcare teams was advocated by the Institute of Medicine in 2003, but it has not been universally embraced by all sectors and stakeholders in the healthcare industry. However, progress is being made, albeit gradually, as many can attest.

Unfortunately, PAs still encounter barriers, such as limited representation in executive leadership and boardroom positions, often referred to as "fiefdoms," "silos," or an "Executive Glass Ceiling." In the realm of administrative medicine, PAs remain underrecognized and undervalued as potential contributors to hospital executive committees and boardrooms.

So, this raises the question: Why is the industry so short-sighted? Despite the progress PAs have made, why are they underrepresented in leadership roles within administrative medicine? These questions remain largely unanswered, but allow me to posit a theory for this, if I may.

As an experienced PA, I am well-acquainted with the challenges faced over the past 35 years in the pursuit of professional recognition and respect in a fragmented industry. Despite our significant contributions and expertise, our underrepresentation may be attributed to several industry barriers, which I will discuss objectively within this commentary—just a personal opinion and observation.

One such barrier was the professional stratification or corporate segregation prevalent in the US. This subtle, unconscious mindset contributes to the exclusion of competent healthcare professionals from leadership roles within healthcare organizations without an MBA or MHA.

Another issue is/was the "assistant stigmatization." Being perceived as subordinate to physicians has led some administrators to undervalue our skills and contributions. For instance, a 2011 American Hospital Association survey found that nurses comprised 6 percent of hospital board members, compared to 20 percent of physicians. PAs are not yet close to these figures. Some healthcare executives are beginning to recognize that the successful operation of complex healthcare organizations requires high levels of cooperation and understanding among diverse professional groups and the need to challenge "professional organizational turfism or siloing." While some online discussions suggest limited advancement opportunities beyond clinical roles, other sources mention that experienced PAs can take on greater responsibilities and seek leadership positions now that many are pursuing and obtaining their doctoral degrees. So, career advancement for PAs in leadership roles and positions is becoming more attainable than ever before.

While the current situation is mixed and somewhat elusive, there is hope that the PA profession will continue to gain recognition for its contributions and collaborative efforts over the past fifty years. For example,

Take Away

It is becoming obvious and increasingly clear that the traditional approach of "business as usual" is becoming outdated; instead, more of our industry leaders are embracing corporate administrative diversity. The old administrative corporate paradigm & the mindset of "nonclinicians" not being part of the C-suite are slowly being replaced by the new reality of "we're all in this together." Definitively a new day is emerging in the C-suites across the US.