← Risk register SOC 29-1071 · reviewed 2026-08-11

Physician Assistants

162,150 US workers · median $135,880/yr · Healthcare

SAFE

PAs spend their day doing physical exams, suturing, injections, casting, assisting in surgery, and delivering diagnoses face to face — none of which a language model or current robot performs. The automatable slice is real but bounded: chart notes, differential lists, order sets, patient instructions, and coding are already being drafted by AI, which compresses documentation time rather than the clinical visit. State licensure plus prescriptive authority means a liable human signs the chart and the prescription.

10-year outlook: Demand keeps growing as PAs absorb visits from physician shortages; AI strips documentation and routine triage from the day, pushing PAs further toward procedures, complex patients, and signed clinical accountability.

US employment, 2019–2025+35.0%
120,090162,150 workers

Headcount grew steadily across the period.

Median pay $112,260 → $135,880 -3.2% in real terms (nominal +21.0%, less ~25% US inflation over the period)

The job count is not the verdict

This line is counted by the Bureau of Labor Statistics — the one figure on this page that isn't a judgement of ours. Headcount moves on demand, offshoring, demographics and the business cycle, and automation is one term among several, often not the loudest.

So a falling line is not evidence that AI did it, and a rising one is not evidence that it won't. Both happen in this register: some occupations resist automation and shrink anyway, others are highly automatable and keep growing. The marked year is 2020.

BLS projection, 2024–2034

+20.4% 162,700 → 195,800 on the projections basis

Hard to automate, and growing

The work resists current AI and the BLS projects +20.4% more of these jobs by 2034. Note that safe does not mean well paid — several of the fastest-growing resistant occupations are among the lowest paid on the register.

Different clocks. The score is what current AI could do to this work today. The projection is how many of these jobs will exist in 2034. Everything between the two — how fast employers actually adopt, whether demand grows in the meantime — is why they can point opposite ways without either being wrong.

~12,000 openings a year on average, including replacing people who leave.

One email if this score changes. Watch as many occupations as you like from the same address — no account, and nothing is sent on a schedule, only when a verdict actually moves.

Also known as — 24 job titles this covers

Titles reported by people doing this work, from the US Department of Labor's O*NET survey. If your job title is here, this page is about your work even though the name doesn't match.

Doctor AssistantAnesthesia AssistantAnesthetic AssistantAnesthesia SpecialistAnesthesia TechnicianPhysician's AssistantUrgent Care SpecialistAnesthesia TechnologistGynecological AssistantPhysician Assistant (PA)Physician Associate (PA)Operating Room TechnicianAnesthesiologist AssistantFamily Physician AssistantMedical Service TechnicianPediatric Physician AssistantCardiology Physician AssistantOrthopedic Physician AssistantCertified Anesthesia TechnicianOrthopaedic Physician AssistantAdvanced Practice Provider (AAP)Radiology Practitioner AssistantFamily Practice Physician AssistantCardiothoracic Anesthesia Technician

Score — 77/100 resistance

Holding it up: embodiment (17/20). Weakest point: task resistance (13/20).

Five dimensions, 0–20 each, summed. Higher means more protected. The arithmetic is shown so you can check it: 13 + 17 + 17 + 15 + 15 = 77. · Scored 2026-08-11, and re-examined when evidence accumulates rather than on a schedule.

Task resistance 13/20

Mixed — a routine tier and a judgment tier 13 rather than 16 because a real fraction of a PA's shift is genuinely displaceable — ambient scribes now draft the H&P and SOAP note, order sets and refill authorizations are protocol-driven, and much of urgent-care triage (strep, UTI, med refills) is already being routed to algorithmic e-visits — but the palpation, wound closure, joint injection, and pelvic exam that anchor the visit stay human.

Embodiment 17/20

Hands-on in uncontrolled environments 17 reflects that PA work happens on live bodies in uncontrolled settings — draining an abscess in a clinic room, first-assisting with retraction in an OR, reducing a dislocated shoulder in an ED bay, splinting on an ortho floor — with the remaining 3 points held back only because some PAs practice in narrow specialties (derm reads, psych med management, telehealth) where the hands-on share drops.

Liability shield 17/20

Licensed human required and personally liable 17 because PAs hold a state licence plus DEA registration and prescriptive authority, are named defendants in malpractice suits in their own right, and their signature on the chart and script is the legally operative act — short of 20 only because most states still tie practice to a collaborating or supervising physician agreement, so the accountability is shared rather than solely theirs.

Trust premium 15/20

The human relationship is the product 15 because in primary care, ortho, and oncology panels the PA is the clinician the patient actually sees every visit and tells things they withhold from the attending, and continuity drives adherence — but locum, ED, and surgical-assist PAs meet patients once, which is what separates this from the 18-20 of a longitudinal family physician.

Judgment & accountability 15/20

Exists to be accountable for ambiguous calls 15 because the PA decides who gets a CT versus reassurance, who is admitted versus sent home, when chest pain is reflux and when it is an NSTEMI, and titrates opioids and antibiotics under stewardship pressure — high-stakes and ambiguous, though tempered by guidelines, standing orders, and the option to escalate to the supervising physician.

Confidence: high · reviewed 2026-08-11 · how scoring works

What this job involves — and which parts are yours

The verdict above describes this occupation as a whole. Almost nobody does the typical version of a job — tick what's actually in your week and see how your own mix sits.

AI already does these at usable quality

These still need a person

Active moats on the surviving side: embodiment, licensure, trust

How to future-proof this job

Where to go deeper on what this job runs on: Khan Academy — reading and vocabulary, all levels, free free · Coursera — critical thinking and logic, audit free free to audit · Coursera — active listening and communication skills free to audit · Purdue OWL — the standard reference for professional writing free · Toastmasters — public speaking practice at local clubs worldwide low · Coursera — active listening and communication skills free to audit

All 35 skills ranked by how many jobs they open →

What would move this back up — beyond any one person

The moves above are yours to make. This is the other half: what would have to change in the world for the occupation itself to score higher. None of it is in any one person's gift, but it is where the floor actually comes from. Scores here are not a one-way ratchet. Only two of the five dimensions — task resistance and embodiment — track what machines can do. The other three track law, what buyers will pay for, and who is answerable, and those move in both directions, often in response to the same pressure AI creates. If every lever below landed, this occupation would score around 86/100, still SAFE.

4 specific changes that would raise this score
  • already happening judgment accountability +3

    Continued expansion of PA full practice authority / optimal team practice (enacted in some form in Utah, North Dakota, Wyoming, Colorado 2024) so PAs own the disposition decision without physician co-signature, making them the accountable decision-maker of record for admit/discharge, escalation, and prescribing under ambiguity.

  • already happening liability shield +2

    State medical/PA boards or legislatures explicitly requiring that AI-generated diagnostic impressions, order sets, and prescriptions be reviewed and signed by a licensed clinician who retains personal liability — the pattern in state 'AI in utilization review' laws already enacted (e.g., California SB 1120, 2024, barring AI-only denials) extended to point-of-care documentation and prescribing. Also DEA rules keeping controlled-substance prescribing tied to a licensed prescriber's DEA number.

  • already happening task resistance +2

    Task-mix shift: as ambient scribes (Abridge, Nuance DAX) and AI coding absorb documentation and billing, the residual day is exam, procedures, undifferentiated complaint triage, and goals-of-care conversations — the judgment tier. Rises further if malpractice insurers require documented independent clinical reasoning separate from AI output.

  • plausible trust premium +2

    Patient-facing rules requiring disclosure when an AI generated a clinical recommendation (Utah HB 452 style disclosure laws for mental health chatbots, extended to general care), plus payer requirements for an in-person examination before certain services — making a human encounter the billable, purchasable unit.

The limit. Already 77 and physically anchored; realistic headroom is a few points, mostly from practice-authority statutes. The main downside risk is not automation of the visit but scope substitution — if AI-assisted triage lets health systems staff more patients per clinician, headcount growth slows without any score changing.

These are conditions, not forecasts — what would have to happen, not what will. Specific rules, cases and bills are named so you can go and check whether they exist and where they stand; verify before relying on any of them. Nothing here is legal or financial advice.

Where this work is, and what it pays there

BLS metro figures for 348 areas. The verdict above does not change by city — the rubric judges what the work involves, not where it happens — but pay and headcount do, and the national median hides a very wide range.

Most of these jobs

New York-Newark-Jersey City, NY-NJ 16,800 $167,650 +23%
Atlanta-Sandy Springs-Roswell, GA 3,970 $111,810 -18%
Los Angeles-Long Beach-Anaheim, CA 3,890 $161,890 +19%
Boston-Cambridge-Newton, MA-NH 3,550 $142,410 +5%
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 3,390 $135,640 +0%
Dallas-Fort Worth-Arlington, TX 3,230 $134,900 -1%
Chicago-Naperville-Elgin, IL-IN 3,050 $127,940 -6%
Phoenix-Mesa-Chandler, AZ 3,050 $134,650 -1%

Best paid

San Jose-Sunnyvale-Santa Clara, CA 1,030 $223,640 +65%
Bakersfield-Delano, CA 350 $198,070 +46%
San Francisco-Oakland-Fremont, CA 1,830 $184,380 +36%

Percentages are against this occupation's national median of $135,880. Counts are jobs in that metro, not vacancies. Metros where the BLS suppressed the cell are absent rather than shown as zero.

Who is actually doing this — nobody, on the record

We have no reported case of a named organisation automating this occupation. Not one deployment, not one announcement.

That is worth saying out loud next to a score of 77. The verdict above is about what the work exposes — what current AI could do to these tasks. It is not a claim that anyone has done it. For this occupation those two things have come apart completely: the capability argument is on this page, and the evidence column is empty.

Read that as a gap in the reporting we can see, not proof of absence — the dispatch runs on English-language feeds and misses plenty. If you know of a case, tell us, or add a field report from inside the job.

Quick take — do you do this job?

Has AI actually changed your work? One tap, anonymous, and the running tally is public. Nothing else is asked of you.

Self-reported and unverified — a sentiment signal, not a survey. One response per person per occupation; you can change your answer.

Field reports — what people say has changed

No field reports yet. A written account takes a paragraph rather than a tap, goes to an editor before it appears, and is the one thing on this page the rubric cannot produce on its own.

File a field report

Concrete beats general: a tool that arrived, a task that moved, a headcount decision you watched happen. Don't include anything that identifies you or your employer if that would put you at risk.

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