{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/physician-assistants/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Physician Assistants",
    "soc_code": "29-1071",
    "category": "Healthcare",
    "us_employment": 162150,
    "median_annual_wage": 135880
  },
  "verdict": "SAFE",
  "risk_resistance": 77,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 13,
    "embodiment": 17,
    "liability_shield": 17,
    "trust_premium": 15,
    "judgment_accountability": 15
  },
  "reasoning": {
    "task_resistance": "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 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 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 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 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."
  },
  "rationale": "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.",
  "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.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "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.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "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.",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "task_resistance",
        "change": "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.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "trust_premium",
        "change": "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.",
        "plausibility": "plausible",
        "would_add": 2
      }
    ],
    "ceiling_note": "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."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 109220,
        "wage": 104860
      },
      {
        "y": 2018,
        "emp": 114710,
        "wage": 108610
      },
      {
        "y": 2019,
        "emp": 120090,
        "wage": 112260
      },
      {
        "y": 2020,
        "emp": 125280,
        "wage": 115390
      },
      {
        "y": 2021,
        "emp": 132940,
        "wage": 121530
      },
      {
        "y": 2022,
        "emp": 140910,
        "wage": 126010
      },
      {
        "y": 2023,
        "emp": 145740,
        "wage": 130020
      },
      {
        "y": 2024,
        "emp": 155540,
        "wage": 133260
      },
      {
        "y": 2025,
        "emp": 162150,
        "wage": 135880
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 48.5,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}