A Brief Overview of Physician Assistants in the United States


  • Mary Showstark
  • David Mittman


United States, Physician Assistants


The PA profession was established in 1965 at Duke University in North Carolina. The first four graduates were Navy Corpsmen (military medical experience). Upon graduation in 1967, they all started practicing at Duke University. Today, there are approximately 150,000 PAs practicing across all 50 states in the US (NCCPA, state information 2020). PAs have more than 400 million patient interactions per year (2019 AAPA Salary Survey). The profession in America is now very well-established. 


There is increasing specialization with 75% of the practicing PAs specialize (AAPA, 2016).  There is an increasing proportion of women with over 69% of all PAs; 73% of students are women (AAPA/PAEA, 2016).  PAs demonstrate high levels of patient acceptance, quality of care, and clinical flexibility. All PAs must graduate from an ARC-PA accredited program to practice in the USA, which means that PAs that intend to work in the US must train at a US university.  There are no bridging programs at the current moment that allow for PAs from other countries to work in the US as a PA.  The PA education training would need to be repeated.

Author Biographies

Mary Showstark

Mary Showstark is a PA (physician assistant) an Assistant Professor at the Yale School of Medicine Physician Assistant Online Program and an affiliate faculty member of the Yale Institute of Global Health and Director of Virtual Interprofessional Education (VIPE).  Showstark’s clinical experience is in trauma surgery, emergency medicine, urgent care and disaster medicine & preparedness for the U.S. Federal government, mass gatherings, & NGOs. Showstark has worked in event medicine and concierge services around the world, working for the professional surfers, Tough Mudder, Burning Man, NYC & Paris Marathons setting up medical and disaster plans. Showstark worked in Haiti, Nepal, Mexico Beach, Cucuta/Venezuela, Bahamas, responding to natural disasters and humanitarian crises providing medical care in rural and austere environments. She has worked the State of the Union for President Obama and President Trump’s inauguration medical team.


Mary Showstark is involved in growing the healthcare workforce for the PA profession globally. She is Director of New Development for PAs for Global Health, a global ambassador to the American Academy of Physician Assistants (AAPA), liaison to Euro-PAC, communications lead for International Academy of PA Educators (IAPAE) and consults with the World Health Organization on the Global Framework for Universal Healthcare to support the 2030 agenda. She is also the creator of the International Federation of Physician Assistant/Physician Associate and Clinical Officer/Clinical Associate/Comparable Students’ Association (IFPACS). Showstark is working with Interprofessional.Global to rewrite the WHO guidelines on interprofessional health.

David Mittman

David (Dave) E. Mittman has served in numerous PA leadership roles over the last 30 years, including serving on the AAPA Board of Directors, the AAPA House of Delegates (HOD), and various state Chapters, specialty organizations and special interest groups. Most recently, he served as on the AAPA Board of Directors from 2015-2018 as director-at-large, after previously serving in the same role in the early 1980s.

Mittman also was a leader for the PA profession in medical publishing and communications, launching journals and web community for PAs. Based in Boynton Beach, Fla., Mittman is currently editor-in-chief of Clinician1, an online community for PAs and NPs, which he launched in 2009. A prolific writer on the value and practice of PAs, Mittman practiced in primary care in Brooklyn for nearly a decade before beginning his career working in medical publishing and communications as a platform to educate the healthcare industry on who PAs are and what they do. He cofounded Clinician Reviews, the first industry publication to serve both PAs and NPs, as well as seven other medical publications.

Mittman is a veteran of the profession, known for the groundbreaking and formative roles he played in the PA profession’s infancy. He was the first PA allowed to practice in the Air Force Reserves, was a founding student member of the New York State Society of PAs (NYSSPA) and led the march on the “March on Trenton” to the New Jersey State House, which ultimately resulted in establishing PA practice in the state. Mittman was also one of the first PAs to co- manage and later manage his own patient panel in the late 1970s and early 1980s. As the profession matured, Mittman has continued leading efforts that challenge the status quo, such as co-founding PAs for Tomorrow and the American College of Clinicians, which advocated for greater PA-NP collaboration.

Mittman has been honored for his work with a number of awards, including AAPA’s Public Education Award and both the NYSSPA and the New Jersey State Society of PAs Lifetime Achievement awards. He has also been recognized by the PA History Society.




How to Cite

Showstark, M., & Mittman, D. (2021). A Brief Overview of Physician Assistants in the United States. Social Innovations Journal, 8. Retrieved from https://socialinnovationsjournal.com/index.php/sij/article/view/996