Compensation and productivity trends among dermatology physician associates: a multistate salary analysis

Background: Physician associates (PAs) are consistently ranked among the top professions in the United States. Dermatology PAs represent a rapidly growing specialty, yet compensation data remain limited. National PA salary surveys often underrepresent dermatology PAs, making it difficult for these professionals to benchmark their earnings. Understanding compensation structures is essential for salary negotiations and workforce planning. Objective: This study evaluates dermatology PA compensation, productivity, and practice characteristics across California, Ohio, Oregon, and Florida to identify salary trends and influencing factors. Methods: A survey, replicating the Pennsylvania Dermatology PA salary survey, was distributed to dermatology PA state societies in the selected states. Eligibility criteria included practicing dermatology PAs with at least 1 year of experience. A total of 2425 survey invitations were sent, yielding 210 responses (8% response rate). Compensation models were categorized into the following types: (1) annual base salary, (2) annual base salary+bonus, (3) hourly base pay rate, (4) productivity: percentage of collections (no base pay), (5) productivity: base pay+percentage of collections (tiered/variable rate), (6) productivity: base pay+percentage of collections (fixed rate), and (7) productivity: percentage of collections only (tiered/variable rate). Statistical analyses included one-way ANOVA, Kruskal-Wallis test, Spearman correlation, and Pearson correlation. Results: A one-way ANOVA demonstrated significant differences in total compensation across models ( P < 0.05). Dermatology PAs paid a fixed percentage of collections without a base salary earned significantly more than those compensated through hourly pay ( P = 0.01), a base salary ( P < 0.001), or a base salary plus bonuses ( P < 0.001). The highest mean compensation was among PAs paid a tiered/variable percentage of collections without a base salary ($249,323), while those with a fixed base salary earned a mean of $134,258. Higher compensation was significantly correlated with autonomy ( P = 0.0076), but no significant correlation was found between salary and benefits, vacation, CME reimbursement, or work schedule. Productivity varied by practice setting, with dermatology PAs in academic settings seeing significantly fewer patients per hour than those in corporate ( P < 0.01) or private practice settings ( P < 0.05). Years of experience did not predict productivity ( P = 0.855). Conclusion: Productivity-based models, particularly tiered/variable percentage-based compensation, yielded the highest earnings. Autonomy correlated with higher salaries, highlighting its role in compensation negotiations. Productivity varied by practice setting, but years of experience did not predict productivity levels. Expanding state-level analyses could refine compensation benchmarks.