The Globalization of the Physician Assistant Profession

The global spread of the physician assistant (PA) profession is a medical workforce phenomenon largely born at the turn of the century. Because this observation comes with little analysis, we used investigative journalism techniques to collect information about the use of PAs outside of the United States. As of 2007, at least seven countries — Australia, Canada, England, the Netherlands, Scotland, South Africa, and Taiwan — are in various stages of expansion of PA-like medical workers that function under the supervision of a doctor. With the exception of Taiwan and South Africa, these countries have American-trained PAs working as expatriates, and most are developing educational programs that produce a health care provider functioning as an addition to the doctor. Each country has made its PA a distinct entity, with cultural and educational influences shaping their roles. Common denominators of these PAs are: they function as semiautonomous clinicians under the direct supervision of a doctor and have roles that tend to complement those of the doctor. Historical observations suggest the development of the PA profession in different countries tends to follow a similar path and that lessons learned from these nations may be useful in further expansion of the profession.