Background: As most health professions in the United States have adopted clinical or practice doctorates, there has been an ongoing debate on whether physician assistants (PAs) should transition from a master’s to a doctorate as the terminal degree. The authors examined perceived risks, benefits and impact of transitioning to an entry-level PA doctoral degree.
Methods: A multi-prong, mixed-methods approach was used that included a literature review and collecting quantitative and qualitative data. Bivariate analysis and binomial logistic regression analysis were performed to evaluate relationships between perceptions/perspectives on an entry-level PA doctoral degree and the anticipated impact of it causing more harm than good to the PA profession. For the semi-structured interviews (38 interprofessional stakeholders), deductive content analysis was used to analyze the qualitative data.
Results: Six hundred and thirty six PA clinicians and PA students (46%) completed the survey. Most respondents (n = 457, 72%) disagreed that an entry-level PA doctoral degree should be required. More than half of the respondents (n = 341, 54%) agreed that it should be offered but not required and 380 respondents (60%) agreed that an entry-level doctoral degree would cause more harm than good. Race, educational attainment, occupation, and length of practice as a PA were significantly associated with having a perception of causing more harm. There was strong positive association between the perception of a doctoral degree causing more harm with expectations of having a negative impact on the availability of clinical training sites (OR = 4.39, p <.05). Based on the analysis of qualitative data, the most commonly cited perceived risks were increased cost for education, decreased diversity in the profession, and negative impact on the PA/physician relationship.
Conclusions: The perceived benefits and risks of an entry-level PA doctoral degree are strongly influenced by the lens of the stakeholder. While the majority of PAs and students appear to be not in favor, the proportion of those in favor is not insignificant and their views should not be ignored in future discussions. Addressing concerns with key stakeholders could help the PA profession to transition to a doctoral degree with minimal adverse impact.