Table 5 Perceived risks and impact expressed by stakeholder

Practicing PAs

“Requiring an entry-level PA doctoral degree will do more harm than good by increasing the cost of PA education, subsequently increasing the cost of patient care. The increase in student loan debt will drive more PAs to work in high-paying specialties, decreasing the number of PAs in primary care, further increasing the shortage of primary care providers in our health system.”

“If adopted, this decision would be detrimental to the trust and understanding that has just recently been adopted in the patient community. It will cause a significant barrier in healthcare delivery, both financially and geographically. It will also change the landscape of admission to the profession, forsaking the heart of the individuals who love the mission and vision of, and who are called to, the physician assistant profession.”

“I think that the entry level PA doctoral degree is needed to keep parity with the NP profession. I have experienced firsthand the disadvantage when applying for jobs against NPs. I think the doctoral degree will provide needed leverage to push of autonomous practice which is long overdue.”

“I see a doctoral degree as beneficial for the non-clinical aspects of being a PA. Informatics, MSL, research, leadership. It should not impact clinical practice unless there is a way to practice without a SP if one has a doctorate.”

PA Students

“…. What would be the difference between PAs and physicians at that point? The public would be confused, and it could damage the physician relationship if they believe we are trying to be like them or replace them. The doctoral degree could do some good but overall I think it will hurt the profession in too many ways for it to be worth it.”

“Increasing length and cost of training will likely diminish diversity of the PA profession and result in further deviation from primary care.”

“I feel this this the only feasible step toward ensuring optimal team practice and parity with DNPs.”

I do see potential with those who decide to pursue a doctorate after being in clinical practice - it allows a pathway for continued professional growth and future opportunities as a PA (our career ladder would not stop at the clinical level or be as limited), however this should not be the required entry level degree for our profession.

Clinical Partners (i.e., Physician Practitioners)

“…. This is more about independent practice like NPs want to do in some states, but it needs to be interdependent. Interdependence is of higher value than independence. The only way the whole planet will survive is if we are more interdependent.”

“.... no return on investment, increase in clinical role/salary unlikely post transition.”

“I don’t anticipate change in scope of practice.”

“There are no benefits in terms of the PA profession now. The master’s degree is very appropriate.”

Academic Leaders (i.e., Dean, Provosts, Presidents - Across the health professions)

“PAs with a master’s degree may feel marginalized.”

“Be prepared for push-back from other professional groups like medicine and a subset of population within PA profession”

“No anticipation for change in scope of practice, there is potential for increased role within academic settings and research capacity.”

“It will put the PA profession on par with other allied health professionals that have transitioned.”

PA Association Leaders and Members

“It is a high risk to the profession. PAs may no longer be a value add for patient care.”

“The master’s degree is appropriate, otherwise PA profession will be less accessible and out of reach for those we need to enter the profession.”

“If the efforts to diversify the profession are distracted by a doctoral degree then it should not be endorsed.”

“A doctoral degree will enhance the image of PAs and level the playing field with the other health professions, there will be professional parity.”

PA Program Directors and Faculty

“Faculty shortage will likely increase.”

“….. A doctoral degree is taking us from away from original mission.”

“This will create a barrier to workforce supply.”

“If there are more hoops to jump through it might drive applicant pool down, but I am not sure if it will affect the diversity of the applicants.”

“It will have more leadership opportunities, such as clinical managers or clinical/medical directors.”

PA Employers

“They cannot refer to themselves as doctor, there is risk of misrepresentation.”

“…. Will it decrease flexibility of the profession?”

“This will confuse patients.”

“This may challenge the cost savings of PAs as the pay difference between MDs and PAs is decreasing.”

“PAs with advanced degree may benefit from increase in patient preference.”