PA Maturation and Consolidation Era (1991-Present)

Health care reform provides new opportunities and risk for PAs. States continue to revise legislation, rules and regulations to reduce barriers to use PAs effectively in variety of health care settings. Veterans Administration Medical Centers, Military and other Federal sponsored health care institutions rely heavily on PAs to bolster medical staffs. Health Maintenance Organizations recognize vital roles of PAs and NPs in reducing cost. Steps are taken to foster and maintain close working relationships with organized medicine. PAs are recognized as one of the top five careers in the United States. There is a rapid expansion of physician assistant programs and trend towards master's level education. The PA concept spreads globally to Canada, the United Kingdom, the Netherlands, Australia, India, and New Zeeland. Duke University PA Program celebrates its 50th anniversary in 2015.