Purpose. Although physician assistants (PAs) became part of the U.S. h
ealth scene in 1967 and have made important contributions to primary c
are, available information about the factors that may influence the ca
reer choices of this rapidly-growing group of health care providers is
sparse. The intent of this analysis was to identify the main factors
underlying the specialty-choice decisions of PAs in the first practice
year after completing PA training and the reasons for their selection
s. Method. Data were collected from a 1994 survey of 4,416 PAs who had
graduated in 1991-1993. Usable responses were obtained from 1,472 PAs
(33%). Each PA was asked to state the specialty he or she had entered
in the first practice year and also to rate each of 33 possible reaso
ns for this decision. Primary care specialties were defined as family
medicine, general internal medicine, and general pediatrics. The ratin
gs were subjected to a factor analysis. Results. The 33 original varia
bles were reduced to nine basic factors influencing the specialty-choi
ce decisions of the PAs, accounting for 47.3% of the variance. The two
most important factors were intellectual content of the specialty and
a technical orientation. Then factor scores were computed for each PA
and subjected to further examination, in which the PAs were divided i
nto two groups: 776 who had entered primary care specialties, and 646
who had entered non-primary-care specialties (50 did not specify their
specialties). For the PAs in non-primary-care specialties, the most i
nfluential factors were technical orientation and income/employment. F
or the PAs in primary care, the most influential factors were preventi
on academic environment, debt/scholarship, intellectual content, and p
eer influence. Conclusion. For this recently graduated group of PAs, f
actors representing the kinds of activities they would be engaged in a
s health care providers were among the most influential, but the relat
ive importances of the factors varied according to whether the PAs wer
e in primary care or non-primary-care specialties, with the latter gro
up being more strongly influenced by market forces such as income and
employment opportunities.