Job Placement · Healthcare · Physician Assistant
Physician assistants are certified by NCCPA and licensed by the state, but whether a named physician relationship is legally required depends entirely on where you practise. BEG scopes that first, then places a permanent PA your organisation employs, billed at $12,864 to $15,437 against milestones.
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TL;DR
The PA profession is large and growing fast, so headcount is not your constraint. Two other things are. First, the practice agreement question: ten states have removed the legal requirement for a PA to be tied to a specific physician, and in the rest that arrangement has to exist before the PA can see a patient. Second, satisfaction: NCCPA finds 83.6% of PAs content in their present job, which means almost nobody good is reading your advert. BEG runs the direct approach and bills $12,864 to $15,437 on milestones, against the $27,176 to $33,970 a contingency percentage would take.
Why This Search Turns On Regulation, Not Supply
Because supply is not the binding constraint. The binding constraints are specialty fit, a state-specific agreement requirement that the employer has to satisfy, and a workforce that is largely happy where it is.
The Dependency That Stops A PA Working
NCCPA certification, a state licence built on it, a practice or collaboration agreement if your state still requires one, then credentialing and payer enrolment. The third item is the one employers underestimate.
| Requirement | Who it sits with | What employers get wrong |
|---|---|---|
| NCCPA certification and PANCE | The PA, through the national certifying body, which publishes PANCE pass rates by programme. | Assuming graduation equals certification. A programme graduate who has not yet passed the PANCE cannot be licensed, and the exam calendar is not yours to move. |
| State licence | The state medical or healing arts board, or a separate PA board where one exists. | Underestimating board timelines for an out-of-state hire, then discovering the start date belongs to a board meeting calendar rather than to the offer letter. |
| Practice or collaboration agreement | The employer, in every state that has not removed the requirement for a specific physician relationship. | Building the role around one named physician. If that physician resigns, the PA can be stopped from practising until a replacement signs. |
| Credentialing and payer enrolment | The employer, with the PA supplying documentation. | Booking the PA into clinic from day one. Enrolment queues mean the billable date usually trails the start date, and the practice carries that gap. |
AAPA publishes the current position on which states have removed the legal tether and which have not on its PA practice modernization page. Certification, licensure and enrolment stay with the PA, the board and your credentialing team. BEG's job is to make sure none of it is a surprise after acceptance. More on the healthcare placement service page, and note that the nurse practitioner route is regulated entirely separately, by the board of nursing.
Why Milestone Billing Beats A Percentage Here
Contingency pricing takes a slice of the PA's first-year compensation. Against the $135,880 median that is $27,176 at 20% and $33,970 at 25%, and in a surgical or emergency medicine search where the base runs well above median, the fee climbs with it. BEG prices a PA search as a Tier III engagement at $12,864 to $15,437 fixed against milestones. On a median hire that is roughly $14,300 to $18,500 less, and on a high-band specialty hire the gap widens rather than narrows.
What The Unfilled PA Line Costs Per Week
At the $135,880 median, the clinical work not being done is roughly $2,613 a week. In a surgical service the real number is higher, because the lost output is theatre throughput and clinic follow-up rather than salary. Three months unfilled is about $34,000 of unworked capacity at median, before you count the physicians absorbing the overflow and the call rota carrying the hole. A 23 to 35 day search, on isolved placement data, is the comparison that matters.
If You Came Looking For Locum Cover
Three different commercial arrangements. Two of them rent a clinician by the day. Only one of them ends with a physician assistant on your payroll, in your credentialing file and on your call rota.
| Model | Who employs or contracts the PA | How you pay | Right when |
|---|---|---|---|
| Locum tenens PA agency | The agency | Daily or hourly rate for the assignment, usually plus travel and lodging | You are covering a defined gap, a parental leave or a vacancy, and the seat itself is not being closed yet. |
| Contracted group or per diem | The contracted group | Per shift or per session, invoiced to the practice | Coverage is intermittent, and continuity with a named clinician is not what the service needs. |
| BEG permanent placement | You | Tier III milestone fee of $12,864 to $15,437, agreed before sourcing begins | The line is permanent and budgeted, and you want a fixed fee with a 45-day replacement term. |
BEG is not a staffing agency and never employs the clinician. That is a deliberate limit, not a gap: it is why our fee does not scale with the salary you agree and why we have no reason to keep a clinician on assignment. If per diem or locum coverage is what today actually calls for, say so and we will tell you plainly that it is a different service. For the leadership layer above this seat, see clinical director recruiting.
FAQ
Certification comes from NCCPA. A PA graduates from an accredited programme and passes the Physician Assistant National Certifying Examination, the PANCE, which NCCPA scores against a passing standard of 350. Every state licence is built on top of that certification, so it is the first thing verified on any shortlist.
NCCPA recorded 189,907 board certified PAs as of 31 December 2024, a profession that grew 27.8% between 2020 and 2024. It is a large and fast-growing pool, which is precisely why the constraint on your search is specialty fit rather than headcount.
It depends on the state. AAPA reports that Delaware, Iowa, Maine, Montana, New Hampshire, North Dakota, South Dakota, Utah, Virginia and Wyoming have eliminated the legal requirement for a specific relationship between a PA and a physician. Everywhere else some form of practice or collaboration agreement is still required before the PA can work.
Because the agreement is an operational dependency, not paperwork. Where a named physician is legally required, that physician leaving can stop the PA from practising. AAPA also notes that removing the tether reduces physician liability for care the physician was not involved in, which is a point worth raising with your medical staff.
A PA is a Tier III search at $12,864 to $15,437 on milestone billing. For comparison, a 20% to 25% contingency fee against the $135,880 BLS median for physician assistants would be $27,176 to $33,970 for the same permanent hire.
No, and the distinction is not cosmetic. Staffing and locum firms employ or contract the PA and bill you by the hour or the day for as long as the assignment runs. BEG runs a permanent search and the PA joins your payroll. If the real need is coverage during a leave, locum is the right answer and we will point you at it.
The ones competing with surgery and emergency medicine. NCCPA data shows surgical subspecialties, family medicine, emergency medicine and internal medicine subspecialties among the largest PA practice areas, and 22.0% of PAs worked in primary care in 2024, down from 24.4% in 2020. A primary care seat is recruiting against that drift.
BLS puts the median at $135,880 in May 2025, with the lowest tenth under $99,380 and the highest tenth over $190,280. NCCPA reports a mean income of $129,291 across certified PAs, up 12% over five years. Specialty and call structure move that number more than geography does.
Because most of them are content. NCCPA found 83.6% of PAs satisfied with their present job and 87.1% satisfied with their career. A satisfied workforce is a passive workforce. Reaching it takes a direct approach with a specific reason to listen, which is what the search actually buys you.
BLS projects 21% employment growth for physician assistants from 2025 to 2035, much faster than average, with about 11,500 openings a year. Growth at that rate means the PA you approach today is likely to have another conversation running in parallel.
AAPA reports that Medicare has authorised direct payment to PAs since 2022, though some insurers and state laws still route payment to the employer. It matters for contracting structures and for practices that use group or contracted arrangements, so it is worth settling before the offer is drafted.
A 45-day replacement guarantee applies, with 50% off a repeat search for the same seat. In practice, early PA departures in this market are usually a scope or call conversation that was never had, so we scope call burden, supervision structure and procedure mix before sourcing rather than after.
Staffing the wider clinical team? See nurse practitioner, physician, registered nurse and medical assistant and CNA, or all healthcare placement.
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