Physician Assistant Interview Questions and Scorecard
Physician assistant interview questions for small practices: 6 sets by specialty, seniority, and stage, plus credential checks, red flags, and a scorecard.
Physician Assistant Interview Questions and Scorecard
Six question sets for the employer side of a PA hire: core clinical, new graduate versus experienced, specialty setting, interview stage, culture fit, and situational judgment, with good-answer notes, a red-flag list, and a scorecard. Download as DOCX.
Almost every guide to physician assistant interview questions is written for the candidate. This one is written for you, the person on the other side of the table: the practice owner, the physician, or the office manager who has to decide whether this PA can safely carry a share of your patients starting next month.
That is a harder problem than it looks. A PA hire is usually the largest single addition to a small practice's clinical capacity, the credentialing tail runs for weeks after the yes, and the person running the interview is often not the person qualified to grade the medicine. At FirstHR we build for exactly that situation: a small business making a serious hire without a recruiting department behind it.
These six question sets cover the role from every angle you actually need: a core clinical set, a seniority split for new graduates versus experienced PAs, specialty setting blocks, an interview-stage sequence, culture and team fit, and situational judgment with a full scorecard. Pair them with the physician assistant job description templates if the role is not written up yet.
TL;DR
Interview a physician assistant on clinical judgment, scope and escalation, documentation, setting-specific experience, and team fit. Put the collaborating physician in a clinical panel and judge the rest yourself. Verify state license, NCCPA certification, and DEA registration at the source. Federal wage data puts the median at $135,880 a year.
What a PA Actually Does in a Small Practice
A physician assistant examines patients, orders and interprets diagnostics, makes treatment decisions, prescribes, and performs procedures, working within a practice relationship with a physician that your state defines. In a small practice the practical answer is narrower and more useful: the PA carries a real share of your daily schedule so the physician can spend time on the cases that need them.
That is the frame for the whole interview. You are not testing whether the candidate can practice medicine in general. You are testing whether they can hold your specific schedule, in your specific setting, with the amount of physician backup you can actually provide. The split below is what most small practices are really buying.
What the PA typically carries
What usually stays with the physician
Acute visits, follow-ups, and stable chronic disease management
Complex or undifferentiated cases and new diagnostic puzzles
Routine prescribing within state limits and practice policy
Cases requiring a physician signature or review under state rules
Procedures matched to the setting: suturing, injections, biopsies
Procedures outside the PA credentialed privileges at your site
First contact for most walk-ins and same-day additions
Escalations, unstable patients, and final calls on disputed plans
Same-day charting, coding support, and patient follow-up calls
Overall clinical accountability and the collaboration agreement
How that split lands depends on the setting. A primary care PA works a panel of chronic disease patients, while a surgical PA runs post-operative visits and first-assists in the operating room. Decide which version of the role you are hiring before the first call, because it determines which question set below you use, and it changes who you should be comparing against. If you are weighing this against a nurse practitioner for the same slot, settle that question first.
Supervision and Collaboration Agreements
Whether you need a written supervising or collaborating physician agreement is set by your state, not by federal law, and the requirements differ substantially from one state to the next. Confirm the rule with your state medical or PA licensing board before you make an offer, because the agreement usually has to exist before the PA sees a patient.
Federal rules defer to that state answer. Under 42 CFR 410.74, Medicare covers PA services only when the PA is legally authorized in the state and performs services in accordance with state law and state scope of practice rules. Any state requirement describing the practice relationship, including explicit supervisory or collaborative requirements, counts as the form of supervision for federal purposes. Where a state has no explicit rule, the regulation expects a working relationship documented at the practice level.
Ask the Scope Question in the Interview
Candidates carry expectations from their last state and their last employer, and those expectations are not always portable. Ask directly what supervision or collaboration structure they worked under, how often charts were reviewed, and how quickly a physician was reachable. A candidate who expects markedly broader autonomy than your state rules or your coverage allow is a mismatch you want to find in the interview, not in month three. Verify the current requirement with your state board; this is general information, not legal advice.
Which Question Set Should You Use?
Pick the set that matches the role, then use the same set for every candidate applying to it. The core clinical questions run through all six, and each set adds the questions that fit one specific dimension of the hire: seniority, specialty setting, interview stage, culture, or situational judgment.
General PA Questions
The core set
Clinical judgment, scope and escalation, prescribing, documentation, and patient communication, with good-answer notes so a non-clinician can judge the response. Start here.
New Graduate vs Experienced
By seniority
Two blocks. New graduates get asked about gaps and the supervision they need. Experienced PAs get asked about ownership, volume, disagreement, and why they are leaving.
Specialty Setting
Where the work differs
Blocks for primary care, urgent care, surgical and orthopedic, emergency medicine, and dermatology. Procedures, volume, and escalation look different in each.
By Interview Stage
Screen, panel, final
A short credential and expectations screen, a clinical panel with the collaborating physician, and a final conversation that closes the terms. Three stages, two weeks.
Culture and Team Fit
Small practice reality
How they work with medical assistants and front desk, handle a schedule falling apart, take feedback, and feel about work outside the exam room.
Situational + Scorecard
Judge and decide
Seven scenarios drawn from real clinic days, a master rubric scored out of 30, a red-flag list, and a pre-hire verification checklist.
Match the Set to the Hire
Start every process with the General set. Add the seniority block once you know whether the candidate is a new graduate or experienced. Add the specialty block for your setting. Use the stage set to structure the sequence, the culture set in the final conversation, and the situational set plus scorecard to decide. Most small practices end up using four of the six for any given hire, and all six across a mixed candidate pool.
6 Free PA Question Sets to Download
Download all six as one Word document or copy the sets you need. Each follows the same structure: when to use it, the questions with good-answer notes where they help, a what-to-listen-for block, and a scoring section at the end. The situational set adds the master rubric, the red-flag list, and a pre-hire verification checklist.
Download All 6 PA Interview Question Sets
General, new graduate versus experienced, specialty setting, interview stage, culture fit, and situational judgment with a scorecard. All in one DOCX.
Set 1: General Physician Assistant Questions
The core set: clinical judgment, scope and escalation, prescribing, documentation, and patient communication, with notes on what a good answer sounds like so a non-clinician can judge the response. Start here for every candidate.
General Physician Assistant Interview Questions
GENERAL PHYSICIAN ASSISTANT INTERVIEW QUESTIONS
Candidate: __
Practice: __
Interviewer: __
Date: _
HOW TO USE THIS SET
This is the core set for a practice hiring its first or main physician assistant.
Ask 7 to 9 of these questions and ask the same ones of every candidate. Each
question that needs it carries a "good answer sounds like" note, so an owner or
office manager who is not a clinician can still tell a strong answer from a thin
one. Score at the end while the conversation is fresh.
CORE QUESTIONS
1. Walk me through a typical patient panel on your last full clinical schedule.
(Good answer: names volume, visit types, and the mix of acute versus follow-up
care. Talks in specifics, not in job-posting language.)
2. What did you handle independently, and what did you route to the supervising
or collaborating physician?
(Good answer: a clear, confident line, with real examples on both sides.
Neither "everything" nor "I checked in on all of it".)
3. Describe your prescribing practice, including controlled substances if the
role requires it.
(Good answer: knows their state limits and their DEA registration status, and
describes a documented process rather than a general willingness.)
4. Tell me about a diagnosis you got wrong, or nearly missed. What happened next?
(Good answer: names a real case, explains the correction, and describes the
change in practice afterward. Deflection here is a signal.)
5. How do you decide when a patient needs to be escalated, referred, or sent to
an emergency department?
6. What does your documentation look like at the end of a clinical day?
(Good answer: closes charts the same day, or has a specific reason and plan
when they do not. Open charts become billing problems.)
7. What electronic health record systems have you worked in, and what did you do
in them beyond charting?
8. How do you handle a patient who is unhappy with your plan and wants the
physician instead?
9. What kind of supervision or collaboration structure do you work best under?
WHAT TO LISTEN FOR
•Specific patient examples with real detail, not general statements
•A clear, self-aware line between independent work and escalation
•Ownership of a clinical error, with a concrete change afterward
•Same-day documentation habits and comfort in your record system
•Questions back about your patient mix, coverage, and physician availability
Fit with our setting [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Notes: __
__
Set 2: New Graduate and Experienced PA Questions
Two blocks for two different hires. New graduates get asked about honest gaps and the supervision they need. Experienced PAs get asked about ownership, sustainable patient volume, disagreement with a physician, and why they are leaving.
New Graduate and Experienced PA Questions
NEW GRADUATE AND EXPERIENCED PA INTERVIEW QUESTIONS
Candidate: __
Practice: __
Interviewer: __
WHEN TO USE THIS SET
A new graduate and a PA with a decade of practice are different hires, and the
same questions do not test both well. Use the block that matches the candidate,
alongside the general set. A new graduate costs more supervision time up front
and often stays longer when the ramp is good. An experienced PA is productive
sooner and asks harder questions about your coverage and your call schedule.
NEW GRADUATE QUESTIONS
1. Which rotations felt strongest, and which exposed a gap you are still closing?
(Good answer: names an actual gap. A new graduate who claims none is either
not reflective or not honest.)
2. What onboarding and supervision do you need in your first three months to be
safe and useful here?
(Good answer: asks for structure. Chart review, shared visits, a named
physician to call, and a ramp on patient volume.)
3. Walk me through the last patient you saw on rotation from presentation to plan.
4. How will you tell us when you are past your comfort zone in the room?
5. Where do you want your practice to be in three years, and does this setting
get you there?
EXPERIENCED PA QUESTIONS
1. What did you own end to end at your last position that you would expect to own
here?
2. How many patients did you carry per clinical day, and what made that number
sustainable or not?
3. Tell me about a time you disagreed with a physician on a plan of care. How did
it resolve?
(Good answer: raised it directly, documented it, and respected the final call
without going silent or going around it.)
4. What have you built or improved beyond seeing patients: protocols, triage,
quality measures, training?
5. Why are you leaving, and what would have kept you?
(Good answer: specific and unbitter. Vague answers about culture deserve a
follow-up question.)
6. What is the one thing about a small practice that would make you say no?
WHAT TO LISTEN FOR
•New graduates: honest gaps, a request for structure, a real learning plan
•Experienced PAs: ownership beyond the exam room, and a clean exit story
•Realistic patient volume expectations for a practice of your size
•A match between what they want next and what this role actually is
SCORING
Depth for their stage [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Self-awareness [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Ramp cost to us [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Likely retention [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Notes: __
Still Using Spreadsheets for Onboarding?
Automate documents, training assignments, task management, and track onboarding progress in real time.
Blocks for primary care, urgent care, surgical and orthopedic, emergency medicine, and dermatology. Procedures, volume, and escalation thresholds look different in each one, and direct setting experience shortens the ramp more than anything else on a resume.
Specialty Setting Interview Questions
PHYSICIAN ASSISTANT QUESTIONS BY SPECIALTY SETTING
Candidate: __
Setting: __
Interviewer: __
WHEN TO USE THIS SET
A PA is trained as a generalist and then shaped by setting. A dermatology PA and
an emergency medicine PA do different work every hour of the day. Use the block
for your setting on top of the general set. Direct experience in your setting
shortens the ramp more than anything else you will see on a resume.
PRIMARY CARE AND FAMILY MEDICINE
1. How do you manage a panel of chronic disease patients between physician visits?
2. Walk me through your approach to a new diabetic patient with poor control.
3. How do you handle preventive care gaps, screenings, and recall lists?
4. What is your approach to a patient requesting antibiotics you do not think are
indicated?
URGENT CARE
1. What procedures do you perform without assistance: suturing, splinting,
incision and drainage, foreign body removal?
2. How do you triage when the waiting room is full and one patient looks unwell?
3. What is your threshold for imaging in a busy shift, and how do you avoid both
over-ordering and missing a fracture?
4. How do you manage a patient who needs follow-up but has no primary provider?
SURGICAL AND ORTHOPEDIC
1. What is your first-assist experience, and in which procedures?
2. How do you run a post-operative visit and manage a wound that is not healing?
3. What is your comfort with casting, splinting, and joint injections?
4. How do you handle post-operative pain management and controlled substances?
EMERGENCY MEDICINE
1. Which acuity levels have you carried independently, and with what backup?
2. Walk me through a case where you escalated to the attending immediately.
3. How do you manage a fast-track queue without missing a sick patient?
4. What is your experience with procedural sedation, airway support, and trauma?
DERMATOLOGY AND SPECIALTY CLINIC
1. What is your biopsy and excision volume, and which techniques do you perform?
2. How do you decide between treating, biopsying, and referring a lesion?
3. What cosmetic or procedural work have you done, and under what supervision?
4. How do you handle a patient pushing for a procedure you would not recommend?
WHAT TO LISTEN FOR
•Named procedures with volume, not a list of things they have "been exposed to"
•Setting-specific vocabulary used correctly and unselfconsciously
•Honest boundaries: what they have done, what they would need training for
•Curiosity about your case mix, your equipment, and your referral network
A three-stage sequence built to run inside two weeks: a short credential and expectations screen, a clinical panel with the collaborating physician including a chart-review exercise, and a final conversation that closes the terms.
Phone Screen, Panel, and Final Interview Questions
Set 5: Culture, Communication, and Team Fit Questions
How the candidate works with medical assistants and front desk staff, handles a schedule falling apart, gives and takes difficult feedback, and feels about the work outside the exam room that a small practice always needs.
Culture, Communication, and Team Fit Questions
PHYSICIAN ASSISTANT CULTURE AND TEAM FIT QUESTIONS
Candidate: __
Practice: __
Interviewer: __
WHEN TO USE THIS SET
In a small practice the PA is not one clinician among many. They are a large
share of your clinical capacity, they talk to your patients all day, and they
work shoulder to shoulder with your medical assistants and front desk. Fit is not
a soft extra here. Use this set in the final conversation, and ask about behavior
that already happened rather than about values in the abstract.
QUESTIONS
1. Describe the practice where you did your best work. What made it work?
2. How do you work with medical assistants and front desk staff?
(Good answer: treats them as colleagues with names and a role in the visit,
not as support that fetches things.)
3. Tell me about a time a colleague made an error that affected a patient. What
did you do?
(Good answer: addressed it directly and factually, protected the patient
first, and did not turn it into a personal issue.)
4. What do you do when the schedule falls apart and everyone is behind?
5. How do you prefer to receive difficult feedback, and give it?
6. What frustrates you most in a clinical team?
(Listen for whether the frustration is about systems or about people.)
7. In a small practice you will be asked to help with things outside the exam
room: protocols, training, coverage gaps. How do you feel about that?
8. What would your last supervising physician say is the thing you most need to
work on?
WHAT TO LISTEN FOR
•Respect for the whole clinical team, including non-clinical staff
•Comfort with the shared, flexible reality of a small practice
•Direct handling of conflict, without blame stories
•A real answer to the development question, not a disguised strength
SCORING
Team orientation [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Conflict handling [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Flexibility [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Feedback readiness [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Notes: __
Set 6: Situational Judgment and Scoring Rubric
Seven scenarios drawn from real clinic days, plus the master rubric scored out of 30, a red-flag checklist, and a pre-hire verification checklist covering license, certification, DEA registration, and exclusion screening.
Situational Judgment, Red Flags, and Scoring Rubric
PHYSICIAN ASSISTANT SITUATIONAL JUDGMENT AND MASTER SCORECARD
Candidate: __
Practice: __
Interviewer: __
Date: _
HOW TO USE THIS SET
Situational questions are where a non-clinician learns the most, because the
answer structure matters as much as the medicine. Read the scenario, stay quiet,
and let the candidate think out loud. Then score the whole interview on the
master rubric below and check the red-flag list before you decide.
SITUATIONAL SCENARIOS
1. It is the last appointment of the day. A patient has chest pain that you think
is musculoskeletal, but something is off and the physician has already left.
Walk me through what you do.
(Good answer: patient safety first, escalates or sends out rather than
rationalizing. Never optimizes for the schedule over the finding.)
2. A long-standing patient asks you for a controlled substance refill early. The
story does not hold together. What do you do?
(Good answer: checks the prescription monitoring program, follows practice
policy, has the conversation directly, documents it.)
3. A patient tells you the physician gave them different advice last week. How do
you handle it in the room?
(Good answer: does not undermine the physician in front of the patient, gets
the facts, closes the loop with the physician afterward.)
4. You are running an hour behind and there are four patients waiting. What gets
cut and what does not?
5. A medical assistant hands you a chart with a vital sign that does not match
the patient in front of you. What do you do?
6. A patient asks you to document something in a way you do not think is accurate.
(Good answer: firm and unbothered. The record reflects the encounter, and
there is no negotiation on that.)
7. You disagree with the physician about a plan and the patient is waiting.
What is your move in the moment, and after?
WHAT TO LISTEN FOR
•Patient safety chosen over convenience, every time
•A visible thought process: gathers information, then decides
•Comfort escalating without either paralysis or bravado
•Documentation treated as non-negotiable
MASTER SCORING RUBRIC
Score each area from 1 to 5 immediately after the interview, anchored to
something the candidate actually said. If two people interview, score
independently first, then compare. Use the same rubric for every candidate.
5 = Strong, specific evidence 4 = Solid evidence 3 = Some evidence
2 = Weak or mixed evidence 1 = No evidence or red flags
Clinical judgment and diagnostic reasoning
Score [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Evidence: ______
Scope awareness and escalation behavior
Score [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Evidence: ______
Setting-specific and procedural experience
Score [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Evidence: ______
Patient communication and bedside manner
Score [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Evidence: ______
Documentation and follow-through
Score [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Evidence: ______
Team fit for a small practice
Score [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ]
Evidence: ______
RED FLAGS (WEIGH CAREFULLY)
[ ] Vague about license status, certification, or DEA registration
[ ] Cannot describe what they escalated and what they handled alone
[ ] No example of a clinical error, ever
[ ] Blames every former employer, physician, or team
[ ] Dismissive about documentation, charting, or coding
[ ] Wants far broader autonomy than your state rules or your setting allow
[ ] Gaps in the work history that get shorter answers each time you ask
[ ] Reluctant to give a supervising physician as a reference
PRE-HIRE VERIFICATION CHECKLIST
[ ] State PA license verified on the state board site, not from a copy
[ ] NCCPA certification verified and current
[ ] DEA registration verified if the role prescribes
[ ] Federal exclusion list checked
[ ] Supervising or collaborating physician reference completed
[ ] Malpractice history and claims disclosure reviewed
[ ] Collaboration or supervision agreement drafted per state requirements
How to Judge Clinical Skill Without Being a Clinician
Split the job. Let the supervising or collaborating physician test the medicine in a clinical panel, and evaluate everything else yourself by the shape of the answer rather than its clinical content. Strong candidates are specific, name real cases, and describe what changed afterward. Weak candidates are absolute, vague, or busy assigning blame.
What did you handle independently, and what did you route to the physician?
Strong answer: Draws a clear line with examples on both sides: the presentations they managed start to finish, and the specific findings that always triggered a call. A strong answer treats escalation as a professional judgment they make often, not as an admission of weakness.
Weak answer: A weak answer is absolute in either direction. Someone who escalated nothing will strain a practice that depends on judgment, and someone who escalated everything will consume the physician time you were trying to free up.
Tell me about a diagnosis you got wrong, or nearly missed.
Strong answer: Names a real case, describes how it was caught, explains what they did for the patient, and states the specific change they made afterward. This is the single most informative question on the list, and you do not need medical training to judge the shape of the answer.
Weak answer: A weak answer cannot produce an example, produces a fake-humble one where they were right all along, or blames the patient, the record, or the previous provider.
What does your documentation look like at the end of a clinical day?
Strong answer: Charts closed the same day, or a specific, honest reason and a plan when they are not. A strong answer connects documentation to billing, to the next provider who sees the patient, and to the record standing up if it is ever reviewed.
Weak answer: A weak answer treats charting as an annoyance, describes a chronic backlog with no plan, or is vague about how far behind they typically run.
Two mechanics make this reliable. First, a chart-review exercise: hand the candidate a de-identified note and ask what they would do next and what is missing. Second, a reference call to a physician who actually watched them practice, which is worth more than any answer given in a room. The skill areas below are what you are scoring across the whole conversation.
Clinical judgment
Reasons out loud before deciding
Gathers information, then commits
Names a real error and the fix
Scope and escalation
Clear line between own work and referral
Escalates without paralysis or bravado
Knows their state scope rules
Documentation
Charts closed the same day
Understands the billing consequence
Will not document what did not happen
Patient communication
Explains a plan in plain language
Handles a patient who wants the physician
Holds a boundary without a fight
Verify Credentials Before the Interview
Verify credentials at the source before you spend panel time, not after the offer. A screenshot from the issuing board takes a few minutes per candidate and removes the most expensive category of surprise in a clinical hire. Every item below has a public verification path.
What to verify
Where it comes from
When
Active, unrestricted state PA license
Your state medical or PA licensing board
Before the phone screen
National certification (PA-C)
National Commission on Certification of Physician Assistants
Before the phone screen
DEA registration and state controlled-substance registration
Federal and state registries, if the role prescribes
Before the offer
Federal exclusion status
HHS Office of Inspector General exclusion list
Before the offer
Malpractice claims history
Candidate disclosure plus your carrier
Before the offer
Supervising physician reference
A physician who observed their practice
Before the offer
The exclusion check is the one small practices skip most often. Federal health care programs will not pay for items or services furnished by an individual on the HHS Office of Inspector General exclusion list, so screening before hire protects your billing as well as your patients. Run it alongside your standard background check and reference check process.
Red Flags in a PA Interview
Most PA candidates are exactly who they say they are, so treat red flags as prompts to ask one more question rather than as automatic disqualifiers. The four patterns below come up most often in small-practice hiring, and each has a follow-up that resolves it quickly.
Fuzzy on credentials
A practicing PA knows their license number, their certification cycle, and their DEA status. Approximate answers here are worth a same-day verification before you go further.
No escalation line
A candidate who cannot describe what they routed to a physician has either not practiced much or has been working outside a structure your state expects.
Charting is beneath them
Dismissiveness about documentation or coding predicts open charts, denied claims, and a record that will not hold up if anyone ever looks at it.
Everyone else was the problem
One difficult former employer is a story. Three in a row, with no self-reflection in any of them, is a pattern you will inherit.
Keep the questions job-related in every case. The EEOC prohibited practices guidance is the reference point: probe the work, the license, and the behavior, and stay away from protected characteristics. Asking the same questions of every candidate is itself protective, which is one more argument for a structured interview.
Scoring and the Hiring Decision
Score every candidate on the same rubric within an hour of the interview, anchored to something they actually said. Memory decays fast and favors whoever was most charming, which is not the same as whoever was most competent. The rubric in Set 6 scores out of 30 across six areas.
Scoring area
What a 5 looks like
Clinical judgment
Reasons out loud, gathers information, then commits to a plan
Scope and escalation
Clear line between independent work and the physician call
Setting-specific experience
Named procedures with volume, in your setting
Patient communication
Explains a plan plainly and holds a boundary calmly
Documentation and follow-through
Charts closed same day, understands the billing consequence
Team fit for a small practice
Treats the whole staff as colleagues, flexible about scope
If the physician and the owner both interview, score independently before comparing, then talk through the gaps. That conversation is usually where the real decision happens. Feed the scores into a clean interview feedback step, and use an evaluation form if you want one sheet per candidate.
Physician Assistant Pay
Physician assistants are among the highest-paid non-physician clinicians, and base salary is only part of what you commit to. Anchor to federal wage data first, then adjust for your specialty and local market before you publish a range.
Median $135,880 a Year (BLS OEWS, May 2025)
According to the Bureau of Labor Statistics Occupational Employment and Wage Statistics survey (May 2025), physician assistants had a median annual wage of $135,880, about $65.33 an hour, with the highest 10 percent earning more than $190,280. The same agency puts employment at about 162,700 in 2024, projected to grow 20 percent through 2034, with roughly 12,000 openings each year (BLS Occupational Outlook Handbook).
Budget above the base for malpractice coverage, a continuing medical education allowance with time off to use it, license and DEA fees, and payer credentialing, which delays the date the role starts generating revenue. Salaried PAs are generally treated as exempt learned professionals under the FLSA, but an hourly PA can be owed overtime, so classify the role deliberately rather than by title.
What Small Practices Get Wrong in PA Interviews
A hospital system hires PAs through a recruiting team, a credentialing department, and a standing interview panel. A small practice hires through a physician who is between patients and an office manager doing four other jobs. Three failure patterns follow from that, and all three are fixable.
You are hiring a clinician and you are not one yourself
Most practice owners hiring a PA are either a physician with no interviewing training or an office manager with no clinical training. Both are working with half the picture. The fix is to split the job: the collaborating physician tests the medicine in a clinical panel, and you test everything else, using the good-answer notes to judge the shape of a response rather than its clinical content. A candidate who names a real diagnostic miss and the change they made afterward is telling you something you can evaluate without a medical degree.
A slow process loses the candidate, not the other way around
Federal projections put about 12,000 physician assistant openings a year through 2034, and a licensed, certified PA in a common specialty is usually holding more than one conversation. Small practices lose these hires by taking three weeks to schedule a second interview, or by leaving compensation until the end and discovering a mismatch that a five-minute phone screen would have caught. Run three short stages inside two weeks, put compensation on the table in the screen, and answer every message the same day.
Nobody at the practice owns the paperwork after the yes
A PA hire has more moving parts after the offer than almost any other role a small business fills: license and certification verification, DEA registration, a collaboration or supervision agreement where your state requires one, malpractice coverage, payer credentialing, plus the standard employment paperwork. In a small practice this usually lands on whoever is least busy that week, which is how a start date slips a month. This is exactly the gap FirstHR was built for: e-signature, document management, and task workflows that make the credentialing sequence a checklist someone owns instead of a pile of emails. FirstHR is an onboarding and HR platform, not a credentialing verification service or a payroll provider. Applicant tracking is coming soon to FirstHR.
Trait
New Graduate PA
Experienced PA
Productive in the first month
Needs structured chart review and shared visits
Trains cleanly into your protocols
Costs less in base compensation
Asks hard questions about coverage and call
The rule of thumb: if your collaborating physician can genuinely commit real supervision time in the first months, a new graduate is often the better long-term hire. If they cannot, hire experience and pay for it. The quality of that first ramp is what I would watch most closely, and it is the same lesson behind most healthcare retention strategies.
From Offer to First Patient
The interview is the short part. A PA hire carries a credentialing tail that a small practice has to actively manage: the signed offer and any collaboration or supervision agreement, source-verified license and certification, DEA registration, malpractice coverage, payer enrollment, and the standard new hire paperwork including I-9 and W-4. Start the long items the day the offer is accepted.
Offer and agreement signed
The offer, the restrictive covenant if you use one, and the collaboration or supervision agreement your state requires, all signed and dated before the start date.
Credentials verified at the source
State license, NCCPA certification, DEA registration, and the federal exclusion list, checked on the issuing site rather than from a copy the candidate sent.
Systems and access ready
Record system login, e-prescribing, scheduling access, and payer enrollment started early, because credentialing is usually the long pole.
Records stored and dated
Signed offer, agreement, verification screenshots, I-9, W-4, and policy acknowledgments kept together and easy to produce on request.
An onboarding template gives the new PA a structured first weeks, and the same sequencing discipline behind good healthcare onboarding applies here. FirstHR connects the offer, the e-signature, the document storage, and the credentialing task list in one place, so a small practice can run a clinical onboarding without a credentialing department. FirstHR is an onboarding and HR platform, not a credentialing verification service or a payroll provider, so pair it with those. Applicant tracking is coming soon to FirstHR.
Key Takeaways
Interview a PA on clinical judgment, scope and escalation, documentation, setting-specific experience, and team fit.
Split the evaluation: the collaborating physician tests the medicine, you judge the structure of the answers.
Check your state rule on a written supervising or collaborating physician agreement before you make an offer.
Verify state license, NCCPA certification, DEA registration, and federal exclusion status at the source, not from a copy.
Run three short stages inside two weeks and put the compensation range on the table in the phone screen.
Anchor pay to the BLS OEWS May 2025 median of $135,880, then budget for malpractice, CME, and credentialing time.
Frequently Asked Questions
What questions should I ask when interviewing a physician assistant?
Ask questions that test clinical judgment, scope awareness, documentation habits, and fit with your setting. Strong core questions include: walk me through a typical patient panel on your last clinical schedule; what did you handle independently and what did you route to the supervising physician; tell me about a diagnosis you got wrong or nearly missed; what does your documentation look like at the end of a clinical day; and how do you decide when a patient needs escalation or referral. Add a specialty block for your setting, because a dermatology PA and an emergency medicine PA do different work. Finish with two or three situational scenarios drawn from your own patient mix, since the structure of the reasoning tells a non-clinician more than the clinical detail does. This page includes six downloadable sets plus a scorecard.
Does a physician assistant need a supervision or collaboration agreement?
It depends on your state, and you have to check your own state law rather than assume. State practice acts and scope of practice rules set the required practice relationship between physicians and PAs, and they differ substantially: some states require a written collaborating or supervising physician agreement filed or held at the practice, some require only a documented working relationship, and the details of chart review, prescribing, and physician availability vary. Federal Medicare rules recognize whatever the state requires as the form of supervision for billing purposes, and where a state has no explicit rule, they expect the practice to document the PA scope of practice and the working relationship with the supervising physician at the practice level. Confirm the requirement with your state medical or PA licensing board and have the agreement drafted before the first patient. This is general information, not legal advice.
How do I evaluate a physician assistant if I am not a clinician?
Split the evaluation. Put the collaborating or supervising physician in a clinical panel to test the medicine, and judge everything else yourself using the structure of the answers rather than their clinical content. Three questions work particularly well for a non-clinician: what did you handle independently versus escalate, tell me about a diagnosis you got wrong, and what does your documentation look like at the end of the day. Strong answers to all three are specific, name real cases, and include a change the candidate made afterward. Weak answers are absolute, vague, or blame someone else. Add a chart-review exercise with a de-identified note and ask what is missing. Then verify credentials at the source and call a supervising physician reference, because a reference from a physician who watched them practice is worth more than any interview answer.
What credentials should I verify before hiring a PA?
Verify four things at the source, not from documents the candidate emails you: an active, unrestricted state PA license on the issuing board site; current national certification from the National Commission on Certification of Physician Assistants, the PA-C credential; a current DEA registration plus any state controlled-substance registration if the role prescribes; and the federal exclusion list maintained by the HHS Office of Inspector General, since federal health care programs will not pay for services furnished by an excluded individual. Confirm the education requirement is met through an accredited physician assistant program. Add malpractice claims history and a supervising physician reference. Build every one of these into a written pre-hire checklist with a named owner, because in a small practice this step is the one that quietly slips. Verification takes a day and prevents a problem that can last years.
How much does a physician assistant cost to hire?
Physician assistants are highly paid clinicians and the salary is only part of the cost. According to the Bureau of Labor Statistics Occupational Employment and Wage Statistics survey (May 2025), physician assistants had a median annual wage of 135,880 dollars, about 65.33 dollars an hour, with the highest 10 percent earning more than 190,280 dollars. Pay varies by specialty and geography, with surgical, emergency, and dermatology roles typically at the higher end. Budget on top of base pay for malpractice coverage, a continuing medical education allowance with time off to use it, license and DEA registration fees, and payer credentialing, which also delays the date the role starts generating revenue. Benchmark to your specialty and local market before you post a range, and check whether your state or city requires pay transparency in job advertisements. This is general information, not legal advice.
Should I hire a new graduate PA or an experienced one?
It depends on how much supervision time your collaborating physician can genuinely give in the first months. A new graduate needs structured onboarding, chart review, shared visits, and a ramp on patient volume, which is real physician time that a busy small practice may not have. In exchange, new graduates are often more affordable, train into your protocols cleanly, and tend to stay longer when the onboarding is good. An experienced PA is productive faster and needs less oversight, but costs more and will ask harder questions about your coverage, call schedule, and physician availability. Ask a new graduate what supervision they need to be safe in their first three months, and be honest with yourself about whether you can provide it. If you cannot, hire experience.
How long should a PA interview process take?
Keep the whole sequence inside two weeks. A practical structure is a 15 to 20 minute phone screen covering licensure, certification, DEA status, schedule, and compensation range; a 45 to 60 minute clinical panel with the supervising or collaborating physician covering judgment, escalation, specialty questions, and a chart-review exercise; and a 30 minute final conversation with the owner to close the terms. Federal projections put about 12,000 physician assistant openings a year through 2034, so a strong candidate is usually in more than one process. Small practices lose these hires to scheduling delays and to leaving compensation until the end. Put the range on the table in the screen, answer every message the same day, and decide within a day or two of the final conversation. Applicant tracking is coming soon to FirstHR.
Are these physician assistant interview questions legal to ask?
Yes. Questions about clinical experience, licensure and certification status, procedures performed, scope and escalation, documentation habits, schedule availability, and how a candidate handled specific past situations are job-related and permitted. The legal caution is general to all interviewing rather than specific to clinical roles: avoid questions that touch protected characteristics such as age, race, religion, national origin, disability, genetic information, or family status, and keep every question focused on the job and applied consistently to all candidates. Asking the same structured questions and using the same scorecard for every candidate is itself a safeguard, because it evidences that you evaluated everyone on the same job-related criteria. Follow applicable rules for background checks and for any pre-employment medical inquiry, which generally cannot come before a conditional offer. Consult EEOC guidance or a qualified advisor for specifics. This is general information, not legal advice.
