You book an appointment, you walk in, and the name on the door reads Chad Jarvis, PA-C instead of something followed by MD. Somewhere between the front desk and the exam table, a question shows up. Am I getting the same quality of care?
Almost everything written about PA vs MD is aimed at 22 year olds deciding where to apply to school. Very little of it is written for the person who just wants to know who is managing their blood pressure. It is one of the most common healthcare questions people never actually ask out loud. So here is the patient version, written by a direct primary care practice in Tooele that is built around a physician assistant with more than two decades in the medical field.
What those letters actually stand for
MD stands for Doctor of Medicine. A medical doctor holds an MD degree earned at an allopathic medical school. You will also see DO, Doctor of Osteopathic Medicine, a fully equivalent license with added training in musculoskeletal manipulation. Both are physicians. Both can practice any medical specialty.
PA stands for physician assistant, and PA-C means that physician assistant passed the national certifying exam and holds current certification. The national professional body, the AAPA, voted in 2021 to change the title of the pa profession to physician associate, though state licensure law still uses the older term in most states, Utah included.
One clarification worth making early, because the names sound alike. A physician assistant is not a medical assistant. A medical assistant completes a certificate or two year program and handles rooming, vitals and administrative work. A PA holds a graduate degree, diagnoses conditions, orders and interprets testing, prescribes medication and builds your treatment plan. Different job, different license, different level of responsibility for your medical care.
Two roads into the same exam room
The most useful way to understand the difference is to look at how each person got there, because the shape of the training explains almost everything about how they practice.
The PA path
Before pa school, most applicants stack up direct healthcare experience. The AAPA notes that a typical entering student arrives with roughly three years of hands on work as a paramedic, EMT, respiratory therapist, surgical tech or nurse. That matters. PA students often begin their pa education with thousands of hours of real clinical experience already behind them, which is unusual anywhere else in the healthcare workforce.
A pa program then runs about 27 months and awards a master’s degree, frequently titled physician assistant studies. The first year covers the same foundational sciences a medical student sees in the opening years of medical school, compressed and taught with less research emphasis. The second year is more than 2,000 hours of clinical rotations across family medicine, internal medicine, surgery, pediatrics, psychiatry and emergency care, deliberately weighted toward primary care.
After that comes the PANCE, the national certifying exam. Certification is maintained with 100 hours of continuing education every two years and a recertifying exam every ten. A pa program is not a shortened medical school, and it does not pretend to be. It is a different curriculum built to produce a generalist quickly, and there is no residency requirement attached to it.
The MD path
The MD route is longer and more front loaded. A bachelor’s degree, the MCAT, and an application submitted through the Association of American Medical Colleges. Then four years of medical school, split roughly into two preclinical years and two clinical years, plus the USMLE licensing sequence.
Here is the part patients underestimate. Finishing an md program does not make someone ready to practice. A medical school graduate must complete residency, which runs three years for family medicine and up to seven or more for surgical fields. Residency is where a physician builds the deep, supervised repetitions inside one medical specialty that shape the rest of their medical career.
Add it up and the MD path is usually eleven or more years after high school. The PA route is typically six to seven. That gap is not a shortcut in disguise. It is a different design for a different role in the healthcare system.
Side by side
| Physician assistant | Physician | |
| Graduate training | pa program, about 27 months | medical school, four years |
| Postgraduate training | none required | residency, three to seven plus years |
| Certifying exam | PANCE, then PANRE | USMLE sequence, then board certification |
| Trained as | broad generalist | specialist by residency |
| Changing specialty | possible without returning to school | usually means starting the training over |
Both pa school and medical school are nationally accredited, and both end in a licensing exam that a graduate has to pass before touching a patient independently.
The key differences that actually show up in your visit
Depth versus breadth. Medical school plus residency produces a physician trained very deeply in one specialty. PA training produces a generalist trained broadly, which is why a PA can move between specialties without repeating school. A physician who wants to switch specialty generally repeats residency.
Where the ceiling sits. For routine and moderately complex primary care, the day to day work looks nearly identical. Both take your history, examine you, order labs, prescribe, and adjust the plan. The difference appears at the edges. Rare presentations, complicated multi system disease and procedural work are where the extra years of medical school and residency earn their keep, and where a good healthcare provider of either type refers out.
Continuity. Physician assistants tend to stay in outpatient roles rather than rotating through hospital service lines, so in a small practice you often see the same face at every visit. Continuity of patient care is not a credential, but it changes outcomes.
Cost. Physician assistants earned a median of $133,260 in May 2024 according to the Bureau of Labor Statistics, while the same source puts family medicine physicians well above $250,000 on average. Comparing a PA salary to an MD salary is not a statement about worth. It is a statement about how much overhead sits behind one appointment slot, and it is a real driver of healthcare costs. Practices staffed by physician assistants can often price patient care lower, which is part of why flat fee membership medicine works at all.
What Utah law says about physician supervision
This is where most articles are years out of date, and where the answer genuinely depends on your state.
The older national model required a supervising physician and a written delegation agreement for every PA. Utah changed that in 2021. SB 27 removed the requirement for physician supervision and delegation of services agreements. Under current law, a Utah PA provides medical services within their own skills and competence and collaborates with the appropriate member of the healthcare team as the patient’s condition indicates. PAs with fewer than 10,000 hours of practice carry additional collaboration requirements. Past that threshold, Utah allows what functions as independent practice, and the PA is accountable for the care they provide.
Ten thousand hours is roughly five years of full time clinical work. A PA with twenty plus years in practice cleared it a long time ago.
So in Utah, the honest answer to who is supervising your PA is that the framework is collaboration rather than supervision, and the responsibility sits with the PA.
When you should want an MD
Being straight about this is more useful than a sales pitch.
Look for a physician when your situation is procedural, rare, or clearly subspecialty territory. Complex cardiology, oncology, surgical management, difficult rheumatologic or neurologic disease, and unusual presentations that have already stumped a generalist belong with medical doctors who spent residency inside that specialty. Certain hospital and academic healthcare settings are also structured around physician led teams by design.
The better test is not the credential. It is whether the medical professional in front of you knows the boundary of their own competence and refers past it without ego. Some of the least safe care in the medical field comes from providers of every letter combination who do not.
What this looks like at Summit Direct Health
Chad Jarvis, PA-C brings more than twenty years across family medicine, internal medicine, urology and orthopedics. In a direct primary care model, that experience gets used differently than it would in an insurance based healthcare clinic. There is no fifteen minute visit cap and no billing code steering the conversation. Visits run as long as they need to, and members reach their primary care provider directly.
That structure is the real point. When people ask about PA vs MD, they are usually asking a proxy question. Will someone know my history, take my concern seriously, and have time for me? Those outcomes track far more closely with how a practice is built than with which graduate school your provider attended.
Questions patients ask
Can a PA prescribe medication? Yes, including controlled substances, under Utah licensure.
Can a PA be my main provider? Yes. In Utah a PA can serve as your primary care provider and manage chronic conditions, preventive care and acute illness.
Is a PA a doctor? No. A PA holds a master’s degree, not an MD degree, and should not be called a doctor. The distinction is real, and any good PA will make it themselves.
Do PAs go to med school? No. They attend pa school, a separate graduate program with its own accreditation and its own certifying exam.
Do PAs treat kids and older patients? Yes. Rotations in a pa program cover the full age range, and family practice PAs care for entire households.
Who coordinates my specialists? Your PA does, and in a small practice that person is often the one holding your whole healthcare picture together instead of seeing one slice of it.
The short version
The distinction is real, not a marketing technicality. The MD path buys depth through medical school and residency. PA training buys breadth and reaches patient care faster, usually with substantial healthcare experience already in hand. In Utah, an experienced physician assistant practices with real autonomy and real accountability.
For everyday primary care, what should drive your choice is access, continuity and judgment, not the letters.
Curious what unhurried health care actually feels like? Summit Direct Health offers membership based primary care in Tooele with unlimited visits and direct access to your provider. Reach out to schedule a meet and greet.
