Advancing Readiness: The Evolving Role of Physician Associates in Joint Interagency Missions.

Author: COL James J. Jones, PhD, PA-C 11th Physician Associate Consultant to The U.S. Army Surgeon General

Abstract

Amidst an increasingly complex geopolitical landscape, rapid technological advancements, and the dynamic nature of multi-domain operations, the role of the Physician Associate (PA) in military medicine is undergoing a critical transformation. This article examines the competencies and strategic initiatives required for PAs to remain operationally relevant, clinically indispensable, and institutionally influential within joint and interagency environments. Informed by outcomes from the 2024 SAPA Annual CME Conference in San Antonio, Texas, field observations, academic symposia, and collaborative interagency engagements, this analysis delineates the evolving clinical, operational, academic, and leadership expectations of the next-generation PA. Furthermore, it proposes actionable strategies for aligning PA capabilities with Joint Force doctrine, whole-of-government partnerships, and global health platforms. By expanding their scope and enhancing integration across strategic echelons, Physician Associates will serve not only as force enablers but as key drivers of future combat readiness and medical superiority in large-scale operations and beyond.

Introduction

Physician Associates (PAs) have long been vital contributors to force health protection, operational readiness, and the continuum of care across military treatment facilities and deployed environments. However, the demands of modern conflict—defined by Multi-Domain Operations (MDO), great power competition, and increasingly complex humanitarian and interagency missions—require a fundamental shift in the PA’s professional identity and operational role.

In this evolving battlespace, technical clinical proficiency remains essential, but it is no longer sufficient. Tomorrow’s PAs must be more than proficient clinicians—they must become operational integrators, medical planners, academic leaders, and policy influencers who contribute meaningfully to strategic objectives. This expansion of the PA role is not aspirational—it is operationally required.

The 2024 virtual Joint Interagency PA Meeting in San Antonio laid the groundwork for this transformation, bringing together military and civilian leaders across services and agencies to assess the future of the profession. That dialogue continues into 2025 with a renewed focus on ensuring PAs are not only prepared to meet evolving threats but positioned to lead at the intersection of clinical care, operational medicine, and national security policy. The imperative is clear: future-ready PAs must be clinicians who lead, educators who inspire, researchers who generate evidence, and strategists who shape outcomes across domains.

Discussion

As the U.S. military transitions toward readiness for large-scale combat operations and expanded interagency engagements, the need for Physician Associates to evolve in parallel is paramount. Lessons learned from recent operations—ranging from pandemic response to disaster relief, and from partner-nation training to contested logistics in combat zones—highlight the critical role that PAs play not just in care delivery, but in system design, policy development, and operational synchronization.

To meet these demands, future PAs must demonstrate five core domains of expanded capability:

1. Operational Integration: PAs must embed deeply within Joint and interagency planning cells, advising commanders on medical risk mitigation, casualty estimation, evacuation routes, and prolonged care strategies. Their firsthand operational insight and clinical judgment are essential in synchronizing medical plans with tactical realities.
2. Leadership and Policy Influence: Beyond clinical tasks, PAs must shape institutional policy at the service and Joint levels. This includes participating in doctrinal development, contributing to Lessons Learned processes, and informing future medical force design to support distributed operations and competition below armed conflict.
3. Academic and Research Engagement: Evidence-based decision-making requires that PAs contribute as academic leaders—designing CME curricula, leading simulation-based training, and publishing in peer-reviewed forums. PAs must also drive readiness-focused research on topics such as casualty survivability, prolonged field care, and force health trends.
4. Global Health and Interagency Collaboration: The PA’s role increasingly includes advancing global health objectives and responding to interagency crises. PAs must bring cultural competence, operational agility, and scalable clinical expertise to diverse and dynamic environments.
5. Digital Proficiency and Innovation: PAs must lead in the adoption of emerging technologies including biosensor analytics, AI-assisted triage, digital twin modeling, and remote patient monitoring. Digital fluency enhances decision-making, increases force lethality through better readiness assessments, and reduces preventable attrition.

These domains of growth are not theoretical—they are operational imperatives. To codify and refine these evolving priorities, the profession will convene at the first-ever Joint Interagency PA Summit, scheduled for 18–22 August 2025 in San Antonio, Texas. This landmark event will bring together leaders from across the Department of Defense, interagency partners, and allied nations to align Physician Associate capabilities with emerging threats, strategic objectives, and modern battlefield requirements.

The momentum from past engagements must now be translated into institutional reform and individual action. Training programs must adapt to teach not only medicine, but leadership, operational art, and strategic communication. Evaluation systems must evolve to reward innovation, policy engagement, and team development. Most importantly, the profession must foster a mindset of continuous evolution—understanding that in future fights, the best clinicians will also be the most agile leaders.

What the Future PA Must Be Able to Do:

1. Master Clinical Complexity: Physician Associates (PAs) in operational environments must execute trauma resuscitation, airway management, prolonged field care, and damage control surgery with autonomy under austere conditions. They interpret complex diagnostic imaging and laboratory data in low-resource settings and maintain procedural fluency in emergency ultrasound, advanced cardiac life support (ACLS), orthopedic stabilization, wound debridement, and burn care. These providers lead patient stabilization efforts and coordinate evacuation planning across Role 1 to Role 3 transitions, ensuring continuity of care under duress.

2. Lead Digital Transformation: Future-ready PAs are expected to operate, troubleshoot, and apply digital diagnostic tools, virtual reality training modules, and remote monitoring systems. They integrate AI-based triage algorithms and digital twin technologies into clinical workflows, conduct virtual mentorship for dispersed teams, and lead remote consultations in denied environments. Monitoring biosensors and leveraging predictive analytics for unit health surveillance, they enable early identification of illness trends and enhance force readiness.

3. Operate as Interagency Assets: These leaders drive joint humanitarian medical missions. They must develop and execute infectious disease containment strategies for displaced populations and coordinate with agencies such as the Department of Homeland Security (DHS) during domestic emergencies. PAs also serve on planning cells for building strategic health infrastructure resilience in preparation for conflict and disaster response.

4. Shape Doctrine and Strategy: Operationally grounded PAs contribute to the development of tactical and operational medical guidance for inclusion in joint service publications. They evaluate medical gaps through after-action reviews (AARs) and input findings into Lessons Learned databases. Their participation in multinational interoperability exercises and doctrinal validation events ensures continuous improvement. As trusted advisors, they brief commanders and policymakers on force health protection policies and comprehensive medical risk assessments.

5. Drive Research and Academic Progress: Physician Associates lead battlefield studies on survivability, prolonged care protocols, and evacuation timelines. They serve as principal investigators for readiness-oriented clinical trials and quality improvement initiatives. As educators, they design continuing medical education (CME) content and simulation-based training aligned with military medicine needs. Many expand their academic footprint by teaching in military and civilian graduate education programs, particularly in cardiology, public health, and healthcare leadership.

6. Master Soft Skills for Leadership and Influence: To lead effectively in volatile environments, PAs must demonstrate emotional intelligence by reading non-verbal cues, maintaining composure, and modeling empathy under stress. Resilience and self-regulation practices, including mindfulness and adaptive thinking, help prevent burnout. Strategic communication skills are essential for delivering briefings to general officers, multinational stakeholders, and interagency partners. PAs empower teams by mentoring, resolving conflict, and cultivating a culture of trust. Cultural competence allows them to adapt care to diverse populations, while strong teaching and instructional abilities enable them to guide junior officers. Finally, moral courage anchors their ethical decision-making, ensuring that patient rights are upheld even amidst the fog of war.

7. Advocate for the Profession: Physician Associates shape policy by engaging with legislative liaisons, supporting the American Academy of Physician Associates (AAPA), and influencing PA utilization strategies across the Department of Defense (DoD) and Veterans Affairs (VA). Through op-eds, white papers, and national presentations, they elevate the strategic value of the PA profession. Collaborations with medical associations help define national standards and credentialing benchmarks. PAs also champion diversity, equity, and inclusion, ensuring military medicine reflects the values of the nation it serves.

Conclusion

The Physician Associate (PA) of the future is not merely a provider of clinical care but a multidomain force multiplier—operating at the critical intersection of medicine, operations, policy, and innovation. As global threats become increasingly diffuse and complex, the demand for adaptable, operationally fluent, and technologically empowered PAs will grow exponentially. Meeting this challenge requires more than clinical proficiency; it demands strategic leadership, accelerated skill development, and unwavering professional foresight.

To remain indispensable within the Department of Defense, the PA profession must undergo a deliberate and dual-pronged transformation—both institutional and individual. While systemic investment in doctrine, joint education, and interagency collaboration is essential, it is not sufficient on its own. Every PA must embrace personal responsibility for professional evolution: mastering emerging technologies, contributing to strategic planning, and leading beyond the clinical domain.

At the heart of this transformation lies a strategic mandate: to enhance warfighter lethality, ensure combat medical readiness, and improve survivability across the continuum of care in future large-scale combat operations (LSCO) and hybrid threat environments. PAs must be capable of leading in ambiguity, sustaining operations in contested logistics, and delivering precision health interventions under fire.

The future of the PA profession—and its enduring relevance to national defense—depends not on passive adaptation but on deliberate action. We must not only respond to change; we must be the vanguard of it.

References

• Harari, R., McCauley, M., & Chen, L. (2023). AI Integration into Military Triage and Casualty Care. Military Medicine, 188(9), e2191–e2202.
• Jones, J., & Thompson, M. (2024). Leadership Resilience in High-Stress Environments. JPA Military Leadership Review, 5(2), 76–85.
• Department of Defense. (2024). Joint Medical Modernization Strategy 2024–2028.
• Defense Health Agency. (2023). MHS Reform and Digital Health Performance Report.
• U.S. Army Medical Center of Excellence. (2025). PA Training for LSCO: The Future Force Doctrine.
• Government Accountability Office. (2023). Medical Workforce Readiness Gaps and Opportunities Report.

Contact 📧 jamesjonespa@gmail.com 🌐 jamesjonespa.com 🔗 LinkedIn