In the UK secondary care setting, the case for physician associates is based on the cover and stability they might offer to medical teams. We assessed the extent of their adoption and deployment – that is, their current usage and the factors supporting or inhibiting their inclusion in medical teams – using an electronic, self-report survey of medical directors of acute and mental health NHS trusts in England. Physician associates – employed in small numbers, in a range of specialties, in 20 of the responding trusts – were reported to have been employed to fill gaps in medical staffing and support medical specialty trainees. Inhibiting factors were commonly a shortage of physician associates to recruit and lack of authority to prescribe, as well as a lack of evidence and colleague resistance. Our data suggest there is an appetite for employment of physician associates while practical and attitudinal barriers are yet to be fully overcome.