henryd Posted March 30, 2015 Share Posted March 30, 2015 in terms of money and scope of practice? I really want to know about this. read some posts here and was wondering. Link to comment Share on other sites More sharing options...
PennPA4 Posted March 30, 2015 Share Posted March 30, 2015 The good part about PA that if you feel that you reached ceiling in scope or salary, you can transition to different specialty to challenge yourself and may be even higher salary. Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 30, 2015 Moderator Share Posted March 30, 2015 yes for the most part always exceptions, and some people are comfortable with this role, but others are not always more to learn, but easy to just fit into the box of "only a PA" and not continue to excel, and at the same time stop demanding higher pay and responsibility Link to comment Share on other sites More sharing options...
henryd Posted March 31, 2015 Author Share Posted March 31, 2015 The good part about PA that if you feel that you reached ceiling in scope or salary, you can transition to different specialty to challenge yourself and may be even higher salary. I heard its now getting hard to move around specialities like that. Link to comment Share on other sites More sharing options...
andersenpa Posted March 31, 2015 Share Posted March 31, 2015 The good part about PA that if you feel that you reached ceiling in scope or salary, you can transition to different specialty to challenge yourself and may be even higher salary. With all due respect this is bad advice Why should a health care professional need to transition out of a specialty that they love to do something because arbitrary forces determine that they have reached their "ceiling"? These limits are often imposed by miscalculated value (inability to track PA productivity by hard metrics like RVU), prejudice (PA can't do XYZ because they are a PA and not a doc), or plain old ignorance of PA scope. Just like the nurses say- allow us to practice to the fullest extent of our training and competency. Base it on something real, not "perception". Link to comment Share on other sites More sharing options...
Guest Paula Posted March 31, 2015 Share Posted March 31, 2015 Yup, been out for 10 years and just came to the realization I've hit the pinnacle and just took a cut in pay to get closer to home. My new job has 40% less responsibilities than my former job because I no longer am practicing on the rez and am with a big group. I get dished the bread and butter case more times than I can count and will be bored out of my mind or lose all my skills within a few years. After thinking about this and watching my collaborating physician get hammered by administration because he can't make his metrics (because he has no time to see the bread and butter cases) I am beginning to think it's not all bad to be in my situation. So far, I am adjusting but since I'm such a type A person, I hope I don't burn out from boredom. Then I will be ready to retire. However, I am starting a PA practice council at my facility and have 3 interested PAs and we all want to discuss restrictions, scope of practice, pay and the misguided perceptions MD/DO/nurses have of the PA profession. Onward, soldier. Link to comment Share on other sites More sharing options...
Joelseff Posted March 31, 2015 Share Posted March 31, 2015 I am hitting my 5th year now. I hit the ceiling last year I think. I had my own panel of pts and thought that was it. I stepped out/away from that and ended up taking an urgent care type job in a hospital system where I DON'T have a panel and see overflow/urgent care pts. I used to think this would be the pits but actually I rather like it so far. True I deal with much less autonomy but at least I'm getting paid a lot more, get more time with family and I don't take work home. If I thought about it though, If I started my career at this job I probably would have killed myself (not literally) LOL. Who knows though, I may end up hating this and do something else. Time will tell... Link to comment Share on other sites More sharing options...
electric130 Posted March 31, 2015 Share Posted March 31, 2015 Yes, in some ways you will hit a glass ceiling in both regards. I have been practicing almost 13 years, the first seven I was completely satisfied with pay, autonomy, pretty much everything. The last five I have felt like although I contribute a great deal to the practice, am very productive and very knowledgeable in my field I am at the top 10 percent for PA pay and if anything if I change specialties I will take a large pay cut. I honestly don't see making any more than I do now besides small raises for at least the next five years. I have autonomy and see everything at my practice so no restrictions, but have felt treated like an employee not a fellow practitioner quite frequently. Where this was not a problem for me my first five years, now it is a harder pill to swallow. For example, recently my SP gave me a list of dates he was going to be out of town and said he expected me to be in the office those dates. He would never do that to one of his fellow group partners, and I came back with a list out of those that I already had plans and we would just not be available those days. That is the mindset that bothers me, at this point in my career I just don't tolerate it, but sometimes the lack of respect after so many years is demoralizing. I do think there are some very forward thinking practices that treat PA's like fellow clinicians, ask for their opinion on policy, allow them to have more of a pay structure based on production, and allow profit sharing, those seem to be few and far between, but hopefully with time this will improve. Overall, I would still encourage students to go to PA school, it is rewarding to practice medicine. I personally did not want to go to medical school, but I understand some of the more seasoned PAs feelings of being at that glass ceiling, it is there, I think it is just how you react to it and if you can accept where you are and be content. Link to comment Share on other sites More sharing options...
SocialMedicine Posted March 31, 2015 Share Posted March 31, 2015 this is a problem with a career in medicine .... especially a career in medicine as a PA. Once you learn a lot and manage your own patients there really is no next step. This is what separates those who love medicine and those with a real type A approach from everyone else. The type A approach for lack of a better term is thinking about next steps .... health management, consulting, academics, practice ownership, and maybe did a part time degree or developed some skills along the way. At year six I felt my private practice was getting old .... yet there was an MD who had been practicing there for 20 years and he seemed to enjoy every day .... to each his own. edit the above text does not show why MD is preferred to PA ... rather shows how one person just enjoyed the same old routine put patient medicine for 20 years and someone else felt it was a glass ceiling w.o growth potential. Link to comment Share on other sites More sharing options...
henryd Posted March 31, 2015 Author Share Posted March 31, 2015 yikes. Link to comment Share on other sites More sharing options...
kayakr Posted April 3, 2015 Share Posted April 3, 2015 Not sure about opinion in the specialities, but I would argue that probably even many physicians in primary care feel like they've hit a glass ceiling at some point. Link to comment Share on other sites More sharing options...
BruceBanner Posted April 3, 2015 Share Posted April 3, 2015 The grass is always greener. Physicians can hit their own glass ceiling, but it's high enough it may not matter. I got into this field with the understanding I would probably cap out in the ~$120k range for salary if I stayed in the IM/FP spectrum. Maybe more if I get into a niche or work multiple jobs. And I don't expect that to change...ever really, regardless of inflation. No one is ever going to throw more money at you unless you are in extremely high demand or bring something rare and valuable to the table. With the exception of some really progressive group practices, the vast majority of healthcare organizations treat PAs as cheaper alternative to doctors that can move bread-and-butter cases and generate revenue. Look at it from the perspective of the people paying us. There is absolutely no incentive for them to give a dependent practitioner expansive salary potential. This is just the way it is. I'm not saying we shouldn't continue to demand professional respect and fair compensation, but I think the glass ceiling is very real and something you should make peace with, or plan other business ventures. Just being the friendly neighborhood PA is a good and noble profession but does not provide unlimited advancement. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 3, 2015 Moderator Share Posted April 3, 2015 I think of the glass ceiling more in terms of scope of practice and autonomy than pay. you can always make more money by working more shifts. I could make 200k/yr if I never wanted to be home or even more if I were willing to be a whipping boy at a local hmo that pays 1.5x for anything over 8 hrs/day or 40 hrs/week and has lots of differentials for unpopular shifts by working 220+ hrs/mo and doing all nights/weekends/holidays (I quit that job already thank you very much.....) Link to comment Share on other sites More sharing options...
Guest Paula Posted April 4, 2015 Share Posted April 4, 2015 My new practice is wRVU based and I'm still on salary. I met yesterday for my 30 day check-in with the Service Excellence Coach (the most recently retired MD who I worked with years ago in my first job on the rez who recommended they hire me). We never discussed the intent of her meeting which was to coach me on how to be a great clinician and how to get good satisfaction scores. WE discussed the wRVUs and she told me some of the PAs and a few NPs are making more than a few of the physicians. Maybe I haven't met my ceiling yet as far as compensation if I meet and exceed the median they expect for the Advanced Practice Clinicians. We shall see. My goal is to go off of salary by the end of 6 months. I'll get my first month's metric by the end of April for March. Then I can estimate how many more people I can see. I am seeing complex patients, new patients, f/u pts from the ER, some bread and butter sinus infections, etc. (one which really turn out to be trigeminal neuralgia), annual exams, psych pts, and the usual mix you get in PC. So far loving it and hope to get the challenging cases more. Also, I have discussed with the Coach about getting representation on some of the committees that have no PA/NP members. She thought that the management would be open to it, so I will figure out which one to be on. That must be my way to expand my skills and hoping I will at least see the skylight now and then. Link to comment Share on other sites More sharing options...
HMtoPA Posted April 5, 2015 Share Posted April 5, 2015 I would say that, in general, one will hit an earnings ceiling in the majority of professions. Do you expect linear growth in earnings for the remainder of your working life? To me, that's just not realistic. In terms of objective professional growth, you can always pursue residency/fellowship training and/or CAQ certification. May not translate to higher earnings, but may make you more marketable, and may make you feel better. Again, in most professions one begins to level off sooner or later. Link to comment Share on other sites More sharing options...
UGoLong Posted April 5, 2015 Share Posted April 5, 2015 I was not a PA for most of my working career and found that, in most non-PA environments too, there was a ceiling as to how far you could go in a given job. At some point, you had to take on more responsibility, work longer hours, or change jobs to make more money. The exceptions were if you were in senior management at a successful company and got sizable bonuses or stock options, if you started your own successful company, or if you were an ace in sales and got paid straight commission. I’ve spent my nine years as a PA in the same specialty in the same private practice. I’ve gotten some raises along the way, but nothing like those I received over the same period of time in other jobs I’ve had. Reimbursements have dropped close to 40% in aspects of our specialty and we are all working harder these days. If I had it to do over again, I would still have become a PA at the same point in my life that I did because I really enjoy the work. I’m on my own most of the time, and I enjoy our patients and trying to solve their problems. I might have gone into a hospital-based practice instead, but I’m not sure; it seems a little less personal. I don’t know how I would feel if I had started out as a PA as a young guy, but I am very happy with the collection of careers that I’ve had. I truly loved going back to school later in life and coming out to do this; it’s been a great capstone on my working life. I don’t know what I would have chosen as a 20-year-old, but I would have considered becoming a PA. Knowing my personality however, if I had chosen medicine back then, it would probably have been as a physician. Now that I actually work with physicians, I’m glad I didn’t make that choice. I got to spend time with my family, raise my kids, watch my grandchildren grow, and enjoy family time. If you can do that and still have an enjoyable series of jobs that facilitates it while giving you personal satisfaction, you are indeed a happy person. What I do know is that, whatever I would have started out doing, I would still have changed course along the way. That’s what I did and I strongly suspect that it’s in my DNA. It’s not the 1950s anymore; you don’t necessarily do the same thing your whole life and assume that it (the pay, the satisfaction, the retirement benefits, etc) will meet all of your needs. Whatever you choose to do, let it satisfy you at the time, let it build skills that would be useful doing other things, and let it not trap you into thinking that it's the only job you could possibly get. Link to comment Share on other sites More sharing options...
winterallsummer Posted April 5, 2015 Share Posted April 5, 2015 If you truly hit a ceiling, saying you have a job in the field you want, good hours, respect, autonomy, and a 6 figure salary, and still you are unsatisfied, then you can always get your MBA and go into admin, PHD and go into teaching or other fields, or the DO bridge program, or begin your own clinic (there are PAs on this forum that have done all of those things). Link to comment Share on other sites More sharing options...
UGoLong Posted April 5, 2015 Share Posted April 5, 2015 Not being satisfied can be a strong motivator to try something new. Nothing is as futile as being somewhere you no longer want to be and spending your time just cursing the situation. Link to comment Share on other sites More sharing options...
SocialMedicine Posted April 5, 2015 Share Posted April 5, 2015 I do not think of the glass ceiling as a calling to do something such as a DO or MD program .... maybe in a surgical specialty where your autonomy is restricted .... but for many PAs that is not the case .... rather the glass ceiling is something many in medicine feel ..... a career in medicine does not offer as much versatility as many other occupations ... and the mundane thoughtless tasks of paperwork can be draining after many years. In my opinion PA or MD is a unique and valuable experience/perspective with skills generalizable towards many fields and it is too often leveraged by the stakeholder. Link to comment Share on other sites More sharing options...
henryd Posted April 16, 2015 Author Share Posted April 16, 2015 very mixed answers. So the answer is yes, and the solution to that is to look for something different within your speciality? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 16, 2015 Moderator Share Posted April 16, 2015 very mixed answers. So the answer is yes, and the solution to that is to look for something different within your speciality? or to work on the cutting edge of your specialty. develop a niche skill (endoscopic vein harvesting, ability to work solo, etc). Link to comment Share on other sites More sharing options...
henryd Posted April 22, 2015 Author Share Posted April 22, 2015 or to work on the cutting edge of your specialty. develop a niche skill (endoscopic vein harvesting, ability to work solo, etc). thats an idea..do you do anything like that? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 22, 2015 Moderator Share Posted April 22, 2015 thats an idea..do you do anything like that? I work solo at 2 out of 3 jobs and double coverage alternating charts with a doc at the other. I am completing a doctorate in global health this summer, which has given me a lot of new skills applicable to international medical missions, leadership, study design and implementation, etc Link to comment Share on other sites More sharing options...
henryd Posted April 24, 2015 Author Share Posted April 24, 2015 clearly its true based off the posts here...so once u hit that ceiling, the best option to change up the setting? Link to comment Share on other sites More sharing options...
BruceBanner Posted April 24, 2015 Share Posted April 24, 2015 Changing a setting is easier said than done and will probably not give you the ceiling increase you're looking for. Best to get another job, business venture, or dont be a PA. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.