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NP Favoritism?


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I am an east coast based PA seeking a new job in California (likely LA area). From what ive seen available on most hospital sites it seems like there are a ton of jobs open for NPs but not as many for PAs- and most are not interchangeable. Ive looked on Stanford's site and they make most positions open to AHP (adv healthcare provider) that is open to PA or NP. Is it me or is the west coast behind the times with how valuable PAs are? Has anyone who works in California felt that in the hospital system there is a greater preference for NPs over PAs? If so, do you think their compensation is higher, their responsibilities are greater, or they are integrated into the team differently than us PAs? Id love any feedback!

 

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I am an east coast based PA seeking a new job in California (likely LA area). From what ive seen available on most hospital sites it seems like there are a ton of jobs open for NPs but not as many for PAs- and most are not interchangeable. Ive looked on Stanford's site and they make most positions open to AHP (adv healthcare provider) that is open to PA or NP. Is it me or is the west coast behind the times with how valuable PAs are? Has anyone who works in California felt that in the hospital system there is a greater preference for NPs over PAs? If so, do you think their compensation is higher, their responsibilities are greater, or they are integrated into the team differently than us PAs? Id love any feedback!

I have not worked in CA for 15 years, so take this with that caveat. Yes, there are a lot of NP jobs in CA, mainly due to strong nursing unions and yes, the west coast is way behind in it's utilization of PAs. I routinely see stories on these boards about new grads on the east coast landing jobs that would only be open to very senior PAs on the west coast; high autonomy, broad scope of practice, etc jobs, which are hard to find on the west coast. after 20 years as an em pa I am starting to land solo jobs equivalent to what some of my friends on the east coast got within just a few years of graduation. CA has a lot of PA programs also so supply is high and demand in desirable locations may not be as high. If you are willing to live >100 miles from the ocean there are plenty of jobs. If you want nice parts of LA, San diego, bay area, etc those areas are almost closed to new grads.

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thank you! I have about 3yrs experience. Was just made an offer from a decently reputable hospital out in LA but not sure i would be utilized in the way I am utilized on the east coast- but it'd also be me switching from inpatient to outpatient work with a tough population. I'm going to have to give this some thought!

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Timon I couldnt help but see your FM offer on another posting- sounds like a great offer!! Mind if I ask what part of SoCal you're in? I ideally want a PA hospitalist job or even Urgent Care, given i have 3yrs experience in it but cant seem to find one! I have an offer in ortho but not sure I truly want to commit and will need to decide by next week!

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Timon I couldnt help but see your FM offer on another posting- sounds like a great offer!! Mind if I ask what part of SoCal you're in? I ideally want a PA hospitalist job or even Urgent Care, given i have 3yrs experience in it but cant seem to find one! I have an offer in ortho but not sure I truly want to commit and will need to decide by next week!

I'm I'm the Inland Empire / Rancho Cucamonga area. So about an hour east of Los Angeles. The pay here is greater and there are more opportunities as there is a greater underserved population in my area.

 

I know that PIH Downey (EM Care) is hiring as well as Queen of the Valley (CEP) and Pomona Valley (CEP). Their offers would be something to consider as I have a classmate that took a CEP job in the LAX area at $60 an hour (new grad) and I know a few PAs who have about 3 years experience are making $80 / hr through EM care at PIH Downey. These are ER gigs with lots of fast track work involved.

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I'm in central California right now. I'm in the military, but am currently transitioning to the civilian world. For a time, I was considering staying in California and I had no shortage of job offers, primarily from central and southern California. I didn't apply anywhere in northern California so I can't comment on that.

 

The thing is that you have to keep in mind that California is very competitive overall. I work with an NP that moved from Los Angeles because she couldn't find a job that paid as much as the job she took in central Cali. She told me that the LA area if over-saturated with providers and that everyone is having trouble getting jobs.

 

That wasn't my experience overall, but I think it illustrates that this may not be a "PA vs. NP" thing as much as it is an "over-saturated area" thing.

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  • 2 weeks later...

I am brand new to California and did not even have CA on my radar when I decided to job hunt.  I practiced in Ohio for 7 years, before moving to Hawaii for a year  I just left Hawaii and took a job in Northern Cali.  When looking for job I started talking to recruiters and they kept throwing jobs at me in Cali with pay at the highest of my career.  So, I'm working in Cali now and it is actually much better then I thought. 

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The nursing union in CA is a strong force. PA's are relatively new to CA and people are not as familiar with them. At work my supervising doc has to look over 5% of my charts and I need verbal consent when giving controlled substances to any patient. However, he doesn't have to do these tasks with the NP. Also the NP training is different. They do rotations only in their chosen specialty so they have great preparation for their future job. I did rotations in all kinds of specialties, so in a way, I at a disadvantage; I still need a lot guidance with my dx and treatment plans!  With that said, my pay (so far) is the same rate as the NPs.

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The nursing union in CA is a strong force. PA's are relatively new to CA and people are not as familiar with them. At work my supervising doc has to look over 5% of my charts and I need verbal consent when giving controlled substances to any patient. However, he doesn't have to do these tasks with the NP. Also the NP training is different. They do rotations only in their chosen specialty so they have great preparation for their future job. I did rotations in all kinds of specialties, so in a way, I at a disadvantage; I still need a lot guidance with my dx and treatment plans! With that said, my pay (so far) is the same rate as the NPs.

You need to do the controlled substance course which eliminates the need for precauthorization to write for controlled substances.

 

"Effective January 1, 2008, as a result of CAPA’s sponsored legislation, AB 3, California law establishes a mechanism for a PA to administer, provide, or issue a drug order for Schedule II through V controlled substances without patient specific advanced approval if the PA holds a certificate of completion from an education course that meets the requirements in Sections 1399.610 and 1399.612 of Title 16 of the California Code of Regulations."

 

I also disagree with your statement about NPs having an advantage having only rotated in their area of specialty. I had a NP I rotated with who was 3 months from graduating that confided in me her disappointment in their training structure mentioning how they were treating diabetes in their clinical rotations (which were for 8-16 hours a week) without ever having a lecture regarding diabetes and its evaluation and management. They had mentioned it was a recurring theme throughout their NP education with multiple other common diseases.

 

As a matter of fact, this was the same experiences that was shared by other NP students I rotated with at other programs as well.

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I also disagree with your statement about NPs having an advantage having only rotated in their area of specialty. I had a NP I rotated with who was 3 months from graduating that confided in me her disappointment in their training structure mentioning how they were treating diabetes in their clinical rotations (which were for 8-16 hours a week) without ever having a lecture regarding diabetes and its evaluation and management. They had mentioned it was a recurring theme throughout their NP education with multiple other common diseases.

 

As a matter of fact, this was the same experiences that was shared by other NP students I rotated with at other programs as well.

yes, this is very true. a FNP may only train in FP, but at a good pa program you will likely get that same 500 hrs of primary care plus at least 1500 hrs in other specialties. those extra hrs help, because folks with surgical problems, ortho problems, etc still present to primary care.

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  • 4 weeks later...

I am a NY PA School grad working in Primary Care in CA. There are jobs here. I was back home on the East Coast last year looking for a job but never found a good fit. I found it here on the Central CA Coast. I was also offered a pretty salary, $16K more than any job in the NY/NJ area.

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