Life after PA practice

[UGoLong]

I retired to start my PA career at 60. Now, 10 years in, I've cut back to a day per week in the clinic and teaching for a local PA program half-time (two days per week). Fridays with a granddaughter and an occasional Monday day riding with an EMS unit. And taking vacations. And taking all of this a day at a time.

[GetMeOuttaThisMess]

I'm with you. I spent twenty years teaching young people the art and science of maritime search and rescue. I absolutely love to teach, and I'm very good at it. But the political BS is very, very deep in academia.

Just to clarify, I'm referencing the Bach. of Science only bug.

[Reality Check 2]

I wouldn't mind teaching still but I've been bitten by the BS only bug.

 

 

 

Same boat. Only a Bachelors Degree from 25 yrs ago. BUT a full fledged PA for all those 25 yrs. I am good enough to be an adjunct lecturer at a PA program but can't get hired as faculty full time because No Masters.

There is absolutely ZERO benefit to me to go get a Masters because it won't change my insurance reimbursement or my salary and just adds some letters to my title.

So, might affect my teaching abilities in the future.....

 

We did the same work and we worked hard - just don't have those little letters.

Kinda sucks

[electric130]

Totally agree RC, I only have a bachelor's as well. I think I would enjoy teaching but the time and money to get a masters just doesn't make sense for me.

[Reality Check 2]

And I have more than earned my honorary social work degree all these years. 

 

Going to bat for patients. Countless hours spent seeking out specialists, home care, counselors and working through paperwork and jumping through hoops to get patients what they need.

 

I think the local MSW program should spend a week with me at work and see if they can bestow a degree upon me (and so many others I work with and know) based on what we already do.

 

We do it because we care and it is what the patient needs. Sometimes I would just like that teensy bit of recognition that might help me out in the long run.

 

Feeling a little less appreciated lately........

[mackjacks]

Second thought, and this is just me thinking out loud....the vast majority of today's PAs are very young people who, arguably, took the "quick and easy route" to medicine (PA vs MD/DO).  I wonder how much of this personality type do the long-term planning for retirement.

 

I'm one of those, but am a super-planner. I remember laying in bed at 15 planning on 18-22 in college, being a PA at 25 or finishing family med residency at 29 and weighing the pros/cons. Currently 27, looking forward to the day around age 30 when I am debt-free and instead of putting 3500 per month toward loans I can invest it, sometime between 50-55 I should have saved enough that I could retire. At that time, I hope to be in good health and be able to work 3 days per week or do per diem/locums and travel the country/world, garden, hike, and enjoy life outside of work. Theoretically. In actuality, I'll probably get married and have a couple kids and only work 2-3 days per week when they are young, but as long as I don't marry someone with less earning potential than myself and we structure a budget based on one salary of 100K (even if they make much more) some form of this plan should work out. Barring no traumatic health issues/etc/what the heck will college tuition for those potential future offspring be like?! Aiyiyi :)

[Maverick87]

I'm one of those, but am a super-planner. I remember laying in bed at 15 planning on 18-22 in college, being a PA at 25 or finishing family med residency at 29 and weighing the pros/cons. Currently 27, looking forward to the day around age 30 when I am debt-free and instead of putting 3500 per month toward loans I can invest it, sometime between 50-55 I should have saved enough that I could retire. At that time, I hope to be in good health and be able to work 3 days per week or do per diem/locums and travel the country/world, garden, hike, and enjoy life outside of work. Theoretically. In actuality, I'll probably get married and have a couple kids and only work 2-3 days per week when they are young, but as long as I don't marry someone with less earning potential than myself and we structure a budget based on one salary of 100K (even if they make much more) some form of this plan should work out. Barring no traumatic health issues/etc/what the heck will college tuition for those potential future offspring be like?! Aiyiyi :)

 

Retiring at 55 is pretty old, especially these days. You can do it much earlier than that if you plan well.

 

I'm around your age and if I've learned anything from my parents' generation, it's that you can't rely on an employer or a job market to get you where you want to be. Things can change too much and much of it is out of your control.

[GetMeOuttaThisMess]

I would argue it is harder to do these days due to school loans and lesser returns on investments. In many sectors home ownership not being the investment return down the road as it has been for a couple of generations also factors in to planning. Factor in kids and costs of their schooling, assuming you plan on covering these expenses, as well as having to manage your own retirement contributions in lieu of those of us who are eligible for pensions makes it even more challenging. The good news? Old recommendations of needing to replace seventy percent of pre-retirement income look to be overstated.

[Maverick87]

I would argue it is harder to do these days due to school loans and lesser returns on investments. In many sectors home ownership not being the investment return down the road as it has been for a couple of generations also factors in to planning. Factor in kids and costs of their schooling, assuming you plan on covering these expenses, as well as having to manage your own retirement contributions in lieu of those of us who are eligible for pensions makes it even more challenging. The good news? Old recommendations of needing to replace seventy percent of pre-retirement income look to be overstated.

 

That's only if you follow the traditional mold. If one was to start an online business, for example, their reach is global. So if you are able to develop a good product and find a solid niche, you can potentially become a millionaire fairly quickly. I'm part of various entrepreneur groups in my local area and have met people that have done this in as little as 2 years. Of course, they were single when they did this and pretty much spent every waking moment dedicated to these ventures. But I believe that doing something like this is easier today than it's ever been (though not saying that it's even remotely easy because it's not).

 

Another option is to save like crazy. A good blog for this is Mr Money Mustache. There are a ton of posters there that retired early (some as young as their 30s).

 

Yet another option is the military, especially for PAs, who are commissioned officers. If you come in as an officer, you can retire as an O5 after 20 years. Your pension would be approximately $4k+ per month starting immediately. So one could potentially retire in their mid-40s. I know a nurse that did that. He became an O5 and retired. Now, he serves wine for a living and works as a nurse per diem. Of course, the military option has been around for years.

 

As I said in other posts, if I decide to never get married, I could potentially retire right now at age 29 if I really wanted to based on my spending habits and investments. Of course, if I get married and have children, this will not be possible at least not at this present moment.

 

In any event, these kinds of things would be absolutely unheard of in previous generations.

[UGoLong]

Interesting plans. As an old guy, please remember that the fun is in the living. Plan for tomorrow, but don't give up on having a life. 

 

My life would have been incredibly smaller without my fantastic wife and our three kids.

[BruceBanner]

I'm a little late to the investing game, but I'm intent on retiring from full-time work by 50, and being financially independent by 55. I'll do it much sooner if I can. For me it's not so much about retirement as it is being independent enough to say F-you.

 

There are 3 keys to retiring "young"; themes I've seen in every early retiree: 

 

Living well below your means, avoiding/mitigating debt, and investing the surplus. It's human nature to live right at or above your means. In fact it's the American way. Nothing wrong with this per se, but you'll never be free of the chains of employment.

 

It's a balance. The human race has a 100% mortality rate, and none of us get to choose our passing date. That said, it's good to have faith you will live a long lifespan and try to plan accordingly. Living only for now is irresponsible and living only for retirement is unwise.

[Maverick87]

Interesting plans. As an old guy, please remember that the fun is in the living. Plan for tomorrow, but don't give up on having a life. 

 

My life would have been incredibly smaller without my fantastic wife and our three kids.

 

Agreed, but it's not like I've lived in a bubble throughout my life. I've traveled all over the world. I've lived in many different places throughout the US. I'm a PA, a military veteran, and a business owner. In my free time, I mostly hike and go to the gym (both of which I'm able to do for free or close to it). I am pursuing women for long-term commitment, but who knows, may not work out (out of my control for the most part).

 

My spending habits and investments have allowed me tons of options. In the past few months, I've considered all of the following:

 

- LECOM bridge program

- MBA

- Going hardcore on my own business and scaling it up

- Just saying eff it all and getting an RV, living minimally

 

Ultimately, I decided to go into what I think is an interesting specialty as a PA. But all of the above are still options. I'm not beholden to a job right now, but I like what I'm doing. It's crazy that just a few months ago, I was in the military and felt like I was in jail. Now it's very much the opposite.

 

Life can be crazy and unpredictable like that, which I'm sure you know. I've read your story on here and you're a very interesting guy, UGoLong. Inspirational even.

[Reality Check 2]

I am almost 50 and nowhere near retiring financially.

We made choices along that way that others might not have.

BUT, I don't regret doing things with my kids now and having the memories. 

Stashing money away doesn't work in some cases and life happens and you hit rough spots.

 

I don't want to live like a miser now and not enjoy some things and have experiences WITH my kids and husband.

 

So, choose your way and live it - others might do it different.

 

I graduated very young, got married, went through fertility hell to have kids and then finally got them. That took a lot of resources.

 

I get a kick out of reading about plans to graduate by 28, practice for XX years and retire financially independent. Hope it works out for you.  

 

I've got colleges to pay for and help out with and I make a lot more than my husband and we like our lifestyle - it is what we chose and enjoy.

 

Don't get all hung up on the money or you will miss life right in front of your eyes......

[GetMeOuttaThisMess]

Live for today, but plan for tomorrow. Hopefully my wife and I have had a nice balance. No debt aside from my mid-life crisis (Jeep Wrangler last year) and my plan is to sell home (finally in a hot market after 25 years) in a couple of years and move into a condo w/o upkeep concerns, and preferably within site of water (thus Hawaii references). Looking now since I'd be willing to start mortgage now with retirement contributions and then lump sum payoff later.

[Joelseff]

I'm really starting to think about teaching now! (only been practicing for 5-6 years).

 

Had my annual review last week and my press ganey went down a few points since last review so they brought it up. I chocked it up to the recent increase in drug seeking Medicaid pts I've told no to and the pts who are pissed because they couldn't get in to see their PCP so they got booked in my schedule. Management actually acknowledged their part in this and said they will try to alleviate it somehow... Yeah I won't hold my breath. At the end of the day, I'm the one who has to see these pts.

 

A couple of things recently contributed to these situations above, ACA increased our Medicaid enrollment 30% over the past year. This in itself is not a bad thing. Access to medicine is a need in this country, Not all are bad but we have gotten a bunch of 20 something opiate seeking pts who have never had an injury, or imaging or other TX modalities but Narcs who I say no to refilling usually end up saying BS like "you are a horrible doctor, I'm gonna call your manager" or some BS. Also, one of the docs left in Feb who had a panel of 3000 pts who now belong to my group. This wouldn't be a problem... had he not been a freaking candy man!

 

These issues are enough to make me rethink what I want to do in life. I've thought about going back to specialty medicine (GI/HIV or even ortho) but I'm honestly sick of Medicine right now.

 

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[mmiller3]

I'm really starting to think about teaching now! (only been practicing for 5-6 years).

 

Had my annual review last week and my press ganey went down a few points since last review so they brought it up. I chocked it up to the recent increase in drug seeking Medicaid pts I've told no to and the pts who are pissed because they couldn't get in to see their PCP so they got booked in my schedule. Management actually acknowledged their part in this and said they will try to alleviate it somehow... Yeah I won't hold my breath. At the end of the day, I'm the one who has to see these pts.

 

A couple of things recently contributed to these situations above, ACA increased our Medicaid enrollment 30% over the past year. This in itself is not a bad thing. Access to medicine is a need in this country, Not all are bad but we have gotten a bunch of 20 something opiate seeking pts who have never had an injury, or imaging or other TX modalities but Narcs who I say no to refilling usually end up saying BS like "you are a horrible doctor, I'm gonna call your manager" or some BS. Also, one of the docs left in Feb who had a panel of 3000 pts who now belong to my group. This wouldn't be a problem... had he not been a freaking candy man!

 

These issues are enough to make me rethink what I want to do in life. I've thought about going back to specialty medicine (GI/HIV or even ortho) but I'm honestly sick of Medicine right now.

 

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I feel you. Between the insurance "best practices" and patients becoming customers, complete with satisfaction scores, medicine has gone to the dogs. It is frustrating, and I went and got an MHA just in case I decide enough is enough.

[jmj11]

Regarding the state of medicine--one observation.

 

I am a friend of my son's girlfriend on FB. I became her friend two years ago when I was helping her buy plane tickets to join us in Istanbul (I had bought my son's ticket myself, BTW he is 29). But I have remained her "friend" partially as the only way I can know what my son is up to.

 

Last week she did a long rant on how horrible medical care is in America. What shocked me as how her thread went on and on with constantly new people commenting on her original post and agreeing that heath care here is horrible. I did not comment of course, but what I heard was frustration because people had vague symptoms and they were very disappointed that when they saw the doctor, PA or NP, that they didn't get an instant and definitive diagnosis and a cure.

 

I think, in our area at least, that CAM practitioners are much to blame for this disillusionment. The CAM people all have the definite answer (which they make up on the spot) and a cure. The cure will work if the placebo effect is strong enough, but when it is not, they come to us. We scratch our heads and say, "This does not fit any easy to diagnose illness nor does it have a cure" (often it sounds like functional complaints). Our test come back normal because they are real tests.

 

I would say that 25-30% of my headache patients have seen a nautropath before seeing me. The nautropath tells then exactly what is causing their headaches (often by a bogus lab test) and gives them the "cure."  After a couple of years of the cure not working, they come to see me. But they come in the door thinking I will give them a simplistic cause and a simplistic cure (that would not involve medications). 

 

I also think the insurance industry is behind most patient's dissatisfaction and they project that dissatisfaction towards us. I got off the phone this morning with a patient who came to me with severe daily headaches. I worked for months to find something that rendered her almost headache free. Then, I started a long battle with her insurance, who refused to cover it. She had to stop the medication on August 20th and has been back in bed with severe headaches, missing work, for 6 days. She is mad at me. If she doesn't change her attitude soon (I am giving her a break because she is in so much pain) I will have to dismiss her. I did my job of finding the right treatment.  Her insurance company is the one who denied that care.

[Reality Check 2]

Don't forget TV shows.

 

Started for me with the series ER - you can nearly die, be resuscitated and miraculously walk out of the hospital all in under an hour.

 

Didn't matter that the patient had a one in 50 million diagnosis that no one in the ER had ever seen - they fixed it - done - no fuss, no muss - no insurance issues. Everyone is happy and the credits roll.

 

Didn't matter that the ER was seeing things that ERs don't do or that surgeons and residents were operating WAY out of their specialties - meh - they fixed it.

 

So, our instant gratification society watches this garbage and applies it to real life and - voila - our expectations as providers are set.

 

Expectations that cannot be met. Expectations that do not set ANY responsibility for the patient or reality that insurance often doesn't pay for anything and honestly doesn't care. Insurance in the US if FOR PROFIT - for the CEO's salary and bonus and has nothing to do with the actual ART of medicine.

 

So, I agree with the above. How do we change the mindset of our population? How to we make the expectations realistic? 

[GetMeOuttaThisMess]

Just had a pt., rhinopharyngitis/bronchitis, who says two friends were seen and were better in 1-2 days and she wants that also. Gave meds, explained natural course, and still wants to know if she'll be cured tomorrow morning for work? Then to top it off, asks at front desk if we're sending prescriptions over after I just detailed what we were prescribing. It just can't get here soon enough...

[Joelseff]

 

 

Regarding the state of medicine--one observation.

 

I am a friend of my son's girlfriend on FB. I became her friend two years ago when I was helping her buy plane tickets to join us in Istanbul (I had bought my son's ticket myself, BTW he is 29). But I have remained her "friend" partially as the only way I can know what my son is up to.

 

Last week she did a long rant on how horrible medical care is in America. What shocked me as how her thread went on and on with constantly new people commenting on her original post and agreeing that heath care here is horrible. I did not comment of course, but what I heard was frustration because people had vague symptoms and they were very disappointed that when they saw the doctor, PA or NP, that they didn't get an instant and definitive diagnosis and a cure.

 

I think, in our area at least, that CAM practitioners are much to blame for this disillusionment. The CAM people all have the definite answer (which they make up on the spot) and a cure. The cure will work if the placebo effect is strong enough, but when it is not, they come to us. We scratch our heads and say, "This does not fit any easy to diagnose illness nor does it have a cure" (often it sounds like functional complaints). Our test come back normal because they are real tests.

 

I would say that 25-30% of my headache patients have seen a nautropath before seeing me. The nautropath tells then exactly what is causing their headaches (often by a bogus lab test) and gives them the "cure." After a couple of years of the cure not working, they come to see me. But they come in the door thinking I will give them a simplistic cause and a simplistic cure (that would not involve medications).

 

I also think the insurance industry is behind most patient's dissatisfaction and they project that dissatisfaction towards us. I got off the phone this morning with a patient who came to me with severe daily headaches. I worked for months to find something that rendered her almost headache free. Then, I started a long battle with her insurance, who refused to cover it. She had to stop the medication on August 20th and has been back in bed with severe headaches, missing work, for 6 days. She is mad at me. If she doesn't change her attitude soon (I am giving her a break because she is in so much pain) I will have to dismiss her. I did my job of finding the right treatment. Her insurance company is the one who denied that care.

I should have added that I deal with crap like you describe with the vague sxs on a daily basis and yes the pts are skeptical and a little rude by the time they come see me. I'm sure I got some bad Press Ganeys from these pts as well...

 

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[SurfsPup]

On 8/26/2016 at 2:40 PM, Reality Check 2 said:

My husband still says he wants to be reincarnated as one of my fur babies because he will be fed better, have more toys and get to sleep closer to me.....

 

Folks love their pets and I love animals.

 

Doggy day care has great appeal!!!

I retired from PA life and opened a mobile doggie day care catering to surfers in southern california - best decision I have ever made!  I hated being a PA, I was miserable for 10 years....I am so much happier now in my early 40's than ever before!

[Cideous]

4 hours ago, SurfsPup said:

I retired from PA life and opened a mobile doggie day care catering to surfers in southern california - best decision I have ever made!  I hated being a PA, I was miserable for 10 years....I am so much happier now in my early 40's than ever before!

Wow.

It's funny, the thought of leaving medicine is almost unconscionable.  It's nice to hear stories like this.  I'm glad it's working out for you because life is way to short to do something that makes you miserable.  

Edited February 20, 2020 by Cideous

[GetMeOuttaThisMess]

I’m wearing out the carpet with our vacuum cleaner. All the clothes and towels have never been so clean either.


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[RadAssPA]

On ‎2‎/‎20‎/‎2020 at 1:06 PM, SurfsPup said:

I retired from PA life and opened a mobile doggie day care catering to surfers in southern california - best decision I have ever made!  I hated being a PA, I was miserable for 10 years....I am so much happier now in my early 40's than ever before!

Do you hang out at Dogpatch? Love that spot.