"Experience is the new black"

[LKPAC]

I had a headhunter tell me last week that concerning APP's that "experience is the new black."  His point was that experienced PAs are what people want nowadays, not recent grads with less than 5-10 years experience.  Also, he feels that NPs are over-saturating their market and lowering salaries and that "the bubble is about to burst" for NPs.

 

This guy works for a fairly major national medical recruiting firm.  He's been in the business for several years.  What he said is not out-of-line with some posts on this board.

 

Thoughts?

[Reality Check 2]

That is completely NOT what I am getting where I live.

 

I am experienced therefore might be TOO independent thinking despite not needing training wheels. I am not good drone material from a corporate aspect - I question things and advocate for my patients and refuse to refer patients to specialists ONLY within that corp organization. So, experience makes me somewhat questionable at best.

 

Also, experience might be black but it is also grey.

 

Many of the docs I am being interviewed to work with are young - very young - young enough to be my kid young. Some of them find that intimidating and don't see the team approach or utilizing my time in the trenches. There are still doc egos who want to be on the helm of the ship and everyone salutes...........

 

So, love to hear what you heard but it is not what I am hearing or experiencing.

[mmiller3]

I had a headhunter tell me last week that concerning APP's that "experience is the new black."  His point was that experienced PAs are what people want nowadays, not recent grads with less than 5-10 years experience.  Also, he feels that NPs are over-saturating their market and lowering salaries and that "the bubble is about to burst" for NPs.

 

This guy works for a fairly major national medical recruiting firm.  He's been in the business for several years.  What he said is not out-of-line with some posts on this board.

 

Thoughts?

It seems like every week near me they open up a new Minute Clinic (or some other WIC). There are always positions available for NPs, experience not required.

[rpackelly]

I agree with reality check. Docs especially want you to have experience but not too much; that is, very specifically, not more than they have. There is a point of diminishing returns which tends to coincide with age discrimination (and experience discrimination). A doc two years out of residency in a urgent care does not want to work with a retired army PA colonel who had two tours in fallujah and a bronze star with a v for valor and the army emergency medicine residency. . Those folks get jobs like EMDPA where they are the sole provider, but they still have what we used to call "freedom hassles" over autonomy when newer docs come on board.

[BruceBanner]

That's consistent with what I've seen/experienced in the Denver area, or any desirable location. Experience, experience, experience. Derm wont even look at you without 2+ years pure derm. EM as well.

 

I think NPs will continue to populate PC and walk-in retail clinics. That's fine, they can have 'em. PAs---I feel experienced PAs with 5+ years in have nothing to worry about. New grads, remains to be seen.

[ventana]

Residency is the answer. Corp medicine thought they could abuse any PA to be productive but have realized less then five years doesn't buy them much in the way of a truely experienced provider.

[Lauren R]

I'd say experience is preferred in most fields, including the PA field.  For the record, I have had administrators tell me they are hoping to hire a new grad so they can train them.  I suspect this is also so they can pay them less.  However, definitely the consensus seems to be that most employers prefer to hire experienced PAs.

[Ollivander]

I had a headhunter tell me last week that concerning APP's that "experience is the new black."  His point was that experienced PAs are what people want nowadays, not recent grads with less than 5-10 years experience.  Also, he feels that NPs are over-saturating their market and lowering salaries and that "the bubble is about to burst" for NPs.

 

This guy works for a fairly major national medical recruiting firm.  He's been in the business for several years.  What he said is not out-of-line with some posts on this board.

 

Thoughts?

I was signing up for a short-term EMT certification program today and the director of it echoed the same sentiments during our conversation. Which I've thought this for a while after looking at the economics of the career and several healthcare careers. With as many schools that are increasing their seats on an annual basis and as many schools that have popped up in the last decade it was bound to happen. Although I don't think we reach where say pharmacy currently sits until another decade. He and I agreed that NPs are saturating the market, that a NP degree is becoming way less valuable, and that it's going to be tough finding good gigs in prime locations in the coming years. Although I think the demand in primary care will help cushion us for a bit, and I think that a PA is more attractive than a NP despite the independent practice rights of NP. I just think docs would rather hire a PA 8/10 than a NP due to their training and clinical experience. That other 20% being docs who are just lazy and don't want to oversee and sign off on everything.

 

I think if you're willing to move to a rural area for a bit to get some experience, you can still break into specialties like emergency medicine and dermatology with ease in those type of locations. I also think those locations will be favorable regarding salary, and you can just move to a more desirable location after gaining 2 or so years of experience. This is all just my opinion, but that director and former PA happened to agree with me. I fear for those students who pursue any healthcare field other than MD/DO a decade from now though. Given saturation and tuition costs associated with dentistry, pharmacy, optometry, and PA it seems like the only path to financial security through the healthcare industry a decade from now will be strictly MD/DO. Scary times we're venturing into. I put all the blame on our government for allowing schools to continually jack up the cost and gouge as many students as they can by increasing seats/number of schools since the schools are at no risk due to the loans being backed up by the Fed. The next generation is so screwed.

[BruceBanner]

^Well said. I heard from a dentist recently that dentistry is experiencing the same thing. Private practices and corporate groups want experienced dentists only, and the government sponsored dentistry jobs are outrageously competitive.

 

That's also why many think the next great bubble will be student loans. I dont think it will 'burst' the way the housing market did, but should there be another economic downturn where jobs start drying up, people will be defaulting left and right.

 

PA/NP programs are immense money-makers for any institution. Not that expensive to implement compared to medical schools because almost all faculty can be adjuncts and they can outsource their labs, rotations, etc. Once they are in place the revenue will just keep rolling in for decades. There is money to be made and a direct pathway to a job (without a residency in most cases), so more and more students are going down these pathways. 

 

My thought is in 10-15 years we will look back on the early 2000's as the 'golden years' of the PA job market; where pay and demand were at their highest. I'm optimistic our scope and legal independence will improve, but what happened in pharmacy is very real and we are headed down the same path.

[Ollivander]

^Well said. I heard from a dentist recently the dentistry is experiencing the same thing. Private practices and corporate groups want experienced dentists only, and the government sponsored dentistry jobs are outrageously competitive.

 

That's also why many think the next great bubble will be student loans. I dont think it will 'burst' the way the housing market did, but should there be another economic downturn where jobs start drying up, people will be defaulting left and right.

 

PA/NP programs are immense money-makers for any institution. Not that expensive to implement compared to medical schools because almost all faculty can be adjuncts and they can outsource their labs, rotations, etc. Once they are in place the revenue will just keep rolling in for decades. There is money to be made and a direct pathway to a job (without a residency in most cases), so more and more students are going down these pathways. 

 

My thought is in 10-15 years we will look back on the early 2000's as the 'golden years' of the PA job market; where pay and demand were at their highest. I'm optimistic our scope and legal independence will improve, but what happened in pharmacy is very real and we are headed down the same path.

Your post is spot on.

 

Dentistry is in a bad spot right now too if you can't get into your state school(s). If you're taking out $350-500K for dental school by going to an out-of-state or private, you're being deluded by the schools of what it will really cost you after accumulated interest of 4 years of being in school. We're talking about just shy of or more than half a million dollars after interest if you have no options other than going out-of-state or private. I don't see how that's a better position than PA. Especially considering all these healthcare professions are heading toward extreme saturation other than MD/DO.

 

I just hope I can get into a sweet spot where I have my debt paid off and at least 5-10 years of experience before everything hits the fan.

[violetta23]

Do you think, that when the metaphorical bubble bursts, it will matter more where you went to school if you don't have as much experience in the field yet/are a new grad?

[Guest HanSolo]

I think it will. Think about an employer looking at two resumes for new grads except for one went to a top university for PA school and the other went to the University of Used Playground Equipment. If neither had exceptional previous experience - you be the judge. 

[Ollivander]

Do you think, that when the metaphorical bubble bursts, it will matter more where you went to school if you don't have as much experience in the field yet/are a new grad?

For a new grad? Absolutely. For someone with 5-10 years of experience under their belt? Probably not as much.

 

You'll always have people that would rather take a Yale grad over say Adventist University of Health Sciences grad despite your level of experience though.

 

I'd be particular about which schools you do and don't apply to if you're still in undergrad. If the universities have medical schools as well that's a good sign.

[BruceBanner]

Do you think, that when the metaphorical bubble bursts, it will matter more where you went to school if you don't have as much experience in the field yet/are a new grad?

 

With an experience level of zero, maybe. I can tell you experience trumps everything at the present time.

 

We are already seeing it now--employers mandating X years experience, 'no new grads', etc. Saturation is regional. Again I predict in 10 years the job market will be so competitive that pre-PAs will be counseled to reconsider their career paths. Precedents have already been set in Law, Pharmacy, and Dentistry. It's just a simple economic equation: available jobs relative to the number of applying individuals.

[Ollivander]

With an experience level of zero, maybe. I can tell you experience trumps everything at the present time.

 

We are already seeing it now--employers mandating X years experience, 'no new grads', etc. Saturation is regional. Again I predict in 10 years the job market will be so competitive that pre-PAs will be counseled to reconsider their career paths. Precedents have already been set in Law, Pharmacy, and Dentistry. It's just a simple economic equation: available jobs relative to the number of applying individuals.

What alternatives do you think will be viable at that point aside from MD/DO?

[sk732]

Irony of course is that you can't get experience if you don't get hired...time to do a short fellowship in medical business planning and open your own shop to get that needed experience.

 

SK

[Katera]

With an experience level of zero, maybe. I can tell you experience trumps everything at the present time.

 

We are already seeing it now--employers mandating X years experience, 'no new grads', etc. Saturation is regional. Again I predict in 10 years the job market will be so competitive that pre-PAs will be counseled to reconsider their career paths. Precedents have already been set in Law, Pharmacy, and Dentistry. It's just a simple economic equation: available jobs relative to the number of applying individuals.

 

 

I absolutely agree with this, but I don't think it will take 10 years.  I already see it in DFW.  I think the bubble will burst in 5-8 max.

[ventana]

With an experience level of zero, maybe. I can tell you experience trumps everything at the present time.

 

We are already seeing it now--employers mandating X years experience, 'no new grads', etc. Saturation is regional. Again I predict in 10 years the job market will be so competitive that pre-PAs will be counseled to reconsider their career paths. Precedents have already been set in Law, Pharmacy, and Dentistry. It's just a simple economic equation: available jobs relative to the number of applying individuals.

 

 

more of the "the sky is falling"

 

Have been hearing this for many many years now

 

 

The reality of the situation is the the PA profession is advancing, salaries increasing, demand increasing, program number increasing

 

With this you will get more out layers  - ones that do not succeed as being a PA due to personality and employment issues - they they become vocal and everything thinks "oh this is a bad career"

 

Not me

 

I am happy to be a PA and believe there is a great future in the field as long as AAPA and more particularity NCCPA advocate for us (and not against like NCCPA did) 

[BruceBanner]

What alternatives do you think will be viable at that point aside from MD/DO?

 

Hard to say. It's not that PAs wont be able to find jobs, it's just they will have sacrifice more time and money to have a competitive strategy. Residencies, paid internships, and selective location hunting all would apply.

 

 

more of the "the sky is falling"

 

Have been hearing this for many many years now

 

 

The reality of the situation is the the PA profession is advancing, salaries increasing, demand increasing, program number increasing

 

With this you will get more out layers  - ones that do not succeed as being a PA due to personality and employment issues - they they become vocal and everything thinks "oh this is a bad career"

 

Not me

 

I am happy to be a PA and believe there is a great future in the field as long as AAPA and more particularity NCCPA advocate for us (and not against like NCCPA did) 

 

This isnt alarmism, just simple math. I'm not suggesting the entire profession is doomed like our departed friend overthehorizon. There are now 218 accredited programs (counting provisionals). Since 2010 ( i counted) there have been 76 new programs accredited, including those accredited in 2010. 76!! That is a dramatic increase in nationwide enrollment and the number of new grads being churned out. If you tell me this is just to keep up with demand you are blowing smoke.

 

MOST people will want to live in major metro/suburban areas, so naturally these cities will over-saturate first and push people into either low-paying jobs, residencies, or unemployment.

 

I think we will remain viable for a long time, and I'm optimistic about our independence. But it would be foolish to ignore what happened in pharm, dentistry, and law. Likely wont affect our careers, just the next generation.

[GetMeOuttaThisMess]

Don't just look at number of programs but also consider class sizes. '81, three programs in Tx for public to apply to and class sizes were probably comparable to mine at 25.

[ventana]

What you have to realize, and apparently have not, is their are over 800,000 practicing physicians in the USA 

also 

> 30% of physicians are age 60 or over https://www.fsmb.org/Media/Default/PDF/Census/2014census.pdf

 

This means that their is likely some 200,000 impending retirements

 

this dwarfs PA numbers (and yes we can not replace a physician in the specialties, we certainly can and do in the pcp fields.....)

 

So if we even pick up 25% of the retiring doctors (this has no bearing on the reality of that demand for PAs projection of grow 30 percent from 2014 to 2024, much faster than the average for all occupations. per https://www.bls.gov/ooh/healthcare/physician-assistants.htm )

 

 

So we have about 100,000 practicing PA, some of which want to retire in the next 5 years

We have 200,000 docs retiring soon

We have about 6000 new grad PA per year

We have a projected career increase f 30% from '14-'24

 

These are not numbers that show a career field that is stagnating....

 

 

Then add in the reality of the aging baby boomers and increasing utilization and we have a recipe for a continued growth as long as NCCPA does not screw it up....

What you have to realize, and apparently have not, is their are over 800,000 practicing physicians in the USA 

also 

> 30% of physicians are age 60 or over https://www.fsmb.org/Media/Default/PDF/Census/2014census.pdf

 

This means that their is likely some 200,000 impending retirements

 

this dwarfs PA numbers (and yes we can not replace a physician in the specialties, we certainly can and do in the pcp fields.....)

 

So if we even pick up 25% of the retiring doctors (this has no bearing on the reality of that demand for PAs projection of grow 30 percent from 2014 to 2024, much faster than the average for all occupations. per https://www.bls.gov/ooh/healthcare/physician-assistants.htm )

 

 

So we have about 100,000 practicing PA, some of which want to retire in the next 5 years

We have 200,000 docs retiring soon

We have about 6000 new grad PA per year

We have a projected career increase f 30% from '14-'24

 

These are not numbers that show a career field that is stagnating....

 

 

Then add in the reality of the aging baby boomers and increasing utilization and we have a recipe for a continued growth as long as NCCPA does not screw it up....

[BruceBanner]

Fair points, but something you have to realize, (and apparently have not), is that there are over 18,000 medical graduates each year. Specifically, 18,938 in 2015-2016.

 

https://www.aamc.org/download/321532/data/factstableb2-2.pdf

 

Also, you failed to recognize the number of NP graduates each year. 11,000 in 2011, and 20,000 in 2014-2015.

 

https://www.aanp.org/all-about-nps/np-fact-sheet

 

So with your theoretical figure of 200,000 docs retiring in say the next 10 years, we still have almost 19,000 medical school grads, 20,000 NP grads, and as of 2014, 6,411 PA grads, which we can probably round up to 7,000 by now. Additionally, the number of active PAs in 2015 (108,717) exceeded the predicted modeling number of 93,099 back in 2011.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3151188/

 

(PAEA)

 

So that gives us---at present---~46,000 new MD/DO/PA/NP graduates each year to supplant the ~20,000 docs retiring each year. Even when you take into account PA and NP retirements, which cant be more than 10,000 a year ( a generous estimate), we are still ahead of the game.

 

A more accurate way to look at this would be an Aggregated Demand Index (ADI), similar to one done in pharmacy. The ADI uses a 5-point scale to measure the availability of jobs relative to the number of applying providers. 

 

​You're arguing strawman points that weren't even made---e.g. that we are stagnating.

 

So are we growing in the absolute sense? No question. But growth and position availability, competition, and market saturation are totally different realities.

 

 

[Katera]

Don't just look at number of programs but also consider class sizes. '81, three programs in Tx for public to apply to and class sizes were probably comparable to mine at 25.

 

Texas has more then doubled it's number of programs and the class sizes are MUCH bigger now then they were when I went and there were only 3 programs.  Hell, that doesn't even count the number of NP programs now in Texas.