Questions to Current PAs

[ChiPA]

Hi. Currently, I have been second guessing the choice of pursing a PA career. I am in my twenties, have a BS degree, several years of experience as a pharmacy tech, and I am currently finishing up a CNA program for my HCE. I admit that I am undecided between PA and MD/DO, however I am leaning more towards the PA profession. The problem is that no one supports the notion of me becoming a physician assistant.

 

Everyone also says/asks "Why don't you just become a NP/MD?" "Why are you settling?" "Why settle for second best?" "PAs aren't guaranteed jobs" "What is a PA anyway?" "But PAs don't make as much as doctors..." "You are young, just become a doctor" "Med school is long, but it will pay off" and etc, etc, etc.

 

I am sure that you many of you have heard this before, but I admit that it has been taking a toll on me. Many people that I have come across, including NPs, are surprisingly negative about the PA profession. Therefore, I keep wondering if I am making the right decision. The reasons why I focusing more towards becoming a PA is mainly due to time, debt-load, and personal lifestyle. As the mother of a toddler and with limited support, I know that med school/residency would be a huge challenge for me. I have spent many hours researching both professions and when comparing the potential earnings for both careers, it will make more sense financially to become a PA. However, I also have to admit that becoming a doctor is tempting due to their prestige and the level of the respect that they receive across the health care field.

 

 

So my questions to you are this:

 

1. Do you ever wish that you had become a doctor instead?

2. Are you satisfied with your career as a PA?

3. Would it be wise for me to apply to both PA and MD/DO programs?

 

Please provide any comments if necessary. I believe that shadowing PAs and physicians would help me towards making a choice, but every situation is unique and everyone has their own opinion.

[PAtoB]

NPs and some nurses are literally the only ones who've challenged, confronted or put up an affront to my decision to pursue PA school, and I think the reason is obvious enough that it doesn't warrant any worries.

 

The reasons you are considering PA school are nearly the exact same reasons I am, although I'm in my late 30s. Even if I was in my 20s, I'm confident I'd still be going for PA over MD, for the same reasons. But I'm debt-averse.

 

During their residencies, my 2 doctor neighbors/friends both confided to me that if they had known what a PA was before they started med school, they would've gone the PA route for the debt and time reasons. But then, both of them had toddlers and families at home while they were living at the hospital. 

 

Regardless, anyone who asks you 'why are you settling?' doesn't know what they're talking about, imho. 

[SHU-CH]

If you are going into medicine to take care of sick people, it is likely that being a PA will allow you to do pretty much everything you want to.

 

At this point, the only thing I sometimes find missing from the PA profession is the ability to have a seat at the table in terms of high-level policy discussions. This situation is improving as PAs are starting to move higher into the ranks of healthcare organizations and academia. And organizations like PAFT are helping to stir the pot and get people involved. But in the grand scheme of things, we are still a young, small profession. I like this fact - for me, it is exciting to be involved while the profession is still evolving and defining itself. Only you can decide how much the prestige issue may bother you.

 

If you look at the AAPA satisfaction surveys, something near 90% of PAs say they would do it all over again. Perhaps more telling, a lot of PA programs are seeing the children of physicians come through their doors.

[EMEDPA]

personally MD/DO would have been a better choice for me. I like seeing critically ill patients, doing lots of advanced procedures, and calling all the shots without having to present straight forward cases. I will get a consult any time I need one but I want to decide when that is, not some arbitrary rule that says "PAs only see X:" or must present X".. hard to do as a PA. to do it I drive hundreds of miles from home every month to cover small rural ERs. at my regular "city" job I  solo staff a satelite facility of a larger trauma ctr on night shifts(yes, all nights if I want to work alone) but have to transfer lots of folks due to inadequate resources for big workups. at my rural jobs I am either solo or working double coverage with a doc alternating pts from the same rack. it would be nice to have that scope of practice in a metro area but that is almost impossible to find. in my mid-40s I still think about the PA to DO bridge program...

[rn2pa]

My husband is an MD and I have a few MD friends who have said they wish they had done PA.  Although my husband is happy with his decision it was a very long and expensive road.  Seeing what he went through I would never ever want to go to medical school!!

[EMEDPA]

if you consider residency to be your first job we are really only talking about 2 more years of school for a much better scope of practice, more autonomy, MUCH more resppect, and although less important to me, significantly more money for less hrs of work/mo.

I currently work 180-220 hrs/mo and make about 1/3 what a well paid em doc makes who works 120 hrs/mo.

[AREID]

It is all about what you want in life. There was a study done a while back comparing salaries of female PAs vs MDs. The PAs actually made more money down the road...why is that? Well, something women did not take into consideration was pregnancy and having a family. A large percent actually reduced their hours to part time because family was more important than staying at work for 60-80 hours per week.

 

In my honest opinion if you are having doubts I would choose PA. The amount of work and sacrifice it takes for med school is tremendous and if you don't want it bad enough you will regret it. You not only have to worry about getting in, but once you are in you have to worry about making the grades for residency. What if you only get a residency out of state...would you move? What if you don't get a residency in the specialty you want...will you be able to conform and settle? These are all to real risks. You already have a toddler, so this is something you need to ask yourself if you are capable of doing. If you heart is set on an MD, and are willing to do these things, then do not "settle" for PA.

 

I personally love what I do and have thought many times about going back to school to become a physician. There are obviously pros and cons to both. But, what works for me won't necessarily work for you and visa versa. There are a lot of things to think about. Good luck!

 

 

Sent from my iPhone using Tapatalk

[ChiPA]

It is all about what you want in life. There was a study done a while back comparing salaries of female PAs vs MDs. The PAs actually made more money down the road...why is that? Well, something women did not take into consideration was pregnancy and having a family. A large percent actually reduced their hours to part time because family was more important than staying at work for 60-80 hours per week.

 

In my honest opinion if you are having doubts I would choose PA. The amount of work and sacrifice it takes for med school is tremendous and if you don't want it bad enough you will regret it. You not only have to worry about getting in, but once you are in you have to worry about making the grades for residency. What if you only get a residency out of state...would you move? What if you don't get a residency in the specialty you want...will you be able to conform and settle? These are all to real risks. You already have a toddler, so this is something you need to ask yourself if you are capable of doing. If you heart is set on an MD, and are willing to do these things, then do not "settle" for PA.

 

 

 

I have seen the study/article that you are referring to and it really opened up my eyes. It does make a lot of sense that women make less because they work less hours in order to be at home with their families or to start a family.

 

Growing up, I always wanted to become a pediatrician. However, as I went through college and switched possible careers from pharmacist to physician therapist, I still had physician in the back of my mind. When I went to the ER and was treated by a young female physician assistant (most likely in her 20s) I was excited. As soon as I went home I started to research about PAs and here I am now.

 

I love that PAs are able to do many of the things that doctors do. However I do understand that it is a relatively "new" and up-and-coming profession that many people lack knowledge about. As bad as I always wanted to become a physician, I believe that I will be happy as a PA. I'm thinking about specializing in plastic/cosmetic surgery. It's not so much about the title, it is about the job description.

 

Someone once told me "It's not about what is the better profession, it's about what profession is best for you." I think PA suits me better. It is hard to really know what it is like to be a PA because I don't know any. I just don't want to feel as if I "gave up" on becoming a physician.

[ChiPA]

 

During their residencies, my 2 doctor neighbors/friends both confided to me that if they had known what a PA was before they started med school, they would've gone the PA route for the debt and time reasons. But then, both of them had toddlers and families at home while they were living at the hospital. 

 

Regardless, anyone who asks you 'why are you settling?' doesn't know what they're talking about, imho. 

 

Yes, this is actually what I am worried about. Thanks for your input.

[ChiPA]

if you consider residency to be your first job we are really only talking about 2 more years of school for a much better scope of practice, more autonomy, MUCH more resppect, and although less important to me, significantly more money for less hrs of work/mo.

I currently work 180-220 hrs/mo and make about 1/3 what a well paid em doc makes who works 120 hrs/mo.

 

I have thought about this, too. That is what makes the decision that much harder. I am not so much worried about respect because I feel that respect is earned. Sometimes I feel that people put doctors high on a pedestal and many doctors that I know have an ego that matches. The salary that PAs start with in my state is higher than the national average so I feel that I would be satisfied with the pay, hopefully :)

 

I do want to say, that I question how long I would be happy with being a PA because no matter what I will have to be "supervised". If I get into PA school next year, I will finish before I am 30. Eventually down the line I think there will be more PA to DO/MD programs. Depending on my job satisfaction, I may or may not decide to go that route.

 

But like you said, DO/MD probably would've been better for you. I feel like it all just depends on each individual person and what they really want in life. I really want to have time with my family and to be in less debt. It is just difficult to get becoming a doctor out of my mind. I hope that when I finally find some PAs to shadow (which has been extremely difficult) that it will help me to become content with whatever choice that I make.

[UGoLong]

The decision about what to do in life (or, maybe more importantly, what to do “next”) is often our biggest challenge. I’ve found that making this decision based on how much respect others may -- or may not -- give you is not particularly productive. It’s really just a Munchausen-by-proxy version of going into a career because someone else wanted you to.

 

In my early 40s, I agonized about going back to school and becoming a physician. It was going to take about 7 years (counting the residency and not counting the prerequisites), lots of money, and lots of time away from my family. I decided not to do that and eventually became a PA instead. Now that I see the life of physicians up close, I have learned that “lots of time away from your family” often doesn’t stop at the end of your training.

 

And so, I have a supervisor. Guess what? We all do. Many physicians work for larger organizations, or at the very least, for their business and its patients. I think I get a great deal of respect from people I treat or work with.

 

A lesson I learned as a young 2nd lieutenant in the Air Force: enlisted personnel will have to salute you, but you will have to earn their respect. Little gold bars on my collar didn’t buy respect then and neither will the particular degree you decide to earn. 

[WeBuyAndSellJunk]

I could sit here and rattle off all the obvious reasons people decide to become PAs, but one really appealing thing in my mind was the ability to move on (career wise) if I ever desired to. PA school is short and the debt burden isn't too heavy. I feel like I see a lot of physicians who are or feel entrenched in their career. They invested 7+ years of schooling, who knows how many more years to pay off their debt, and they are limited to one or so specialties.

 

If you want to go back to medical school, step up to the plate. If you find you want out of medicine, hop on the bus gus. If you are happy as a PA, stick around.

[EMEDPA]

If you want to go back to medical school, step up to the plate. If you find you want out of medicine, hop on the bus gus. If you are happy as a PA, stick around.

make a new plan stan. you don't need to be coy roy, just listen to me. just drop off the key lee and set yourself free.

classic.

[GetMeOuttaThisMess]

But if you hop on the bus you have to have the busfare.

[GetMeOuttaThisMess]

EMEDPA, the majority I bet won't get it. Just

like Puff, the magic...., heck, that's even before your time.

[EMEDPA]

EMEDPA, the majority I bet won't get it. Just

like Puff, the magic...., heck, that's even before your time.

..dragon lived by the sea

And frolicked in the autumn mist in a land called Honah Lee,

Little Jackie paper loved that rascal puff,

And brought him strings and sealing wax and other fancy stuff

[EMEDPA]

But if you hop on the bus you have to have the busfare.

not if you are Paul simon or Art garfunkel...

[Acebecker]

While those songs are before my time, I recognize them both.  Enjoyed them when I was a youngster.  

[Guest Paula]

..dragon lived by the sea

And frolicked in the autumn mist in a land called Honah Lee,

Little Jackie paper loved that rascal puff,

And brought him strings and sealing wax and other fancy stuff

You guys make me laugh and I am thankful for the entertainment on PAForum!

[GetMeOuttaThisMess]

And for all those years I had always thought he lived in a land called "Hominey". I always thought of him when eating the stuff as a kid. It didn't matter that the phrase didn't make sense.

[ChiPA]

The decision about what to do in life (or, maybe more importantly, what to do “next”) is often our biggest challenge. I’ve found that making this decision based on how much respect others may -- or may not -- give you is not particularly productive. It’s really just a Munchausen-by-proxy version of going into a career because someone else wanted you to.

 

In my early 40s, I agonized about going back to school and becoming a physician. It was going to take about 7 years (counting the residency and not counting the prerequisites), lots of money, and lots of time away from my family. I decided not to do that and eventually became a PA instead. Now that I see the life of physicians up close, I have learned that “lots of time away from your family” often doesn’t stop at the end of your training.

 

And so, I have a supervisor. Guess what? We all do. Many physicians work for larger organizations, or at the very least, for their business and its patients. I think I get a great deal of respect from people I treat or work with.

 

A lesson I learned as a young 2nd lieutenant in the Air Force: enlisted personnel will have to salute you, but you will have to earn their respect. Little gold bars on my collar didn’t buy respect then and neither will the particular degree you decide to earn. 

 

I love this response. Thank you so much. The first part about going into a career because someone else wants you to is my dilemma. Sometimes it is difficult to put my all into a PA career with minimal support from others. Thanks again for your post, you gave me some motivation :)

[UGoLong]

ChiPA,

 

I was lucky in that I have a very understanding wife! As you move along with prereqs, volunteering, or whatever, you will meet other people who will give you encouragement. They're out there; just keep looking for them!

 

Good luck!

[Febrifuge]

So my questions to you are this:

 

1. Do you ever wish that you had become a doctor instead?

2. Are you satisfied with your career as a PA?

3. Would it be wise for me to apply to both PA and MD/DO programs?

 

Please provide any comments if necessary. I believe that shadowing PAs and physicians would help me towards making a choice, but every situation is unique and everyone has their own opinion.

1. Nope. I started out in my post-bacc program (my BA degree was already almost 10 years old, and had no math or science in it to speak of, so I needed a post-bacc) right there with all the other pre-meds, but it soon became obvious to me that I did NOT want to jump through the hoops, take the stupid weed-out classes, and wind up turning 41 in my first week of intern year. Having worked as an ER tech, I had no doubt I could get into med school, and through it, and then residency, and at the end I'd be capable, confident, and prepared, but... ugh. The process. If I'd gone that route, today I'd be one of those "old" residents. No thank you.

 

2. Very much so. I work solo in an Urgent Care, nothing too fascinating or dramatic but it's the un-differentiated patient, I get to see a bit of everything, and I get to use my brain and diagnostic skills. At the same time I'm working in my clinic, in some of our other locations it's an MD seeing patients, and functionally there's no difference. I strive to make sure the quality of care is the same (or better), too. Not to mention, during weekdays I am a stay-at-home dad. Try doing THAT with an MD, without the world thinking you're insane.

 

3. No. Applying to both is, in my opinion, a terrible idea. Decide, for yourself, and to the point where your reasons are meaningful and convincing. I absolutely guarantee that there will be questions from all sides, even worse than you're getting now, about why you didn't go down some other path. Whatever you decide to do, you need to know the reasons why you've decided your choice is the right one, and those reasons have to be solid. Because I also guarantee that no matter what you decide, there will be a series of 3AM conversations with yourself about what you've done, and how much it sucks, and how much greener is the grass on the other side of the fence. Remember: you need to convince an admissions committee once, but you need to convince yourself forever.

[Febrifuge]

 

And so, I have a supervisor. Guess what? We all do. Many physicians work for larger organizations, or at the very least, for their business and its patients. I think I get a great deal of respect from people I treat or work with.

Quoted for truth. The decision got really, really easy for me when I realized a few key things about myself:

 

- I have no interest in owning and running a practice/ being a small business owner at the same time as being a clinician

- I don't care about being a department head, supervisor, or any other kind of "VIP." I just want to practice medicine.

- Everybody has a boss, and the more people you are the boss of yourself, the more your own boss is going to demand time and energy from you for things that are not actually your job. (This was confirmed when I spoke with several MD/ DOs who told me the now-classic thing about wishing they had done PA instead.)

 

So, like I tell patients, we're not the pointy part of the pyramid. We're the part that holds the pyramid up in the first place. I happen to like that.