PA vs DO, Which career give more family time now and in the future?

[guywithsomequestions]

I'm a 28 year old male and I have just been accepted to a great PA school and I will start in June. After shadowing a PA friend I felt like the career is great and a good fit for me. I am married and plan to start having kids in the next year or two and my wife will be a stay at home mom. I want to be there for my kids when they are young and as they grow up, and not tied down by my career. I definitely feel that medicine is the right choice for me and my personality and I believe i will be a good PA, However lately I have wondered if the DO route may in the long term give me more time to spend with my family and friends. To go the DO route I would need to go back and take a few more classes and take the MCAT of course, but I am afraid of being a PA and deciding to go to DO school 10 years from now, when It will be almost impossible to go back to school and study for the MCAT. I have read a little about the PA to DO bridge program, but it just knocks off a year of DO school and would still be difficult to go that route. and I would still have PA school debt to add to my Med school debt.

 

 

I know some PAs who have a great 8-5, 5 days a week job and do alright financially, but I am not sure how common that is. There are things I like about the PA career and there are things I like about the DO career, But by far the the main reason I decided to go the PA as opposed to DO route is that i will be out of school and working in two years and not still in Med school and doing my residency for the next 8 or so years. I do understand that I will probably be working a lot of hours as a new PA, just like as a new DO, but I wonder if in the long run as a DO I will be able to work fewer hours than I will as PA later in life. I understand that the answer to this question will be different depending on the person and the location, but I want to hear from current PAs if they are satisfied with the time they have with family and friends compared to the physicians they have worked with or currently work with. I also want to get an idea of how many hours a week are common for an established PA, making around an average salary. Thanks for your feedback.

[Soulfari]

Disclaimer: I'm not a PA nor a DO (yet). 

 

Your intuition seems to be on par with the majority of future medical practitioners who are on the fence between a Doctorate of Medicine versus a PA-C. This question has been hashed out quite thoroughly throughout these forums; try searching some keywords from your post and you will have plenty of reading material. To be honest, I badgered myself incessantly with this question during the last couple years of undergrad. In retrospect, I was waiting for someone to make the decision for me; to tell me exactly what I NEEDED to do. But in reality, you just need to do all of your research, pick which diving board height you wanna jump off of, and go for it.

 

An elderly patient once told me, "Listen, you're gonna be 10 years older after 10 years from now regardless of how you spend those 10 years...where do YOU want to be in 10 years? Follow your heart." 

 

I start PA school at UF next summer, and could not be more stoked/excited. 

Good luck 

[guywithsomequestions]

To be honest, I badgered myself incessantly with this question during the last couple years of undergrad. In retrospect, I was waiting for someone to make the decision for me; to tell me exactly what I NEEDED to do. But in reality, you just need to do all of your research, pick which diving board height you wanna jump off of, and go for it.

 

 

I appreciate your advice and I feel the same way you described you felt. I wish I had a time machine that would send me 10 years into the future so I could ask future me if I made the right choice, but the uncertainty of the future is what life is all about. I have read other topics that are similar to my situation but none that are the same. I guess i'm mostly looking to hear the experiences of current PAs or those who know PAs who have shared their experience regarding satisfaction with work hours and family time compared to docs they know or work with.

[AREID]

I'm a PA in family practice. I currently work 5-6 days a week 9-6 with an hour lunch. I am able to take any days off I please. There are many per diem positions available that allow you to set your schedule, however those are usually ED or urgent care positions. If you plan on having children in the next year or two, and you haven't even finished the required classes for med school, then be prepared to miss a lot of important moments. Med school requires a lot of sacrifice, and if you are not 100% committed, don't do it.

 

 

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[guywithsomequestions]

Areid, Thanks for giving me your perspective. I would love to have a set up like you have when I enter the workforce. You make a good point about my not even having the prereqs all done for med school and by the time I do have them completed and I've been accepted, I would be probably 29 or 30 and I'm not super excited about being a new med school grad at age 38 with a ton of debt, but I would rather be that than be a PA going back to to get my DO while in my 40s.

Don't get me wrong I have carefully and methodically made the decision to become a PA, however, recently I have been hearing about PAs working 60+ hours a week being a very common thing. I don't mind working crazy hours as i'm a new PA getting established, but when i'm in my 40s+ I want more freedom and less hours. I plan to talk to some PAs in my area soon and find out if they are happy about the decision they made in regard to having time to enjoy life too. 

[tunafish]

If your wife doesn't plan to work and you want to have time off with your kids - there is no way you can do it comfortably as a PA the way the salaries are right now. I do not know what is the advantage of the stay at home mom - that's for you 2 to decide, but just divide your salary among the numbers of your family and you will see that you can get by, but it won't be a comfortable life at all. 

From what I see, medicine is not a field where you can make money comfortably. Signing contracts while eating Prime rib and golfing. I know 2 surgeons who are in their 40s- and 50s. One has a mansion but he leaves it 5am daily and comes back after 8. Yes, his kids have it all, but I do not see how you can do it for money. The other one asks for guilt-free golf for his birthday. Tells you something, right?

[bradtPA]

IMHO the hours spent on the job is not so much PA versus physician dependent; it varies according to specialty. If anything, PAs tend to work more hours than their physician counterparts. The surgical PA that tends to make rounds at the hospital admitting and discharging preops and post ops, the cardiogy PA making morning rounds while the cardiologist is cathing patients, etc. Even in internal medicine when I had great hours coming in at 8 and leaving at 5, the MDs showed up at 9 and left at 2, plus I had to pull all of the telephone call when they pulled none, and I also had to work every 3rd Saturday. Bottom line, be a PA if you want to be a PA or a physician if you want to be a physician; both work hard....

[EMEDPA]

as an em pa I typically work 180-220 hrs/mo

my physician partners max out at 140 hrs/mo

[Simplify]

If your wife doesn't plan to work and you want to have time off with your kids - there is no way you can do it comfortably as a PA the way the salaries are right now. I do not know what is the advantage of the stay at home mom - that's for you 2 to decide, but just divide your salary among the numbers of your family and you will see that you can get by, but it won't be a comfortable life at all. 

From what I see, medicine is not a field where you can make money comfortably. Signing contracts while eating Prime rib and golfing. I know 2 surgeons who are in their 40s- and 50s. One has a mansion but he leaves it 5am daily and comes back after 8. Yes, his kids have it all, but I do not see how you can do it for money. The other one asks for guilt-free golf for his birthday. Tells you something, right?

Considering that the average household income in the US is around the $50,000 mark, I would say it is probably within reason to think you can live comforably on twice that amount.  Infact I would argue that the problem for most people who aren't "comfortable" with this kind of an income has very little to do with what they are earning but rather with what they are spending.  3 12 hour shifts per week is also not an uncommon work schedule...heck pick up a 4th day per week a few times per month and take the family out for Sizzler.

[tunafish]

Considering that the average household income in the US is around the $50,000 mark, I would say it is probably within reason to think you can live comforably on twice that amount.  Infact I would argue that the problem for most people who aren't "comfortable" with this kind of an income has very little to do with what they are earning but rather with what they are spending.  3 12 hour shifts per week is also not an uncommon work schedule...heck pick up a 4th day per week a few times per month and take the family out for Sizzler.

I know the stats well, but "average" is an interesting thing. Also average credit card debt is about 20K and average person in this scenario is living paycheck to paycheck. There is also on average several pay day loans offices per sq. mile in an average city. I know that lots of people do moronic financial decisions, but from my own experience with double the average income and two kids under the belt I can not call my life comfortable. I can not send kids to private school that i like, I will not be able to pay cash for college tuition for my kids, I can not fly to Miami ad hoc and spend a weekend on south beach and I am not talking about Paris for that matter. My 403b is far from solid, and I was fortunate enough to live in the area where I could take 15 year mortgage with 20% down, but it would not be true in many places in this country. I do not know... I guess we have to define "comfortable".

[AREID]

If your worries are financial don't become a physician. It's not what it used to be by any means. There are easier ways of making well over six figures!

 

 

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[Guest Paula]

I'm in FP and work M-F 8-4 with one hour paid off for lunch.  I work in a remote rural area on a reservation.  No call, no weekends, federal holidays off and random other days off....like last week was off because of snowstorm and ice and the area shut down.  I make a good salary and have a comfortable living.   I work more than the physician at this practice and spend a lot of time with taking care of patient details.  

 

BUT.......

 

I worked for it.  The first 8 years out of PA school I worked 2 part time jobs in FP/ER/UC  and worked 6 days a week several weeks a month.  I traveled 100 miles round trip or more to do that.  I worked 10 and 12 hours shifts when I was at the ER/UC, 8 hours at the FP job.  I paid off my school debt and paid for the kids college tuition (they had to do their part, too by working summer jobs, scholarships, etc. )  I still had time to spend with family and since my kids were graduating high school soon after i graduated PA school it was not as much of an issue to spend time with them. We are sort of a one income family since my husband is self-employed and you could say during those years he was the stay at home Dad. 

 

AND..........

 

I do not take my job for granted as I believe everyone is replaceable.  SO even tho I make 6 figure income and my job seems stable I always have a back up plan in place.

 

OP: You will know what is right for you and your family and future kids.  Be prepared to work for whatever career you choose. 

[mashlee]

very interesting thread

[guywithsomequestions]

AREID and Paula thanks for your advice and for sharing your experiences. Paula, your story gives me hope that if i work really hard and pay my dues it is possible and maybe even likely that I have a nice stable decent paying job as a PA in the future. I feel that I could be happy as a PA or as a physician and years from now I can have hours that I would be happy with in either career path, But it makes more sense to stay on the path that I am on now.

The school where I will attend has a double major available, where I can take online classes after competing and maybe some during my rotations to get a masters in healthcare administration. Is this worth considering? will it make me more marketable as a PA searching for jobs? will it allow me to take on an administrative positions more easily as a PA? 

[rpackelly]

Very interesting to read this.  From the perspective of having graduated in 1980, I both didn’t know about the career my last year in high school (1969) and had absolutely no idea in 1978 where it was going to end up.  As a matter of fact, looking back at those days, there is no way I or anyone else could have predicted the way things have turned out, with informatics and computing playing such a huge role and with PAs being as accepted as they are and the other huge world changes.     So obviously I suck as a futurist, but I haven’t read any other predictions that were better along the way.  

 

Whatever you choose you will be  in some ways just along for the great ride of “life” and not in control of many variables or unforeseen/inexplicable happenings (I could insert here the percentages that you will always have a stay at home wife, for example).   In some ways over-planning and deferring gratification can be just as risky as choosing what you want to do right now.   The one thing I would be willing to predict with at least a 70/30 chance is that “bridging” between health care careers will become more common and easier rather than less common or harder.  So, to use another old saying, you might just grab that “bird in the hand” that is UF (a great school) and go with it, and then just judge other opportunities as they come along (and they will).    

[mashlee]

rpackelly, I appreciate you're insight and you make good points. It's true, as much as I want to plan out my future and all of the variable to fit exactly what I want, It will never happen because the PA, Physician, PT, Dentist and other health career will not be the same in 20 years . I plan to continue on my path and start PA school in June.

[skyblu]

I have had many, many doctors tell me, "If I had to do it all over again, I'd become a PA." I have never, on the other hand, ever heard a PA say, "I wish I were a doctor." 

 

The only times I ever wish I was a doctor is when I have to explain for the umpteenth time what a PA is. For example, we had a bad injury at one of my son's football games and the AT was not really able to handle it, so I ran onto the field and said, 'I am an ER physician assistant, how can I help?" People then were saying "Let her in,s he's a physician!", and I had to explain over and over. No, not a physician. No, not an assistant, either. Not an MA. Oh for God's sake, just get out of the way and let me take care of this open tib-fib fracture!

 

It would have been so much easier to say, "I'm a doctor." However, being a DO is probably not much easier to explain! One of our attendings had a difficult patient the other day. The doc is a DO and her jerky patient kept telling her, "You're a 'doh'? What the &8%^ is a 'doh'? I want an MD!" She had to explain over and over that she was, in fact, a physician. 

 

You're male, and I don't know the stats for that. But a fairly recent Forbes article showed that over a career, a female PA in Primary Care makes more money than a female physician. This is obviously not true in most other specialties, and most likely not true of male physicians vs PA's. But I thought it was interesting and eye-opening.

 

http://www.forbes.com/sites/gerganakoleva/2012/07/16/economists-show-primary-care-especially-unrewarding-for-women-doctors/

[True Anomaly]

 

 

 

 

It would have been so much easier to say, "I'm a doctor." However, being a DO is probably not much easier to explain! One of our attendings had a difficult patient the other day. The doc is a DO and her jerky patient kept telling her, "You're a 'doh'? What the &8%^ is a 'doh'? I want an MD!" She had to explain over and over that she was, in fact, a physician. 

 

 

 

 

If I were a DO, I wouldn't introduce myself as a DO to patients- I'd simply say I was a physician or a doctor...which they are.

[wjm7]

I have never, on the other hand, ever heard a PA say, "I wish I were a doctor." 

 

 

 

Hang around the forums a bit more regularly, I think you'll see that sentiment expressed.  But you make a fine point, job satisfaction does tend to be higher among PAs, at least according to the numbers I've been shown.

[EMEDPA]

I have had many, many doctors tell me, "If I had to do it all over again, I'd become a PA." I have never, on the other hand, ever heard a PA say, "I wish I were a doctor." 

 

I wish I were a doctor. life would be much easier. no scope of practice/autonomy/respect issues.

we have a member of the forum here in the first PA to DO program. she obviously was not satisfied as a pa either.

[skyblu]

Huh. Interesting. Question for those who do wish you were doctors: why aren't you? Is it a length of schooling issue? A money issue?

 

Truly interested to find out what the obstacles are, because I don't often (never, in real life) hear that from PA's.

[Acebecker]

I'm a little over 2 years out of school.  I have 3 children, one on the way.  Aside from my student loans hanging over my head and the cost of our health insurance, we are quite comfortable.  Even with the expenses of student loan debt that is above average and health insurance that is unholy expensive, we do ok.  I can afford a mortgage on a smaller-but-newer construction home, we have two vehicles that don't break down regularly, my children don't starve and stay warm, we can enjoy the occasional meal out for a date or with friends and I can afford to feed the awesome pregnancy cravings that my wife gets occasionally.  We have a modest savings that grows slowly.  Overall, we're doing alright.  Not flush with cash, but I'm meeting all of my family's needs and having fun while doing so.  Our practice requires 32 hrs/wk for full time provider status, which is what I work plus 10-15 weekends/year.  The weekends suck, but having at least 3 days off when I'm not on for the weekend is nice.  You'll notice that in the description of how we live, nothing is "huge," "elaborate," "extravagant," "expensive," but rather moderation predominates.  It's the way we like it.  My wife is a stay at home mom. 

[GetMeOuttaThisMess]

I think the simple answer to the question of why more of us who have been out for 20 or 30 years and wish that we had considered medical school is because medical school back at that time was more competitive than it is today. At the time that we went to PA school the major selling point was that you were able to practice medicine and yet were not going to have to put in the same hours as the physicians. That is no longer the case. Back in the time window that I'm referencing it was almost unheard of for PAs to be named in malpractice cases as well. That certainly is no longer the case. My primary motivation today, with regard to having it to do over, would be not being dependent on someone else for my livelihood. I would want to be at the top of the food chain, at least as far as practitioners are concerned. Most of us now realize that the hospital networks are primarily in control of the overall employment picture for both physicians and mid-level providers.

[EMEDPA]

Huh. Interesting. Question for those who do wish you were doctors: why aren't you? Is it a length of schooling issue? A money issue?

 

Truly interested to find out what the obstacles are, because I don't often (never, in real life) hear that from PA's.

several factors-

the only program that I would even consider at this point is the PA to DO bridge at lecom. no mcat and I would only need to take 1 more prereq class which I could take online.

my wife is an artist and her income could in no way support our family.

we would need to take out loans for the price of school as well as living expenses. I have kids who are almost teenagers and they will need their dad around for the next decade.

we would need to move across country.

my opportunity cost(lost income + price of school for 6 years+ loans to pay for life expenses) would be well over 1 million dollars.

 

all that being said if there were a local program I would probably still go for it, even in my mid 40s.

[EMEDPA]

I think the simple answer to the question of why more of us who have been out for 20 or 30 years and wish that we had considered medical school is because medical school back at that time was more competitive then it is today. At the time that we went to PA school the major selling point was that you were able to practice medicine and yet were not going to have to put in the same hours as the physicians. That is no longer the case. Back in the time window that I'm referencing it was almost unheard of for PAs to be named in malpractice cases as well. That certainly is no longer the case. My primary motivation today, with regard to having it to do over, would be not being dependent on someone else for my livelihood. I would want to be at the top of the food chain, at least as far as practitioners are concerned. Most of us now realize that the hospital networks are primarily in control of the overall employment picture for both physicians and mid-level providers.

my main motivation for not going to medschool back in the day was fear of ochem and fear of the mcat. as a paramedic with a BS degree in hand I needed no additional coursework to apply to pa school. it was the path of least resistance and for me at least it was the wrong decision. I also thought docs put in long hrs all the time and could not have a family. I had poor role models in this regard and didn't realize until too late that many PAs put in far more hrs than the docs they work with. my typical work month over the last 5 yrs was probably 180 hrs. none of our docs work more than 140 and most work around 120.