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Hello, I am currently a PA-C working as a hospitalist in Pennsylvania. While I love my job, the people I work with, I'm just not happy in the area I live in. With my job, there is also not much room for growth. I am still fairly new, offically practicing for 1 year. I am actively looking to relocate, likely within the next year. I would like to say that at least I have been committed for 2 years to one employer.

 

I'm looking for a state that is PA friendly, salaries are competitive, and there are plently of opportunites / activies in the area. I'm currently looking at Texas, Oregon but open for to any suggestions. I understand all areas have there pros / cons. I would just like to get YOUR opinions on where you practice, and what advantages/disadvantages you have as a physician assistant in your state.

 

Thanks!

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The AAPA keeps a great database concerning PA friendly states.

It is based upon the 6 key elements of PA practice.

It is found under the Advocacy tab in the state section.

You have to be a member to access the pdfs.

Bottom line for you, Pennsylvania only has 2/6, Oregon 4/6, Texas 5/6. So that should provide a reference point for you when you get responses.

I would venture to look at the cost of living in both places along with climate.

I spent 6 months in Texas, May to October, many years ago. At least it was a dry heat. But Texas seems to have a significant lower cost of living, probably lower than PA or OR.

Good luck in your search.

GB PA-C

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The AAPA keeps a great database concerning PA friendly states.

It is based upon the 6 key elements of PA practice.

It is found under the Advocacy tab in the state section.

You have to be a member to access the pdfs.

Bottom line for you, Pennsylvania only has 2/6, Oregon 4/6, Texas 5/6. So that should provide a reference point for you when you get responses.

I would venture to look at the cost of living in both places along with climate.

I spent 6 months in Texas, May to October, many years ago. At least it was a dry heat. But Texas seems to have a significant lower cost of living, probably lower than PA or OR.

Good luck in your search.

GB PA-C

Yep, and people often get the wrong idea about Texans. They think we're just a bunch of red necks who prefer fishing and hunting to visiting art museums and they think we would rather drive a quarter ton four-wheel-drive pick up than get behind the wheel of a Prius. Well, actually, I guess that's petty much true, but we do have a low cost of living and we aren't regulated and taxed into oblivion. As for climate, it's a big ass state. Galveston, Amarillo and El Paso have very different climates. Though I think Texas is a very good place for PAs in terms of regulation, pay and autonomy, recent law has made it impossible for a PA to own their own practice and hire an SP.????

 

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Though I think Texas is a very good place for PAs in terms of regulation, pay and autonomy, recent law has made it impossible for a PA to own their own practice and hire an SP.????Sent from my KFAPWI using Tapatalk

TAPA will tell you that 2012 legislation was a big win for us because PAs can now be part owners of a practice despite always having to be a minority owner and not being able to own more than any of the docs(i.e. If doc A owns 5%, the max I can own is 4.99%).

 

 

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That can be deceiving.  Washington State theoretically scores worse (3/6) than Oregon (4/6), but I'm sure all of my peers here in the great ol' PNW will attest that Washington is far more PA-friendly than Oregon.

 

Curious what makes Washington far more PA friendly than Oregon? What are other important factors that new PA grads should take account when looking at PA state friendliness? 

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TAPA will tell you that 2012 legislation was a big win for us because PAs can now be part owners of a practice despite always having to be a minority owner and not being able to own more than any of the docs(i.e. If doc A owns 5%, the max I can own is 4.99%).

Interesting that the AAPA doesn't cover freedom to own a practice as part of it's top six, while unlimited number of PAs a physician may supervise is.

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TAPA will tell you that 2012 legislation was a big win for us because PAs can now be part owners of a practice despite always having to be a minority owner and not being able to own more than any of the docs(i.e. If doc A owns 5%, the max I can own is 4.99%).

 

That's interesting because I know two PAs in Tyler that, together, own their own practice and, while grandfathered in by that legislation, they could not open that practice today. So a PA owned practice was previously allowed, probably because it wasn't specifically disallowed. TAPA may consider it a win because the legislation didn't prohibit PAs from owning any part of a practice but it seems to me to be a step backward from the status quo. Perhaps TAPA had to fight hard to keep the legislation from being more damaging.

 

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Wow....KY looks like a horrible place to practice based on that chart.

As a current PA student in KY, I have to agree that it looks pretty bad compared to the regulations in other states. Among other things...

-You can't write for controlled substances and that's not going to change anytime soon

-The number of PA's a physician can supervise JUST changed from 2 to 4 within the last couple of months

 

One of the positives though is that there is a HUGE demand for PAs right now as this state is among the leaders in a large list of chronic medical conditions. We were one of the quick adopters of obamacare so there are a ton of additional people with health insurance. Also there are only 2 PA programs in the entire state.

 

While the regulations aren't doing us any favors, there will be no problem finding good paying jobs!

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Curious what makes Washington far more PA friendly than Oregon? What are other important factors that new PA grads should take account when looking at PA state friendliness? 

One thing that's not reflected is the time is takes to turn around paperwork.  WA DOH approved a practice plan in 4 business hours.  WA DOH issued me my final PA license the same day my PANCE scores were published.  Oregon... I have no firsthand experience with, but will let others comment.

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One thing that's not reflected is the time is takes to turn around paperwork.  WA DOH approved a practice plan in 4 business hours.  WA DOH issued me my final PA license the same day my PANCE scores were published.  Oregon... I have no firsthand experience with, but will let others comment.

OR = Months for even minor changes....

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Things that matter, in my opinion, for PA 'friendliness':

 

-Scope: Can we do everything (minus surgery) a physician can, either by the letter of the law or MD/PA agreement?

-Prescriptive authority: Up to and including Schedule II's?

-License/admin turnaround time. Example-- It took Delaware over 3 months to get me my license after passing the boards. Colorado took about 3 weeks.

-PAY. Example-- average pay in CO is wayyy lower than the northeast and upper midwest. Mostly a supply and demand thing.

-Co-sig requirements: Only matters if the state mandates an SP sign all of your charts, because that is a pain in the as$.

-Job market: How many jobs are there vs available PAs? Job boards and salary norms probably give you the best idea of this.

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Kentucky has its advantages and disadvantages like any other state. If you're willing to work rurally, you can find a great paying job with a ton of autonomy. If you want to stay and work in the city, you have to compete with the NP's who will usually beat you out on the job front. Reasons for this include: an extremely strong nursing board passing laws yearly, co-signature of charts (the law has changed to 10%, but not every university/hospital has adopted that rule), inability to write for schedule II's, and physicians can only supervise 2 (just changed to 4) PA's at one time. Just two years ago the law changed that recent PA graduates didn't need 18 months of onsite supervision by their supervising physician. We have a long way to go in Kentucky to get PA's where the need to be, we just need to keep working at it. Thankfully, things are better than they were two years ago, and hopefully they will be better two years from now.

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Kentucky has its advantages and disadvantages like any other state. If you're willing to work rurally, you can find a great paying job with a ton of autonomy. If you want to stay and work in the city, you have to compete with the NP's who will usually beat you out on the job front. Reasons for this include: an extremely strong nursing board passing laws yearly, co-signature of charts (the law has changed to 10%, but not every university/hospital has adopted that rule), inability to write for schedule II's, and physicians can only supervise 2 (just changed to 4) PA's at one time. Just two years ago the law changed that recent PA graduates didn't need 18 months of onsite supervision by their supervising physician. We have a long way to go in Kentucky to get PA's where the need to be, we just need to keep working at it. Thankfully, things are better than they were two years ago, and hopefully they will be better two years from now.

Thank you for sharing, that was very informative :)
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As much as I love my home state of Texas, one of the most frustrating things about the state and trying to change practice laws is the legislature only meets once every 2 years for only 6 months at a time...so if you don't get your legislation together in that short amount of time, gotta wait for another 2 years for another chance

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