If you could do it over again, would you do it differently?

[TWR]

I have been a member of this forum for many years and one other as well.  I have practiced for 30 years in Family medicine.  I have watched our profession (PA) evolve during this time and as an observer, the NP profession.  If this was a Kentucky Derby the NP is round the final curve and the PA has just come out of the first curve.  Knowing what we do now as PAs, how many of us would have chosen a different path instead of  PA school?  Most of what I read on the 2 web sites I read daily and also comment on as well, are "negative comments" and disappointment.  I think our AAPA has let us down not on purpose.  As bureacracy in medicine comes more to the forefront, it is imperative that we get autonomy.  How did the nurse get so far ahead and we can't keep up?  I know big lobby, etc.  If anyone who has practiced 10 years or more says they would do PA school again I would like to know why.  IMHO

[PACdan]

Disclaimer, I'm still a naive second year PA student who is full of hope. :)

 

I have lots of hope for our profession. The majority of PAs I've worked with and been taught by, both inside and outside of academia, seem happy. The career is (can be) very rewarding and I see the recognition most of our colleagues in medicine have for our skills, knowledge, and high level of training. I think where recognition is lacking and not so clearly understood is in the legislative and public realm. But even so, the younger generations have been exposed to PAs more frequently, and better understand our role as providers (from what I've seen on rotations). Older patients who have established PAs as their PCP or go to specialist also get it. Where we need to work harder is in the realm of legal and public recognition.

 

It is disheartening to see what appears to be greater leaps forward by a similar profession, in a shorter period of time. But there is some positive there. I don't feel NPs will force PAs out of any arenas of medicine, any time soon. The demand is high enough that "all comers" are being taken to fill jobs. And maybe that is partly why NPs have advanced so much in primary care. I think if we're smart, we can set ourselves apart while taking advantage of the trail they blazed. We can observe their pitfalls and avoid them ourselves. But it is incumbent upon all new and future PAs to keep that in mind. To not devalue ourselves and to promote ourselves through proven work and benefit.

 

I think the crushing aspects of medicine are just as crushing across all realms of providership. Being smart and being adaptable will be our biggest allies. I wince at my loan balance every now and then, but I still feel rewarded each day I go out and learn something new. I encourage my classmates and fellow new PAs to take as active a role as they can in steering our profession towards greater things and more recognition. Even if we don't agree on particular points, as long as we're not complacent, as long as we're not willing to accept pay or treatment or labels that demean us, I think we will continue to move forward and improve ourselves.

[SocialMedicine]

Still would do PA. The PA training and model is definitely for me. While the NP laws are nice the far majority of PAs are not in primary care or an out patient setting where this would make tremendous difference. How many APRN has you seen put up a shingle and have a successful private practice ? PAs  need to improve the brand and push for greater autonomy and even indep in primary care. This is essential for the profession.

[BruceBanner]

I'm about 4 years in, not quite 10. Also in Family Medicine.

 

In retrospect I chose a curious profession for being an introvert. I find constantly being needed and hounded rather draining. Most days I feel like a glorified drug dealer and order signer. Patients are more annoying than not, their "problems" are mostly self-created or not real problems at all, and the work is largely thankless. After 4 days straight of a full schedule, I am pretty much fed up with everybody.

 

That said there is the odd case that really takes some detective work, and the occasional emergency. I have developed some nice relationships with a few patients. My hours are good, the call is light, and I don't worry about money. I could certainly make more, but my bills are paid and I mostly do what I want. I don't have bosses breathing down my neck so that is nice. I have very good autonomy for a PA. 

 

To be honest I still don't regret it, I'm just not sure how many more years I want to tolerate. Healthcare in general is too mechanized and restrictive, for provider and patient. I do not think the grass is greener on the physician's side, with the exception of some niche specialists who are really killing it. Ideally I would like to practice 1-2 days a week, and devote the rest of my time to more fulfilling endeavors. Writing novels, backpacking, helping people out in a meaningful way. 

 

I think to advance as a profession we need to push hard and loud for independence in primary care. Like PACdan said, the NPs have already blazed the trail, and when comparing PA/NP training side by side, nobody can argue with us. As our unofficial "leader" the AAPA has let us down by being too politically neutral. But, we also partly have ourselves to blame. Personally I dont love this work enough to lead a charge. But I'll gladly throw in my chips and pitch in to break the assistant shackles.

[jb5158]

BruceBanner, thank you for your input. I feel like I could have written what you posted. In fact, it's amazing to see that written out because I am often so drained or irritable after work and can't exactly figure out why - am I bored, is it management, is it the patient population, is it the job itself as a PA, etc.I guess I dont' have much to add for this thread, but it's just refreshing knowing that I'm not the only one who is introverted, drained when a million people need me all day, or feel like they're essentially seeing customers, not patients. It's just not as fulfilling as I expected and I feel awful for not actually being motivated to help every single person with every single little thing, most of which are psych related and not truly neurologic. I guess to add as well, I do have the odd case that is interesting and invigorating - someone with real, progressive weakness or something I've never seen before that excites me. Even in neurology, this happens a lot less than you would think. 

 

I am all for the name change and more autonomy, although I have a lot of autonomy currently which is great,  because I feel like I'm still having to prove myself to patients even though I know I'm good at my job. Sometimes I think about what if I had gone the MD route, but then I remind myself that many of my issues would be the same, the only thing better would be not just being an "assistant" in everyone's eyes. 

[True Anomaly]

Been practicing 6.5 years, so not quite 10.  I have it very good as a PA, but I worked for it for sure.  And I'm still involved behind the scenes to help further improve the profession.  

 

All that being said, my frustrations with my job have everything to do with our healthcare system in general, and not my own role as a PA in it.  

[Reality Check 2]

I am 25 yrs in with hx in Ortho, ER, Occ Med and Family Medicine. Been in 2 states. Born and raised in Texas and went to school there. The Bible Belt HURT PAs immensely and Texas is still far lagging behind. We didn't even have licenses when I graduated and didn't have any Rx privileges when I left the state nearly 20 years ago.

 

I am in the Pacific Northwest now and have much better laws and privileges.

 

If I had to do it all over again - I would have gone to Medical School.

 

That said, I can't change my path. I probably wouldn't be married to the same person or even have ever met him. My kids wouldn't be my kids. I wouldn't ever want to change those things.

 

The professional frustrations - yeah, I would change those in a heartbeat. Working for corporate medicine and making ⅓ of what the docs make but seeing the more complex patients and billing out TWICE what they did - that sucks. Being treated like an hourly employee and having to ask permission to get enough time off to see a school play - that sucks. Having patients tell my surgeon that they like me better than him and would prefer to see me - that didn't do anything positive for my job relationship with the surgeon. The constant frustration of PA laws - WHY can I declare you dead and give you Category I drugs but can't sign for diabetic shoes or home health???????? 

 

I LOVE what I do and I am, quite frankly, excellent at it. I am still a PA in the eyes of everyone and limited by that. 

 

AAPA has NOT supported our profession over these years and has not helped us advance or meet the needs of the US population and its healthcare needs. We have NOT made inroads with physicians to strengthen our team approach or build the autonomy that can work while not ousting physicians. We have not done nearly enough to overcome the RN/ARNP lobbies and population who railroad over us at every possible opportunity despite our education, knowledge base and abilities.

 

As a profession, we have to do something or risk dying out or becoming the scribes that so many new grads describe as jobs they are entertaining. 

 

We have TOO MANY PA SCHOOLS and too many new grads with not enough docs to help us or be supervisors on paper or to teach new grads. 

 

We have brains and compassion and skills - it is time to use them.

 

Those of us who have been out a while need to change this.

 

My very old 2 cents

[adru373]

I would do it again for sure.  We have great job security, the ability to change fields, few years of grad school, good salaries, and opportunities to help people.  Every job in the world has its frustrations and we're certainly not immune, but overall I think we're pretty lucky.

[Maverick87]

I'm 3.5 years in and I don't regret it at all.

 

So far, I'm happy that I went to PA school, as opposed to NP or medical school.

 

If that changes, you all will be the first ones to know.

[iafsp409]

I'm about one year into practice in primary care. For the first 6 months I was solely focused on doing the right thing (or at least not doing the blatantly wrong thing). Now that the right thing is a little more intuitive or practiced, I've had time to reflect on my first year and how reality compares to what I had hoped being a PA would be like. There are occasional moments that are as satisfying as what I had imagined:  seeing a patient back a month later and finding out that starting an SSRI kept him from losing his mind (and with it, his family and his job) or diagnosing uncontrolled hypertension and helping a patient take control of his own health. These are rare gems. Many days I feel like a very knowledgeable customer service representative. Many days I feel like I've failed at being effective at making a difference. Many days I feel like I'm on autopilot. I think these feelings are rooted more in the problems with healthcare in general and primary care in particular vs. being PA-specific.

 

I miss thinking like a scientist. I miss problem-solving. I miss technology and data analysis and concrete solutions to problems. Some days my work feels too "soft." But I think, again, that this is more related to my personality than being PA-specific. I also become overwhelmed by the continuous interruption of other people needing me and by the necessity of constant dialogue and small talk throughout the day. Some days I long to sit at my desk and quietly and meticulously do my work. Again, this is more related to my introverted tendencies than to being a PA.

 

Is it a good choice of career? Yes - for the right person with the right personality and the right expectations going into it. Do I regret choosing it? I think I could have chosen a career that fits me better but I also think I could have made much poorer choices. I don't think being an MD or NP would be better.

[Sticks]

I've been a PA for 8 years including Primary Care, ED, and UC. I still love what I do, but all of my frustrations are rooted in our healthcare system and the amount of workload it creates. I practice in California and know many Docs, PA's, NP's, and RN's and they all have the same complaints about workload. We are constantly doing more paperwork and seeing more patients with fewer and fewer resources and support staff. So, to answer the question: Yes I would do it all over again. I just wish I could take the proper amount of time required to do a thorough and professional job without constantly being rushed and sidetracked.

[Guest Paula]

12 years in.  Introvert.  Type A.  Like to solve problems.  Can't stand administration.  

 

Hate being shamed in public and having satisfaction scores posted on the bulletin boards with a bright red line around those of us (yes, I'm in that group) who fall into the 25%.  Can't stand the administrators who do not know how to communicate effectively and just send emails.

 

Getting burned out.

 

Would rather go to my art studio and paint.  (can't make much money doing that, but it makes me happy)

 

Thought about medical school my senior year of college and the thought petrified me.  I had not heard of the PA profession then in the 70's.

 

Physicians and NPs do not have it any better. Therefore, even though I wish I would have gone the MD route, my life would not be any different as far as job satisfaction since the medical climate and bureaucracy of organized and corporate medicine would still be the same. 

 

Hate the title Assistant since I am not one and I have a type A personality, we are not assistants.

 

My whole organization physician group is on the verge of rebellion.  I will lead the charge (at least in my dreams)

 

I'm very active in changing the PA profession on the local, state and national level and can't stand the slow grinding of the cog.

 

I have difficulty tolerating PA mindset that we must not upset the medical society. 

 

Other than that:  I love my job.