How do you view the future of the PA profession?

[Ol_tumbleweed]

Hi all,

 

First I'd like to thank you for sharing a wealth of information on these boards. I'm not currently a PA, but I've been working like mad over the past year and a half preparing to apply to PA school. Even as someone in his mid-30's making a hard correction in career trajectory, I've felt confident in my decision to pursue PA. Which brings me to why I'm posting!

 

On top of the great stories and advice I've come across in this forum, I've also seen a lot of opinions on the future of the PA profession. From doom and gloom ("This profession is dead within 10 years") to a bright and shiny future, opinions seem as varied as they are deeply rooted. I doubt that it's likely to change my resolve in getting through PA school, but having invested so much time and money into even just preparing for the application process, I'd like to get as much information as I can from seasoned PAs on where they think the field is heading, and perhaps why?

 

Where do you see this profession heading, and why? Is there legitimacy to the ominous warning to avoid PA school, that the profession will die within the decade? How about those on the other side of the spectrum, where do you see the bright spots? I've been doing a lot of reading in the forum and I couldn't find a thread focusing on this question, so I do apologize if it's already out there.

 

Thanks in advance for your time and thoughtful replies!

[EMEDPA]

I think long term PAs will end up with a few major changes from where they are now:

1. full practice responsibility in all states predicated on everything below

2. required postgraduate training in a specialty for at least 1 year

3. required specialty exams after completion of postgraduate training

4. doctorates awarded after completion of postgrad training and specialty exams

 

so path for PA to be fully credentialed would be this:

undergrad 4 yrs

PA school 2-3 years(I think eventually all programs will be 3 years)

postgrad training 1 yr

for a total of 7-8 yrs vs 11 for the physician route.

[Marinejiujitsu]

I think long term PAs will end up with a few major changes from where they are now:

1. full practice responsibility in all states predicated on everything below

2. required postgraduate training in a specialty for at least 1 year

3. required specialty exams after completion of postgraduate training

4. doctorates awarded after completion of postgrad training and specialty exams

 

so path for PA to be fully credentialed would be this:

undergrad 4 yrs

PA school 2-3 years(I think eventually all programs will be 3 years)

postgrad training 1 yr

for a total of 7-8 yrs vs 11 for the physician route.

I know UC Merced have been planning a 5 yr md/undergrad combo meaning 8 yr physician in family med or EM. Crazy.

 

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[EMEDPA]

yup.

at this point if you are just entering the field you really need to weigh the pros and ccons of each pathway.

my reasoning for the above changes is historical: the docs went through all of those changes from apprenticeship(you used to be able to train that way as a pa) to required training to required internship/postgrad training to required testing.

those on these boards for a while have heard me tell this story before. I come from a medical family going back generations.

my great-great grandfather became a doc by following his dad around for 7 years from age 14-21 then he hung his own shingle. never went to school

my grandfather went to medschool and did 1 yr of surgical training. did it all as a surgeon; kids, trauma, ob, etc

my dad went to medschool and did a residency, but never took specialty boards and practiced as a neurologist for 30 years

a doc of my generation has to go to school, do a residency, and pass specialty boards to practice.

[BruceBanner]

OP, you kind of answered your own question---It depends on who you ask.

 

The real questions you need to be asking yourself are:

 

1. Is all this debt worth it? (personally my biggest regret)

2. Do I really want to spend all day every day dealing with patients, staff, insurance, and docs? 

 

It's not an easy profession for introverted types and the "fulfillment" thing totally depends on the person. Sure you are helping people, but so is the local auto mechanic or a massage therapist. You're getting paid to do a job, and fulfill customer's requests. You're just highly educated and the stakes are higher. I'm not saying there is no satisfaction, but that aspect of medicine is oversold, IMO.

 

Despite the abundance of threads to the contrary, I dont think you have to worry about job security. I do NOT think we will ever go backwards in scope or privilege. Likely what you will see is a bit of market saturation with amount of NP and PA grads being churned out, and a slow credential creep towards post-grad training. I'm just speculating though, I really dont know. Once you're a PA, you're a PA. As long as you keep your license clean and advance as a provider, you will have work for the duration of your career.

[Ol_tumbleweed]

Thanks EMEDPA!

 

OP, you kind of answered your own question---It depends on who you ask.

 

The real questions you need to be asking yourself are:

 

1. Is all this debt worth it? (personally my biggest regret)

2. Do I really want to spend all day every day dealing with patients, staff, insurance, and docs?

 

It's not an easy profession for introverted types and the "fulfillment" thing totally depends on the person. Sure you are helping people, but so is the local auto mechanic or a massage therapist. You're getting paid to do a job, and fulfill customer's requests. You're just highly educated and the stakes are higher. I'm not saying there is no satisfaction, but that aspect of medicine is oversold, IMO.

BruceBanner, thanks for the advice/caution. I’m still relatively young (if you ask someone over 35), but I’ve experienced a number of different lines of work. I’ve been in an office at a law firm and I’ve been in the office at an internet start up. I’ve donned the blue collar working construction, cleaned windows and built furniture. I’ve worked food service, and taught English overseas. Outside of woodworking, which I will continue as a hobby, I haven’t experienced a joy in working as I do now even in a more menial healthcare position (therapy aide). I’m under no illusion regarding the work – I’m helping care for sick people. It’s messy, tiring, stressful, and often thankless thing. That being said, I enjoy the work. And perhaps you can inform me further on this, but it seems that education/learning doesn’t end once you have your PA-C, rather you continue to grow and develop (I know you have to continue to take tests, but perhaps it’s an opportunity to hone your skills?) as a professional. I kind of liken that to the woodworking that I’m drawn to. Anyways, I’m verbose, so I’m going to stop typing, but thanks again for your honest feedback.

 

 

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[EMEDPA]

oL_t,

Yes, as a pa you have to commit to lifelong learning. there is a 100 hr/2 yr cme requirement and you need to stay current on all the advances in your chosen specialty as well as in primary care as our recert exam every ten yrs is a primary care exam.

[overthehorizen]

Where do you see this profession heading, and why?

 

I agree with much of EMED's contribution. However, he says things as if they are a fait accompli, that is we will have independent practice rights. I contend that our profession will die within ten years UNLESS  we win independent practice rights. At this point, there is no evidence that things will change on the horizon. Our profession is being destroyed by Physicians and NPs. We have no response to this except things like 1. let's advertise that we take the PANRE and NPs don't  or 2. Let's tell everyone the differences in our training methods between PAs and NPs. the bad news is that nobody with influence to help our profession cares about numbers 1 or 2. 

 

To all of the undergraduates even entertaining the idea of applying to PA school, I stay emphatically, STOP! If medicine if your goal, work towards and MD program. If that is insurmountable (for grades or mcat) then consider the islands or overseas. I have worked with more doctors who were international medical graduate than I have with those who were us medical school graduates. You can get a residency but not the highest paying, most prestigious if you go outside the US. If you are against going to med school outside the US and can't get into US medical schools, just go NP route. Doesn't matter that education is inferior. Doesn't matter that you are ill prepared. You will get the right to go see patients without a physician on your back for the rest of your life. You will start an independent practice. You will greater opportunities than PAs.

 

Please read my other posts on this subject. The VA decision is important. It is a leading indicator of the future of the profession. Trust me when I say, the PA profession will be dead in ten years. We can thank the NCCPA and AAPA for the death of the profession. 

 

Finally, people selling the profession most emphatically are those who make money off of undergraduates. The NCCPA and the PA programs themselves. Neither of those groups tell students the grim reality of a field that will have a lifespan of less than ten years. 

 

Feel free to PM me with your specific questions.

[EMEDPA]

just a comment: my biggest problem with the PA profession in the 30 years I have been aware of it is that what we do is a secret. we have NEVER had a major PR campaign to explain to the american public what a pa is. Know how the DOs gained acceptance after getting rights equivalent to MDs? they advertised. they hired the "Got Milk" ad group to do a series of ads in major magazine profiling DOs doing cutting edge work with a little story like this:

Dr Smith is the head of cardiology at xyz prestigious hospital. he pioneered the technique of xyz , which saves millions of lives. Dr smith is a DO, a new type of physician that leans everything MDs do and undergoes the same rigorous training , but also the following abc...to learn more about the profession or to find a DO near you go to DOsarecool.com for more stories like these.

now everyone knows what a DO is and really nobody has a problem seeing one. I have pushed for a major PR campaign each and every yr I have been a pa student and pa with no response...and I'm not alone...

[overthehorizen]

just a comment: my biggest problem with the PA profession in the 30 years I have been aware of it is that what we do is a secret. we have NEVER had a major PR campaign to explain to the american public what a pa is. Know how the DOs gained acceptance after getting rights equivalent to MDs? they advertised. they hired the "Got Milk" ad group to do a series of ads in major magazine profiling DOs doing cutting edge work with a little story like this:

Dr Smith is the head of cardiology at xyz prestigious hospital. he pioneered the technique of xyz , which saves millions of lives. Dr smith is a DO, a new type of physician that leans everything MDs do and undergoes the same rigorous training , but also the following abc...to learn more about the profession or to find a DO near you go to DOsarecool.com for more stories like these.

now everyone knows what a DO is and really nobody has a problem seeing one. I have pushed for a major PR campaign each and every yr I have been a pa student and pa with no response...and I'm not alone...

I wish I could "like" this post more than once. So true.