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Career Options: Is PA the best one for the kind of provider I'd like to be + the balance I'd like to have?

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Hello! I am a 30-year-old strongly considering a career change. I’m currently in media and when I think about what I want to do for the rest of my life..it is hard to imagine I’d be happy sitting in an office and dealing with people getting worked up over things that don’t really affect anyone’s life for the rest of my life. My current career path is one of those things of…I CAN do it…I’d could work really hard and get great at it, but I’m not sure it’s what I want. I do; however, imagine I’d be happy with the following life:


Working one-on-one with people in a healthcare setting (Especially where I can empower women about their health and choices. More about this below). I would like to continue my hobbies. I want to have a family eventually, but I hope to balance this all. 


Also, FYI: I have been volunteering at a local hospital and also at a women’s clinic, worked as a PT aide and have already begun my prereqs. I’m currently working on getting more one-on-one patient care experience and have enrolled in a CNA program that begins in two weeks. 


My question is two-fold: 1) PA’s who have managed to make time for family/friends, hobbies...how did you do it? 2) I’ve listed the specific things I ‘d like to do in my career as a PA below. I believe I can do those working in an OBGYN setting or in a  digestive health setting (grastroenerology). Are there any PA’s who had similar ambitions…if so, what areas of medicine are you in? Or do one of the careers listed below or some career path I haven't considered make more sense? 


I think I can achieve these things by becoming a PA and working on the rest in my own time. The draw of just continuing down my current path and avoiding more student loan debt along with all the obstacles I’ve been facing on my path to PA so far (I’ve been taking prereqs at a community college and boy is it different than my university experience), keep giving me pause. I want a vacation! Lol. Still the thought of having a more fulfilling career keeps brining me back. 



Things I’d like to do as a PA, (I’m aware I’ll have to do other stuff and there are things in the job that will not always be what I want, but that’s anywhere): 

  • Help people end digestive health issues, internal inflammation, obesity, hypertension...especially through a healthy natural lifestyle, but im aware not everyone is going to follow that ish...so whatever way pa's treat it
  • Teach families preventative lifestyle choices to avoid childhood obesity and other (mostly preventable) issues
  • Counsel women and girls in underserved neighborhoods about STI prevention, sexual health, ways to truly take care of the body including self love, nutrition and sexual discretion
  • Help people stay slim through a healthy natural lifestyle
  • Help people achieve beautiful glowing skin through a healthy natural lifestyle (so magazine-y of me i know, don't judge!) 

What area of medicine could these things fit under? Digestive Health/Gastroenterology, OBGYN, etc. 


Other Careers I’ve Considered along the way & why (including PA):


Dietitian - While this path sounds cool, it has never felt worth it.  It will be a huge debt increase, 4 more years of schooling and debt after already having $150k in debt from undergraduate and previous master’s ( I got the master’s out of desperation to escape my first job out of college…young and dumb), many people are having a hard time getting the required internship to graduate from their programs , the salary will not make sense for obtaining a second master’s degree (salary around $50k, I’d basically go back to school, get more debt and make the same amount I’m making now). There is no loan forgiveness program here. 


Physician Assistant - Very appealing as PA’s often get more one-on-one time with the patient and can work in underserved communities (and get student loan forgiveness for this). I really enjoy being in a hospital setting (I’ve volunteered in a hospital and a clinic), rooms where docs meet one on one with patients and just making people feel welcome/listening/offering support. PAs can work in any speciality so I would choose OBGYN or perhaps gastroenterology(but i’m not sure how much preventive work I get to do in that field). I’ve actually already started taking prereqs at the local community college, but I’m running into issues with student loans so I’m considering just applying to a post bacc program instead. The main issue I have with PA is that I’m afraid I will feel like I’d rather be a doctor because of the respect that comes with it. Perhaps I will feel respected as a PA too though if I choose the right setting with the right doctor? Also, I feel like later in my career I would probably like to open my own practice or start a non-profit org at least. Can I do this as a PA or would I be better off doing this as a doctor? I also wonder if I will get annoyed with pill pushing and recommending antibiotics/flu shots etc when in some cases (DEFINITELY NOT ALL) the better remedy might be to try make a lifestyle adjustment, remove excess from the diet etc.  At the same time, I totally get that most of the population is not going to follow those suggestions or plans so I might have no choice but to push a pill their way. I just want to be a position where I help people understand the importance of these things. 

Random question: are there any natural health doctors that have PA’s? 


Research/MPH: I’ve thought about doing a dual PA/MPH for all the reasons listed above. If I do an MPH alone…I think I’d be a little confused in what to do with it. If I did it with PA, I’d feel like I’d have it just in case! Perhaps while I’m practicing I can also have an impact on community prevention programs with an MPH. Accessing  a community’s needs and helping to research, write about and create effective programs to address those in regards to women’s health (the entire woman from OBGYN to self love) and holistic approaches.

(I could even teach Pilates here maybe!) I really want to help the WHOLE woman).  I'm also just a deep thinker in general, but I don't like thinking for the sake of thinking. I like to apply what I know. 



Physical Therapist: I was a PT aide for a short stint and though it's such an important field, I found it quite boring. I wouldn’t last long focusing solely on the physical in this kind of setting. 



Doctor - Same things listed above as PA. The downfall is that I am 30, have $150k in debt from my two other degrees. I actually wouldn’t mind studying, classes, etc…but that’s 4 more years until I see another paycheck….UMMMM. Not sure about that. Also, the work life balance...I've read on this forum and others is not so great. 


Is PA the route for the goals I listed above? Is it realistic to think I can enjoy life outside of work pursuing my hobbies as a PA? Thanks for reading! 

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2 things stand out:  


1:  it is a myth that PA's have more time with patients.  They don't.  


2: Another myth that PAs have better work/life balance or more free time.  Work/life balance is often the same as an MD.  This varies more based on specialty than title, I would say.



You've got a wide range of professional goals and you likely won't find one single career that fits the bill for all of them (or you might find several that fit equally).  You need to decide what is important to you the most.


Honestly, if it were me and I had the same list as you as far as goals (and with $150k in debt) I'd find an online or part time MPH program (keep working, chipping away at debt) and get certifications for personal training (or additional certifications to your pilates cert).  Seriously.  It's something I looked into if PA school didn't pan out for me and I'd still do it.  You can knock out a LOT of items on your list with those 2 careers.

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I've seen similar questions before, and answers too. It is kind of like describing an elephant from different angles. There are as many PA situations as there are PAs, whether you are talking about hours worked, relative independence, time spent with patients, level of respect, job satisfaction, etc. If nothing else, this should be a driver for you to shadow as many PAs in as many different situations as you can.


That said, your description of your ideal job does sound a bit -- shall we say -- "ideal." In many environments, medicine has become much more of a business, and one where profit margins have dropped substantially over the past few decades or so. PAs are often in systems (like chains that own several hospitals) rather than working for a single physician (though my job is in the latter situation.) The business of medicine -- whether you are a physician, a PA, an NP, or whatever -- tends to drive you to see as many patients as you can in as short a time period as you can. Your salary and benefits are a cost to your employer and your profit comes from how much money can be billed for your services. An important skill to learn is knowing when a patient situation demands that you slow down and pay more attention to the case in front of you. I suspect that, wherever you may go in healthcare, you will have to reconcile business pressures with the need to do a good job for the patient.


Can you have a family and hobbies? Based on what I've seen, yes you can. Work is intense at times, but there is a "duty cycle" about it, and that cycle differs depending on your specialty and your need for income. My friends who work in the ER generally work a certain number of shifts per month (sometimes days and sometimes nights.) Some other jobs require on-call time. Many jobs require you to stay at work until the patients have all been seen and the notes written. I have no idea what life at a federally-funded clinic in a rural area or on an Indian reservation would be like. Another reason to shadow!


As far as respect goes, over the course of my life -- working for 50 years or so in 4 or 5 different careers -- I've found that you mostly get what you earn and that some people are going to be jerks no matter what either of your credentials are. You will mostly be happy based on what you think about yourself and the job you are doing, not what you think someone else thinks about you (if they even bother to think about you at all). That said -- regardless of your career -- sometimes you will have to stand up for yourself and sometimes you have to leave an unsuitable situation and move on.


In summary, asking other PAs about their jobs will only get you so far; they'll talk about what THEY like or don't like, not what YOU might like or not like. Regardless of the job -- or career -- you might be considering, find a way to put yourself in it (even in a small way) and see how it makes you feel. That's one reason why shadowing is so very important -- and in multiple settings -- not just to check a box on an application, but in seeing how the job might suit you. In my case, I started in medicine as a hospital volunteer, then a volunteer EMT, and then a part-time paid paramedic. I also shadowed PAs, when I finally discovered them.


Eyes wide open! And good luck on your search. The lack of clarity at your stage in the process can certainly be annoying, but the exploration can be one of the more exciting times in your life. You have a job and have the luxury to take your time and learn about new possibilities. And, at 30, I suspect that it won't be the last time that you consider a career change.


Good luck!

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You're describing almost perfectly the Nurse Practitioner (NP) profession and I think that may be what you need to consider.  NP's are RN's trained in the nursing model and are able to work independently with the extra training based on pattern recognition, and you often find them predominantly in the holistic sort of arena that you want to find yourself in, especially in women's health.  


Plus with - holy crap btw - $150k in student loan debt already I think the flexibility to stop and work for a few years as an RN is a very wise consideration.  Many or even most NP programs can be done almost entirely online and the supervision during clinicals is a joke, a rather large open secret.


PA's on the other hand are much more similar to doctors.  Our field was created by a physician in the 60's to help with their demand.  PAs do hard science, both before and in school, are trained in the medical model like physicians and are closely supervised during clinicals.  Once we graduate we have a relationship with physicians that varies from state to state, generally working alongside them doing mostly the exact same thing, or stuff like surgery or interventional procedures of various types.  


As far as lifestyle goes, it's a bit of a range.  You'll find some PAs doing similar hours and such but IN GENERAL not as much; that's just common sense.  If you have to have one person at a facility alone, probably going to be an MD.  If there is a complicated medical situation, probably an MD needs to tackle it.  The PA goes home for the day because that is not our forte'.


Before I get checked there ARE PAs reading this right now who work totally independently and/or with complicated situations.  It's just uncommon - the other 95% are ham and eggers punching the clock and going home when we are done.  


Respect is less I suppose that that really bothers some people.  I am not one of them.  I'm older and a really humble guy (especially lately) but I've seen and done some things, so talk to me on a level or I'll ignore you and go around; I got things to do.


Anyway, I see you fitting in as an NP.  I am surrounded by them and they all start out with ideals similar in moat ways to yours. Get thee to the internet and begin thy research.  Good luck.

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Thanks so much for these replies. They mostly fall in line with things I have already thought of and considered. I have family members who are NP's and it doesn't seem like NPs do the things you've named. Still, I appreciate the thought and will look more into it.



Any PA's out there that practice in an underserved community or in a  more integrative setting? 


Any PA's who have struck the balance? How did you do it?

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Thanks so much for these replies. They mostly fall in line with things I have already thought of and considered. I have family members who are NP's and it doesn't seem like NPs do the things you've named. Still, I appreciate the thought and will look more into it.



Any PA's out there that practice in an underserved community or in a  more integrative setting? 


Any PA's who have struck the balance? How did you do it?


There are PAs that work in underserved areas for sure.  And there are plenty who have the work/life balance.


I think the bigger point here is that what you are describing as your goals is not really what modern healthcare is.  It just isn't.  Sure we want to help people but your goals are so idealistic they border on naive.  The ways you want to help people would be better served by a profession(s) other than an MD/PA/NP.

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