bugmenot Posted February 11, 2012 Share Posted February 11, 2012 Hi everyone, I am doing some personal research and would like to know what problems some of you PAs face in the field? You don't neccessarily have be a PA to answer. Thanks! Link to comment Share on other sites More sharing options...
andersenpa Posted February 11, 2012 Share Posted February 11, 2012 The answer you will commonly get from experienced PAs is the "glass ceiling effect. PAs attain considerable expertise in their field after a minimum amount of clinical experience, at least 3-5 yrs if not more. due to our dependent status (something we all knew about when we got into the profession), we are often limited from certain opportunities, most notably issues like practice ownership, certain types of facility credentials, leadership/admin positions....soley based on the degree or "assistant" title. Link to comment Share on other sites More sharing options...
KMD16 Posted February 13, 2012 Share Posted February 13, 2012 Disrespect across the board! It doesn't get better. No matter how hard you try. Also, a constant push to produce the # to increase their bottom-line. You do more shift while they do less and take more vacations. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 13, 2012 Moderator Share Posted February 13, 2012 1. limited by always being a dependent practioner - doc's just don't respect you 2. $$$ limitations by having to have a doc being your SP 3. old fashion laws that limit our ability to practice.... why can't a PA do an EMG or sign a death cert? 4. trying to find a doc that supports the vision of what a PA can be Link to comment Share on other sites More sharing options...
SocialMedicine Posted February 14, 2012 Share Posted February 14, 2012 been in practice 3+ years ... i have had a different experience than the above I guess ... probably because i am in outpatient internal medicine where PAs can have very high degrees of autonomy. my biggest problems have had more to do with health culture in the United States than anything PA specific. Every day I grow more concerned with the way benzodiazepines, amphetamines, non benzo sleeping agents, and narcotic pain medications are prescribed and expected by patients. The way medicine is set up .... it is essentially a business. Patients PAY YOU to GET the script they want. At least that is the expectation many have. I try and manage my practice evidence based and conservative on the pharmaceutical side and meet alot of patient resistance. Link to comment Share on other sites More sharing options...
KMD16 Posted February 14, 2012 Share Posted February 14, 2012 been in practice 3+ years ... i have had a different experience than the above I guess ... probably because i am in outpatient internal medicine where PAs can have very high degrees of autonomy. my biggest problems have had more to do with health culture in the United States than anything PA specific. Every day I grow more concerned with the way benzodiazepines, amphetamines, non benzo sleeping agents, and narcotic pain medications are prescribed and expected by patients. The way medicine is set up .... it is essentially a business. Patients PAY YOU to GET the script they want. At least that is the expectation many have. I try and manage my practice evidence based and conservative on the pharmaceutical side and meet alot of patient resistance. I worked IM outpt as well until few days ago. I left after 2.5-years w/o pay increase or at least my SP honoring the contract to which we both agreed to. In practice for nearly 5years total. Thus far, I've worked in variety of specialty. I tell you this, it virtually the same everywhere you go. Medicine = Business. Those whom you work for primary concern is their bottom line. Are you making us enough $$ or should we replace you? The politics in medicine is insane. I've learn a lot in my few years out and still continue to learn. As PA, you must work/sleep and have one eye close while the other open. Work 2 or more jobs. Surprises comes when you least expect. Sorry, I had a long day if nothing said makes sense to you. Link to comment Share on other sites More sharing options...
terripa Posted February 14, 2012 Share Posted February 14, 2012 Physician Assistant's are constantly compared to Nurse Practioners. But NP has more freedom to practice (at least in Florida). PA's can't prescribe controlled meds, write for Hospice consults, sign orders from certain DME companies, and sign death certificates. It's a shame that PA's are only reimbursed 85% of MD/DO. I feel we provide more than adequate care for less reimbursement. Also, I feel it is outrageous that we have to recertify every 6 years. NP's don't even have to. MD's are every 10 years. We let NCCPA tell us what to do and we have no voice there. Just my 2 cents. Link to comment Share on other sites More sharing options...
browndog Posted February 14, 2012 Share Posted February 14, 2012 Also, I feel it is outrageous that we have to recertify every 6 years. NP's don't even have to. Actually, we do (every 5 years), although it is a joke compared to what PAs must do to re-cert. It is essentially a rubber stamp re-cert for us. Link to comment Share on other sites More sharing options...
Febrifuge Posted February 14, 2012 Share Posted February 14, 2012 Over a year ago, when I was interviewing, I had a good series of interviews with a suburban ER. They were excited because the new hospital administrator had been head of the ER for years, and was a doc himself. There were a lot of smart, young, forward-thinking people in the group. And they were really proud of the plans they had for the midlevels; I remember one guy said, "you're Physician Assistants. We need to let you do more, and 'assist' us, more." It struck me that they thought this was a respectful and positive way to explain things. It turned out they were bravely planning on letting the PAs do more than just fast-track. It wasn't quite as progressive as they seemed to think; I was an EMT in an academic ER where PAs and staff were interchangable in terms of clinical duties. So for me, it's a pervasive lack of respect, usually well-meaning, based on fundamental lack of understanding of what we're capable of. Drives me nuts. And it's why I like Urgent Care, where my clinical duties and hourly pay are the same as they are for MDs who work the same job. Link to comment Share on other sites More sharing options...
L.K. Posted February 15, 2012 Share Posted February 15, 2012 I agree with febrifuge, but I work at an urgent care and have seen a tremendous shift from highly autonomous provider to a provider doing triage, patient phone calls, labs, etc. in the past year. Most of my colleagues have noticed a similar trend at their EDs and UCs. This change seems to be due to the admin wanting faster throughput times and high patient satisfaction, but MDs who are paid for production. This means I see most patients when it's extremely busy but not when it's just steady. I'm concerned about losing my skills and passion for the job if this continues. I may have to look for something more rural to gain a better scope of practice, but with a baby at home the commute is challenging. Risks vs. benefits and a glass of wine ;) Link to comment Share on other sites More sharing options...
bugmenot Posted February 19, 2012 Author Share Posted February 19, 2012 Thank you all for your responses! So far it seems PAs are pushed to work harder for less (respect and $$) :( Link to comment Share on other sites More sharing options...
KMD16 Posted February 20, 2012 Share Posted February 20, 2012 bug-us-not ! Link to comment Share on other sites More sharing options...
BruceBanner Posted February 23, 2012 Share Posted February 23, 2012 I cant offer any personal experience yet, but from a year of rotations I'd agree with Febrifuge and others. It seems largely practice-dependent. Some FP or IM clinics utilize PAs essentially like another doc who gets paid less and has no practice ownership. Hospitals, surgical subs seem to be different. A lot of PAs complain of being overused and under-compensated. I also notice a fair amount of disrespect, more so with the "good ol boy" type docs. To them we'll always be an assistant, a helper, or a paid apprentice. It's a bit daunting to be honest. You get into the field thinking it's going to be awesome, but the grass always seems greener on the other side. I think there are still tons of PAs who are satisfied with their jobs....they probably just arent taking the time to spread the gospel on the PA forums. Link to comment Share on other sites More sharing options...
Febrifuge Posted February 23, 2012 Share Posted February 23, 2012 Don't get too discouraged, Dr. Banner (awesome screenname btw). I love my job situation right now. If my employer wanted me to run things more like what L.K. is describing above, I'd consider quitting, but more likely all the providers would rise up and quash the idea together. I work for a great outfit. In the interviewing phase I mentioned earlier, I also spoke with a clinic inside a major retail chain. I didn't love the idea of having a store logo on my lab coat, but when they talked about "getting out of the clinic" and walking around the store, helping to increase awareness of the clinic, I think the look on my face was why they didn't call me back later on. Professionalism and the esteem the profession holds is, sometimes anyway, down to us and what we allow ourselves to expect. Don't settle if you don't have to -- and please be aware that you usually don't have to. Link to comment Share on other sites More sharing options...
qfwm2001 Posted March 26, 2012 Share Posted March 26, 2012 I have been working as a Physician Assistant for almost five years now and find that most of what is said about the business side of things is true. The employers of PAs want to turn a profit and will drive you to make it happen. This is to be expected. The biggest challenge to me is the constant explaining about what you actually do. Patients are confused at times about your role in their health care and it can be a grind to always be explaining yourself. I have a small blog about this very thing, Top 9 reasons to become a PA Link to comment Share on other sites More sharing options...
qfwm2001 Posted March 26, 2012 Share Posted March 26, 2012 I have been working as a Physician Assistant for almost five years now and find that most of what is said about the business side of things is true. The employers of PAs want to turn a profit and will drive you to make it happen. This is to be expected. The biggest challenge to me is the constant explaining about what you actually do. Patients are confused at times about your role in their health care and it can be a grind to always be explaining yourself. I have a small blog about this very thing, Top 9 reasons to become a PA Link to comment Share on other sites More sharing options...
Joelseff Posted March 26, 2012 Share Posted March 26, 2012 I have been working as a Physician Assistant for almost five years now and find that most of what is said about the business side of things is true. The employers of PAs want to turn a profit and will drive you to make it happen. This is to be expected. The biggest challenge to me is the constant explaining about what you actually do. Patients are confused at times about your role in their health care and it can be a grind to always be explaining yourself. I have a small blog about this very thing, Top 9 reasons to become a PA Enjoyed your blog. It shuld be stickied for all the pre-pa posts on the forum. Made me chuckle...lol great job Sent from my VEGAn-TAB using Tapatalk Link to comment Share on other sites More sharing options...
Joelseff Posted March 26, 2012 Share Posted March 26, 2012 I have been working as a Physician Assistant for almost five years now and find that most of what is said about the business side of things is true. The employers of PAs want to turn a profit and will drive you to make it happen. This is to be expected. The biggest challenge to me is the constant explaining about what you actually do. Patients are confused at times about your role in their health care and it can be a grind to always be explaining yourself. I have a small blog about this very thing, Top 9 reasons to become a PA Enjoyed your blog. It shuld be stickied for all the pre-pa posts on the forum. Made me chuckle...lol great job Sent from my VEGAn-TAB using Tapatalk Link to comment Share on other sites More sharing options...
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