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Hello,

I was wondering what everyone's thoughts/predictions are on the future of the PA profession. I know that the nursing market is oversaturated and more and more schools are popping up and pumping out newly minted RNs/NPs and charging absurdly high tuition. Supply seems to be exceeding demand, which is decreasing the value of RN/NP degrees. There is also a push for requiring NPs have doctorates. I'm wondering with the current PA trend, will we ever get to the point where the PA market is oversaturated? Any rules/regulations you foresee becoming an issue for PAs? Any changes in PA education? Any decrease in pay standards due to job competition? Any foreseeable clashing or merging amongst the PA, NP, and physician professions? It seems like an awesome time to be a PA right now, but what do you think it will be like 10 years from now?

Looking forward to hearing your opinions!

 

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You graduated PA school in 2013 and you're now a third year medical school student. So you hardly spent two years being a PA before jumping ship. How do you know that in ~3-5 years (if you were in pri

1.1To your first point, isn't that all residency is, supervision for a period of time? You don't have to be board certified to practice. I've known some physicians practicing who could NOT pass their

By the hckyplyr logic, only cardiologists should treat hypertension, only urologists should treat pyelo, only GYN should treat irregular menses, only endocrinologists should treat diabetes, only ENT s

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my standard response to this question is that good PAs/NPs will always have jobs and mediocre PAs/NPs won't regardless of the # of PAs/NPs out there. I'm not a fan of the trend in PA/NP education towards less emphasis on experience, more online coursework, and less patient interaction(more observation) on rotations.

After 21 years as a PA my long view is that we are headed for major changes:

transition to doctorate to keep up with NPs, more PA to md/do bridge programs, required postgrad training, loss of lateral mobility, AND increased testing requirements after completion of specialty training.

I am happy where I am now as a PA 21 years in, but if I had to do life over I would do a DO/MPH program with an emphasis in global health then do an em residency and an international em fellowship.

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I agree that good PAs will always have access to good work. By "good" I mean experienced, clean CV, clean record, good bedside manner, professional.

Regional saturation will increase and residencies will become standard. I think lateral mobility will go away as well.

The doctorate thing is tricky because of our title. We cant be doctors of doctor assisting. Im not sure how that will pan out. 

I think our scope could increase to the point of progressive independence in primary care, but not specialties.

Economically speaking we will always be midlevels...but well trained PAs will be better compensated. 

 

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I think independent practice (like NPs with vague "collaboration") is on the near horizon. Michigan basically just got it.

I like DMSc (Doctor of Medical Science) as a title for the degree ,not Dr of PA studies.

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We also need a name change in the next 10 years.

My vote would be Physician Associate to maintain the PA, but a better, albeit, harder name to accomplish would be Medical Practitioner. We practice the medical model, i.e. medical practitioner, and nurses practice the nursing model i.e. nurse practitioner. Just makes sense, and would go along with independence nicely.

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I think the future of the PA profession is extremely bright. Within the past 5 years, we have been in the top 10 in best jobs, best careers, best health careers, etc. etc. ranked by Forbes, money and banking, and numerous other articles. Our salaries have been rising steadily, and we are making progress toward improving scope of practice. Our profession is moving away from the "what is a PA?" to being truly part of a team health practice. At this rate, we are definitely headed for success. 

The people who view our profession as "stagnant" or "not making strides" are the ones who want to compare us to physicians so badly. Yes I do agree in having more autonomy and independent practice, but there is no rush in making it happen right away. Our pay, on average, is really great, but again, those who are disappointed are the ones who expect to get compensated as much as physicians. 

 

Be grateful for our profession. Work towards improving it. We have great prestige and compensation, but it may not seem so if we keep comparing ourselves to our colleagues. Be happy for what we were able to accomplish and what we still have yet to accomplish. 

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I think the future of the PA profession is only getting better. With the passing OTP (Optimal team practice) and the push of doctorate degrees,  sky is the limit. One very obvious problem that's holding us back is our title. I hope the AAPA will hold a special Task force along with a branding company to look at this issue ASAP. We have no time to waste.

I also support the Doctorate degrees for PA. I think OTP will put us on a par with the NPs in areas that won't hire PAs because of our restriction. The doctorate degree will make us "look" equal to other members of the health care team because everyone else is a "Doctor" now. Yes, I do know it is a degree creep, but we have to play the game

4 hours ago, EMEDPA said:

I agree and am a fan of something that maintains the PA initials:

physician associate

practitioner associate

practitioner allopathic

physician alternative :)

I used to support Physician "Associate" but I realized that title is just as confusing. I don't want to be confused with the physicians and I am sure the AMA would also agree with that. We need a name that can stand alone. I suggest Medical Practitioner. That can go along with the Doctorate degrees nicely: John Doe, Medical practitioner, DMS or Dr. John Doe, Medical practitioner, DMS.  We are not  "Doctor Assistant". That just sounds radiculous. It is also very easy for the public to understand what a Medical Practitioner does... They practice medicine, period. You won't need a brochure to explain that.

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There was a post recently on Reddit Medicine about tension between midlevels and docs, written by a doc. I think our community here has a large selection bias for progressive PAs---it was amazing to me how many of the PAs in the comment section were NOT for PA independence. The docs responding were almost unilaterally critical of PA training and felt our roles should never exceed the 'midlevel'.

That's the prevailing attitude of most docs in my experience. Below was my post, and it got down-voted so fast it wasn't even visible.

 

Quote

 

PA here. When i read this i hear "PAs are great. You make my day easier. You provide great care under physician supervision. But you need to remain assistants."

This is the same refrain ive been hearing from physicians since i was a pre med. I will agree that these comparative provider vs. provider studies are almost all flawed, and essentially were designed to highlight a pre-formed conclusion; e.g. "we are just as good as you", whatever that means.

As a profession we are moving closer and closer to un-tethering ourselves from physician dependency. We really dont want to supplant docs, we just dont think direct physician oversight is necessary for the duration of an entire career. The big problem is this is very hard to standardize, and our professional organizations (particularly the NCCPA) often make unilateral lobbying decisions without ANY input from the PA population at large.

IMHO, I think specialty PAs should always be part of a physician-led team. However, I see no reason why Primary Care PAs cannot hang their own shingle after a period of time. I think five years of verified full-time practice with peer references is a reasonable time frame. Full practice authority but also full practice responsibility. There should be zero physician liability, and probably some sort of competency exam comparable to the FM boards.

At the very least there should be a sane bridge program for experienced PAs, not the med school -1 year we have now.

 

 

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Funny you should mention this - the fellow who is the program director at the university here is old school American trained and is dyed in the Kool Aid regarding independent practice of any kind.  I helped with OSCE's one year and was amazed at how dependant the students were on their CP/SP's when it came to taking a simple problem and writing a simple Rx for the scenario I was proctoring.  I graded everyone but 3 the same way - basically a D simply because they came up the Dx, but wouldn't commit to a treatment plan - "I'd have to consult my SP".

 

$0.02 Cdn

 

SK

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we are fine

 

they sky is not falling

 

our numbers are still tiny compared to the doc's and we are filling their slots.... so lots of room to grow - this and the baby boomer generation yields lots of ongoing growth

 

We should have terminal doctorate

 

we need to be responsible for our own - no more doc involvement...

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I'm against the doctorate option unless it automatically comes with a significant increase in salary and responsibility. Why should I keep going to school and go further into debt for the same job I could get with a masters? This political shenanigans is just going to make it worse. What's next? Post-docs?

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On ‎7‎/‎15‎/‎2017 at 10:39 PM, EMEDPA said:

I agree and am a fan of something that maintains the PA initials:

physician associate

practitioner associate

practitioner allopathic

physician alternative :)

physician alternative! haha that's something.

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On 7/15/2017 at 3:07 PM, medbunny said:

Hello,

I was wondering what everyone's thoughts/predictions are on the future of the PA profession. I know that the nursing market is oversaturated and more and more schools are popping up and pumping out newly minted RNs/NPs and charging absurdly high tuition. Supply seems to be exceeding demand, which is decreasing the value of RN/NP degrees. There is also a push for requiring NPs have doctorates. I'm wondering with the current PA trend, will we ever get to the point where the PA market is oversaturated? Any rules/regulations you foresee becoming an issue for PAs? Any changes in PA education? Any decrease in pay standards due to job competition? Any foreseeable clashing or merging amongst the PA, NP, and physician professions? It seems like an awesome time to be a PA right now, but what do you think it will be like 10 years from now?

Looking forward to hearing your opinions!

 

I think there are too many PA schools popping up and saturation is already an issue in many regions. PAs accept bad jobs (underpaid, skut monkey work) because of saturation in some areas. It took me couple months to find the type of job and pay I wanted. I drive 30-60min out of the city I live in, because its getting saturated. I couldnt find an ER job with the autonomy and pay I wanted where I live.  I'm sure this issue will spread. Kind of wish they could put a cap on the amount of schools opening..lol

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On ‎7‎/‎15‎/‎2017 at 10:39 PM, EMEDPA said:

I agree and am a fan of something that maintains the PA initials:

physician associate

practitioner associate

practitioner allopathic

physician alternative :)

This was posted on PA FB page and can be another possibility keeping the PA initials haha!

 

 

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58 minutes ago, dizzyjon said:

This was posted on PA FB page and can be another possibility keeping the PA initials haha!

 

 

image1.JPG

Yikes. I want to assume that her name tag is a typo. There is nothing in the title "Position Assistant" that even remotely leads me to believe that this person works in medicine. Lol, I'll keep "Physician Assistant" in this case.

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57 minutes ago, NikkiO said:

Yikes. I want to assume that her name tag is a typo. There is nothing in the title "Position Assistant" that even remotely leads me to believe that this person works in medicine. Lol, I'll keep "Physician Assistant" in this case.

Sounds like a yoga coach...or sex therapist.

SK

 

 

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On 7/16/2017 at 5:22 PM, ventana said:

we are fine

 

they sky is not falling

 

our numbers are still tiny compared to the doc's and we are filling their slots.... so lots of room to grow - this and the baby boomer generation yields lots of ongoing growth

 

We should have terminal doctorate

 

we need to be responsible for our own - no more doc involvement...

I agree with this post except for "no more doc involvement." This would just be unsafe, as it's unsafe when NPs practice independently.  If you want to be a physician, get paid like a physician and get the benefits of a physician, go to medical school. Plain and simple. But, just like our society, people want to take an easier route but still get the same benefits as others who took a harder route. I read your post about PAs should make physician salaries in primary care because "we do the same thing." Does a pharm tech in retail do the EXACT same job as the pharmacist? Yes, they do. Does that mean they should be paid a pharmacists wage, no it doesn't. I understand the argument you're trying to make, but I certainly don't agree with it. 

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6 minutes ago, Hckyplyr said:

I agree with this post except for "no more doc involvement." This would just be unsafe, as it's unsafe when NPs practice independently.  If you want to be a physician, get paid like a physician and get the benefits of a physician, go to medical school. Plain and simple. But, just like our society, people want to take an easier route but still get the same benefits as others who took a harder route. I read your post about PAs should make physician salaries in primary care because "we do the same thing." Does a pharm tech in retail do the EXACT same job as the pharmacist? Yes, they do. Does that mean they should be paid a pharmacists wage, no it doesn't. I understand the argument you're trying to make, but I certainly don't agree with it. 

You're one of the PAs who then decided to go to medical school if I remember correctly. Just purely out of curiosity, if you were not in med school now, would you still disagree?

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15 minutes ago, Hckyplyr said:

I agree with this post except for "no more doc involvement." This would just be unsafe, as it's unsafe when NPs practice independently.  If you want to be a physician, get paid like a physician and get the benefits of a physician, go to medical school. Plain and simple. But, just like our society, people want to take an easier route but still get the same benefits as others who took a harder route. I read your post about PAs should make physician salaries in primary care because "we do the same thing." Does a pharm tech in retail do the EXACT same job as the pharmacist? Yes, they do. Does that mean they should be paid a pharmacists wage, no it doesn't. I understand the argument you're trying to make, but I certainly don't agree with it. 

Uhh....literature to back safety issues with NP independent practice?  As a new grad and based on the individual, yes it is unsafe to be 100% on your own.  However, after time in practice and agreement by a collaborative physician (or even one day experienced peer PA) then independence can be completely safe.  We don't want to be physicians.  We want to work to our fullest extent possible.  I think our salary should be at about 80% of a physician salary in certain specialties (like FP) because that is what makes sense to me when we can't bill at 100% in some cases.  They get paid more because of extensive schooling, higher degree, higher reimbursement.  That will always be the case. 

I highly disagree that a pharm tech and a pharmacist do the same thing.  This is completely inaccurate and the complex pharmaceutical knowledge a pharmacist has is above and beyond what a pharm tech has.  You can become a pharm tech without stepping into a classroom in some states. 

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