Future of PA

[camoman1234]

Boat: There are a lot of studies that suck, but are still being used for EBM...I have not read every single study about PAs/NPs, but as a whole that are not that "sucky"...it is a very hard topic to study and get statistics on as there are numerous variables... 

[aimyhtixela]

1 hour ago, Boatswain2PA said:

How about some personal and professional respect for a fellow PA, especially one who is med school.  Your attitude toward him is demeaning and (should be) unacceptable on these boards.

No offense Boats but I have seen you argue here with other PAs in what crosses the line of demeaning and unprofessional (esp. when arguments become political) but users here are not crying foul. A point is being made here that his counterargument is "your statements are asinine" and "I'm better than all of you just wait and see." If that is not arrogance then I don't know what is. 

I meant it when I wished him the best of luck. His PA training and education didn't teach him enough medicine by his admission but I would at least hope that it taught him some humility. That said, I suppose it's time for me to step out of this conversation. Namaste. 

[Ollivander]

3 hours ago, Hckyplyr said:

  You're right everyone. Hell, I don't even know why medical school exists, because anything not taught in PA school is useless and a waste of time. Who would know better than the PAs here,  who never went to medical school and saw the difference for themselves. They should definitely close all med schools, and just give independent practice rights to PAs and NPs to handle everything, the "studies" prove that its safe after all. I think its crazy that a physician who went through a more grueling education, boards and residency could even think they would be a better provider. Those physicians are so delusional. 

  Its pointless for me to continue to debate and respond to some of these asinine statements, I'm comforted in knowing that no matter how much you think you deserve the same practice rights and benefits, it just ain't gunna happen. Even if it did happen for some crazy reason, patients would still choose to see the physician 9/10 times. I always said that when I'm a physician I'd hire a PA any day over a NP, because I'm one myself and I know what we have to go through compared to NP school, but after this thread and seeing how many are in complete denial and can't even admit a residency trained physician is a superior clinician (in most cases, because this board has some great PAs), I'm really reconsidering that thought. 

You shouldn't judge an entire profession based on a limited group of people on an internet forum. I believe fully that docs should have superior practice rights, compensation, etc. However, I don't agree with having to re-certify every 10 years as a PA. I also believe PAs should stay on the same level as NPs as far as practice rights are concerned. If they can practice independently, so should PAs. I totally get where your mindset is coming from, but you've got to meet us halfway. Some users here are just bitter they do the same thing every day as their SP and are paid a third of the salary. That's the downside of foregoing medical school in favor of PA school though. You get out what you put in. Again though, you've got to agree that if NPs are going to be able to practice independently, so should PAs. Despite if you think neither should. If one gets to, they both should.

[LT_Oneal_PAC]

4 hours ago, Hckyplyr said:

  You're right everyone. Hell, I don't even know why medical school exists, because anything not taught in PA school is useless and a waste of time. Who would know better than the PAs here,  who never went to medical school and saw the difference for themselves. They should definitely close all med schools, and just give independent practice rights to PAs and NPs to handle everything, the "studies" prove that its safe after all. I think its crazy that a physician who went through a more grueling education, boards and residency could even think they would be a better provider. Those physicians are so delusional. 

  Its pointless for me to continue to debate and respond to some of these asinine statements, I'm comforted in knowing that no matter how much you think you deserve the same practice rights and benefits, it just ain't gunna happen. Even if it did happen for some crazy reason, patients would still choose to see the physician 9/10 times. I always said that when I'm a physician I'd hire a PA any day over a NP, because I'm one myself and I know what we have to go through compared to NP school, but after this thread and seeing how many are in complete denial and can't even admit a residency trained physician is a superior clinician (in most cases, because this board has some great PAs), I'm really reconsidering that thought. 

An honest question: do you think you'll be as good as a physician of 10 years experience when you graduate residency?

[Boatswain2PA]

2 hours ago, aimyhtixela said:

No offense Boats but I have seen you argue here with other PAs in what crosses the line of demeaning and unprofessional (esp. when arguments become political) but users here are not crying foul. A point is being made here that his counterargument is "your statements are asinine" and "I'm better than all of you just wait and see." If that is not arrogance then I don't know what is. 

I meant it when I wished him the best of luck. His PA training and education didn't teach him enough medicine by his admission but I would at least hope that it taught him some humility. That said, I suppose it's time for me to step out of this conversation. Namaste. 

I have never intended to demean another PA here, nor have I been unprofessional.   It is diffiicult getting ones disagreements across on an online forum without sometimes coming across wrong.  Just seemed like lots of people were getting personal with him.

[Boatswain2PA]

3 hours ago, camoman1234 said:

Boat: There are a lot of studies that suck, but are still being used for EBM...I have not read every single study about PAs/NPs, but as a whole that are not that "sucky"...it is a very hard topic to study and get statistics on as there are numerous variables... 

I haven't seen one yet that wasn't terribly biased or poorly constructed.  Most were done entirely by nurses.

[Ollivander]

On 7/21/2017 at 5:05 PM, LT_Oneal_PAC said:

An honest question: do you think you'll be as good as a physician of 10 years experience when you graduate residency?

As a physician? Did you mean to say physician assistant?

A new attendee physician isn't going to be as good as a physician with 10 years experience period.

[LT_Oneal_PAC]

9 hours ago, Ollivander said:

As a physician? Did you mean to say physician assistant?

A new attendee physician isn't going to be as good as a physician with 10 years experience period.

No, I meant a physician. It's a logical progression. Assuming he agrees with you, the next questions are: Why is he better without formalized training? Why doesn't that same logic apply to a PA? Why isn't the more experienced attending supvervising the new one?

Before you try to get into it with me, do you think that a PA shouldn't be able to give so much as a flu shot without a physician? Do you think that PAs aren't good enough to have any scope of practice, from reading a blood pressure to treating an ingrown toenail without a physician?

[Hckyplyr]

On 7/21/2017 at 2:29 PM, wdtpac said:

Hckyplyr,

I'm not sure there is an argument that a new graduate PA is on par or superior to a residency trained physician in FP; you will get no argument from me.  I will however, contest a seasoned PA reaches that point with experience and time.  My first 6 years in practice I worked 40+ per week in a clinic setting, 4-5 inpatient, and 15-30 moonlighting in the ER (not fast track).  During that time, my learning curve was about as steep as one could imagine, and I remained dedicated to the mantra of life long learning and self education.  So, do I think my clinic skill set is equal to a family practice physician after 13 years?  You better believe it, and so do the 2 physicians that I employ at my clinics (yes I am the owner, 4 RHC's) as well as the other physicians that work with me in our communities.  The real problem that exists in my opinion, is the path for a PA to achieve that level of competence is not standardized and that is something we as a profession need to focus on for the next 10 years.  What the answer is to that, I do not know.  A formalized residency program just for PAs that awards a doctoral degree? Bridge program that truly gives credit for previous educational experience?  Build OTP through the states that allows a path, at the practice level, to which one is practicing autonomously?????

Not that your opinions are not valued here, they are, and you make some good points.  I just feel that given your situation and current station, the majority are truly biased for the most part.

I value your years of experience and contribution to the post. Although, the path to independent practice and a clinical doctorate has always been medical school/residency. The standard should always remain the same to be granted that. Not three difference pathways to a doctorate/independence, all of varying time, knowledge requirements/difficulty. If it was that way, why would anyone take the longer/harder route (medical school/residency)

On 7/21/2017 at 2:55 PM, Boatswain2PA said:

Not sure if I'm just reading this wrong, but how about we have some personal/professional respect here.  Hockey is a PA, and in med school.  

The studies suck.  Enough said.

Hcky - you're on a PA board which comes with its inherent bias'.  I think I read something the other day that the majority of PAs don't agree with independent practice, but can't remember where I read that.  

When you're the doc, hire the PA over the NP.  You know the training is much, much better.

That being said, there are a lot of good arguments made here for expanded scope of practice/reduction of stupid bureaucratic hurdles for PA practice.  

How about some personal and professional respect for a fellow PA, especially one who is med school.  Your attitude toward him is demeaning and (should be) unacceptable on these boards.

We are all biased, including the posters who ridicule those of us who are against independent practice.

Hcky - I agree with you.  Want to be a nurse?  Go to nursing school.  Want to be a PA?  Go to PA school.  Want to have a license to practice medicine independently?  Go to medical school. 

We all knew what a PA was when we submitted our program applications.  While I agree we need to remove unnecessary regulatory burdens, I think EVERY patient deserves to have a BC physician somehow involved in their care ("involved in their care" could include knowing they were seen by a PA whom the BC physician personally knows is competent).

Much appreciated Boats. Many of the comments weren't professional and started becoming more of attacks, which I won't even waste time responding to. Completely agree, everyone knew what they were signing up for, but now they want more without having to go the route thats been established since the beginning of medicine. 

On 7/21/2017 at 5:11 PM, Ollivander said:

You shouldn't judge an entire profession based on a limited group of people on an internet forum. I believe fully that docs should have superior practice rights, compensation, etc. However, I don't agree with having to re-certify every 10 years as a PA. I also believe PAs should stay on the same level as NPs as far as practice rights are concerned. If they can practice independently, so should PAs. I totally get where your mindset is coming from, but you've got to meet us halfway. Some users here are just bitter they do the same thing every day as their SP and are paid a third of the salary. That's the downside of foregoing medical school in favor of PA school though. You get out what you put in. Again though, you've got to agree that if NPs are going to be able to practice independently, so should PAs. Despite if you think neither should. If one gets to, they both should.

I agree, although I think neither PAs or NPs should be independent, I certainly don't think NPs should be independent and leave PAs in the dust. PA>>>>NP education and training, if anything it should be the other way around, unfortunately for all the reasons we already know, this train has left the station. 

3 hours ago, LT_Oneal_PAC said:

No, I meant a physician. It's a logical progression. Assuming he agrees with you, the next questions are: Why is he better without formalized training? Why doesn't that same logic apply to a PA? Why isn't the more experienced attending supvervising the new one?

Before you try to get into it with me, do you think that a PA shouldn't be able to give so much as a flu shot without a physician? Do you think that PAs aren't good enough to have any scope of practice, from reading a blood pressure to treating an ingrown toenail without a physician?

-So as a PA gets more knowledge and experience over the years of practice, a physician remains stagnant and doesn't grow either? So you're saying the PA catches up?

-When do you think PAs should be granted independent practice? Just randomly given rights after X amount of years of practice? No standardization? Again, the path to independent practice rights should remain the same, not three different paths, all of varying difficulty. 

[Acebecker]

Hockey, 

I don't know that leaving the practice of medicine the way that it has been since "the beginning of medicine" is the best approach.  There are barriers to medical school that prohibit enough people from going that we have had longstanding shortages of MDs and DOs for decades.  If it weren't for the advent of PAs and NPs, the lack of access to care would be markedly worse than it currently is.  Would you agree?  But if we shouldn't make changes to the practice of medicine since "the beginning of medicine" then we should not have ever started the NP or PA experiment. 

The argument now is that medicine continues to change and that regulations specifically placed on PAs restrict our ability to help patients to the fullest extent possible based on our training.  I find this to be the case when I cannot get procedures ordered for patients who need them without a doc's co-signature.  It's dumb, but I cannot give a liter of IV fluid to a patient through our outpatient clinic without someone (who has never seen the patient) signing their name next to mine.  If I can't find the doc, then the Pt doesn't get the treatment.  That is not good access to care.  I can always send the Pt to the ED, but now we have increased the cost for the same treatment (exponentially, I might add). 

Are you one of those folks who believes that PAs should have a doc on site in order to practice?  If you think that independent practice is a bad idea, where then do you draw the line?  I'm asking this as an honest question and not to be flippant at all.  I think having conversations with PAs-turned-MDs is important.  You have the potential to be our greatest advocate. 

I have often thought of giving up on this experiment and going to medical school because I do value the idea of having residency.  Residency would have been a great resource for learning procedures and treating really sick patients.  I would have seen much more by the 3 year mark than I had seen.  That said, I've now been in practice for 6 years and have seen much sicker patients than some of our newly minted attendings have seen.  I think that is the argument - PAs with experience are very comparable to newly minted attendings.  If attendings can practice independently, then why can't PAs who have experience?  I see no reason why we should not have PANCE step 2 - a standardized exam, the passage of which would allow us independence akin to the newly minted attendings (restricted to primary care specialties is most reasonable).  This plus the endorsement of 3 MDs, perhaps?  My goal is not to have the same status as MDs; I will always respect the training of my attendings - school is hard, residency is hard.  But when they are asking me for help I have to wonder why I need them to co-sign my orders. 

Does that help to clarify the conundrum?  I would in no way endorse independent practice for a newly minted PA (even though this essentially already happens).  But independent practice for a PA with 6 years of experience in a primary care field?  I don't see why that PA should continue to be unable to order certain treatments without MDs co-signature (this is the real restriction that I face).  This restriction impedes access to care which is what the whole experiment has been about in the first place. 

I really hope to have a dialogue on this, peer-to-peer. 

[LT_Oneal_PAC]

7 hours ago, Hckyplyr said:

I value your years of experience and contribution to the post. Although, the path to independent practice and a clinical doctorate has always been medical school/residency. The standard should always remain the same to be granted that. Not three difference pathways to a doctorate/independence, all of varying time, knowledge requirements/difficulty. If it was that way, why would anyone take the longer/harder route (medical school/residency)

Much appreciated Boats. Many of the comments weren't professional and started becoming more of attacks, which I won't even waste time responding to. Completely agree, everyone knew what they were signing up for, but now they want more without having to go the route thats been established since the beginning of medicine. 

I agree, although I think neither PAs or NPs should be independent, I certainly don't think NPs should be independent and leave PAs in the dust. PA>>>>NP education and training, if anything it should be the other way around, unfortunately for all the reasons we already know, this train has left the station. 

-So as a PA gets more knowledge and experience over the years of practice, a physician remains stagnant and doesn't grow either? So you're saying the PA catches up?

-When do you think PAs should be granted independent practice? Just randomly given rights after X amount of years of practice? No standardization? Again, the path to independent practice rights should remain the same, not three different paths, all of varying difficulty. 

I'm saying that an experienced PA that is allowed to practice at the top of their license catches up to an attending fresh out of residency, certainly for PAs that complete a residency themselves, just like that new attending will catch up with his mentor. I think we can both agree that as experience is a curve as well. The knowledge and skills gained early on are much more substantial and steep than later.

I personally believe it should be an examination after a certain amount of time with documentation of caring for x number of patients with x diagnosis and performing x procedures in practice. But since so many are saying "no not at all," instead of trying to shape it, it will turn out however it does. Honestly I wish we could challenge the step one, two, and three and allowed admittance into residency for independent practice rights. Again, keep the money and the title doctor. They let IMGs, who probably had an easier Med school than we have a PA school, do this.

I think you have a very linear and closed mind set. Just because something is more difficult doesn't mean it's better, or because of diminishing returns it's insignificantly better. Other wise we should expect all our physicians to also be pharmDs, biochemists, nurses on top of their education.

[DizzyJ]

12 hours ago, Acebecker said:

Hockey, 

I don't know that leaving the practice of medicine the way that it has been since "the beginning of medicine" is the best approach.  There are barriers to medical school that prohibit enough people from going that we have had longstanding shortages of MDs and DOs for decades.  If it weren't for the advent of PAs and NPs, the lack of access to care would be markedly worse than it currently is.  Would you agree?  But if we shouldn't make changes to the practice of medicine since "the beginning of medicine" then we should not have ever started the NP or PA experiment. 

The argument now is that medicine continues to change and that regulations specifically placed on PAs restrict our ability to help patients to the fullest extent possible based on our training.  I find this to be the case when I cannot get procedures ordered for patients who need them without a doc's co-signature.  It's dumb, but I cannot give a liter of IV fluid to a patient through our outpatient clinic without someone (who has never seen the patient) signing their name next to mine.  If I can't find the doc, then the Pt doesn't get the treatment.  That is not good access to care.  I can always send the Pt to the ED, but now we have increased the cost for the same treatment (exponentially, I might add). 

Are you one of those folks who believes that PAs should have a doc on site in order to practice?  If you think that independent practice is a bad idea, where then do you draw the line?  I'm asking this as an honest question and not to be flippant at all.  I think having conversations with PAs-turned-MDs is important.  You have the potential to be our greatest advocate. 

I have often thought of giving up on this experiment and going to medical school because I do value the idea of having residency.  Residency would have been a great resource for learning procedures and treating really sick patients.  I would have seen much more by the 3 year mark than I had seen.  That said, I've now been in practice for 6 years and have seen much sicker patients than some of our newly minted attendings have seen.  I think that is the argument - PAs with experience are very comparable to newly minted attendings.  If attendings can practice independently, then why can't PAs who have experience?  I see no reason why we should not have PANCE step 2 - a standardized exam, the passage of which would allow us independence akin to the newly minted attendings (restricted to primary care specialties is most reasonable).  This plus the endorsement of 3 MDs, perhaps?  My goal is not to have the same status as MDs; I will always respect the training of my attendings - school is hard, residency is hard.  But when they are asking me for help I have to wonder why I need them to co-sign my orders. 

Does that help to clarify the conundrum?  I would in no way endorse independent practice for a newly minted PA (even though this essentially already happens).  But independent practice for a PA with 6 years of experience in a primary care field?  I don't see why that PA should continue to be unable to order certain treatments without MDs co-signature (this is the real restriction that I face).  This restriction impedes access to care which is what the whole experiment has been about in the first place. 

I really hope to have a dialogue on this, peer-to-peer. 

kudos...people don't like change, but change happens.  Well written post and I hope for a positive dialogue in return. 

[BruceBanner]

This thread took an interesting turn.

There is an inherent amount of "med school dogma" always present in these discussions...it's almost akin to arguing politics.

I think if physicians, residents, med students could remove their arrogance dogmatic lenses they would see that times are changing and so is the way we credential professionals. PAs do not want to be physicians in all but title. We dont need the status of a terminal degree. That's not the direction we are trying to steer things, but unfortunately that's how the physician side of the fence sees our aims.

The way I see it---and I think most other progressive PAs---is that it is not only unnecessary but also restrictive for us to be tethered to mandatory physician supervision for the duration of an entire career. Docs are very protective and proud of their pathway, and they see this as an encroachment or backdoor approach to doctorhood.

As Ace highlighted, the restrictions placed on us eventually become prohibitive to actions and care within our scope, and it doesn't do patients nor the medical team as a whole any favors. Docs will always decry the lack of studies "proving" this, but I ask you how could this possibly be proven without bias? If someone has a design in mind I'm all ears, but we (PAs) feel our argument is rational and stands on it's own. And that is a vetted, appropriately-experienced PA within the primary care spectrum should be able to operate without mandatory physician supervision and co-signature after passing a standardized board-type exam. You could almost look at it like indentured servitude. We've paid our dues, we've demonstrated safe practice and been vetted by our peers, and we've challenged and passed the board exam your profession deems the gold standard of competency. I'm not sure why a doc would even care at that point, because we would no longer be their problem! Full practice authority but also full practice responsibility.

And as the cherry on top, we are campaigning for independence in an area of medicine that fewer and fewer docs even want to be part of anymore.

I totally understand why physicians are so protective of their pathway. I just think the dogma of med school tradition is clouding their view of this issue.

"That's the way it's always been done" is a statement, but never a logical argument.

 

[HemeOncPA19]

Very interesting topic here. I am currently in my first year of PA school and we had a discussion about this practice authority change (We are all still pretty confused about it). I applied to PA school, and even though my name tag will say PA-C and not MD, my goal and my focus will be exactly the same. I will always strive to improve access to healthcare, improve patient outcomes, and provide the best level of care that I can, with my team, whether my team is an assigned supervisory physician, or my friend down the hall who happens to be an MD or a 30 year PA or even a 2 year PA or NP. Point is, I think it is fantastic that the PA scope is always adapting. I think its great that with the change in scope, compensation may increase to match. But that is not what the profession is all about- it is not about taking 2 years of school, working a bit and then deciding it is equivalent to that of medical school. (Granted, many many parallels and some PAs are much smarter than MDs). How would we all feel if medical assistants took a year of college courses akin to our didactic year, started seeing patients on their own, and decided they wanted to be paid the same? I think the tables would turn just a bit. I was a special operations combat medic with a college degree in medical lab science and years as an EMT. SOCMs completed the first phase of 18D school (7 of 12 months) and graduated (also note: no SERE, language, RS, Selection etc, but had multiple tours, and other medical training schools such as JECC and others). I served as an 18D-DMOS while in Afghanistan, but at the end of the tour, all the 18Ds received BSMs regardless of their experience during the tour. I received my 5th ARCOM. I did the same job, I had the same medical skills, but I had a different group of letters after my name and thus I was compensated differently. Was it fair? Probably not. However, I did my job, I did my duty, and all my patients made it home. That is all that matters to me. I filled the gap and because of it more teams had adequate medical coverage. That is the role of the PA. Increase access to care, not replace the MD. I am proud to be a PA-S and soon, PA-C. 

[sas5814]

I had a 4 days weekend and this thread took an interesting turn. End point for most is a somewhat dogmatic belief with not a lot of budge. When I ask "where is the data" and get back "I know they are dangerous" then I know I am pushing back against an inherent hubris that will not bend. It has been that was since time immemorial.

The "magic" in all of this is facts... data...measurable outcomes not personal opinions which as we all know are like.....belly buttons...everyone has one. Personally I am weary of being hobbled by the personal opinions of a small group. recently here in Texas the nurse board decided NPs couldn't give verbal orders to a MA. I don't know why... I believe it is job protection for LVNs more than anything but that is just speculation. Some nurse manager in our organization decided that since it applies to NPs and PAs and NPs are "the same thing" (she actually wrote that in an email) it applies to us as well.Someone (and nobody can or will tell me who) decided it was a patient safety issue. I have been fighting this stupidity now for 4 months and it currently sits on the desk of our physician/CEO who will discuss it with the system CNO. *sigh* So many questions about why something this simple has taken this long or been elevated to this level.

Point being... data and outcomes.  Personal opinions about scope of practice issues are worth the paper they are written on.

We are not physicians. Independent practice is not our goal. Eliminating unnecessary barriers to care and unneeded practice restrictions is. 

[wdtpac]

https://www.ncbi.nlm.nih.gov/m/pubmed/27798540/

[sas5814]

WD I have a stack of these kinds of studies in my "lobbying" file somewhere. Piles of data showing similar outcomes in a variety of different circumstances and yet I hear physicians talk about how "flawed" they are without being able to demonstrate from the methods and data how or why. 

It is a bit of a paradox to me. It seems the highly trained highly skilled confident physician should just laugh us off because we are buffoons and posers...but they can't so things often devolve into anger and name calling and hysteria ( they are dangerous! People are gonna die!). When that doesn't work they circle back to "patient safety" but when asked for measurable data points it goes to opinion....and the circle continues eternally.

If everyone would take the emotion out of it (and money and control and power) and really look at getting the most medical bang for the buck it would all come down to everyone working at the top of their skill set. When I was on a hospital board of directors (chair of credentials for the board among other things) there was a big to-do about podiatrists operating on ankles. The orthos didn't want it. (see above hysteria) I asked the chair podiatry about training, procedures, verification of skills, and continuing proof of their ability I got measured verifiable answers. When I asked the ortho chief for data about lack of safety I got hysteria and anger. Case closed.

[2wheels]

Bottom line: the future is bright. Maybe some regional saturation in some places but overall there's plenty of work to be done whether you're a PA/NP/MD/DO. The ACA isn't goin anywhere for the foreseeable future which means more folks with Medicaid dealing out the same peanuts for reimbursement and cost effectiveness in primary care will be king. Removing some of the arbitrary limitations on our profession will not bring about a mass genocide of patients, only increase access to quality care. 

[sillycibin]

On 7/15/2017 at 10:24 PM, EMEDPA said:

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.

Sorry but Michigan is just another disappointing illusion of independent practice just like the West Virginia law that was under consideration and the mess that is "optimal team practice."  OTP is an attempt to make PAs more palatable to doctors and hospitals in states where NPs have independent practice by reducing paperwork and attempting to shift liability, but it does not get us anywhere near independent practice.  Here is some info on the Michigan law which is just the annoying shell game with verbage:

Q. Does the new law remove the terms "supervision" and "delegation"?

Yes.  PAs in Michigan are no longer required to work under supervision or delegation of a physician according to the new law.  PAs will now be required to work with a "participating physician" according to the terms in a "practice agreement."

Q. Can a PA practice without a physician?

No.  The new law continues to support the PA and physician team.  PAs will now be required to work with a "participating physician" according to the terms in a "practice agreement."

 

[Ollivander]

On 7/29/2017 at 0:30 PM, 2wheels said:

Bottom line: the future is bright. Maybe some regional saturation in some places but overall there's plenty of work to be done whether you're a PA/NP/MD/DO. The ACA isn't goin anywhere for the foreseeable future which means more folks with Medicaid dealing out the same peanuts for reimbursement and cost effectiveness in primary care will be king. Removing some of the arbitrary limitations on our profession will not bring about a mass genocide of patients, only increase access to quality care. 

Think it's possible to move to an area of need and pull significantly more than those in saturated areas? I know this is the case in several other healthcare professions.

[EMEDPA]

13 minutes ago, Ollivander said:

Think it's possible to move to an area of need and pull significantly more than those in saturated areas? I know this is the case in several other healthcare professions.

yup. that is all 3 of my current positions. I am making $20/hr more working rural seeing 12 pts in 24 hrs  than at a busy inner city trauma center seeing 30 pts in 12 hrs.

[Ollivander]

1 hour ago, EMEDPA said:

yup. that is all 3 of my current positions. I am making $20/hr more working rural seeing 12 pts in 24 hrs  than at a busy inner city trauma center seeing 30 pts in 12 hrs.

I realize I'm still in the process of applying to PA school, but how would I actually go about finding these jobs when the time comes? I've been scouting out Indeed, EMCare, and other places but can't really find the rural jobs that offer better pay to offset the undesirable locations. Any recs on how to find them other than just word of mouth?

[Boatswain2PA]

On 7/25/2017 at 7:56 AM, sas5814 said:

We are not physicians. Independent practice is not our goal. Eliminating unnecessary barriers to care and unneeded practice restrictions is. 

Unfortunately there is a growing number of vocal PAs who DO have the goal of independent practice.  AAPA's push for independent PA licensure boards is an example of this.  

We practice medicine.  We should be under board of medicine.  

[Boatswain2PA]

On 8/4/2017 at 10:32 PM, Ollivander said:

I realize I'm still in the process of applying to PA school, but how would I actually go about finding these jobs when the time comes? I've been scouting out Indeed, EMCare, and other places but can't really find the rural jobs that offer better pay to offset the undesirable locations. Any recs on how to find them other than just word of mouth?

Find the areas of low population, and even lower physician density.  This will be places where most people don't want to live.  

Want to live in rural ozarks?  High plains?  Alaska?  Northern New England (not New York, but northern Maine)?  You can make a lot more because they can't get providers.

[MCHAD]

On 8/4/2017 at 9:32 PM, Ollivander said:

I realize I'm still in the process of applying to PA school, but how would I actually go about finding these jobs when the time comes? I've been scouting out Indeed, EMCare, and other places but can't really find the rural jobs that offer better pay to offset the undesirable locations. Any recs on how to find them other than just word of mouth?

3rnet.org is a decent resource for jobs in rural areas. You list the states you're interested in when you create your profile and then potential employers in those states can contact you regarding openings.  You can also just search job postings  just like monster.com or healthecareers.com

most rural areas with good administrators understand the challenge of getting providers to the area and the pay is better from what I've seen.  I currently work in rural Idaho (just moving there after living away from my family in Utah 13 days a month) and make more than I would working in Boise or Idaho Falls.  

You also have to look at the states you're interested in to see if even though it's rural it's a very desireable place to live.  We are leaving Utah for lots of reasons, one of them being that even though a lot of Utah is rural, it's a state that a lot of people just want to live in so pay for PA's (and other professions) sucks because enough people want to be here they accept lower salaries to live where they want (I've actually seen job postings for PA/NP stating starting wage at $33/hour).