Endeavor Posted August 16, 2017 Share Posted August 16, 2017 Hey guys, What are some of the best states to practice as a PA? I'm thinking in terms of job market, saturation, pay compared to cost of living, level of autonomy and states PA legislative authority.. I know a similar question has been asked a couple years ago but I thought I might ask again since new laws have been passed and many schools are opening up, thanks! Link to comment Share on other sites More sharing options...
PharmD Posted August 16, 2017 Share Posted August 16, 2017 Great question, working on going a PA school and would love to read responses from others. Thank you. Link to comment Share on other sites More sharing options...
lancer_dancer01 Posted August 16, 2017 Share Posted August 16, 2017 This link outlines the 6 key practice areas by the AAPA for each state, may be a good place to start. Also, checking the AAPA salary report in terms of salaries. Once you have it narrowed down to specific states you can find their laws for PAs online to get more info. https://news-center.aapa.org/wp-content/uploads/sites/2/2016/12/6-KE-Chart-Plus-12-15-16.pdf Link to comment Share on other sites More sharing options...
PACJD Posted August 16, 2017 Share Posted August 16, 2017 Texas and Arizona are really good in terms of pay vs cost of living. Can have good autonomy in the rural areas, may start to become saturated in the major cities though because of the high pay. Link to comment Share on other sites More sharing options...
DizzyJ Posted August 16, 2017 Share Posted August 16, 2017 There are certainly some states that are better then others, some that look good on paper, and other that are not friendly. I've worked I Ohio, Hawaii, California, and Northern Mariana Islands. Although the 6 key elements can be useful, depending on the job you get it may have no use in your ability to practice. Ohio - current job is solo urgent care coverage and never see a physician unless they are my patient. I've had ER jobs where I'm independent and ER jobs that I had to staff with an attending. No matter what the law says, the health care system dictates what you can/can not do. When I first graduated it was the worse state in the country as we had no RX authority and a clause about not seeing new patients/new conditions without doc also seeing the patient. This has changed and I personally see no difference between practice in any of the places I've worked. Hawaii - worked ER and the physician group was bat shit crazy. Doc saw every patient I saw and wanted me to get doc permission to make a phone call to a specialist or order imaging. State laws had no influence on my ability to practice as I was 100% controlled/dictated to by physicians. Got the heck out of there fast. Cost of living is crazy crazy and the pay is not much better then Ohio. California - My highest paying position, but also expensive to live there. Did outpatient psych independent and only saw the doc in passing in the hallway. California has chart co-signature requirements, but that didn't affect me one bit as the doc did this behind the scenes via EHR and took seconds to do. Also worked in urgent care and saw patients independently. Again, doc co-signed the required number of charts during any down time. We never discussed patients. Northern Mariana Islands - worked ER and was independent. When I was on island of Tinian I was the only provider on the entire island manning the clinic. During my time there we didn't have controlled substance privileges. I fought and fought and eventually won after I left the islands, but when in ED I would have to get the doc write the controlled substances. Good thing is though this happened maybe 2-3 times a month. People there don't go to the ER for narcotics and don't expect them. Bottom line....you can have a state with all 6 key elements and have a crappy, micromanaged, very dependent job all because your employer says so. Link to comment Share on other sites More sharing options...
PharmD Posted August 17, 2017 Share Posted August 17, 2017 3 hours ago, NJPL1213 said: Texas and Arizona are really good in terms of pay vs cost of living. Can have good autonomy in the rural areas, may start to become saturated in the major cities though because of the high pay. Thank you for the info. I also learnt recently PAs can open a clinic away from city limits (rural areas of course) in Texas under a supervising physician. Link to comment Share on other sites More sharing options...
PharmD Posted August 17, 2017 Share Posted August 17, 2017 2 hours ago, dizzyjon said: There are certainly some states that are better then others, some that look good on paper, and other that are not friendly. I've worked I Ohio, Hawaii, California, and Northern Mariana Islands. Although the 6 key elements can be useful, depending on the job you get it may have no use in your ability to practice. Ohio - current job is solo urgent care coverage and never see a physician unless they are my patient. I've had ER jobs where I'm independent and ER jobs that I had to staff with an attending. No matter what the law says, the health care system dictates what you can/can not do. When I first graduated it was the worse state in the country as we had no RX authority and a clause about not seeing new patients/new conditions without doc also seeing the patient. This has changed and I personally see no difference between practice in any of the places I've worked. Hawaii - worked ER and the physician group was bat shit crazy. Doc saw every patient I saw and wanted me to get doc permission to make a phone call to a specialist or order imaging. State laws had no influence on my ability to practice as I was 100% controlled/dictated to by physicians. Got the heck out of there fast. Cost of living is crazy crazy and the pay is not much better then Ohio. California - My highest paying position, but also expensive to live there. Did outpatient psych independent and only saw the doc in passing in the hallway. California has chart co-signature requirements, but that didn't affect me one bit as the doc did this behind the scenes via EHR and took seconds to do. Also worked in urgent care and saw patients independently. Again, doc co-signed the required number of charts during any down time. We never discussed patients. Northern Mariana Islands - worked ER and was independent. When I was on island of Tinian I was the only provider on the entire island manning the clinic. During my time there we didn't have controlled substance privileges. I fought and fought and eventually won after I left the islands, but when in ED I would have to get the doc write the controlled substances. Good thing is though this happened maybe 2-3 times a month. People there don't go to the ER for narcotics and don't expect them. Bottom line....you can have a state with all 6 key elements and have a crappy, micromanaged, very dependent job all because your employer says so. Thank you very much, your info entails lots of things to learn from. If I may ask, ow was the pay and cost of living in Northern Mariana islands? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 17, 2017 Moderator Share Posted August 17, 2017 If you go to Saipan, I know one of the docs in the only hospital on the island. she is very nice... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 17, 2017 Moderator Share Posted August 17, 2017 5 hours ago, dizzyjon said: . Bottom line....you can have a state with all 6 key elements and have a crappy, micromanaged, very dependent job all because your employer says so. this. very much this. I have had great and crappy jobs in the same state. it is all about the facility and the doc group. Link to comment Share on other sites More sharing options...
Endeavor Posted August 17, 2017 Author Share Posted August 17, 2017 5 hours ago, dizzyjon said: There are certainly some states that are better then others, some that look good on paper, and other that are not friendly. I've worked I Ohio, Hawaii, California, and Northern Mariana Islands. Although the 6 key elements can be useful, depending on the job you get it may have no use in your ability to practice. Ohio - current job is solo urgent care coverage and never see a physician unless they are my patient. I've had ER jobs where I'm independent and ER jobs that I had to staff with an attending. No matter what the law says, the health care system dictates what you can/can not do. When I first graduated it was the worse state in the country as we had no RX authority and a clause about not seeing new patients/new conditions without doc also seeing the patient. This has changed and I personally see no difference between practice in any of the places I've worked. Hawaii - worked ER and the physician group was bat shit crazy. Doc saw every patient I saw and wanted me to get doc permission to make a phone call to a specialist or order imaging. State laws had no influence on my ability to practice as I was 100% controlled/dictated to by physicians. Got the heck out of there fast. Cost of living is crazy crazy and the pay is not much better then Ohio. California - My highest paying position, but also expensive to live there. Did outpatient psych independent and only saw the doc in passing in the hallway. California has chart co-signature requirements, but that didn't affect me one bit as the doc did this behind the scenes via EHR and took seconds to do. Also worked in urgent care and saw patients independently. Again, doc co-signed the required number of charts during any down time. We never discussed patients. Northern Mariana Islands - worked ER and was independent. When I was on island of Tinian I was the only provider on the entire island manning the clinic. During my time there we didn't have controlled substance privileges. I fought and fought and eventually won after I left the islands, but when in ED I would have to get the doc write the controlled substances. Good thing is though this happened maybe 2-3 times a month. People there don't go to the ER for narcotics and don't expect them. Bottom line....you can have a state with all 6 key elements and have a crappy, micromanaged, very dependent job all because your employer says so. Very interesting perspectives on different places! Thanks for your input, do you think with all the new schools opening in Ohio, that the market will be saturated? 13 schools in Buckeye nation! Considering there were 7 new schools within the last 5 years?? Link to comment Share on other sites More sharing options...
DizzyJ Posted August 17, 2017 Share Posted August 17, 2017 16 hours ago, PharmD said: Thank you very much, your info entails lots of things to learn from. If I may ask, ow was the pay and cost of living in Northern Mariana islands? The pay at the time I was there was $60,000 plus housing allowance $500 a month. Now, that pay may seem crazy low, but there is no federal tax. They have since gone up to 70 or 80 I believe. I had a decent two bedroom apartment with this beautiful view from my apartment (pic not the best as it was taken on a blackberry uhh some 7 years ago). Rent was $600 a month. Electricity...that is a killer. Would cost minimum $300 a month. 13 hours ago, EMEDPA said: If you go to Saipan, I know one of the docs in the only hospital on the island. she is very nice... Who do you know? I'm still in contact with the ER director and chief of staff. 13 hours ago, OneDayPA-C said: Very interesting perspectives on different places! Thanks for your input, do you think with all the new schools opening in Ohio, that the market will be saturated? 13 schools in Buckeye nation! Considering there were 7 new schools within the last 5 years?? I do fear this happening. From what I've heard I think Columbus is pretty saturated. I'm glad I'm not a new grad. With my experience, a decade in practice, strong interest in leadership/academics, and doctorate degree I am fairly comfortable I need not worry about being out of a job. Link to comment Share on other sites More sharing options...
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