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Combine the benefits of going the PA route and being a PA with the physician burnout rate, increasing red tape, and reduced reimbursement rates, and one may not be so surprised that "more" Millennials are choosing PA over physician. Let's just hope this indeed helps with the predicted shortage of providers rather than result in market saturation. 

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9 minutes ago, BearDown said:

I hope within next 10 years when I'm done with school and practicing there are more concrete routes to progress PA -> MD that are more logical than the present. I think if that bridge was more feasible others would follow?

Why follow, just got to medical school or PA school. PA is not a stepping stone to MD/DO. It is a profession to be proud of and not the "easier route to medical school." You don't see AT-C (Athletic trainers), PT (Physical Therapist), OT (Occupational Therapist) wanting a bridge program to MD/DO school to be an orthopod. Give me a break, if your goal is to become a physician then go to medical school. Don't waste your time doing PA to MD/DO.

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Just now, camoman1234 said:

Why follow, just got to medical school or PA school. PA is not a stepping stone to MD/DO. It is a profession to be proud of and not the "easier route to medical school." You don't see AT-C (Athletic trainers), PT (Physical Therapist), OT (Occupational Therapist) wanting a bridge program to MD/DO school to be an orthopod. Give me a break, if your goal is to become a physician then go to medical school. Don't waste your time doing PA to MD/DO.

I'm familiar with the profession, its backing, and how I can contribute to raising the standard. However, I never believe in being pigeonholed just as others who have pursued further avenues of education. I simply suggested for a possible viable solution to shortage of physicians. Why couldn't a seasoned PA make great contributions as a physician or why would it be wrong to pursue that route? Do you have distaste for every PA that has graduated LECOM? Open the tunnel vision.

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30 minutes ago, BearDown said:

I'm familiar with the profession, its backing, and how I can contribute to raising the standard. However, I never believe in being pigeonholed just as others who have pursued further avenues of education. I simply suggested for a possible viable solution to shortage of physicians. Why couldn't a seasoned PA make great contributions as a physician or why would it be wrong to pursue that route? Do you have distaste for every PA that has graduated LECOM? Open the tunnel vision.

Agreed.  As someone who is half way through my program and considering medical school, more  bridge programs would make the decision more appealing.  I don't see anything wrong with people wanting more avenues.

Edited by SR0525
wording
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31 minutes ago, BearDown said:

I'm familiar with the profession, its backing, and how I can contribute to raising the standard. However, I never believe in being pigeonholed just as others who have pursued further avenues of education. I simply suggested for a possible viable solution to shortage of physicians. Why couldn't a seasoned PA make great contributions as a physician or why would it be wrong to pursue that route? Do you have distaste for every PA that has graduated LECOM? Open the tunnel vision.

No tunnel vision here, re-read your comment, "possible viable solution to shortage of physicians." Apparently you don't know much about the PA profession and what Dr. Eugene Steads vision was for the PA profession and why it was created. Why train a PA and then take them out of service for at least 6 years to become a MD/DO in family medicine to do the exact same job I am doing now. No I do not have distaste for LECOM grads, but for me it is not the title that matters as I literally do everything my CP does in family medicine so for me it would strictly be for the title and to bill a little more. My town of 600 and the only clinic within 25 or so minutes would be devastated if there was a provider missing for 6 years to come back and say hey I am a doctor now, so now I can do what I was doing prior for this poor community. No, I do not have the knowledge of a MD/DO and most likely never will, but I sure can strive to learn as much as I can by talking with other APP/physicians, CME, conferences, etc. Again, your statement of filling the physician shortage is what PAs were invented for. Please become MORE familiar with the profession before you start talking with a PA-C about his own profession.   

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2 minutes ago, camoman1234 said:

No tunnel vision here, re-read your comment, "possible viable solution to shortage of physicians." Apparently you don't know much about the PA profession and what Dr. Eugene Steads vision was for the PA profession and why it was created. Why train a PA and then take them out of service for at least 6 years to become a MD/DO in family medicine to do the exact same job I am doing now. No I do not have distaste for LECOM grads, but for me it is not the title that matters as I literally do everything my CP does in family medicine so for me it would strictly be for the title and to bill a little more. My town of 600 and the only clinic within 25 or so minutes would be devastated if there was a provider missing for 6 years to come back and say hey I am a doctor now, so now I can do what I was doing prior for this poor community. No, I do not have the knowledge of a MD/DO and most likely never will, but I sure can strive to learn as much as I can by talking with other APP/physicians, CME, conferences, etc. Again, your statement of filling the physician shortage is what PAs were invented for. Please become MORE familiar with the profession before you start talking with a PA-C about his own profession.   

Actually, that tunnel vision is exactly what I am referring too. Look I get it, I'm a new guy - I first and foremost respect the right of passage and you've clearly done your time. With that being said you are holding onto a vision that was established in mid 1960's. To say that vision can't progress/branch out/be built upon is exactly the pitfalls that other professional physician assistants experience (For example, something as small as name change.). While you are the seasoned practitioner - I can assure you the application competitiveness mirrors if not exceeds that thereof medical school. Peers that have less merit than myself breezed through medical school applications/acceptances. To say "PA is an easier route to MD" just doesn't really apply anymore. Additionally, it is just silly to think a seasoned PA practitioner - like yourself -  would need to start from square one to become an MD. Your argument regarding title is so surface level its insulting. Myself and others are wanting the possibility to expand our impact back the foundations that got us all into medicine in the first place. I don't care about the few bad apples you are referring to regarding the title.

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1 hour ago, BearDown said:

Actually, that tunnel vision is exactly what I am referring too. Look I get it, I'm a new guy - I first and foremost respect the right of passage and you've clearly done your time. With that being said you are holding onto a vision that was established in mid 1960's. To say that vision can't progress/branch out/be built upon is exactly the pitfalls that other professional physician assistants experience (For example, something as small as name change.). While you are the seasoned practitioner - I can assure you the application competitiveness mirrors if not exceeds that thereof medical school. Peers that have less merit than myself breezed through medical school applications/acceptances. To say "PA is an easier route to MD" just doesn't really apply anymore. Additionally, it is just silly to think a seasoned PA practitioner - like yourself -  would need to start from square one to become an MD. Your argument regarding title is so surface level its insulting. Myself and others are wanting the possibility to expand our impact back the foundations that got us all into medicine in the first place. I don't care about the few bad apples you are referring to regarding the title.

I am not an experienced provider, I have been a PA-C for 4 years. I did have the same classes, pre-req, grades as all my friends that went to medical school. I have years of HCE prior to PA school, advanced science classes, post grad research etc (I know PA is not easier than medical school, but some people think that they can avoid organic chem or the MCAT by PA to MD/DO). I know I could have gotten into medical school, but I picked PA for the reason Dr. Stead envisioned, to get great providers out of school to see patients sooner to help the shortage of MD/DOs and the increasing amount of patients that need to be seen. So your theory about advancing into the MD/DO role is even MORE needed now than 30 years ago? Look at the numbers: healthcare expenditure from 1960 was $147, in 2010 $8,402, females that graduate medical school was 9% of physicians and those same females (8%) went in the work force compared to 2009 where 49% of female physicians graduated from medical school and 29% are in the work force. Medicare enrollees 18 million in 1966, in 2010 44 million. Life expectancy in 1960 was 69.8, 2009 was 78.2. USA population 65 or older in in 1960 was 17 million, in 2010 40 million. Population with diabetes in 1965 was 2.4 million, in 2010 was 23.1 million. So you are telling me that it is adventitious for a PA to go to medical (so be out of the workforce for at least 6 years minimum) to help the physician shortage as this is the newer school thought process? How will all these people get help if you are out for 6 years to come back to family medicine to do 99% of what you were doing prior? We (USA) are spending more on healthcare than ever, have a shortage of health care provider, have 23 million more medicare enrollees, at least 20 million more people with diabetes (statistic form 2010 so it is higher today), life expectancy is 8.4 years longer now and you think Dr. Steads vision is "old school" and doesn't matter today? 

https://www.advisory.com/Daily-Briefing/2012/03/22/After-Mad-Men-What-healthcare-has-gained-and-lost-since-1960s#lightbox/0/

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18 minutes ago, camoman1234 said:

I am not an experienced provider, I have been a PA-C for 4 years. I did have the same classes, pre-req, grades as all my friends that went to medical school. I have years of HCE prior to PA school, advanced science classes, post grad research etc (I know PA is not easier than medical school, but some people think that they can avoid organic chem or the MCAT by PA to MD/DO). I know I could have gotten into medical school, but I picked PA for the reason Dr. Stead envisioned, to get great providers out of school to see patients sooner to help the shortage of MD/DOs and the increasing amount of patients that need to be seen. So your theory about advancing into the MD/DO role is even MORE needed now than 30 years ago? Look at the numbers: healthcare expenditure from 1960 was $147, in 2010 $8,402, females that graduate medical school was 9% of physicians and those same females (8%) went in the work force compared to 2009 where 49% of female physicians graduated from medical school and 29% are in the work force. Medicare enrollees 18 million in 1966, in 2010 44 million. Life expectancy in 1960 was 69.8, 2009 was 78.2. USA population 65 or older in in 1960 was 17 million, in 2010 40 million. Population with diabetes in 1965 was 2.4 million, in 2010 was 23.1 million. So you are telling me that it is adventitious for a PA to go to medical (so be out of the workforce for at least 6 years minimum) to help the physician shortage as this is the newer school thought process? How will all these people get help if you are out for 6 years to come back to family medicine to do 99% of what you were doing prior? We (USA) are spending more on healthcare than ever, have a shortage of health care provider, have 23 million more medicare enrollees, at least 20 million more people with diabetes (statistic form 2010 so it is higher today), life expectancy is 8.4 years longer now and you think Dr. Steads vision is "old school" and doesn't matter today? 

https://www.advisory.com/Daily-Briefing/2012/03/22/After-Mad-Men-What-healthcare-has-gained-and-lost-since-1960s#lightbox/0/

Okay maybe I gave you more credit than you were due. Fundamentally speaking - more MD's = more chances for improved access to healthcare via PA's (In fact, as stated in the original article, the amount of PA's have increased by 37% - there is no shortage.)..just as he envisioned. Why couldn't a PA become an MD to have a deeper impact in that facet? You literally backed up everything I said with all of those stats you googled. Why couldn't a more progressive, logical branch program be developed for PA to MD if they had the merit? This is how you create adaptive solutions to healthcare.

Medicare/Medicaid debate would be absolutely endless and tackling that sector would need truly brilliant minds and almost a complete reset.

Lastly, if you're stuck in a 50 year old vision and refuse to deviate you will get left in the dust.

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1 hour ago, BearDown said:

...Lastly, if you're stuck in a 50 year old vision and refuse to deviate you will get left in the dust.

Agree. It's important to appreciate and understand the origin of the PA profession. But it is also important to understand the changing landscape of healthcare delivery in the US and adapt as a profession. 

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1 hour ago, BearDown said:

Okay maybe I gave you more credit than you were due. Fundamentally speaking - more MD's = more chances for improved access to healthcare via PA's (In fact, as stated in the original article, the amount of PA's have increased by 37% - there is no shortage.)..just as he envisioned. Why couldn't a PA become an MD to have a deeper impact in that facet? You literally backed up everything I said with all of those stats you googled. Why couldn't a more progressive, logical branch program be developed for PA to MD if they had the merit? This is how you create adaptive solutions to healthcare.

Medicare/Medicaid debate would be absolutely endless and tackling that sector would need truly brilliant minds and almost a complete reset.

Lastly, if you're stuck in a 50 year old vision and refuse to deviate you will get left in the dust.

I won't get left in the dust, don't worry about me. That is why Dr. Steads vision worked and is still working, we are gaining more PAs yearly to increase care for patients. Why would I go back to medical school and be gone from my community for 6 years to come back and literally do the exact same thing as I am doing now. RHCs are mandated to be staffed with a PA/NP 50% of the time. So even if I went back to MD/DO school this would not help my RHC or community. My job would not change or what I can offer my patients would not change. I am giving them access to care and the best care we can give them. So tell me how going back to MD/DO school benefit my RHC (rural health clinic)?

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Seems to me the only tunnel vision is that only md's provide care that matters, and PA's, despite years of proof, can not.  

I can, and do, provide the exact same care as an MD.  Period.  I see no no need to enhance myself by adding MD on to it- unless you want admiration and honors and a better parking space.  I leave the exam room, the patients thank me, and I know I made a difference.  I don't wish I could be a MD because then my patients could get the care they deserve.  

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8 minutes ago, camoman1234 said:

I won't get left in the dust, don't worry about me. That is why Dr. Steads vision worked and is still working, we are gaining more PAs yearly to increase care for patients. Why would I go back to medical school and be gone from my community for 6 years to come back and literally do the exact same thing as I am doing now. RHCs are mandated to be staffed with a PA/NP 50% of the time. So even if I went back to MD/DO school this would not help my RHC or community. My job would not change or what I can offer my patients would not change. I am giving them access to care and the best care we can give them. So tell me how going back to MD/DO school benefit my RHC (rural health clinic)?

I think your rural health clinic situation differs from that of most practicing PAs. I don't have an interest in going to med school after having practiced as a PA for a few years. I can't justify the debt and additional time spent in school/residency, especially after having spent nearly 6 years active duty in the US Army prior to going to PA school. That said, I completely understand why some folks do wish to obtain a MD or DO after having worked as a PA for a few years. For the small number of PAs that I've known who have done it, their reasons have differed from person to person as tough decisions like that often do, but the main motivators have been a combination of furthering their medical knowledge deeper than that of what the PA training model instills and commanding greater respect for their role in the healthcare community.

 

To play devil's advocate, I can think of no better ally for PAs than someone who was a PA and then goes on to obtain a MD or DO after they feel they've hit a glass ceiling as a PA. Those folks would have a crucial understanding of what a PA can do for the team, and would no doubt give us a louder voice at the table. I'm not in favor of PA being a stepping stone to MD/DO, but I do support having additional pathways for my PA colleagues who wish to further their education.

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26 minutes ago, thinkertdm said:

Seems to me the only tunnel vision is that only md's provide care that matters, and PA's, despite years of proof, can not.  

I can, and do, provide the exact same care as an MD.  Period.  I see no no need to enhance myself by adding MD on to it- unless you want admiration and honors and a better parking space.  I leave the exam room, the patients thank me, and I know I made a difference.  I don't wish I could be a MD because then my patients could get the care they deserve.  

Regarding this thread, you are the only person that mentioned MD's provide care that matters.

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I won't get left in the dust, don't worry about me. That is why Dr. Steads vision worked and is still working, we are gaining more PAs yearly to increase care for patients. Why would I go back to medical school and be gone from my community for 6 years to come back and literally do the exact same thing as I am doing now. RHCs are mandated to be staffed with a PA/NP 50% of the time. So even if I went back to MD/DO school this would not help my RHC or community. My job would not change or what I can offer my patients would not change. I am giving them access to care and the best care we can give them. So tell me how going back to MD/DO school benefit my RHC (rural health clinic)?
I remember reading an interview with Dr. Stead where he said that he thought PAs should not and will likely not remain dependent providers as the years go by. I can't find it but I distinctly remember reading it...

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43 minutes ago, beattie228 said:

I think your rural health clinic situation differs from that of most practicing PAs. I don't have an interest in going to med school after having practiced as a PA for a few years. I can't justify the debt and additional time spent in school/residency, especially after having spent nearly 6 years active duty in the US Army prior to going to PA school. That said, I completely understand why some folks do wish to obtain a MD or DO after having worked as a PA for a few years. For the small number of PAs that I've known who have done it, their reasons have differed from person to person as tough decisions like that often do, but the main motivators have been a combination of furthering their medical knowledge deeper than that of what the PA training model instills and commanding greater respect for their role in the healthcare community.

 

To play devil's advocate, I can think of no better ally for PAs than someone who was a PA and then goes on to obtain a MD or DO after they feel they've hit a glass ceiling as a PA. Those folks would have a crucial understanding of what a PA can do for the team, and would no doubt give us a louder voice at the table. I'm not in favor of PA being a stepping stone to MD/DO, but I do support having additional pathways for my PA colleagues who wish to further their education.

There are programs to further your education as a PA like LMU and Lynchburg (DMSc). These differ than a DHSc, PhD in Health Science. Not medical school, but does give you rotations plus more sciences classes. I agree having more options for PAs, but I also don't want the patients to suffer while 40% of all PAs go back to medical school...it is a hard subject to discuss and there is not a perfect answer. 

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There are programs to further your education as a PA like LMU and Lynchburg (DMSc). These differ than a DHSc, PhD in Health Science. Not medical school, but does give you rotations plus more sciences classes. I agree having more options for PAs, but I also don't want the patients to suffer while 40% of all PAs go back to medical school...it is a hard subject to discuss and there is not a perfect answer. 
I totally agree. I don't want people to think PA is a stepping stone to MD/DO... Not at all. We are our own profession and we have a niche in which we serve BUT... we should have upward mobility should we choose. I am all for a DMS as outlined by LMU perhaps with a residency giving us more clinical and science education to "fill in the gaps" so to speak of our education in order for us to function at the level of MD/DO. Will it happen? Likely not in my professional lifetime.

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Glad to see people increasingly being aware of and going to PA schools. There's definitely a shortage.  

 

  PAs are expanding very fast and while that's great in some ways for people hiring them - I worry that it might lead to salary depression and people coming out of schools not being able to find good employment. 

 

Med school applications are also breaking records so I don't think it's coming at the expense of medical schools.  Thankfully for medicine (at least from the graduating residents perspective), the residency spots are increasing very slowly meaning for most specialties there's a demand that far outstrips the supply and will continue to do so.  

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