Best place to practice as a PA

[HmTwoPA]

I am not sure if this has been posted and apologize ahead of time if it has. I typed in best place under the search bar and went back a few pages before I gave up. I was curious as to if everyone can chime into great places to practice as a PA. Im mostly looking at comparing salary, COL, autonomy and respect for PAs in the region, jobs available and quality of life. 

I am currently going to school in Phoenix and I would rate this is as a pretty good place to be a PA. You can get a decent house in a good area for 200-300. You can live in the best area of town for 500. Taxes are low. Most PAs and NPs I meet enjoy their autonomy and respect. The pay is great. The NP I'm working with now just got 2 job offers for family medicine with one year experience for 140 and 130. He took the 130 one because it included 5 weeks of PTO and 1 week of sick time. I personally dont care for Phoenix due to the heat and lack of seasons. There is also a lot of ghetto areas, and schools are not the best. 

I know everyone says general regions such as north west or mid west when referencing places, but I am hoping for specific cities or towns.

[sas5814]

It is nearly impossible to answer that question because our values are different and we would have different values in terms of quality of life, autonomy etc.

I like the slower pace of rural living but I like some core amenities so I have split the difference. I work in a town of 100k but live 12 miles away in a town of 10k and it is a very short drive to be in the rural countryside. COL is reasonable but not the lowest I have experienced. I make good money in UC and primary care.

So to get better answers you'll need to parse what your values are. Where do you want to be? Primary care of specialty? City or country? North or south...hot or cold. You get the idea.

There are thousands of square miles of rural Texas that would love to have a good PA and would pay well with a very low cost of living.Not everyone's bag though.

 

[DizzyJ]

This will be a difficult question to really answer as everyone's quality of life definition can vary.  I can share with you my experiences having practiced in 4 different states/territories. 

Cleveland/Toledo, OH - pay has been over 6 figures the past several years I've practiced here.  Experience PA can easily get $120K.  Housing is pretty cheap.  Have a 3000 sq ft house for $260K.  I've worked ER, hospitalist, and urgent care mostly independent.  In the ER I worked the docs had to say hi to the patients, but most docs I worked with for years and they didn't mess with what my treatment plan was and often didn't even discuss the patient with me.  Urgent care I've always worked solo and a couple places never even met my medical director.  Have only dealt with respect issues a couple times and it's been awhile.  All 4 seasons.  

Saipan & Tinian, Norther Mariana Islands -  pay was $60k at the time and has since gone up to $80k from what I've heard.  However, there is NO FEDERAL TAX.  That is a big chunk of money you get to keep.  PAs are respected and I practiced independently in the ED and at a critical access hospital.  PAs are not independent providers there and have a supervisory agreement, but it is just a formality.  Limited resources and I would be the only provider on island when covering the critical access hospital on Tinian.  I rented a two bedroom apartment for $650 up on a hill overlooking the ocean.  It was amazing!  Water and electricity are very expensive.  Gas is expensive, but the island is only 44 sq miles....a tank would last me a month.  88 degrees and sunny pretty much every day.  With a wet season and a dry season. Have to worry about typhoons though.  They got hit pretty hard a couple years ago.  

Honolulu, HI - most expensive and pay doesn't match up to cost of living.  Made around 90K working in ER 130ish hours a month.  The ER group treated PA/NP like garbage and no respect at all.  Little to no independence.  Some docs wouldn't even let me order an xray without permission.   Didn't stay very long.  Housing is crazy.  Paid $2300 for a 3 bedroom apartment.  Was able to walk to work though.  If you have a 9-5 job you better live right next store to your job, because traffic into Honolulu is horrible.  Like LA traffic.  Homeless villages line down the sidewalks (tent row).  Very beautiful areas on the island and amazing hiking and waterfalls.  I'd go back to the Mariana's before ever considering Honolulu again.  Weather is nice, but hurricane potential.  

Sacramento, CA - worked outpatient psych, complete independence and made $150K working 32 hours a week.  Housing is expensive.  Paid $360k for a 4 bedroom split level 1900 sq ft.  $100K more then my bigger/better house in Ohio.  Had an awesome backyard though will palm trees, orange tree, and a pool.  There are I'd say 3 season.  No snow.  Winters are about 40 degrees during the day.  What I loved about Sacramento was the 2 hours to Lake Tahoe, 2 hours to San Fran, 3 hours to Yosemite.  

[BruceBanner]

Avoid Denver. High saturation, high COL, low pay.

I lived in Phoenix many years ago before I was a PA; I'd concur with your assessment.

As others have mentioned it's nearly impossible unless you give us specific parameters---rural, suburban, urban, weather, region, proximity to X,Y, Z, etc.

 

 

[gbrothers98]

Step one: Finish PA school.

Step two: Pass PANCE.

Step three: Check with spouse/significant other concerning expectations.

Step four: Where is family?

Realize employment is a 3 leg stool of compensation, region, specialty. Rare to get 3/3 straight out of school, strive for 2/3. You may have to compromise on any of those dependent upon steps 3 & 4. Timing and good fortune will also play a part, hard to control that.

George

 

[Cideous]

Texas:

-Reasonable house prices except for parts of DFW which have exploded in the last 5 years.  I'm talking So Cal like appreciation.  Rent here has exploded a long with the house prices.  Just remember, if you do by a decent house, you will get obliterated on property taxes here.  $340k house = $8k+ per year in property taxes, so you have to gross around $9500 just for the privilege of living in your house...every year.  Not to mention homeowners insurance is awful.  Average on that same $340k house is $2k more a year.  The same house in say AZ or NV will cost you about $600

-Car registration is cheap here.  So driving a nice car if that's your thing is very doable.  Except for one thing....hail.  My car was destroyed 2 years ago thanks to good old North Texas hail.  So you take your chances.  The day my car was beat to hell, the weather called for the occasional thunderstorm and light rain.  LOL

-Houston is really hurting for providers right now for obvious reasons.  Don't buy a house there unless you are prepared to float away or pay ungodly amounts of flood insurance.

-Small town Texas is hit or miss.  I did it, and it sucked.  I was in Central Texas in a town of 5k.  I could spend all day on how territorial rural Texas can be, but I wont.  If your not from there...good luck.  Minority?  lol yea, good luck.

-The good?  Some people who come from truly awful parts of the country weather wise believe Texas is a step up....so there's that.

-Not as much homelessness here vs the west coast.

-Petty crime seems less and people seems to be a little more respectful of each other then on the coasts.  I suppose because there are a lot of Texans walking around armed.

 

I guess my point is this.  There are a LOT of factors that go into COL.  Many see Texas and say wow!  No state income tax!  They don't realize that it is more then made up for in property taxes if they buy a house in a decent area. They also don't  realize that property insurance here is sky high because of all the natural disasters.  Just things to really keep in mind.  

[GetMeOuttaThisMess]

Texas:
-Reasonable house prices except for parts of DFW which have exploded in the last 5 years.  I'm talking So Cal like appreciation.  Rent here has exploded a long with the house prices.  Just remember, if you do by a decent house, you will get obliterated on property taxes here.  $340k house = $8k+ per year in property taxes, so you have to gross around $9500 just for the privilege of living in your house...every year.  Not to mention homeowners insurance is awful.  Average on that same $340k house is $2k more a year.  The same house in say AZ or NV will cost you about $600
-Car registration is cheap here.  So driving a nice car if that's your thing is very doable.  Except for one thing....hail.  My car was destroyed 2 years ago thanks to good old North Texas hail.  So you take your chances.  The day my car was beat to hell, the weather called for the occasional thunderstorm and light rain.  LOL
-Houston is really hurting for providers right now for obvious reasons.  Don't buy a house there unless you are prepared to float away or pay ungodly amounts of flood insurance.
-Small town Texas is hit or miss.  I did it, and it sucked.  I was in Central Texas in a town of 5k.  I could spend all day on how territorial rural Texas can be, but I wont.  If your not from there...good luck.  Minority?  lol yea, good luck.
-The good?  Some people who come from truly awful parts of the country weather wise believe Texas is a step up....so there's that.
-Not as much homelessness here vs the west coast.
-Petty crime seems less and people seems to be a little more respectful of each other then on the coasts.  I suppose because there are a lot of Texans walking around armed.
 
I guess my point is this.  There are a LOT of factors that go into COL.  Many see Texas and say wow!  No state income tax!  They don't realize that it is more then made up for in property taxes if they buy a house in a decent area. They also don't  realize that property insurance here is sky high because of all the natural disasters.  Just things to really keep in mind.  

Your HOI deductible is also 1% of home value. Glad for the appreciation since after 29 years in my house which I built for $135K, appraisal value for sale is finally over $300K. It’ll go higher if Amazon builds here as well like Toyota did.

[GetMeOuttaThisMess]

On 2/21/2018 at 10:01 AM, DizzyJ said:

This will be a difficult question to really answer as everyone's quality of life definition can vary.  I can share with you my experiences having practiced in 4 different states/territories. 

 

Honolulu, HI - most expensive and pay doesn't match up to cost of living.  Made around 90K working in ER.  The ER group treated PA/NP like garbage and no respect at all.  Little to no independence.  Some docs wouldn't even let me order an xray without permission.   Didn't stay very long.  Housing is crazy.  Paid $2300 for a 3 bedroom apartment.  Was able to walk to work though.  If you have a 9-5 job you better live right next store to your job, because traffic into Honolulu is horrible.  Like LA traffic.  Homeless villages line down the sidewalks (tent row).  Very beautiful areas on the island and amazing hiking and waterfalls.  I'd go back to the Mariana's before ever considering Honolulu again.  Weather is nice, but hurricane potential.  

quote]

 

No kidding on the homeless. Last vaca trip to Honolulu in ‘15 (stayed at Kahala) was a trip through the homeless if anywhere near east end of Waikiki to the zoo area. Trouble is that they can get there but then get down on their luck and can’t get off the island. Guess I’ll stay with Maui, Kauai, and Big Island. Not enough entertainment on Lanai.

[ventana]

Berkshire County MASS

Amazing quality of life, short commute, no traffic, great outdoors

schools are great to outstanding

housing can be found affordable, or not

Close to major city - 1hour to Albany NY, 1 hour to Springfield MA

I can be done work at 4, home by 4:10, on bike by 4:30 in aa 13,000+ acre state forest with amazing MTB trails or Nordic skiing

 

Tangelwood (summer home of Boston Pops) and concert venue

Lenox MASS for culture and all the theather

 

 

local hospital is a monopoly that has realized the value of PA

90-140k per year with great bennies - teaching hospital so reasonable education possibles, L2 trauma center

Houses  - starter for < 180

300 buys a really nice one!

 

 

 

[thinkertdm]

I would avoid middle of NY State.  The place with a museum devoted to non-crystalline amorphous solids.  Personally, I liked Florida.  There were gators swimming in the pond next to McDonalds!

[mmiller3]

If you enjoy the extremely cold winters, hot, humid summers, high property taxes and (depending on where you live) high housing costs, then Illinois is for you!

ETA: Where is my head at? I forgot to mention the mosquitoes, and political corruption so bad even other states' politicians look down on us. Take that, New Jersey!

 

[thinkertdm]

28 minutes ago, mmiller3 said:

If you enjoy the extremely cold winters, hot, humid summers, high property taxes and (depending on where you live) high housing costs, then Illinois is for you!

ETA: Where is my head at? I forgot to mention the mosquitoes, and political corruption so bad even other states' politicians look down on us. Take that, New Jersey!

 

I'm on my way to Danville!  Yay!

[mmiller3]

14 minutes ago, thinkertdm said:

I'm on my way to Danville!  Yay!

To visit, or to live?

[thinkertdm]

Just now, mmiller3 said:

To visit, or to live?

To live.  I meant on my way metaphorically, last day in the land of non-crystalline amorphous solids is April 9.  I worked there once before, wife is from Villa Grove.

[mmiller3]

7 minutes ago, thinkertdm said:

To live.  I meant on my way metaphorically, last day in the land of non-crystalline amorphous solids is April 9.  I worked there once before, wife is from Villa Grove.

Well, then I take it all back. Illinois is a paradise--I just posted to try and keep out the riff-raff lol.

[lkth487]

Wherever your wife wants to be.

[Cideous]

1 hour ago, lkth487 said:

Wherever your wife wants to be.

LOL some truth here....

[greenmood]

Anyone worked in the Nashville area? Also would be interested in hearing perspectives from those in the pacific NW.

[FSUnoles]

ill add to FL

mainly Miami

High COL, High property values..want a 3/2 you are looking at 500k

medial pay. most making 90k out of school after a couple years are only in 110-130k range . there are outliers in ER making good money but few and far between

private practice environment is horrible

weather...hot.. beaches are okay but better in other locations

ive heard better things about the west coast of Florida

 

i feel like PA wise the best state is NC when you factor in everything. you get seasons but not insane ones. its on my shortlist