How far will PA wages fall in the future?

[paul2834]

I was conversing with an orthopedic surgeon the last time I volunteered at the ER and he was telling me about all the reasons why one shouldn't pursue a career in medicine (I then shared my opinions on computer engineering). One he kept stressing is the decline of physician wages, which I was already aware of. Medicare and Medicaid is reducing physician compensation by 25% and it won't be long before the insurance companies follow suit. I've thought about the decline of salaries before, but my talk with the surgeon brought the subject back to the front of my mind again. How much can we expect PA wages to decline by since we're supervised by physicians? In the past, the average PA salary was far less than what it is now and I'm don't know to what extent they thought they would be paid this much now. Is this profession still to volatile to even predict?

[paul2834]

I was conversing with an orthopedic surgeon the last time I volunteered at the ER and he was telling me about all the reasons why one shouldn't pursue a career in medicine (I then shared my opinions on computer engineering). One he kept stressing is the decline of physician wages, which I was already aware of. Medicare and Medicaid is reducing physician compensation by 25% and it won't be long before the insurance companies follow suit. I've thought about the decline of salaries before, but my talk with the surgeon brought the subject back to the front of my mind again. How much can we expect PA wages to decline by since we're supervised by physicians? In the past, the average PA salary was far less than what it is now and I'm don't know to what extent they thought they would be paid this much now. Is this profession still to volatile to even predict?

[mktalon]

Is this profession still to volatile to even predict?

 

It is WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAY too volatile to predict. We can't even continue this conversation because nobody can predict anything because of the volatility! Oh well.

[mktalon]

Is this profession still to volatile to even predict?

 

It is WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAY too volatile to predict. We can't even continue this conversation because nobody can predict anything because of the volatility! Oh well.

[mktalon]

I'm being facetious by the way...

 

but seriously, I do think there are too many changes going on right now for anybody to predict what is going to happen in the next 5 to 10 years. Heck, I don't even have any faith in the economy as whole. All this talk of improvements and the stock market returning to pre-crash levels... bah! To me, it is a little odd that the banks have "recovered" fully, the stock market has "recovered" fully... and yet millions of Americans are still in dire straits. I don't think we've seen the end of the story of the "Great Recession" yet.

[mktalon]

I'm being facetious by the way...

 

but seriously, I do think there are too many changes going on right now for anybody to predict what is going to happen in the next 5 to 10 years. Heck, I don't even have any faith in the economy as whole. All this talk of improvements and the stock market returning to pre-crash levels... bah! To me, it is a little odd that the banks have "recovered" fully, the stock market has "recovered" fully... and yet millions of Americans are still in dire straits. I don't think we've seen the end of the story of the "Great Recession" yet.

[ventana]

I think that the gravy days of doc's making 300-600k per year for a 4 day work week are history

 

i peronsonally think it is a good thing as most doc's i know make less then stellar business people - but I am unsure this has any reflection on PA wages - sort of like the trickle down economics.....

 

in all actuality I think the business pressures might well allow PA salaries to continue to climb due to the fact we are typically a better bargin then the doc's

[ventana]

I think that the gravy days of doc's making 300-600k per year for a 4 day work week are history

 

i peronsonally think it is a good thing as most doc's i know make less then stellar business people - but I am unsure this has any reflection on PA wages - sort of like the trickle down economics.....

 

in all actuality I think the business pressures might well allow PA salaries to continue to climb due to the fact we are typically a better bargin then the doc's

[Corpsman2PA]

I think that the gravy days of doc's making 300-600k per year for a 4 day work week are history

 

 

Thats the key...physician wages are falling in comparison to what? The over-inflated wages they've been receiving prior for less work?

[Corpsman2PA]

I think that the gravy days of doc's making 300-600k per year for a 4 day work week are history

 

 

Thats the key...physician wages are falling in comparison to what? The over-inflated wages they've been receiving prior for less work?

[Walkoffshot]

One way you can look at it is through contrast with the Canadian healthcare system and incorporation of PA's. The profession is in it's infancy stages in Canada, which in turn results in a lower salary based on a number of things... 1.) The profession hasn't established itself in Canada to the extent the US has. 2.) Socialized medicine causes a decline in salaries for upper level providers (physician's) because of government regulation being so strict. Just to throw out a number, PA's in Canada average a salary of ~65,000/year as opposed to the ~80-85,000/year in the US (give or take). That's a 20,000 difference if my math is correct. Again, in Canada it is in it's infancy and the countries health care system has barely had a glimpse of how benefical a PA is to the health care team. The way I see it, is that it can only go up from here.. in Canada that is.

 

Now, look at the US. Physician's make an astounding dollar amount because of the ability to bill higher amounts, in essence. It is not as closely regulated, IMO, as Canada is. Now with the new face of healthcare coming to fruition in the US, you will absolutely see a decline in Physician salaires due to regulations, as well as to keep costs down so you can have essentially a "universal" healthcare. I think the key here is keeping costs down. How can you do this? Simply implementing a system where you can achieve effective healthcare at a lower cost... ie. Mid-level providers such as PA's and NP's. In Canada, physician salaries are already lower in comparison to the US, so there is a non-issue here as far as a decline for PA's.. again, it can most likely only go up.

 

I also believe that as you see more physician's leaving the system, the load will be dispersed on those mid-level providers. This results in less salary being paid out to physician's, and (hopefully) and increase in salary to PA's due to responisiblity increases. This is a good thing, because with socialistic medicine, you can keep costs down, with doing essentially the same work... keeps the workers happy, keeps the citizens happy and keeps the government happy.

 

Just my thoughts.

[Walkoffshot]

One way you can look at it is through contrast with the Canadian healthcare system and incorporation of PA's. The profession is in it's infancy stages in Canada, which in turn results in a lower salary based on a number of things... 1.) The profession hasn't established itself in Canada to the extent the US has. 2.) Socialized medicine causes a decline in salaries for upper level providers (physician's) because of government regulation being so strict. Just to throw out a number, PA's in Canada average a salary of ~65,000/year as opposed to the ~80-85,000/year in the US (give or take). That's a 20,000 difference if my math is correct. Again, in Canada it is in it's infancy and the countries health care system has barely had a glimpse of how benefical a PA is to the health care team. The way I see it, is that it can only go up from here.. in Canada that is.

 

Now, look at the US. Physician's make an astounding dollar amount because of the ability to bill higher amounts, in essence. It is not as closely regulated, IMO, as Canada is. Now with the new face of healthcare coming to fruition in the US, you will absolutely see a decline in Physician salaires due to regulations, as well as to keep costs down so you can have essentially a "universal" healthcare. I think the key here is keeping costs down. How can you do this? Simply implementing a system where you can achieve effective healthcare at a lower cost... ie. Mid-level providers such as PA's and NP's. In Canada, physician salaries are already lower in comparison to the US, so there is a non-issue here as far as a decline for PA's.. again, it can most likely only go up.

 

I also believe that as you see more physician's leaving the system, the load will be dispersed on those mid-level providers. This results in less salary being paid out to physician's, and (hopefully) and increase in salary to PA's due to responisiblity increases. This is a good thing, because with socialistic medicine, you can keep costs down, with doing essentially the same work... keeps the workers happy, keeps the citizens happy and keeps the government happy.

 

Just my thoughts.

[whimsygirl]

I agree. I think the changes could be really good for PAs.

[whimsygirl]

I agree. I think the changes could be really good for PAs.

[jdtpac]

Oh it does this "old timers" heart well to see you younger PAs discuss this issue in an open forum. Let me just start by saying forget about any comparison between the US and Canadian physician assistants or a system of socialize medicine. Everything that was said about quality and competency is correct. But Basic Economics 101 always emphasizes the theory of supply and demand. As long as the supply of physician assistants remains lower than the demand salaries will remain high, bottom line! Should the gap in those 2 factors begin to narrow you will start seeing PAs salaries fall. However, based on the current number of students that are graduating each year I do not see that happening anytime soon. Right now you younger PAs come into the profession at much greater advantage to negotiate starting salaries then ever before. I know of places where new graduates are coming in at salary close to that of PAs who have been on the job for over 20 years. That is why I'm having a hard time understanding why this discussion even began on this forum.

[jdtpac]

Oh it does this "old timers" heart well to see you younger PAs discuss this issue in an open forum. Let me just start by saying forget about any comparison between the US and Canadian physician assistants or a system of socialize medicine. Everything that was said about quality and competency is correct. But Basic Economics 101 always emphasizes the theory of supply and demand. As long as the supply of physician assistants remains lower than the demand salaries will remain high, bottom line! Should the gap in those 2 factors begin to narrow you will start seeing PAs salaries fall. However, based on the current number of students that are graduating each year I do not see that happening anytime soon. Right now you younger PAs come into the profession at much greater advantage to negotiate starting salaries then ever before. I know of places where new graduates are coming in at salary close to that of PAs who have been on the job for over 20 years. That is why I'm having a hard time understanding why this discussion even began on this forum.

[Walkoffshot]

But Basic Economics 101 always emphasizes the theory of supply and demand. As long as the supply of physician assistants remains lower than the demand salaries will remain high, bottom line! Should the gap in those 2 factors begin to narrow you will start seeing PAs salaries fall. However, based on the current number of students that are graduating each year I do not see that happening anytime soon. Right now you younger PAs come into the profession at much greater advantage to negotiate starting salaries then ever before. I know of places where new graduates are coming in at salary close to that of PAs who have been on the job for over 20 years. That is why I'm having a hard time understanding why this discussion even began on this forum.

 

Indeed. I guess I was talking within then next 10 years, but your absolutely right. It has EVERYTHING to do with economics. The rate of employment for PA's is an indication of the need for "cost effective" care, and to be ready for when the baby boomers start retiring. It's going to be quite the balancing act when everything starts to be in effect. Sort of like the perfect storm for PA's.

 

Do not undermine the system though. I referred to the Canada example because its the model of socialized medicine that does have an effect on care, services, insurance and salaries in comparison to the US. You better believe that if the US system starts to trend to socialized medicine it will change the system, the way insurance companies work which directly affects salaries.. of everyone across the board. That's just a small part of it though.

[Walkoffshot]

But Basic Economics 101 always emphasizes the theory of supply and demand. As long as the supply of physician assistants remains lower than the demand salaries will remain high, bottom line! Should the gap in those 2 factors begin to narrow you will start seeing PAs salaries fall. However, based on the current number of students that are graduating each year I do not see that happening anytime soon. Right now you younger PAs come into the profession at much greater advantage to negotiate starting salaries then ever before. I know of places where new graduates are coming in at salary close to that of PAs who have been on the job for over 20 years. That is why I'm having a hard time understanding why this discussion even began on this forum.

 

Indeed. I guess I was talking within then next 10 years, but your absolutely right. It has EVERYTHING to do with economics. The rate of employment for PA's is an indication of the need for "cost effective" care, and to be ready for when the baby boomers start retiring. It's going to be quite the balancing act when everything starts to be in effect. Sort of like the perfect storm for PA's.

 

Do not undermine the system though. I referred to the Canada example because its the model of socialized medicine that does have an effect on care, services, insurance and salaries in comparison to the US. You better believe that if the US system starts to trend to socialized medicine it will change the system, the way insurance companies work which directly affects salaries.. of everyone across the board. That's just a small part of it though.

[paul2834]

Forgive me for oversimplifying the situation, but if supply and demand dictate that PA wages will stay high for years to come, then why are physician wages dropping? Are we finally meeting the demand for physicians? If my understanding is correct, I believe there still is a shortage unless we're taking that deficit and we're dumping it all into the mid level provider bin. I don't know very much about medical politics, but I want to learn, so I ask for your patience even for something so potentially naive as this point I'm conveying.

[paul2834]

Forgive me for oversimplifying the situation, but if supply and demand dictate that PA wages will stay high for years to come, then why are physician wages dropping? Are we finally meeting the demand for physicians? If my understanding is correct, I believe there still is a shortage unless we're taking that deficit and we're dumping it all into the mid level provider bin. I don't know very much about medical politics, but I want to learn, so I ask for your patience even for something so potentially naive as this point I'm conveying.

[LT_Oneal_PAC]

Unfortunately, PAs are interchangeable in some practices with NPs. We can't control their numbers and they are opening more schools and making it easier every day. As opposed to harder like PAs, not necessarily a bad thing, and we are opening more schools as well. We've doubled our numbers in a decade. NPs are making themselves look more attractive as well by getting independent practice, yet still work for MDs. Now docs get someone they don't have to supervise (less liability and paperwork), but still reports to them. I believe we need to do something to distinguish ourselves from them or else they may ruin it for all by creating an oversupply.

[LT_Oneal_PAC]

Unfortunately, PAs are interchangeable in some practices with NPs. We can't control their numbers and they are opening more schools and making it easier every day. As opposed to harder like PAs, not necessarily a bad thing, and we are opening more schools as well. We've doubled our numbers in a decade. NPs are making themselves look more attractive as well by getting independent practice, yet still work for MDs. Now docs get someone they don't have to supervise (less liability and paperwork), but still reports to them. I believe we need to do something to distinguish ourselves from them or else they may ruin it for all by creating an oversupply.

[paul2834]

Oneal brings up a valid point. How much are people considering the proliferation of NP graduates (not hard for this to happen given all the online programs popping up left and right) when they make these projections on the supply of MLPs? It's effectively like injecting more PAs into the market, unless employers are stacking the two against each other and using a magnifying glass to observe who on average provides the better medical care.

[paul2834]

Oneal brings up a valid point. How much are people considering the proliferation of NP graduates (not hard for this to happen given all the online programs popping up left and right) when they make these projections on the supply of MLPs? It's effectively like injecting more PAs into the market, unless employers are stacking the two against each other and using a magnifying glass to observe who on average provides the better medical care.

[PAstudentCanada]

Just to throw out a number, PA's in Canada average a salary of ~65,000/year \

 

Where are you getting this figure from? I am a Canadian PA student in Ontario. Most PAs here make 80 something to start and in Manitoba about 90. The Government of Ontario is subsidizing up to 92 thousand dollars toward PA salaries plus 10 thousand dollar bonuses for rural/underserviced areas. That figure is highly unlikely.