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LKPAC

The "Glory Days" for PAs have passed. It's all downhill.

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I fear that PAs, as a profession, have peaked and are now going downhill.

1.. Too many new grads.  And new grads have less, sometimes no HCE.  This in contrast to previous PAs who were nurses, technicians, therapist, etc before PA school.

2. Too many NPs.  They have a strong nursing lobby driving their laws.  Nurses hire nurses.  PAs get shut out and now we are seeing NPs demanding higher salaries than PAs.

3.  I fear our national organization is not able to combat our problems and make things truly better.

I do not post this to be a flamer.  I'm not suggesting our profession is going away any time soon, but I can see the beginning of the end.  I'm sorry to say that we are losing ground, not gaining.

I hope people here can point out how I'm wrong. 

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I don't think you are wrong if we remain complacent. I believe, as do many people currently in leadership positions, we will be on life support in 5 years if we don't level the playing field.

OTP should be a big help but it is going to take time to roll out. I'm hopeful that once the first state goes the rest will follow in fairly quick succession. Sadly we have some states and some of our own organizations that are resisting and even working against OTP. By the time they are officially wrong, if OTP doesn't start happening quickly, I wonder how many will be pleased that they spent a lot of time and energy trying to stop it from happening. Oh yea.... most of them will be retired leaving the detritus for the young PA to live with....

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I disagree with number one as we need more number to have a more power lobby and more funds. While they have less HCE, the newer generation is younger, more book savvy, more likely to push for advancement than the 40 year old who justs wants to practice medicine with a good salary without spending 7 years in training.

i think eventually we will have to reign it in on the number of graduates, likely performing our own flexner report that effectively shuts down a significant number of schools like what happened with MDs or institute residency requirements. Probably both will happen eventually.

Definitelt agree on 2.

I think 3 will get better as we have more PAs that contribute to the PAC and join AAPA.

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Right about now, a fair number of people think the future will not be as good as the past in many respects, including in PA-dom.

I suspect all any of us know is that the future will probably be different from the past and we have the opportunity to help it evolve.


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Everyone says every profession is dying.  

 

NP forums constantly talk about how some practices prefer PAs over NPs.  And I see the same thing here. I think it’s overblown.  There are enough patients.  I think the PA profession will be more than fine. As will NPs. And MDs. 

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1 hour ago, UGoLong said:

Right about now, a fair number of people think the future will not be as good as the past in many respects, including in PA-dom.

I suspect all any of us know is that the future will probably be different from the past and we have the opportunity to help it evolve.


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Couldn't agree more. Medicine is changing and will continue to change a lot more in the future. I don't think anyone has a firm grasp of what will happen when universal healthcare in the US gets rolled out (it is absolutely inevitable), whether it takes 10 years or 30 is the only question. And of course the details are all up for speculation too (tort reform? elimination of publicly traded pharmaceutical companies? Gov pharmaceutical companies? Gov insurance beyond "medicare for all?" Elimination of private insurance? Federal standardization of practice law? Etc etc). All data I've seen suggests there is overwhelming support for it in the <30y/o crowd, and it is approaching 50/50 in the general population. The only outlier is how politically influential will insurance companies and pharmaceutical companies continue to be? One stats source Pew Research 2017

Food for thought:

“Every generation imagines itself to be more intelligent than the one that went before it, and wiser than the one that comes after it.” ― George Orwell

And from a biology professor of mine that is relevant to the preoccupation with lots of HCE: "Everyone thinks that what they happen to be good at is uniquely important in life." (he was referring to everything from athletics to academics, life experiences, and specific fields of study). If PAs had traditionally been academics with little HCE and there was a push for more of it, we'd be hearing "New PAs don't have a strong enough academic background."

 

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The practice I am part of hires PAs whenever they get the chance - but unfortunately has hired 3 NPs since I started just over 1 year ago...simply because PAs aren't even applying.  Michigan can't produce enough PAs within our state, while NPs are being pumped out like high school graduates.

Personally, I think the reason PAs aren't applying is because our base salary is LOW.  My base salary is $87,550 and this is AFTER my annual raise.  Now, I work hard and am paid a bonus - making $2,650 last month and on track to make well over $4,000 this month - but I feel that part of my bonus is simply to make up for my low salary and then I work really hard to make above.

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3 hours ago, LT_Oneal_PAC said:

I disagree with number one as we need more number to have a more power lobby and more funds. While they have less HCE, the newer generation is younger, more book savvy, more likely to push for advancement than the 40 year old who justs wants to practice medicine with a good salary without spending 7 years in training.

Totally agree.. More numbers will make us stronger as a profession. The main reason, in my opinion, why the NP profession is gaining strength is because it is gaining numbers. There are thousands of RNs that are willing to take online classes to become an NP, and that is why they are pumping out new NPs by the thousands each year. 

 

1 hour ago, lkth487 said:

Everyone says every profession is dying.  

 

NP forums constantly talk about how some practices prefer PAs over NPs.  And I see the same thing here. I think it’s overblown.  There are enough patients.  I think the PA profession will be more than fine. As will NPs. And MDs. 

Exactly. Every profession will point out the negatives within their profession, and will overreact and state that their profession is "doomed." No... Total BS.. I too browse NP forums and all I read about is how the PA profession is gaining strength. Similarly I read about a post that said if and when the PA profession decides on a name-change, this will be a major hit for the NP profession, as the PA will no longer have the "assistant" in its name, but the NP will still have the "nurse" in its name. 

I have also been on forums for lawyers, accountants, PTs, and pharmacy... All bitch and moan about how their profession is oversaturated, the salaries are leveling out, and how their national organizations are doing nothing to advance the profession in a positive light.

4 hours ago, LKPAC said:

I fear that PAs, as a profession, have peaked and are now going downhill.

1.. Too many new grads.  And new grads have less, sometimes no HCE.  This in contrast to previous PAs who were nurses, technicians, therapist, etc before PA school.

2. Too many NPs.  They have a strong nursing lobby driving their laws.  Nurses hire nurses.  PAs get shut out and now we are seeing NPs demanding higher salaries than PAs.

3.  I fear our national organization is not able to combat our problems and make things truly better.

I do not post this to be a flamer.  I'm not suggesting our profession is going away any time soon, but I can see the beginning of the end.  I'm sorry to say that we are losing ground, not gaining.

I hope people here can point out how I'm wrong. 

To the OP. Yes you are overreacting. I have been practicing for over 10 years and this year I have seen massive strides of our profession that people were hesitant to even just talk about when I started, and this has all to do with the younger generation of PAs who are motivated and ambitious. The younger PAs look to get their "Master's" and do not settle for merely a "Bachelor's" in PA studies. The younger PAs look to for leadership opportunities within their hospitals, speciality organizations, state organizations, and national organizations. The younger PAs look to further their education with MBAs, JDs, MHAs, to become more attractive in hospital board elections and fight for their profession. 

Don't mean to call out the older generation of PAs, but from my experience, the older generation PAs seem to be more satisfied with what they are currently doing, practicing medicine with a decent salary, and have no interest in furthering the profession as a whole. Yet they find ways to continue to bitch and moan about things.

I am a preceptor for students in a large city in the northeast, and one of my students has received 5 job offers so far, graduating last month. All offers were >105k and various specialities of a moderate cost of living city. The salaries i have been seeing elsewhere are numbers you couldn't have imagined 10 years ago, and they seem to be getting higher and higher by the year. 

The push for OTP and title change is icing on the cake. Not if, but when, these changes will be made, this profession will finally flourish... 

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as a pre PA applicant, I have a lot of hope for the profession! More and more patients in my scope of practice as a medical assistant are realizing what PAs are capable of and allow the PAs in my office to see them, when they were expecting a visit with the doctor.  The acceptance of the profession in itself by patients is a huge feat.  

There are many eager peers of mine that are excited about this profession, and seeing the perseverance of those applying to schools even shows the attitude that PAs possess. I see many posts in this forum about it being the 3rd or 4th time applying to school, doing whatever it may be to increase their chances to get in school.  

I do appreciate seeing these viewpoints though, but I don't think the profession is going downhill from here, and certainly don't hope so!

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If you really want to see doom and gloom, see SDN forums.  Way back when I started thinking about Medical School (around 2008), SDN was the most pessimistic place on the planet.  It's ten years later and every person in my graduating class who was looking for a job got multiple job offers.

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I think we are reaching our "day of reckoning", so to speak, but I dont think we are doomed. 2 major reasons: 1) there are enough patients to go around, and 2) we generate revenue for less overhead than a doc.

PA programs are as numerous and popular as ever, but that's just evidence of how profitable it can be to have a PA program rather than actual market demand.

The biggest problem is, as LKPAC alluded to, that there are so many of us now without proper organizational representation. So the proverbial day of reckoning is coming, it just remains o be see how the landscape will change for us over the next decade or so. 

My hunch is, not much. We may make some small state-level strides in independence, we may see a slight increase in pay (commensurate with inflation), and we will continue to be the preferred providers for surgical subs and ER groups. But for all intents and purposes I see us remaining the viable but lesser-known and outnumbered cohort to the NPs.

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Yeah but is that a bad thing?  I don’t think it would be good for the profession if there were as many PA graduates as NP graduates.  

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5 good years is optimistic.  I predict the death spiral starts in 3 if our name is not changed....which it won't be.  I feel bad for younger PA's, they are really going to be screwed trying to pay back loans.

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12 hours ago, lkth487 said:

Yeah but is that a bad thing?  I don’t think it would be good for the profession if there were as many PA graduates as NP graduates.  

Agree, but PAs need to get the respect/recognition they deserve for the work they put in. We are actually the closest thing to a physician out there, and most folks, especially those in HR, don't often make that distinction. We are trained by physicians in the medical model with a standardized curriculum and over 2000 hours of rotations in all the major medical disciplines(IM, Peds, EM, Surgery, Psych, FP, OBGYN), not to mention specialty electives. The number of PA postgrad programs is going through the roof. There are likely well over 100 now, with 32 in EM alone. When I graduated 22 years ago there were no EM postgrad programs. USC had one prior to 96. I applied for the class that would have started in 1996 and what I thought was my "come interview phone call" was actually my "we are sorry, there will be no new class next year" phone call ?. I think our future is bright. We all just need to get on board with OTP one state at a time. and I agree with cideous, we need a new name yesterday.

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