Job Outlook

[PACJD]

Same I live in a major city and jobs are everywhere near me. I make more than 150k but I do have 10 years experience. I precept students and have several new grads accept offers in the 100k-110k area. This one new grad had 5 job offers each at least 100k, turned everyone of them down because he didn't like something about each of them. i though he was stupid and he was gonna end up unemployed, but he ended up getting a nice gig in a major PA dominated hospital, starting rate at 125k. 

Honestly, I am one of those who aren't a strong supporter of PA residency. They would definitely allow you as a provider to feel more comfortable, but you are taking a pay cut in the process. Many of my colleagues went the PA route so they wouldn't have to do a residency. Pay cut, long hours, significant responsibilities, poor treatment for what? In the area that I am, residency doesn't really benefit much in terms of pay or hiring. Really just  a way for a new grad to feel more comfortable starting to work. I would suggest it if you didn't really have significant hands on exposure in your clinical rotations, but if you are pretty comfortable seeing patients, I don't really think a residency is needed. Just my two cents. 

[PACJD]

8 minutes ago, EMEDPA said:

I am not down on the profession, I am down on my choice to pursue it. PA is a great match for some folks. Others really would just do better as physicians. I am one of those. 

Don't mean to stir up any controversy or anything but a lot of what you are saying in this topic and what others are saying isn't really helping the profession in any manner. In fact, you guys are swaying the younger generation from pursuing this career, which in the end will hurt this profession in the long run. 

Truth is there are both pros and cons of every profession, PA/MD, education, law, business, engineering, so on and so forth. If you wanted to do MD, you should have done MD. It does no good by listing the downfalls of the profession and expressing your regrets in life. If someone chooses to become a PA, then they accept the responsibilities and possible consequences of their decision. 

This isn't the first post where i have seen just the negatives of PA vs MD. These are two totally different professions. Its like saying to all these young folks don't do PA go to school and become a teacher instead. Makes no sense. 

[EMEDPA]

24 minutes ago, PACJD said:

These are two totally different professions. 

don't agree with this. we both practice medicine and are both expected to practice it to the same standard. It's not ok to say

" I missed that case of appendicitis because I am a PA". 

[EMEDPA]

26 minutes ago, PACJD said:

If you wanted to do MD, you should have done MD. It does no good by listing the downfalls of the profession and expressing your regrets in life. If someone chooses to become a PA, then they accept the responsibilities and possible consequences of their decision. 

except maybe one does not know up front what the reality of the profession is until they enter it. Do they tell you in school that the vast majority of physicians will disrespect you, either to your face or behind your back? Do they tell you that consultants will refuse to talk to you on the phone because you are a PA? No, they do not. 

[PAtoMD]

4 minutes ago, EMEDPA said:

except maybe one does not know up front what the reality of the profession is until they enter it. Do they tell you in school that the vast majority of physicians will disrespect you, either to your face or behind your back? Do they tell you that consultants will refuse to talk to you on the phone because you are a PA? No, they do not. 

This right here. The PA community often times likes to hide certain aspects of the career. It often gets shadowed by USA Today headlines “PA is number one career for the fifth year”. We hide it’s history and how that dictates the education. It was designed for experienced healthcare professionals not a 22 year old who worked as a CNA for 9 months. We hide the pitfalls. This along with what EMED is why they recommend against it. 

It took me a year of PA school to realize all of this and for me to decide I want to pursue medical school after. I could be happy as a PA too, but I think something would be missing. Being a PA is a great career but we have to be honest about many aspects of it.

[EMEDPA]

19 minutes ago, SR0525 said:

This right here. The PA community often times likes to hide certain aspects of the career. It often gets shadowed by USA Today headlines “PA is number one career for the fifth year”. We hide it’s history and how that dictates the education. It was designed for experienced healthcare professionals not a 22 year old who worked as a CNA for 9 months. We hide the pitfalls. 

yup, this is a big part of it. most of today's applicants would not have been given an interview 20 years ago because they lack real health care experience, long considered the foundation of the profession. This leads to a situation where only 1/3 of practicing PAs feel it is more than just a job:

https://www.physicianassistantforum.com/topic/47508-a-calling-a-job/?page=2

[PACJD]

29 minutes ago, EMEDPA said:

except maybe one does not know up front what the reality of the profession is until they enter it. Do they tell you in school that the vast majority of physicians will disrespect you, either to your face or behind your back? Do they tell you that consultants will refuse to talk to you on the phone because you are a PA? No, they do not. 

How do you know there aren't similar realities in MD. Like you said, people do not know up front what the reality of the profession is until they enter it. You entered a PA profession, you do not know what the MD profession holds. I come from a long line of doctors in my family, my father being one of them. He was actually the one who told me to stay away from becoming an MD if what I loved to do was help others and have real patient contact. He spent a majority of his days doing paperwork and said MDs are becoming primarily a desk job with very little patient interaction. So, there are downfalls of the MD profession as well. I agree with you that some people are better suited to be MD and some PA. There are downfalls of every profession, no need to bitch about it and express your regrets. 

 

36 minutes ago, EMEDPA said:

don't agree with this. we both practice medicine and are both expected to practice it to the same standard. It's not ok to say

" I missed that case of appendicitis because I am a PA". 

Yes I agree that we both practice medicine and should practice at the same standard. We should all care for whatever is best for our patients. But it is not ok for a PA/NP to say "I don't get as much respect as a doctor" or "I don't get paid as much as a doctor" just because we all practice medicine at the same standard. Truth and reality is that we have different training, different education, different governing boards, hence we are all different professions acting toward a similar purpose. That is how the profession was advertised to me prior to me entering school, and that is how my mindset and attitude is toward the profession now. That is why I am not jealous, envious, or regretful. I knew what I was getting myself into and you should have done the research prior to entering school. If you still were unhappy with your career even after entering it, you still had the ability to go back to medical school after that. No one said you couldn't practice 5 years as a PA and then go back to medical school. Obviously circumstances (family, finances, age) would affect that, but if you were really unhappy about it then you should have made a change.

Again, not trying to start anything...

[Cideous]

For me it’s not about PA vs MD vs NP.  It’s medicine in general.  It’s become twisted and perverted into a pure cash grab.  It’s horrifically expensive to the point of being ludicrous.  

Trying to manage good care while at the same time dancing around insurance hell, eye popping deductibles and lawsuits.  It’s become some kind of twisted nightmare.

I advised all of my kids to stay clear.  Cynical?  Maybe.  Truthful?  Absolutely.

[PAtoMD]

30 minutes ago, EMEDPA said:

yup, this is a big part of it. most of today's applicants would not have been given an interview 20 years ago because they lack real health care experience, long considered the foundation of the profession. This leads to a situation where only 1/3 of practicing PAs feel it is more than just a job:

https://www.physicianassistantforum.com/topic/47508-a-calling-a-job/?page=2

Yeah I am one of the straight From undergraduate PA students.  My experiences were slim but I’m trying to make up for it by being proactive during rotations. I understand now why it was so important. 

[PACJD]

10 minutes ago, Cideous said:

For me it’s not about PA vs MD vs NP.  It’s medicine in general.  It’s become twisted and perverted into a pure cash grab.  It’s horrifically expensive to the point of being ludicrous.  

Trying to manage good care while at the same time dancing around insurance hell, eye popping deductibles and lawsuits.  It’s become some kind of twisted nightmare.

I advised all of my kids to stay clear.  Cynical?  Maybe.  Truthful?  Absolutely.

Now this is something i can agree with. The whole healthcare system is messed up and run by money hungry officials. 

[EMEDPA]

41 minutes ago, PACJD said:

If you still were unhappy with your career even after entering it, you still had the ability to go back to medical school after that. No one said you couldn't practice 5 years as a PA and then go back to medical school. Obviously circumstances (family, finances, age) would affect that, but if you were really unhappy about it then you should have made a change.

went back to school several times while working full time to take extra genetics, a yr of physics, stats, etc. Almost applied to be in the first Lecom class with Primadonna when my wife lost her job, one of our kids had health issues, etc. Trust me, it's not for lack of trying. My dad was also a doc. I don't think docs do much more paperwork than PAs unless they own a practice. A doc and a pa in family medicine do basically the same things all day long. I am not saying I should make what they do. They have more education, etc. I get that. I am saying they should treat us better. Many of the docs who treat us like crap are dying or retiring. I actually am hopeful for the future given current changes in the profession and the fact that more docs now are training with PAs as they come up. It has just been a long/hard road to get to where I am today. A road that would have been much easier as a physician. 

[PACJD]

12 minutes ago, EMEDPA said:

went back to school several times while working full time to take extra genetics, a yr of physics, stats, etc. Almost applied to be in the first Lecom class with Primadonna when my wife lost her job, one of our kids had health issues, etc. Trust me, it's not for lack of trying. My dad was also a doc. I don't think docs do much more paperwork than PAs unless they own a practice. A doc and a pa in family medicine do basically the same things all day long. I am not saying I should make what they do. They have more education, etc. I get that. I am saying they should treat us better. Many of the docs who treat us like crap are dying or retiring. I actually am hopeful for the future given current changes in the profession and the fact that more docs now are training with PAs as they come up. It has just been a long/hard road to get to where I am today. A road that would have been much easier as a physician. 

I got ya.. Wasn't tryna attack you personally, just trying to point out that no profession is all bells and whistles. Some are more suited to be MDs, others PAs. Both are rewarding, but both have their downfalls. People shouldn't try to persuade prospective PAs and say "why don't you just become a doctor" as I'm friends with old docs and some of them regret becoming an MD. It's all about the individual. 

[PrePA94]

15 minutes ago, EMEDPA said:

went back to school several times while working full time to take extra genetics, a yr of physics, stats, etc. Almost applied to be in the first Lecom class with Primadonna when my wife lost her job, one of our kids had health issues, etc. Trust me, it's not for lack of trying. My dad was also a doc. I don't think docs do much more paperwork than PAs unless they own a practice. A doc and a pa in family medicine do basically the same things all day long. I am not saying I should make what they do. They have more education, etc. I get that. I am saying they should treat us better. Many of the docs who treat us like crap are dying or retiring. I actually am hopeful for the future given current changes in the profession and the fact that more docs now are training with PAs as they come up. It has just been a long/hard road to get to where I am today. A road that would have been much easier as a physician. 

Its unfortunate that some doctors treat PA's poorly. I don't think this is a reflection of the physician, but of the selected doctors who lack respect. Ive always been a person who gave respect to others, but also demanded respect in return. As an MA who the past 7 years (and I know its much more different as an outsider), doctors, PAs, and NPs all respected and worked with another. They bounced ideas and asked for help from one another. Respect was always there, and mutual. I think so long as you respect me, and I respect you, we can all do our job.

[BruceBanner]

The disrespect thing is specific to where you work; but always there to some degree. That's a straight fact, no matter how nice docs are to your face. It's not that they are secretly conspiring against us, it's that sh!t rolls downhill, and guess where you are? Under the docs. 

With the exception of 1 job, all of the docs I have worked with have been (generally) collegial. The devil comes out in the details. Office space, call schedules , benefit allocations, clinic responsibilities. You will get the shorter end of the deal. If you haven't experienced that yet, you haven't worked long enough.

[EMEDPA]

13 minutes ago, BruceBanner said:

The disrespect thing is specific to where you work; but always there to some degree. That's a straight fact, no matter how nice docs are to your face. It's not that they are secretly conspiring against us, it's that sh!t rolls downhill, and guess where you are? Under the docs. 

With the exception of 1 job, all of the docs I have worked with have been (generally) collegial. The devil comes out in the details. Office space, call schedules , benefit allocations, clinic responsibilities. You will get the shorter end of the deal. If you haven't experienced that yet, you haven't worked long enough.

yup, this. I have worked with probably an equal # of great docs and assclowns and some mediocre ones in the middle. My first job at a place with an FP residency was great. loved everyone there. my next few jobs, not so much. my current jobs are great. it was the 15 years between job 1 and job 6 that made for a rough road. The funny thing was the place that utilized the most PAs/NPs treated us the worst in terms of respect/autonomy/scope of practice. they use us because financially we make sense, but would replace us all with docs in a heartbeat if they could. 

[Guest ERCat]

Tired of the negativity in this post... I love being a PA. Sure, our job security is not that of an MD, and I have thought about what it would have been like to go to medical school, but at the end of the day I am very happy with my choice. At the end of the day, my classmates who I am close to who are also happy with the profession, spent two years of our lives immersing ourselves fully in the supportive, challenging, engaging (not cutthroat) learning environment of PA school, then got out and landed jobs making six figures. And now with potential for growth. My former classmates are incredibly intelligent people with experience and most I believe were med school competitive, so I don’t buy the “low standards” crap - standards for PA school in some sense are getting stricter because there are so many people who want in. While gathering pre-req classes and experience, applications, and PA school was challenging I didn’t ever go through what my med school friends went through - years of biting their nails with anxiety through undergrad preparing for the MCAT, then getting into medical school after a long application and interview process (somerimes YEARS long) and suffering more years of intense pressure to pass Step 1, Step 2, etc and then HOPE they get matched in a cutthroat competitive residency program so they don’t have to eat beans for a year while their 200K+ in loans accumulates interest. Then go through the pressures of residency, working 80 hours a week even though you’re not legally supposed to, making little more than minimum wage when you consider the hours it takes to make your resident salary, then getting thrown out on your butt in your first big boy job expected to know everything and have zero oversight/back up/protection from liability because you’re the doctor. I freaking LOVE that I didn’t stomach years of going through all of the above and I can still immerse myself in medicine and take care of patients and make a damn good living, and also have the support and oversight of a physician. If I don’t know something, I can ask a physician. If I can’t handle something, I can ask a physician to take over. And that’s freaking lovely. Almost every single doctor I have talked to has discouraged anyone who asks about medical school to go to medical school. Quite frankly most do not seem happy with their jobs. Maybe that’s just medicine in general. The good news is, compared to a physician our investment in training in terms of time and money is much less;  therefore if medicine gets to be too terrible we can always jump ship with much less at stake than a physician. Or, we can just attempt switch into derm.

[Guest ERCat]

And about the occasional lack of respect - who cares if some a$$ hat talks down to you for being a PA? I used to let this wear on me and then I made the realization that 95% of the physicians I interact with are supportive and respectful. I can only remember a few negative interactions wirh docs because of my PA status, but I remember a heck of a lot more positive ones - “Wow,  thanks for figuring out what that rash was!” “You were right to tell me you wanted the CT - that kind has a orbital cellulitis wirh an abscess.” “That PE you found on the old lady with back pain was a crazy good catch -I would not have found that.” “Can you tell me the guidelines for statin use; you PAs know a lot about primary care.” If a few don’t respect me here and there,  it’s my choice if I’m going to let it bother me. I can get upset about it because my ego is bruised, or I can just think “Hmm, some people are jerks” and move on. It sucks to be disrespected occasionally but it doesn’t have to POISON all the other stuff that is right and good about this career.

[PACJD]

52 minutes ago, ERCat said:

And about the occasional lack of respect - who cares if some a$$ hat talks down to you for being a PA? I used to let this wear on me and then I made the realization that 95% of the physicians I interact with are supportive and respectful. I can only remember a few negative interactions wirh docs because of my PA status, but I remember a heck of a lot more positive ones - “Wow,  thanks for figuring out what that rash was!” “You were right to tell me you wanted the CT - that kind has a orbital cellulitis wirh an abscess.” “That PE you found on the old lady with back pain was a crazy good catch -I would not have found that.” “Can you tell me the guidelines for statin use; you PAs know a lot about primary care.” If a few don’t respect me here and there,  it’s my choice if I’m going to let it bother me. I can get upset about it because my ego is bruised, or I can just think “Hmm, some people are jerks” and move on. It sucks to be disrespected occasionally but it doesn’t have to POISON all the other stuff that is right and good about this career.

Well said. I think the negativity comes from the more seasoned folks who have experienced a lot and certain remarks from younger docs start to take a toll. And it is understandable why some of these PA vets start to look at the profession in a negative fashion.

But, as I was trying to make my point, the PA profession has its downfalls, just likely every other profession out there. The decreased salary and lack of respect are two of its downfalls, but you also have to look at the numerous positives as well. ERCat named the negatives of going MD, but obviously there are a ton of positives (salary, respect, autonomy) seen in MDs. No one individual can judge which is better or not, and no one should tell others that they should go PA vs MD. Bottom line.

[EMEDPA]

54 minutes ago, PACJD said:

No one individual can judge which is better or not, and no one should tell others that they should go PA vs MD. Bottom line.

aside from someone who has done both....we have quite a few of those around here. 

[SMcG8]

Always wanted to be a doctor when I was younger.  Shadowed a 60yo surgeon when I was 16.  He was working 65-70hrs a week, making crazy money, but his life revolved around the OR.  Shadowed a 55yo FP doc, worked 9-5 M-F, but with paperwork and making calls after work was more around 9a-8p.  I did more research on schooling, residency and average working schedule of MDs and realized - I didn't want to be a doctor.  PA seemed like a perfect happy medium of life/medicine.  I want to travel, golf, snowboard, hike, surf, raise a large family, coach their sports, be around while they grow up, enjoy life outside of work and most importantly - BE HAPPY.

Less school, no residency, able to enjoy my 20s, less debt, less hours, more time outside of work, AND still be able to help patients and make six-figures?  SIGN ME UP

At the end of the day, everyone should do what makes them happiest in this life, cause after all - you only get one.  Personally, I value the possibility of my future endeavors outside of the hospital with my family and friends more so than inside. 

With that said... Take everything I said with a large handful of salt because I am a 23yo PA-S.  My opinion on these matters does not come with a lengthy experience as a practicing PA or as an adult for that matter, simply from the outside looking in (for now).  

[Guest HanSolo]

11 minutes ago, EMEDPA said:

aside from someone who has done both....we have quite a few of those around here. 

you really are an instigator today 

[SMcG8]

15 minutes ago, EMEDPA said:

"No one individual can judge which is better or not, and no one should tell others that they should go PA vs MD. Bottom line."


aside from someone who has done both....we have quite a few of those around here. 

With all due respect, that's like saying someone can tell you which flavor ice-cream you would prefer because they have tried two kinds and you've only tried one.  It's quite subjective.  Everyone experiences things differently and looks for different things in life that satisfy them.  Would they be able to give information on aspects of each profession better than most? Absolutely.  They could give information that you could find helpful in determining which was more suitable for you, but they would not be able to tell you whether you should go PA/MD or tell you which job you would prefer.  To each their own

[EMEDPA]

2 hours ago, EMEDPA said:

aside from someone who has done both....we have quite a few of those around here. 

I meant for that individual, not the population at large. obviously I can't tell anyone what they personally should do, but If I did both I could say X was better for me because....

[PAtoMD]

9 hours ago, SMcG8 said:

Always wanted to be a doctor when I was younger.  Shadowed a 60yo surgeon when I was 16.  He was working 65-70hrs a week, making crazy money, but his life revolved around the OR.  Shadowed a 55yo FP doc, worked 9-5 M-F, but with paperwork and making calls after work was more around 9a-8p.  I did more research on schooling, residency and average working schedule of MDs and realized - I didn't want to be a doctor.  PA seemed like a perfect happy medium of life/medicine.  I want to travel, golf, snowboard, hike, surf, raise a large family, coach their sports, be around while they grow up, enjoy life outside of work and most importantly - BE HAPPY.

Less school, no residency, able to enjoy my 20s, less debt, less hours, more time outside of work, AND still be able to help patients and make six-figures?  SIGN ME UP

At the end of the day, everyone should do what makes them happiest in this life, cause after all - you only get one.  Personally, I value the possibility of my future endeavors outside of the hospital with my family and friends more so than inside. 

With that said... Take everything I said with a large handful of salt because I am a 23yo PA-S.  My opinion on these matters does not come with a lengthy experience as a practicing PA or as an adult for that matter, simply from the outside looking in (for now).  

As a 24yo PA-S I haven’t found much of what you said to be true. The medical students im friends with interact with have more time than me and my classmates. I also see PAsworking just as long hours. The work life balance of a physician can be just as good if not better than a PA. The doctors I’ve interacted with on rotations take 3 week vacations 3 times a year or work 8 shifts a month. Don’t get me wrong, a lot of physicians work a ton but to make it a selling point for the PA career just doesn’t do it for me anymore. 

However, your mileage may vary this is just another anecdote on the internet. 

[PrePA94]

Hey everyone, thank you for all your comments- both positive and not. I really wanted to know more about the profession than what a simple google search would give me, and I think I got that for the most part in this post. However, I didn't get a concise answer about how easy/hard it will be finding a job in the profession later-- can someone provide that answer? Do you think professions like derm, surgery, ER, and urgent cares will always need PAs, as opposed to NPs?

 

And honestly, THANK YOU (!!!!) to everyone who wrote here. I think I can safely say we all care about this profession, and there are legit concerns that I hope current and future PA's will solve. I think that there is power in teamwork, and so long as we work together the changes we yearn for will happen. Lastly, I hope no one has gotten upset over this forum. Were all entitled to our own opinions, and I have asked and appreciated each and every one.