Job Outlook

[MT2PA]

1 hour ago, PrePA94 said:

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.

The point, I think from all of this, is that sure, you will probably find A job.  Will it be the perfect job?  Not necessarily.  Will it be a great job?  Not necessarily.  Will it be the holy grail of PA jobs with great hours, amazing pay, and outstanding benefits?  Eh those are hard to come by for anyone.

Of the 4 specialties you listed surgery is the only one that I haven't seen NPs in.  I have no idea who outnumbers who in those fields but PAs don't have a monopoly in those fields.  It's certainly not a guarantee.  Derm, surgery, and ER are also fairly hard to get into as new grads because experience is highly valued.  Again, not impossible.  But they are competitive. 

No one can predict the future.  Go to a job search site and you'll see there are PLENTY of PA job openings.  Again, though, they may not be in your preferred field or location or be with great mentors or appropriate pay.  Will you find a job?  Probably.  But nothing is ever guaranteed.

[BruceBanner]

14 hours 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.

That's all feel-good stuff to think about, but it's about deeds over words. Acta non verba. You can get disrespected verbally in ANY profession, and I can tell you there are some a hell of a lot worse than healthcare. Go work in construction, or join the military. Where it really starts to chap your as$ is when you do the same day-to-day work as a physician and get not only 1/2 the pay (expected), but a smaller office (or no office), less vacation, more saturdays, more walk-in shifts, no seats at the decision-making table, etc. Less time with your family and less input on workflow when you do the same job...that can make the best of us feel indignant.

Anecdotes about the docs who talked down to us are fun to read and get us all riled up but I'm telling you that happens in every field. The real disrespect is in the pudding, and we're just giving honest answers that these are some potential realities of being a PA. That's not negativity.

 

[PACJD]

13 hours ago, EMEDPA said:

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

I mean if you went to PA school, then went through another 4 years of med school and at least 3 years of residency, then there was obviously something that you were not happy with in the PA career that made you invest all that time and money. So for that individual to judge and say X is better than Y would most certainly be biased toward the MD route. They could say that route was better for them, but they cannot say that route is better in general. Again, bringing it back to my initial point, that preferences are subjective.

[EMEDPA]

Agree- I think as a general rule if you like being respected and running the show, you should go to medschool. If you are ok with a great job and salary, but always being second fiddle to someone else, then PA is a totally acceptable route. I just don't deal with being disregarded or submissive* behavior very well. If I know I am right(and certainly I am wrong often enough) I want that to count for something and not have someone old enough to be my kid change my plan on a whim.

*Or any of these internal medicine/surgical attitudes either:

http://www.thesaurus.com/browse/dismissive

[SedRate]

8 hours ago, PrePA94 said:

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?

To kind of piggyback on MT2PA's post, I think the PA field will continue to be around. In my experience, there's a bias toward surgery and ER but who knows what the future will hold. The dependent status will make admin/employers shy away from PAs, especially as NPs gain independence, but I think there will always be a need for PAs, especially in surgery. Hospitals still require physician supervision of midlevels, even with independence, so you may still see a PA presence in the hospital. 

Regarding how easy or hard to find a job, that depends on the specialty, location and pay. The big three. 

[ohiovolffemtp]

I'm a relatively recent (5 years of practicing EM) old model PA: many years in corporate America doing IT while being a FF/medic on the side, then continuing that to pay the bills while taking the prereqs for PA school.  I had those many years of healthcare before becoming a PA.  I was the only 1 of my PA school class of 40 with this profile, next closest was a former airforce corpsman who'd also worked as a ED tech for awhile.  Most where in their 20's with a few years as an athletic trainer or equivalent.  I considered medical school (DO), was told I was an attractive applicant, but decided against it because of my age.

I'm always perplexed by current and prospective PA students who say they'll have a better lifestyle and/or more time to spend with patients vs. their MD/DO colleagues.  I've got a lot of contact with EM PA's & NP's and hospitalist PA's & NP's.  Everyone's schedule and pressures to see patients are the same as the docs.  The biggest reason I spend more time with some of my patients: I'm suturing them.  The specialist PA's & NP's, e.g. cardiology, seem not to take call like the docs.  Still, I don't know any NP or PA who's lifestyle is better than the docs - it's pretty much determined by the field of medicine.

The one thing that's very true: MD/DO spends many more years upfront in their education, sacrificing time and income, to get a much deeper education than we do as PA's.  Consequently, they are at the top of the food chain and make 2-6x what we make.

That's the key to making the proper decision: how much time and $'s you want to invest up front vs the size of the downstream rewards.

For me, given my age when I did this, I'm convinced I make the right choice.  I envy the doc's their knowledge and training.  They earn their compensation.  I strongly believe that there are way to many arbitrary ceilings on what an experience PA can do.  That's why I support and am hopeful about what will come over the next 5-10 years from OTP.

[EMfuturePA]

Anyone else trying to bridge to DO because  they are worried about future job opportunities  as a PA? Independent NP's are already taking over and are more popular over dependent ASSISTANTS, right?

[sas5814]

I have been away on vacation so I am catching up on a lot of threads and this has been interesting. I think what you are hearing is a spectrum of experience and opinions and that is, really, a good thing. No one of us has had a career that defines the profession but only what it was for us.

I was a medic in the military so, when I reached a fork in the road where I was either going to push troops or stay in something medical, PA school was a logical way to advance in the professions and in the military. I applied and was accepted first time (24 slots for about 400 applications). The military was...the military. I was respected and well treated because I was taking care of troops and their family members at a unit/community level where we, along with 1 or 2 doc, were health care. My first tour the nearest hospital and/or consultant was 90 miles away. Then there were field problems, combat deployments, advanced training programs etc etc.

When I retired I had spent the last 6 years caring for young healthy people. My experience in IM and the like was non-existent. I had never managed insulin. I barely remember having any diabetic patient but if you were on insulin you were showed the door. It gave me a very steep learning curve.

I started in the "real world" in rural health/family medicine and until recently was in rural, small, private owned practices including private UC clinics. I have always been well treated, reasonably well paid, and in demand. That has mostly been a function of geography. I have been where the majority of PAs don't want to be and that can make a huge difference.

Now, because we needed to be closer to aging parents I am in a small city working in corporate medicine and, in a word, it blows. Bean counters and nurse administrators run everything. Money is the driving force behind every decision and staff satisfaction is so far down the list of concerns I don't think it even got a number (though they make a lot of feel good noise about it). Staff gets an opinion about nothing. Mid management can't manage anything because all decision making power is accumulated in a very small group. I haven't met anything that faintly resembles a leader. When a physician acts like a fool I just tell them I will document their comments in the patients chart and kick it up for QA and med staff to review. I'm too old to dither with their tender egos. The youngsters don't fare quite so well but I am teaching them.

I think the single biggest issue confronting the profession is staying competitive in the market with NPs. They are years ahead of us and the same aforemention bean counters are doing the hiring based on the afore mentioned worship of the dollar. Physicians don't get a vote on hiring. I sincerely believe the profession will be on life support in 5 years if we don't address this. I could be wrong but some pretty smart folks share my opinion.

So would I apply for school now? I don't know. It is hard to take my experience and translate it to now in the civilian marketplace. I am not heartened by what passes for leadership in large health care organizations.

[PACJD]

5 hours ago, sas5814 said:

No one of us has had a career that defines the profession but only what it was for us.

Very important to understand...

[lkth487]

I don't understand this paperwork and 'spending less time with patients' thing - how does a typical physician have to do more paperwork than a typical PA in the same field?  Hasn't really been the case in any specialty I rotated in.

[CAdamsPAC]

On 7/9/2018 at 12:51 AM, KindnessMatters said:

I'm curious as to why you say this? My husbands a fourth year med student and every rotation he's worked at with PAs, he says he wishes he was a PA. 

The grass is always greener, over the septic tank.

[IMGtoPA]

On 7/11/2018 at 9:55 AM, MT2PA said:

The point, I think from all of this, is that sure, you will probably find A job.  Will it be the perfect job?  Not necessarily.  Will it be a great job?  Not necessarily.  Will it be the holy grail of PA jobs with great hours, amazing pay, and outstanding benefits?  Eh those are hard to come by for anyone.

Of the 4 specialties you listed surgery is the only one that I haven't seen NPs in.  I have no idea who outnumbers who in those fields but PAs don't have a monopoly in those fields.  It's certainly not a guarantee.  Derm, surgery, and ER are also fairly hard to get into as new grads because experience is highly valued.  Again, not impossible.  But they are competitive. 

No one can predict the future.  Go to a job search site and you'll see there are PLENTY of PA job openings.  Again, though, they may not be in your preferred field or location or be with great mentors or appropriate pay.  Will you find a job?  Probably.  But nothing is ever guaranteed.

I have 1.5 yrs of experience in primary care and I'm trying to get out of it into a specialty (ANY SPECIALTY). I've been applying to jobs endlessly for 6 months. I live in central FL in a suburb of a medium-sized city. I apply to jobs in the middle of the city, the suburbs, and out to the rural areas. I feel like there is definitely a saturation in my area, especially when you throw NP's into the mix. When a post goes up on Indeed, it's like the applicant vultures come out and apply like crazy.

A lot of the people on this forum preach about how we (collectively) shouldn't take a job that offers low pay, but with the saturation in effect, I feel like someone can definitely price themselves out during interviews and salary negotiations.

[sas5814]

You are correct! Like real estate our jobs are often about location location location. There are some well known areas that are saturated like south Florida and Dallas Texas and many others I am sure. If you are limited by geography as many are then you may have limited options. I saw a job ad for a remote site off Washington state that started (for the right candidate) at $155k I believe there was more than one and they have been advertised with no applicants.

geography, specialty, experience....that drives the availability of jobs. Want to work primary care in under served portions of Texas (which we have hundreds and hundreds of square miles? Take your pick....there are hundreds of unfilled positions. Want to work specialty in Dallas? Lots of luck.... the market is saturated. Think you're worth 150k in a primary care position but someone else will do it for 120k? You ain't getting the job.

Major employers like big hospital systems are even less likely to bend a whole lot. Benefits are fixed and they have a salary range in mind. get outside those lines and you won't get hired.

In the inverse if being in a certain area is very important to you but the pay is low...take it. Each of us decide what factors are most important in our job searches and it is a sliding scale that changes. I used to be allllllll about the money. Now I am more concerned with quality of life and my time off to spend with family and friends.

 

My grandfather used to say walk a mile in a man's shoes. Then you are a mile away and you have his shoes.

[EMEDPA]

2 minutes ago, sas5814 said:

Each of us decide what factors are most important in our job searches and it is a sliding scale that changes. I used to be allllllll about the money. Now I am more concerned with quality of life and my time off to spend with family and friends.

Yup, I'm there too. I could make $15/hr more and decrease my commute by an hr and get benefits to work at a local community hospital doing scut work 3 days/week, but it is worth it to me to be able to work 24s, have lots of time off, call all the shots, do all the procedures, and be the only provider in the hospital. Honestly this is the first job I have ever accepted without knowing the pay up front until I saw my first paycheck. I knew with what they were looking for (EMS experience, > 10 years as an em pa, prior solo coverage experience, acls/atls/pals/difficult airway/procedural sedation training) that they would pay me fairly and they did. When I started at this job as a per diem employee 5 years ago I would have done it for 1/2 what they ended up paying me. When they asked me to come on full time we did negotiate a pay raise to cover the lack of benefits as a 1099 employee, but I was seriously considering taking it even without the raise and just working more.

[MT2PA]

1 hour ago, IMGtoPA said:

I have 1.5 yrs of experience in primary care and I'm trying to get out of it into a specialty (ANY SPECIALTY). I've been applying to jobs endlessly for 6 months. I live in central FL in a suburb of a medium-sized city. I apply to jobs in the middle of the city, the suburbs, and out to the rural areas. I feel like there is definitely a saturation in my area, especially when you throw NP's into the mix. When a post goes up on Indeed, it's like the applicant vultures come out and apply like crazy.

A lot of the people on this forum preach about how we (collectively) shouldn't take a job that offers low pay, but with the saturation in effect, I feel like someone can definitely price themselves out during interviews and salary negotiations.

Florida is not only a notoriously saturated market but also typically just pays less in general across all healthcare specialties (I know first hand).

But just to prove my point:  you HAVE a job.  You could GET a different job but the pay is sub par.  So while you can be employed as a PA, it might not be ideal.  You also, if absolutely necessary, could potentially have to move to another area or state to be employed.

So yes, "we" say don't take that job that is paying $50k requiring 3 yrs experience (a real post from FL), you do what you have to do.  Ideally no one would take said job and the employer would remove head from sphincter but....that's not life.  "We" get that.  And if that particular specialty or location are worth making half of what you should as a PA, then you've made your choice.  You are choosing the specialty and location over pay.  Someone else might move to a less desirable area and make twice as much.  That's their choice.  The days of having it all are over, if they ever existed.  Which just reinforces what the OP was asking.  Sure, he/she will be able to get a job but....it's not sunshine and puppies.

[IMGtoPA]

1 hour ago, MT2PA said:

Florida is not only a notoriously saturated market but also typically just pays less in general across all healthcare specialties (I know first hand).

But just to prove my point:  you HAVE a job.  You could GET a different job but the pay is sub par.  So while you can be employed as a PA, it might not be ideal.  You also, if absolutely necessary, could potentially have to move to another area or state to be employed.

So yes, "we" say don't take that job that is paying $50k requiring 3 yrs experience (a real post from FL), you do what you have to do.  Ideally no one would take said job and the employer would remove head from sphincter but....that's not life.  "We" get that.  And if that particular specialty or location are worth making half of what you should as a PA, then you've made your choice.  You are choosing the specialty and location over pay.  Someone else might move to a less desirable area and make twice as much.  That's their choice.  The days of having it all are over, if they ever existed.  Which just reinforces what the OP was asking.  Sure, he/she will be able to get a job but....it's not sunshine and puppies.

True. If I was single and didnt have kids, I would totally move and be willing to move anywhere, (i.e. overseas, military, underserved area). But I'm not in that situation so it is what it is. My goal was to finish 1 year of general medicine and get into a specialty, as many have suggested-- easier said than done with a job market saturated. Again, I'm even applying to rural areas in my state (FL). I have friends in South Florida (one of the most saturated areas in the country) making less than me, so I guess things could be worse.

[EMEDPA]

54 minutes ago, IMGtoPA said:

True. If I was single and didnt have kids, I would totally move and be willing to move anywhere, (i.e. overseas, military, underserved area).

If I was single and didn't have kids I would go do the Lecom bridge program...

[ohiovolffemtp]

But, if I were single and didn't have kids I'd be mighty lonely.  As many have said, it's all about choosing wisely.

[Hope2PA]

Guess I am on a roll  with several posts today, but looking for  job postings in my area, and most say "Independent Nurse Practitioner". Sent in a couple resume's and response was that they are only hiring NP, not PA, because NP do not need Physician oversight.  They will hire a new NP with little to no RN experience because they can be independent very soon over experienced PA.

[Guest HanSolo]

"Expanding NP independent practice also improves access to healthcare, boosts the quality of healthcare and lowers patient costs, according to the Pennsylvania Coalition of Nurse Practitioners (PCNP)."

I'm sure hiring a brand new grad NP over an experienced PA will surely boost the quality of healthcare and lower costs...

You probably don't want to work at those places anyway, Hope2PA, so consider that a good screening tool...

[davidccs]

On 7/6/2018 at 9:39 AM, PrePA94 said:

Hello everyone!

Im currently applying for PA school, and Im really excited in terms of learning, practicing medicine, helping people, and having a good, respectful job that I can do amazing things in. However, I have been looking around on this forum, and I keep seeing posts about how the profession is changing, the "feud" for jobs/equal pay between PA's/NP (which I obviously had no prior idea about), and just a lot of other things that I was not aware of previously. It has made me question whether this profession is what I thought it was before I began applying. Nonetheless, I am so excited to become a PA, but I am just wondering how the future PA's might be affected with all the drastic changes happening today(and those that will happen in the future). Like many other pre-PA students, I want to help people, and have the job security I imagine I would have as a provider in the US. I have begun to become discouraged as I read posts about how the profession will be "over saturated" and how PA's in many ways will be at a disadvantage when compared to NP's due to us having the "assistant" in our name, not being able to practice independently, and obviously not having the strong background that nurses do (I keep reading about their strength in numbers and their union). I think NP's are awesome, as are PA's, and that we are similar in many ways, as are different. with all due respect to the nursing profession, becoming a nurse practitioner is not nearly as competitive and hard as becoming a PA is. I think nurse practioners are needed and provide something that PA's might not, but I also think PA's do the same (in providing something NP's do not). I just worry that because of their strengths in numbers and their union, PA's will be put at a disadvantage in the field.

Additionally, although I Obviously  do not expect anyone to know the future, I am curious to know what are your best predictions about how things will play out in the future for PA's in healthcare? Do you anticipate the field growing for PA's (in a positive way)? Do you think that for PA's to find jobs, theyll have to start doing more (residencies) and sticking to a specific field, as opposed to having the luxury of switching fields freely?

I hope my question(s) makes sense, but I really care about this field, and I want to become a PA in the future and see the field grow. I think its important now for PA's to worry about this, and do what is in our power to secure our future (not to sound too pessimistic, but I truly have no idea what's in store). What does the field need now to secure our positions? 

 

 

 

I know I am SUPER late to this convo, but I just wanted to give my experience as a PA that is 3 weeks from graduating.

I didnt read every post because the thread is 3 pages long so I apologize if you have already heard something similar, but if anything itll reinforce the point.

As I said I am 3 weeks away from graduating. Just to give you a background, my strong points for applications are a 6 year paramedic background, ER experience, and I speak Spanish.

I applied to about 10 jobs, mainly ER jobs, 1 ICU, 1 cardiology job.

I heard back from the cardiology job, they asked if I wanted to do 5 nights/week - I politely declined

I heard and interviewed from 1 ER job that "takes" 2 grads - three of my 19 classmates also interviewed and got jobs - I was placed on the "we like you but not quite pile"

I heard and interviewed from 2 ER jobs that DONT take new grads - one offered me a job that starts about 10k above the new grad avg salary (according to AAPA), the other is a contracted job that says they would email me with the offer and apparently will pay almost $100/hour but only covers malpractice.

So 10 applications, 1 call back that I declined, 3 interviews, 2 offers - whats not to love?

I have 5 other class mates that have jobs, all in various specialties, based on what they wanted to do. No one has taken a job in a field they didnt want to be in. Keep in mind this is before graduating.

Now for the clinical experience: There has only been 1 person, one, in my last 14 months that has treatment any differently, it was an older doctor. No patient has treated me different. I eat at the "doctors" lounge, go to "doctors" lectures, treat patients the same as a doctor would. In the ER I only interact with the doctors when I need to, most of the time the patient is seen, treated, and discharged without having to consult to the docs.

I had one patient's family member give me a "look" when I said I was a PA student, but by their discharge they expressed how glad they were that it was me that treated their family member. If you carry yourself with assertion, and show that you know what you are doing, no one will bat an eye.

The younger docs are very easy and open to work with, the older ones were trained in a different era, most are out the door. We are their replacement.

I may be a new PA, but I am not new to the game. You have made the right choice. Be proud, and represent the rest of us well.

[EMEDPA]

you might look at that 100/hr , malpractice only job. I get less than that at my 1099 job that covers malpractice only with 22 years as an em pa. benefits will cost you 20-30/hr. not too many jobs paying new grad em pas 70/hr.

[PrePA94]

On 8/10/2018 at 5:45 PM, davidccs said:

I know I am SUPER late to this convo, but I just wanted to give my experience as a PA that is 3 weeks from graduating.

I didnt read every post because the thread is 3 pages long so I apologize if you have already heard something similar, but if anything itll reinforce the point.

As I said I am 3 weeks away from graduating. Just to give you a background, my strong points for applications are a 6 year paramedic background, ER experience, and I speak Spanish.

I applied to about 10 jobs, mainly ER jobs, 1 ICU, 1 cardiology job.

I heard back from the cardiology job, they asked if I wanted to do 5 nights/week - I politely declined

I heard and interviewed from 1 ER job that "takes" 2 grads - three of my 19 classmates also interviewed and got jobs - I was placed on the "we like you but not quite pile"

I heard and interviewed from 2 ER jobs that DONT take new grads - one offered me a job that starts about 10k above the new grad avg salary (according to AAPA), the other is a contracted job that says they would email me with the offer and apparently will pay almost $100/hour but only covers malpractice.

So 10 applications, 1 call back that I declined, 3 interviews, 2 offers - whats not to love?

I have 5 other class mates that have jobs, all in various specialties, based on what they wanted to do. No one has taken a job in a field they didnt want to be in. Keep in mind this is before graduating.

Now for the clinical experience: There has only been 1 person, one, in my last 14 months that has treatment any differently, it was an older doctor. No patient has treated me different. I eat at the "doctors" lounge, go to "doctors" lectures, treat patients the same as a doctor would. In the ER I only interact with the doctors when I need to, most of the time the patient is seen, treated, and discharged without having to consult to the docs.

I had one patient's family member give me a "look" when I said I was a PA student, but by their discharge they expressed how glad they were that it was me that treated their family member. If you carry yourself with assertion, and show that you know what you are doing, no one will bat an eye.

The younger docs are very easy and open to work with, the older ones were trained in a different era, most are out the door. We are their replacement.

I may be a new PA, but I am not new to the game. You have made the right choice. Be proud, and represent the rest of us well.

Thank you SO much. I needed to read this more than you think, believe it or not. Hope you the best as you embark on this new journey as a PA-C!!

[ravenspac]

Im 6 years practicing, I live in PA which is literally one of the worst states in the country salary wise.

 

Job oppo's have dropped significantly since I've graduated. There are literally no open hours four my hospitals ED on a PRN basis. The nearby local non academic hospitals have exactly 2 openings for ED - both requiring 5+ years experience. The Local UC's which used to be easy to get PRN hours now are either not hiring at all or requiring 3-5 years of ED or UC experience. 

 

The in Demand "PA only" specialties like surgery are non existant as well here. 1 major hospital position, 1 private practice position open.

 

If I had the choice and I didnt slack in HS and college the first time, Id be an MD simply for the job opportunities are not drying up (We have 20 PA schools now)