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OT considering career change

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I am an occupational therapist that has unfortunately realized I made the wrong career choice. I had the feeling when I was in school, but now that I am in the work force the feeling is stronger. There are a lot of reasons why I think OT isn’t for me (the job market where I live isn’t what I was told it was going to be, how much insurance has negatively affected the profession, the upcoming changes in Medicare reimbursement model will negatively affect the job market, lack of respect for the profession in general, lack of upward mobility, stagnant salaries, etc.) but the main reason is that my heart isn’t in it. I always knew I wanted a career in healthcare, but realized in undergrad that I did not want to spend 4 years in med school, 3-4 in a residency, and take on that much debt, so I settled for OT. I know I would be much happier on the medical side of things than I am right now with therapy.

So, I have been considering making a career change to PA. I have also been considering NP. I am hoping someone can help me with my questions.

1. Besides the fact that it would take me less time to become a PA than it would a NP, what other advantages are there to being a PA instead of a NP?

2. Do you think either PA or NP is more respected than the other? Why or why not?

3. How much room is there for mobility in the PA profession? For example, if towards the end of my career, I wanted to get out of a clinical role, would that be possible/easy?


Thanks in advance for your help.

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Disclaimer; I am not a PA, PA-C, NP, PA-S, or Pre-PA.

1: You're trained to be a diagnostician under the same philosophy as your physician collaborators. PAs are gaining strides in the medical community, although slower than their NP colleagues, they are achieving more respect by patients and members of the health care team. In training, PAs have a much stronger science-based background as compared to NPs. This is a huge benefit upon graduation but becomes even once the individual gain real-world experience while doing their due diligence in staying up-to-date with current practice.

2: This is a loaded question. Respect is achieved when respect is given. In the general public, both clinicians are respected by patients and their medical team. Politically, NPs are much more powerful than PAs hence why more than half of America favor "independent" practice for NPs and none for PAs. That said, I have yet to witness "independent" practice for NPs in hospitals. Yes, many NPs own their own practice (they have to hire a medical director), as do many PAs. So this is arbitrary and just colorful words.

  • Although anecdotal, two Emergency Departments that I have worked in do not hire NPs on their ER team, only MDs, DOs, and PAs. Their reasoning for hiring PAs was somewhat disrespectful from my interpretation. One ED hires both PAs and NPs as house providers when patients are considered admitted and waiting for an inpatient bed. 

3: During its first inception, PAs were encouraged to have specialty mobility. However, during recent years, the Certificate of Added Qualifications (CAQ) and Residencies have become more common making it a tad harder. However, in comparison to NPs who specialize in either Family Care, a generalized concentration, to more specialized areas (Acute Care, Peds, Neonatology, Geriatrics, etc), it is much easier for a PA to go from let's say FM to EM, ICU, Surgery than it is for FNPs to go from FM to ICU without obtaining post-grad NP certificate. 

3b: It is much easier for NPs to obtain nonclinical positions due to also being an RN by nature. If you take a look at administrative positions in hospitals, many are filled by RNs or MSN/DNP/PhD wielding RNs. It is not impossible for PAs to obtain such positions, it's just not as common due to the fact many PAs rather be at the bedside. It is encouraged in nursing school that RNs must naturally progress from clinical to administrative/political positions. Their reasoning? To shape the future for the millions of nurses in America.

In the end, you must decide what you seek in a career than it is to focus on titles of the profession. Do extensive research; practice limits, political influences, career ladder, and pay. Remember, you should strive to work to live, not live to work. No one should spend more time at work than they do at home doing what they love to do. 

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