How likely to find job as PA working 90hrs week? which speciality?

[kayala224]

Hello all,

New to the forum; Pre-Pa student. I have the grades (currently) to make it into a M.D./D.O. program but would prefer to go the PA route for various reasons. Contemplating.

Question: As a PA, are there opportunities out there to work hourly 90hrs a week or close to it? I know, I know, this is madness, but it's what I am used to and what I would like to do. Single, no kids; don't judge me.

If there are opportunities to work this amount of hours, what specialty would be best? What could a PA expect for a yearly gross income working these types of hours?

Bonus Question: How involved in medical research can a PA be? Are they not looked at as credible as a real M.D.?

 

[Cideous]

No judgment but you are looking at either Urgent Care or Emergency medicine.  Just don't work for salary.

[PAtoMD]

4 minutes ago, Cideous said:

Just don't work for salary.

I was about to post about how you shouldn't be joining this field for the money. 

 

OP may be in this for the wrong reason. The only part that perplexes me is that they inquired about research, which is not a high paying endeavor. 

[mgriffiths]

4 hours ago, kayala224 said:

are there opportunities out there to work hourly 90hrs a week or close to it?

I mean pretty much any employer on the planet would love to have you work 90 hour weeks.  The question is whether they will pay you for all of those hours.

But, working 90 hour weeks for any extended period of time is not healthy and not recommended.

[ohiovolffemtp]

I have worked 90 hour weeks as a firefighter/paramedic.  Not great, but it was 4 24 hour shifts.  Doable if you're not at stations with reasonable overnight call volume.

I can't think of any situation as a PA other than solo coverage in an extremely low volume ED/clinic where you got to sleep most nights with minimal interruptions.  You just can't be mentally sharp that much.

[LT_Oneal_PAC]

CT surgery first as resident, then continuing in that specialty. All the work you can handle. You could also do this in EM, but likely would need more than one job. But believe me, as a former resident, that life gets old quick.

You can be as involved in research as you want. It’s unlikely you’ll get a faculty position though where they will pay you for that research time, but it can happen. I know a couple. More resources will be available at an academic center. Your work will be judged on merit, not your initials. 

[kayala224]

10 hours ago, mgriffiths said:

I mean pretty much any employer on the planet would love to have you work 90 hour weeks.  The question is whether they will pay you for all of those hours.

But, working 90 hour weeks for any extended period of time is not healthy and not recommended.

How can they get away with not paying me? I was under the impression that we are paid hourly, not salary. I’ve read a thread somewhere in here where PAs had trouble getting there time and a half, so maybe that’s what your referring to?

i just want to work 90 hours a week at $70 am hour + time and half. Is that really that much to ask for? 

[kayala224]

4 hours ago, LT_Oneal_PAC said:

CT surgery first as resident, then continuing in that specialty. All the work you can handle. You could also do this in EM, but likely would need more than one job. But believe me, as a former resident, that life gets old quick.

You can be as involved in research as you want. It’s unlikely you’ll get a faculty position though where they will pay you for that research time, but it can happen. I know a couple. More resources will be available at an academic center. Your work will be judged on merit, not your initials. 

Thanks for the thorough response. As a currently licensed EMT, working in EM is the direction I’d like to go, but I would have to work two jobs? No one needs an PA in the ER to work 13-17 hour days or 4x24hr shifts every week? 

[mgriffiths]

8 minutes ago, kayala224 said:

How can they get away with not paying me? I was under the impression that we are paid hourly, not salary. I’ve read a thread somewhere in here where PAs had trouble getting there time and a half, so maybe that’s what your referring to?

Hourly vs. salary is significantly dependent on specialty.  Many UC/ER pay hourly, but most other specialties you are salaried with potential for productivity bonus.

10 minutes ago, kayala224 said:

i just want to work 90 hours a week at $70 am hour + time and half. Is that really that much to ask for? 

Honestly it really is because you are asking to work over 2x the normal hours, and most employers either would not think you are serious or would know that it is not sustainable and therefore would expect you to burn out rapidly.  As others have said, there is a limit to how long your mind can stay sharp to both assess and diagnose patients properly AND chart appropriately to protect yourself and your employer in the case of litigation.

There is a reason there were limits placed on hours worked for residents.  Main reason was to protect patients, secondary was to protect residents.

9 minutes ago, kayala224 said:

No one needs an PA in the ER to work 13-17 hour days or 4x24hr shifts every week?

You would be scheduled the same hours as everyone else, but could pick up extra shifts as they became available.  24 hour ED shifts are generally rural ED's where overnight you won't see much as most ambulances would pass you due to acuity and during the day you will have a slow, steady stream (with periods of increased busyness).

[LT_Oneal_PAC]

5 hours ago, mgriffiths said:

Hourly vs. salary is significantly dependent on specialty.  Many UC/ER pay hourly, but most other specialties you are salaried with potential for productivity bonus.

Honestly it really is because you are asking to work over 2x the normal hours, and most employers either would not think you are serious or would know that it is not sustainable and therefore would expect you to burn out rapidly.  As others have said, there is a limit to how long your mind can stay sharp to both assess and diagnose patients properly AND chart appropriately to protect yourself and your employer in the case of litigation.

There is a reason there were limits placed on hours worked for residents.  Main reason was to protect patients, secondary was to protect residents.

You would be scheduled the same hours as everyone else, but could pick up extra shifts as they became available.  24 hour ED shifts are generally rural ED's where overnight you won't see much as most ambulances would pass you due to acuity and during the day you will have a slow, steady stream (with periods of increased busyness).

I disagree with one point on the last one. No one bypasses my rural ED unless they are in a private vehicle as it’s 1.5 hours away from the nearest medical center that has any better capabilities. Rarely have I had an ambulance crew who wants to manage any acuity patient, much less a high one, for 1.5 hours. We do 72 hour shifts.

[LT_Oneal_PAC]

5 hours ago, kayala224 said:

Thanks for the thorough response. As a currently licensed EMT, working in EM is the direction I’d like to go, but I would have to work two jobs? No one needs an PA in the ER to work 13-17 hour days or 4x24hr shifts every week? 

It’s just rare for people to have so few employees there is that much needed coverage. Sure it could happen some weeks, but it would be uncommon for someone to need 2FTE. It would require to give you guaranteed OT as well, which they wouldn’t like, even if it’s technically cheaper. Plus they know it’s dangerous. Whether you think you could handle or not, decision fatigue is real.
 

I have one job that is a 72 hour shift every other weekend and two others that are PRN. The PRN gigs are basically time and half or more since I get more pay in lieu of bennies. I theoretically could get enough shifts between all these to hit 90 hours every week. None have that much need by themselves.

youre going to dig an early grave doing 90+ in ER though. 

[EMEDPA]

1 hour ago, LT_Oneal_PAC said:

It’s just rare for people to have so few employees there is that much needed coverage. Sure it could happen some weeks, but it would be uncommon for someone to need 2FTE. It would require to give you guaranteed OT as well, which they wouldn’t like, even if it’s technically cheaper. Plus they know it’s dangerous. Whether you think you could handle or not, decision fatigue is real.
 

I have one job that is a 72 hour shift every other weekend and two others that are PRN. The PRN gigs are basically time and half or more since I get more pay in lieu of bennies. I theoretically could get enough shifts between all these to hit 90 hours every week. None have that much need by themselves.

youre going to dig an early grave doing 90+ in ER though. 

Agree with all of this. I have had up to 6 jobs at once before, but aside from short stretches I try not to work more than 50 hrs/week. This week I am doing 4 24s, but that is rare and only because one of our regular providers is away on a medical mission for 2 weeks. 

I did 15 years of 55-60 hr weeks and got burnt crispy. Now I do only high acuity, low volume settings, so even when the weekly hours are high(like this week) the census is not. I am in my 7th hr of a 24 right now and have seen 5 patients so far. 

[kayala224]

On 2/2/2020 at 7:32 PM, PAtoMD said:

I was about to post about how you shouldn't be joining this field for the money. 

 

OP may be in this for the wrong reason. The only part that perplexes me is that they inquired about research, which is not a high paying endeavor. 

If you weren’t getting paid, your still showing up to work then? Interesting. I applaud your altruism. As for me (and 99% of higher level health care professionals, if honest) I would like to make money. 

A lot of people are mentioning burn out, which is obviously a real thing.... but how do surgeons survive their 70-90hr work weeks? If a surgeon can do it, why can’t a PA?

Edited February 13, 2020 by kayala224

[LT_Oneal_PAC]

On 2/13/2020 at 6:14 AM, kayala224 said:

If you weren’t getting paid, your still showing up to work then? Interesting. I applaud your altruism. As for me (and 99% of higher level health care professionals, if honest) I would like to make money. 

A lot of people are mentioning burn out, which is obviously a real thing.... but how do surgeons survive their 70-90hr work weeks? If a surgeon can do it, why can’t a PA?

A) if didn’t have to chart, I would do this job for room and board just about. But that’s not the point we are making about doing it for the money. People who do it for money can be seen time and again doing the least work that will pay the most. Nothing wrong with wanting to to live comfortably, but it leads to unnecessary testing, procedures, and poor care as the current incentive in our system is RVU based. Not saying you are ethically devoid as to falsify cancer diagnoses to justify chemo treatments as happened recently with an MD, but we prefer more altruistic aspirations.

B)surgeons do it and most surgeons are dicks because of this. It has nothing to do with PA vs MD. Plenty of CT surgery PAs work 80-90 hour weeks. They aren’t pleasant either. I’ve seen many a good person in my time as a nice resident become a giant douche because of the repeated abuse of them by the system. There are some surgeons who make it through intact, but even then you can see it rear it’s ugly head on a particularly bad night. Also, surgeons aren’t making nearly as many decisions per hour as EM. Ask anyone who has rotated through the ED in residency, going nonstop for 12 hours can be brutal. You get home and your decision fatigue is so bad you can’t decide if you shower or eat first. There is published EM literature on this. Now there are slow paced shops where you can do 72 hour shifts, but even those can flip and be brutal. I slept a total of 12 hours in a 72 this last weekend. It was a nonstop onslaught of very sick patients. Usually I work about 24 hours in a 72. Just never know. 
 

you came here to ask the advice from experience. It’s given, so you can do what you want. Free country. Everyone has to learn for themselves. Just don’t expect people to understand or approve of it. 

[PAtoMD]

12 hours ago, kayala224 said:

If you weren’t getting paid, your still showing up to work then? Interesting. I applaud your altruism. As for me (and 99% of higher level health care professionals, if honest) I would like to make money. 

A lot of people are mentioning burn out, which is obviously a real thing.... but how do surgeons survive their 70-90hr work weeks? If a surgeon can do it, why can’t a PA?

Did anyone say to show up without making money? If you're referring to don't work for salary, I believe you're intentionally misinterpreting it. 

 

And as @LT_Oneal_PAC said it is different. That being said, do they actually enjoying putting in those hours? 

 

I don't understand why you're being so combative over this concept of working 90 hours a week. 

[DiggySRNA]

I don't have the same level of responsibility as PAs but do work in a high stress environment where OT can be achieved. There's a nurse who averaged 72 hours for 1 week at least once a month in my ER.

I've worked 56 hrs one week and booked a vacation the following week for 6 days to decompress...and I'm only 27 years old, single, no kids, and no real responsibilities. I can't imagine adding another 34 hours.

Burnout is real and I've learned that first handed. Now I use my PTO to fulfill my 36/hr FT commitment but only work 24 hours/week.

 

But good luck with whatever you choose. But remember, QOL > any job.