The number of jobs on Indeed specifying just NP's with no mention of PA's are now 2:1 and growing...

[Cideous]

Several point out ONLY NP's will be considered....

Such a massive change since I graduated.  I just grieve for new PA's.  How long before PA schools start closing like over-saturated law schools?

I don't know why I keep pointing these things out, but sometimes it's like I'm standing in the middle of a house that's on fire screaming for everyone to get out and no one will wake up from their beds...

Edited November 11, 2020 by Cideous

[kang1208]

Here’s what I see:

Jobs that list both PA/NPs- plenty 

Jobs that list NPs only- uptrending

Jobs that list PAs only- none/rarely

And tell me why folks would still want to go for PA as opposed to NP? 

 

[FiremedicMike]

14 hours ago, kang1208 said:

Here’s what I see:

Jobs that list both PA/NPs- plenty 

Jobs that list NPs only- uptrending

Jobs that list PAs only- none/rarely

And tell me why folks would still want to go for PA as opposed to NP? 

 

Speaking from the perspective of someone who’s choosing the NP route over the PA route, despite coming from a profession that was originally one of the core student groups of PA programs - I don’t know why folks choose PA in 2020.

When I looked at the big picture, I couldn’t see a single justification to choose PA school.  From the pre-reqs which are identical to med school requirements, to the 2.5 years of full time hell while in the program, to coming out on the other side and AT BEST competing for the same jobs/pay.. it’s just a no brainer to me. 
 

 

Edited November 11, 2020 by FiremedicMike

[sas5814]

^This outlines it from the student perspective. The economics of it from the employer perspective has been discussed many many times. And I still hear a few loud "leaders" who want long term studies and data before we take any action. It makes my brain hurt.

[EMEDPA]

4 hours ago, FiremedicMike said:

 

When I looked at the big picture, I couldn’t see a single justification to choose PA school.  From the pre-reqs which are identical to med school requirements, to the 2.5 years of full time hell while in the program, to coming out on the other side and AT BEST competing for the same jobs/pay.. it’s just a no brainer to me. 
 

 

I agree that the NP route has lots of advantages. If you are looking for just one reason to choose PA over NP, I would direct you to compare a PA and NP program at the same institution and decide for yourself which has the more rigorous education and will produce a better clinician day one out of school. 

[surgblumm]

Regardless of the argument as to who has the better training, it still comes down to a plus for NPs when looked at from job opportunities. The NP must first be an RN which makes this particular professional hire-able in all fifty states. The Master's and NP title allows them entrance into a vast number of specialties whereas the Doctorate gives them a legitimacy to the public that we are lacking. The playing field is getting narrower and students are doing more intense investigation.

[FiremedicMike]

1 hour ago, EMEDPA said:

I agree that the NP route has lots of advantages. If you are looking for just one reason to choose PA over NP, I would direct you to compare a PA and NP program at the same institution and decide for yourself which has the more rigorous education and will produce a better clinician day one out of school. 

I actually typed this out but then deleted it because I didn't want my post to become a wall of text..

I realize my choice means I'll need to work harder on my own to focus on the areas I'm weak in, and I believe I have the pride and work ethic to do so.. I also recognize it'll take diligence up front to find a solid NP program (which I believe I've located, just need to gain admission when the time comes).

There was a part of me that wanted the PA/med school experience, but at the end of the day it just wasn't going to work in my life.. 

 

[GetMeOuttaThisMess]

E, while you know that you won’t get an argument from me regarding quality of education between the two options, one also has to look at the long-term and ask “Would I rather be better educated and potentially unemployable, or less educated, which I can improve upon on my own, and be employable?”

Using my dear mother as an example, it is inexcusable that she’s discharged from a hospital in February and has her levothyroxine dose adjusted by a hospitalist and yet the gerontologist and her NP don’t bother to notice that it hasn’t been followed up on until I again bring it to their attention after initially pointing it out to the physician following her return from the hospital!  Result this past week?  TSH >50 with low T3 warranting increase in her levothyroxine and yet they wonder why a drop off in memory recall.  Ugh...  I can’t even get away from it when retired.

Edited November 11, 2020 by GetMeOuttaThisMess

[FiremedicMike]

26 minutes ago, GetMeOuttaThisMess said:

E, while you know that you won’t get an argument from me regarding quality of education between the two options, one also has to look at the long-term and ask “Would I rather be better educated and potentially unemployable, or less educated, which I can improve upon on my own, and be employable?”

Using my dear mother as an example, it is inexcusable that she’s discharged from a hospital in February and has her levothyroxine dose adjusted by a hospitalist and yet the gerontologist and her NP don’t bother to notice that it hasn’t been followed up on until I again bring it to their attention after initially pointing it out to the physician following her return from the hospital!  Result this past week?  TSH >50 with low T3 warranting increase in her levothyroxine and yet they wonder why a drop off in memory recall.  Ugh...  I can’t even get away from it when retired.

To clarify, this was also missed by the physician gerontologist?

[thinkertdm]

I agree, 100%.  Today I received an email about the value of NPs in helping our heroes (at the va).  No one gives a diddley damn about PAs, collaboration, “optimal team practice “ or other bull-oney.  They only care about value to the practice, and once we have involved terms like “supervising”, “teams” and the fact we have to have an md (no matter how informal it is) listed when we go to license makes us a practice liability, not an asset.   
 

Clinics are businesses, pure and simple.  With any business, a simple and cheap process will always beat a complex and more expensive one.  What’s cheaper, an np who requires no oversight, or a pa, who needs an md “supervisor”, a team approach, blabity blah blah blah.  
 

most of us are idealists.  We see differentials, what is best for the patient...unfortunately, medicine is a retail business.  Retail.  You want to practice medicine?  Move to a developing country.  Here, you are an end product in a production line.

[PAinPenna]

So what do we do ? This is not a rhetorical question ! 
Here in this country we have around 150k well-educated capable health care providers making a difference in our patients ‘ lives every day . It saddens me that so many are hopeless for our future . I truly believe that as long as we push for updated practice laws we will be ok - just going to be an uphill battle for sure .

[GetMeOuttaThisMess]

57 minutes ago, FiremedicMike said:

To clarify, this was also missed by the physician gerontologist?

Yep.

[FiremedicMike]

22 minutes ago, GetMeOuttaThisMess said:

Yep.

So for the sake of argument, it's not really an indictment on the NP's education, but rather the lax attitude of that practice, don't you think?

 

[GetMeOuttaThisMess]

It's in a care facility with the NP in on a daily basis at each of their four small facilities (7-8 patients per home).  They are isolating the physician away from the patients since she's the PCP for the majority of occupants.  The PCP is still the one responsible for the overall care.

Sorry for the delay.  I was out hoarding toilet paper and paper towels for the winter, just like a squirrel storing away nuts.  I also got hand soap.  Watch for my listings on eBay (jk).

Edited November 11, 2020 by GetMeOuttaThisMess

[PAinPenna]

In other news - Joe Biden is considering Karen Bass for HHS Secretary . She is a PA  

[surgblumm]

P- I was in the first wave of PAs and I retired this past year. I have faith in our practice and education and accomplishments but it will be an uphill battle and how many will have the stamina to run the course? As far as Karen -- this will make no difference for PAs as our numbers are the smallest in the mix.

[rev ronin]

6 hours ago, FiremedicMike said:

There was a part of me that wanted the PA/med school experience, but at the end of the day it just wasn't going to work in my life..

To me, PA school was a concession that my family was more important than maximizing my training and options: I got through PA school with my family intact, and that was still worth the inconveniences of having an SP--which are in turn counterbalanced by the *advantages* of having an SP: while administratively it might all be negative, I've found having SPs be beneficial as I'm switching into new specialties (more on that at some other point).

I wish there was a reasonable bridge program.  In lieu of that, I am going to be doing a DHSc or DMS and advocating for staged independence, that, as a 10+ year provider, would apply to me at that point. I still would not have picked nursing.

[ANESMCR]

I’m a GI PA. This week I had a referral from a NP to evaluate an 86 year old male for Marfan’s. Not kidding.

[thinkertdm]

35 minutes ago, ANESMCR said:

I’m a GI PA. This week I had a referral from a NP to evaluate an 86 year old male for Marfan’s. Not kidding.

So what you do?  

[Rose66]

So I saw my "PCP " for the first time today, ( change ins.) 

He presented as hi I am Dr..., did not pay much attention and cont. with the consult, at the end I ask for the Dr. card to the MA. Guess what....he was DNP. I have to admit he was excellent, and I wouldn't had known his credentials if I hadn't ask for his card. He presented himself as a Doctor. Now tell me, as a PA, I always present mayself as a PA to patients, who do you think they will trust more, No matter how much experience you have, when people hear Doctor, they don't think NP. 

[rev ronin]

Just now, Rose66 said:

So I saw my "PCP " for the first time today, ( change ins.) 

He presented as hi I am Dr..., did not pay much attention and cont. with the consult, at the end I ask for the Dr. card to the MA. Guess what....he was DNP. I have to admit he was excellent, and I wouldn't had known his credentials if I hadn't ask for his card. He presented himself as a Doctor. Now tell me, as a PA, I always present mayself as a PA to patients, who do you think they will trust more, No matter how much experience you have, when people hear Doctor, they don't think NP. 

Depending on the state, that may have been illegal.

[ventana]

Ugh. 
 

one yr PA to NP bridge 

 

part time 

less 20k

you would see the PA field melt away 

[Cideous]

3 hours ago, ventana said:

Ugh. 
 

one yr PA to NP bridge 

 

part time 

less 20k

you would see the PA field melt away 

Yup, I've been saying this for years.  Go way back and read my "It's Time..." titled thread.  It's exactly about this.

[surgblumm]

For the PA who saw Dr. NP. I agree with Rev Ronin that in many states this is illegal but people will do it until they are censored. I always look for their ID card that they should be wearing and at times have seen the same situation in NY. It's true that the NP has earned it but it is also true for the PA and we are accustomed to following regulations. I used to think that nurses were both female and acquiesced to the AMA but my wife reminded me that back in the day, PAs were mainly male and it is the PA who worshiped at the throne of the AMA and were always fearful of reprisals. I say that we need the boldness that our counterparts have already demonstrated.

[ANESMCR]

23 hours ago, thinkertdm said:

So what you do?  

I wrote a fancy little note. That the patient would be more appropriately evaluated by cardiology, Rheum, Ophtho, etc. (Prob doesn’t need any of that either). First words out of this pleasant gentleman’s mouth “I don’t know why the hell I'm even here”.