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Better medical education than NP but fewer opportunities. What gives?


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I have a question for you all that affects myself and my PA colleagues.

I worked in FM for a couple years before coming to Cardiology M-F 8-5. I've been trying to find a side gig (other than UC or ED) because our family still lives like college students even after 3 years of working as a PA. I have found that supervision requirements and state/federal/Medicare restrictions have obstructed my every attempt to find work over the last year. Many of my NP colleagues have side gigs that require little effort with good income, but none of my PA colleague do (other than a PA who uses his prior RN for less pay on weekends). I have had lots of interest from employers to do home care, hospice, psychiatry, addiction medicine, DOT physicals, insurance physicals, aesthetics, but once we get to the "I need supervision" part or "Medicare only allows NPs or MDs to do that", the hiring process ends. 

Can anyone tell me what side jobs and independent contractor gigs are actually accessible for PAs? What can I do to find these positions? I hate to say it but I regret not going to nursing school and then taking NP classes at night for 1/4 the cost of PA school. Does our profession just need to get its *#&! together? Is there anything coming down the pike such as hospice recertification authority? Sorry to sound upset, I've become exhausted by the hurdles and have run out of ideas.

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Another day...another WTF is going on with this profession thread.  You are not alone, but sadly state and national leadership is impotent to do much of anything.  Hell, we are having knock down/drag out fights over losing the "Assistant" from our name!  It's a hell of a thing.  I guess I would say, just be glad you have a job at all.  Many PA's do not.

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Yep, the model of PAs is pretty much born out of times when physicians owned all the medical practices as that is no longer a reality, we are rapidly loosing ground to more independent NPs. Your best bet is probably UC or ED

Edited by iconic
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I honestly thought all of this was exagerrated until I started looking for new employment myself.  18 years experience, no gaps in employment, squeaky clean resume.  No calls at all.  Fortunately my current employment has improved and I plan to stay where I am, honestly hopefully until I can retire in 5-6 years.  I feel like even 5-10 years ago things were so much better.  A Physician that works for a larger group or hospital does not want to take on the "supervision" role.  If it does not directly benefit them, why would they want to spend the time and "liability" to do that.  It is eye opening.  

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7 hours ago, electric130 said:

Boatswain2PA....funny you list those skilled workers as possible side jobs.  People with those skills are killing it right now, at least in my area real estate is booming.

My plan B was to go back to teaching piano. 

Good point! I had an electrician come and do a job that took about an hour, walked out w $180 cash! Thats living! 

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2 minutes ago, Cideous said:

I am currently sending my 19 year old to HVAC school.  $9k for the school, average salary for commercial is $70k + bonus with SICK benefits.  Yeah, do the math.  

40 years x 100k = 4 mil - 200k = 3.8 mil

40 years x 70 k = 2.8mil - 9k =2.71 mil

I'm liking what I chose personally.

Now if we are talking about the mental stress and burn out factored in, hey, I might still be pretty happy doing HVAC

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4 hours ago, LT_Oneal_PAC said:

40 years x 100k = 4 mil - 200k = 3.8 mil

40 years x 70 k = 2.8mil - 9k =2.71 mil

I'm liking what I chose personally.

Now if we are talking about the mental stress and burn out factored in, hey, I might still be pretty happy doing HVAC

Was a union ironworker for years. I'll take the mental stress and burnout over the physical burnout and mental drudgery any day.

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7 minutes ago, MediMike said:

Was a union ironworker for years. I'll take the mental stress and burnout over the physical burnout and mental drudgery any day.

My dad was a physician, but grandfather was a forester, so I grew up plowing fields, cutting brush, putting lime in ponds. Definitely knew I was a chair and AC kind of guy. Yet, I don’t know man. Days like yesterday where the ED physician is completely missing a posterior stroke and way undersells it when I force a neuro consult, but admin says I must say yes to every admission, I think I wouldn’t mind plowing a field again.

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43 minutes ago, LT_Oneal_PAC said:

My dad was a physician, but grandfather was a forester, so I grew up plowing fields, cutting brush, putting lime in ponds. Definitely knew I was a chair and AC kind of guy. Yet, I don’t know man. Days like yesterday where the ED physician is completely missing a posterior stroke and way undersells it when I force a neuro consult, but admin says I must say yes to every admission, I think I wouldn’t mind plowing a field again.

I get it. And I'm in the same boat...for about 5 minutes then I remember busting rods in the snow and go back to take another one on the chin. The ineptness gets to me as well.

This the same doc from your last experience with the VIPs? 🙄

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The nursing board have definitely  a better lobbing, they and the school that are money hungry  that foresee our job, got better degrees DNP and are taking all over our Internal medicine and FM PA's jobs, we can't do much since we are physician assistants dependent always on a MD, I just don't understand why there are some people who still want to pursue  a PA education ..... I can wait for my retirement... and to hopefully have a job until then...sad reality check. At the end the same thing will happen to then.

 

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10 hours ago, MediMike said:

I get it. And I'm in the same boat...for about 5 minutes then I remember busting rods in the snow and go back to take another one on the chin. The ineptness gets to me as well.

This the same doc from your last experience with the VIPs? 🙄

Same PRN job and same ED group. The guy with the VIPs I think is actually good, he just plays politics. This guy is actually the medical director of the EM group. Let’s just say he should stick to admin.

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20 hours ago, Rose66 said:

The nursing board have definitely  a better lobbing, they and the school that are money hungry  that foresee our job, got better degrees DNP and are taking all over our Internal medicine and FM PA's jobs, we can't do much since we are physician assistants dependent always on a MD, I just don't understand why there are some people who still want to pursue  a PA education ..... I can wait for my retirement... and to hopefully have a job until then...sad reality check. At the end the same thing will happen to then.

 

Because nobody has the heart to tell them not to. All they hear is how great things are, how lucrative it is, and ohhh the endless career possibilities.

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I graduated 3.5 years ago from a class which was 85% female and I was the geriatric at 30 years old. These young folks didn't see any problem with working 30-40 years with a SP, as the SP will mentor them and take liability (plus do the "busy work"). Also probably 70% of the other females planned on having kids within 1-3 years and going part time (which for the most part has happened). So maybe a large portion of the fastest growing fraction of the PA body is complacent with current scope of practice (seems to be the case when I ask other PAs their opinion.) Anyone know what percentage are <30 y/o? I should prob check the latest AAPA salary report.

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Here is a néw one

 

 

applied for a NP job at a State hospital.  I am highly qualified and possibly over qualified for it.  Immediately rejected because I did not have an RN license.  Mind you this is an NP position.  HR lady actually got a bit testy when I was talking to her and she flat out says “ we have never hired a PA and we’re not going to”. What the heck.  State hospital that is tax payer funded.  Why does thus go on?  Suspect old school doc, don and administrator that have been drinking the cool-aide too long!!!

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1 minute ago, ventana said:

Here is a néw one

 

 

applied for a NP job at a State hospital.  I am highly qualified and possibly over qualified for it.  Immediately rejected because I did not have an RN license.  Mind you this is an NP position.  HR lady actually got a bit testy when I was talking to her and she flat out says “ we have never hired a PA and we’re not going to”. What the heck.  State hospital that is tax payer funded.  Why does thus go on?  Suspect old school doc, don and administrator that have been drinking the cool-aide too long!!!

 

 

I have encountered this multiple times.

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19 minutes ago, ventana said:

Here is a néw one

 

 

applied for a NP job at a State hospital.  I am highly qualified and possibly over qualified for it.  Immediately rejected because I did not have an RN license.  Mind you this is an NP position.  HR lady actually got a bit testy when I was talking to her and she flat out says “ we have never hired a PA and we’re not going to”. What the heck.  State hospital that is tax payer funded.  Why does thus go on?  Suspect old school doc, don and administrator that have been drinking the cool-aide too long!!!

I usually call first to find out if a PA qualifies as the position often requires independent practice. Our hospital doesn't hire PAs to do outpatient psychiatry which I think it goes back to independent practice and historically not hiring PAs.

Maybe instead of legislating for independence which might scare physicians (maybe more accurately the AMA), we should ask for the same privileges as NPs. "Senator XYZ, we would like to help physicians and other medical providers at the same level as NPs since we do the same thing with the same level of training." I bet once everyone thinks of NP and PA as essentially the same thing, the laws will become the same. Kinda like MD vs DO.

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21 minutes ago, Servant_to_All said:

I usually call first to find out if a PA qualifies as the position often requires independent practice. Our hospital doesn't hire PAs to do outpatient psychiatry which I think it goes back to independent practice and historically not hiring PAs.

Maybe instead of legislating for independence which might scare physicians (maybe more accurately the AMA), we should ask for the same privileges as NPs. "Senator XYZ, we would like to help physicians and other medical providers at the same level as NPs since we do the same thing with the same level of training." I bet once everyone thinks of NP and PA as essentially the same thing, the laws will become the same. Kinda like MD vs DO.

nope

although they are out legislating us I would not want to "be like an NP"

lets stand on our own, ( or as was just posted let NP make a bridge program and those of us with exceptional skills in the PCP fields can just jump ship to independence.....)

 

one way or another we need to stand alone

 

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1 minute ago, ventana said:

nope

although they are out legislating us I would not want to "be like an NP"

lets stand on our own, ( or as was just posted let NP make a bridge program and those of us with exceptional skills in the PCP fields can just jump ship to independence.....)

 

one way or another we need to stand alone

 

Clarifying questions:

You would not want to be "like an NP", but would like the option to become an NP via bridge program in order to be independent?

What is the purpose of standing alone? I would suspect lateral mobility, but I don't know how much lateral mobility NPs have. I work in cardio and we have a bunch of NPs, but they didn't do some kind of cardio specialization. I really would like to know the difference in terms of function.

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10 minutes ago, Servant_to_All said:

Clarifying questions:

You would not want to be "like an NP", but would like the option to become an NP via bridge program in order to be independent?

What is the purpose of standing alone? I would suspect lateral mobility, but I don't know how much lateral mobility NPs have. I work in cardio and we have a bunch of NPs, but they didn't do some kind of cardio specialization. I really would like to know the difference in terms of function.

I am not an NP

don't want to be "like and NP" as I think their training and knowledge is not on par with PA

BUT

Their political advocacy historically is FAR better (not so much right now) - so if I could get an NP license, with my training, and then practice independently I would consider it. Just to get out of the PA supervision nightmare

 

confusing I know

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