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Going through a mid-career identity crisis, curious if anyone feels the same/advice?

PA for 15 years (Bachelors degree, my program didn't offer a Masters at the time), but worked in healthcare since 99.  Worked in surgical subspecialties since graduation, inpatient and clinic, now working for the govt.  Make a decent salary, good benefits, but just wholly unfulfilled with healthcare in general.  I'm just burnt out with clinical medicine but have no idea where to go from here.  

There are virtually no administrative avenues for advancement where I am, and if there are, PAs aren't exactly the first in line (i.e. newest Director of the Hospital is a DNP).  Trying to figure out if I want to spend $35k for a DMSc degree vs an MBA for less, but I don't even know if either pathway will have a good ROI.  There's pharma/clinical research organizations, but the gold standard seems to be doctorate level for those too.  

Anyone been in the same spot, have any advice?  

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Only get a doctorate if you know how it will advance your career. You would make more working for the govt with a doctorate. You could also advance more quickly in PA education with one. I got mine to increase my knowledge of global health and to obtain a teaching position. It paid for itself in 2 years of part time teaching. An MBA or an MPH will likely not help you much unless you have a specific job in mind that requires one. 

Nova southeastern does have a BS to doctorate track to DHSc with an interval MS if that interests you. 

https://healthsciences.nova.edu/healthsciences/mhs_dhs/index.html

Thanks for the input gents....

A doctorate doesn't automatically increase pay in the Govt.  The government PA pay scales changed recently and are now on a 5 level scale.  I'm at a PA3, which is for those PAs holding doctorate degrees or 10+ years as a PA and some administrative experience.  Anything above that is PA4 which is a hospital lead PA type position (there's only 1 in my facility and they aren't leaving for the next 20 years) or PA5 which is district wide (there are something like less than 200 in the country).    I could go on about the VA pay scales and ceilings for PAs in the govt, but that's for another thread!

I didn't think about the part time teaching part of it, that's certainly a thought.  

To answer the question about what would I do in medicine....I don't know anymore.  I'd love to do something to affect more than one patient at a time (policy writing, QA/QI, research, etc), I just don't know how to crack into that upper administrative realm.  

Love the 'stash btw rev!

  • Administrator
1 hour ago, YourAveragePA said:

Love the 'stash btw rev!

In my profile pic, or the one I have here at AAPA 2022? 🙂 (They're actually almost indistinguishable) Now that I no longer am IDLH qualified (thanks, long-ish Covid) I may retire from EMT response and actually grow a full beard back for the first time in ~20 years, just to see how much gray is in it. :-S

If you want to impact multiple people for good and get out of the clinical rat race, education sounds like the thing to do. BUT, there are more/other options, as touched on above.

- Medical research and writing. This might be a good reason to get a doctorate to go along with what you're trying to accomplish.  If you're already in the governmental system, this might be a good thing.

- Policy? Same thing. Might be a good excuse to go back for a doctorate, being in government already might help.

You could always try to start your own clinic. What crazy fool would try and do that as a PA is beyond me... 😉

  • Like 1
1 hour ago, YourAveragePA said:

I just don't know how to crack into that upper administrative realm.  

Become a NP. They rule the world and the zillions of nurses in admin will help you get where you want to be.

  • Moderator
28 minutes ago, sas5814 said:

Become a NP. They rule the world and the zillions of nurses in admin will help you get where you want to be.

Faster for a PA to become a physician than an NP....

  • Like 1
On 5/23/2022 at 12:03 PM, YourAveragePA said:

Thanks for the input gents....

A doctorate doesn't automatically increase pay in the Govt.  The government PA pay scales changed recently and are now on a 5 level scale.  I'm at a PA3, which is for those PAs holding doctorate degrees or 10+ years as a PA and some administrative experience.  Anything above that is PA4 which is a hospital lead PA type position (there's only 1 in my facility and they aren't leaving for the next 20 years) or PA5 which is district wide (there are something like less than 200 in the country).    I could go on about the VA pay scales and ceilings for PAs in the govt, but that's for another thread!

I didn't think about the part time teaching part of it, that's certainly a thought.  

To answer the question about what would I do in medicine....I don't know anymore.  I'd love to do something to affect more than one patient at a time (policy writing, QA/QI, research, etc), I just don't know how to crack into that upper administrative realm.  

Love the 'stash btw rev!

If you have the fortitude for it (meaning desire and consider it fun) getting a graduate degree or MBA related to health care administration could be a good ticket. My wife went that way via nursing and I could not believe the perks she got as a hospital VP. It was a plush job, but long hours when COVID hit. She is now teaching. But there were days I considered that route. I owned my own practice for 5 years and part of admin I loved and part I hated, but the part I hated was the discrimination that insurance companies applied to small practices own by non-physicians. But if you don't mind lots of meetings and minimal patient contact with a salary of 250K plus great benefits, then admin is a great direction. I hope to see more PAs in admin. 

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13 hours ago, jmj11 said:

If you have the fortitude for it (meaning desire and consider it fun) getting a graduate degree or MBA related to health care administration could be a good ticket. My wife went that way via nursing and I could not believe the perks she got as a hospital VP. It was a plush job, but long hours when COVID hit. She is now teaching. But there were days I considered that route. I owned my own practice for 5 years and part of admin I loved and part I hated, but the part I hated was the discrimination that insurance companies applied to small practices own by non-physicians. But if you don't mind lots of meetings and minimal patient contact with a salary of 250K plus great benefits, then admin is a great direction. I hope to see more PAs in admin. 

An RN with an MBA has many more options for administrative advancement in 2022 that a PA with an MBA. I know of very few PA/MBA folks out there in significant positions. I know the guy who runs the Hopkins EM group is a PA/MBA https://www.hopkinsmedicine.org/emergencymedicine/Faculty/scheulen.html

and there is some guy down south who is a PA/MBA who is an ER director(in what would normally be an RN slot). 

Not trying to discourage anyone here, just pointing out that the RN helps as much as the MBA?MHA for many of these positions. 

  • Upvote 1
25 minutes ago, EMEDPA said:

An RN with an MBA has many more options for administrative advancement in 2022 that a PA with an MBA. I know of very few PA/MBA folks out there in significant positions. I know the guy who runs the Hopkins EM group is a PA/MBA https://www.hopkinsmedicine.org/emergencymedicine/Faculty/scheulen.html

and there is some guy down south who is a PA/MBA who is an ER director(in what would normally be an RN slot). 

Not trying to discourage anyone here, just pointing out that the RN helps as much as the MBA?MHA for many of these positions. 

Its true for all the wrong reasons. Its mostly true because admin is already stuffed full of RNs who will bring more RNs up behind them. 

I have seen 1 PA in admin for every 200 RNs. That may be too conservative a number.

On 5/25/2022 at 10:54 AM, EMEDPA said:

They are, but as a licensed physician. 

Right, but you can't just gloss over residency. It is still schooling. You are working 80 hours a week for 60K a year for 3-5 years, then possible fellowship for a year after that. If it wasn't for residency, I would have more seriously considered going the MD route rather than PA.

  • Upvote 2
  • Administrator
3 hours ago, AbeTheBabe said:

If it wasn't for residency, I would have more seriously considered going the MD route rather than PA.

Lots of us who went to PA school between 30-50 with families felt the same way.

  • Like 1

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