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Pa or Doctor, Recommendations


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I know this has been covered, but from everything Ive read on this forum the argument boils down to age vs HCE vs money vs time. Ive been looking into getting into ER medicine whether as doctor or PA. I was leaning pretty heavy towards PA until I started reading some of these forms and talked to a Primary care PA. Ive also had plenty of positve of input but none from where Im trying to into and would love to get a general consensus

 

Ive always had an interest in medicine but initially wrote it because I didn't think I had the aptitude, or maturity. Long story short I joined the Air Force as an enlisted flyer and after 4 years found out that not only do I have the drive to succeed, I also have alot more potential than I gave myself credit. I pretty strong in biology but pretty weak in chemistry, is this something you can overcome through determination or do you have to have a natural inclination towards it? I truly have a desire to help people but not only help but fix, I want to be on both sides of the process and that's when PA was first recommend to me. So my first and most important question for the PA's out there is did you ever feel limited on your ability to deliver patient care? Second I'm currently about to turn 24 and dealing with health problems stemming from my time in the service, I got 44 credits but most of its through the AF or CLEP's and most of them are electives. Since I missed the fall semester I enrolled in an EMT-B course and next year I'm going to pursue a bachelors. I know some of you recommend against this "forced" route towards PA but even though I'm keeping my options open, in my situation is this a good route towards a PA?

 

Ultimately I'm just interested in hearing why you joined the field, and why you would or would not recommend it to someone like me. If anyone has any ED experience and has any input I and appreciate that too. I know that was kinda of a rant but I appreciate your time and your responses.

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if I could go back in time and go to medschool after a few years as a medic I would do it without question.

to get the autonomy to practice to your full level of training and experience can take years of building respect and working your way up the ladder.

just go to medschool. you will never regret it.

I have the potential to have a good majority of a PA school paid off by the government, with that in mind would still echo the same advice? Ive seen you on here discouraging PA for the younger generation but at the same time on the SDN forums establishing your authority of your position in the ER, based on what Im seeing on those forums is the respect issue that bad or do PA's not have the same kind of role in the ER as they do in primary care? Im just worried that by the time Im done with my undergrad Ill be 27, 28, Ill be starting to get to old to start med school.

You caught me looking until that last sentence! You are young! Both options are open for you. There are plenty of med students that were in their late 20s when they start. They even have their own national organization! (OldPreMeds)

 

The bigger question for you is what do you really want to do? I enjoy being a PA and, since I was in my early 50s when I decided to start prereqs, it fit in with my life and family. Even if I had been younger, I'm not sure I would want to work the hours my supervising physician does. It's a calling, and you either are or you aren't.

 

Decide what you want to do next. Not necessarily what's easiest or what's cheapest, but rather what fits it with who you want to be in the totality of what that means. Then figure out a way to do it.

 

Good luck!

 

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Im not really concerned about the prestige of being Doctor but I am worried about what EMEDPA alluded to, is hitting a glass ceiling. The respect factor is truly irrelevant to me but I do want to posses all the tools within reason to help patients and to not "cap" out on my abilities. Have you ever felt limited in your scope as a Physician Assistant in comparison to a Doctor?

In my case, I have only felt limited because my state says I can't practice unless my SP is within an hour of my location while NPs in my state only require "reasonable contact." In my daily life, I am generally wherever my SP isn't, which is why I was hired. I am on my own most of the time, yet I have the comfort of being able to call him when I need advice. That was every few minutes when I started and now it's every few days.

 

PAs work in differrent environments. If you are in surgery, you are across the table from your SP most of the day. If you work in the ER, you have more than one SP and one is probably on site with you. If you work in multiple offices and multiple hospitals like I do, then you talk to your SP on the phone way more than you would see him in person. In my case anyway, I feel that I have enough clinical independence. I can't speak for everyone.

 

I don't feel "capped out" in the sense that every day I learn something new and get to apply it to our patients. I would say that, compared to other jobs I have had, there is probably less opportunity to move forward in terms of salary, etc and I will never be in charge of the practice. For my stage of life, that's fine. I wouldn't want to work my boss' hours anyway. As more physicians work for hospital systems as time goes on, I'm not sure they will have as much growth potential either, unless they leave clinic medicine for managment jobs that will probably become more plentiful.

 

Getting to where I am took time and the journey was mine. I can't say that you should be taking it. I described it, and what it feels like to be a PA in my position, in a book called "Old Man on Campus" that's available on Amazon, if you're interested.

Limited every single day. In every job. In 4 different states with very different scope of practice laws. In 3 different practice settings (outpt primary care, urgent care, EM).

You will always feel limited as a PA. Many make peace with this. I could not and am winding down my 2nd year of med school, 13 years into my PA career. I will graduate next year at 40 and residency by 43-44 depending on path and have no regrets.

Thank you. We must all take our own journey. I have been profoundly blessed to be a PA and am grateful for the opportunity to go further.
Good for you Primadonna and good luck I wish you the best!
if I could go back in time and go to medschool after a few years as a medic I would do it without question.

to get the autonomy to practice to your full level of training and experience can take years of building respect and working your way up the ladder.

just go to medschool. you will never regret it.

 

Do you think this is a fair assumption for everyone emedpa? Both my parents are MDs and have been practicing family medicine for 20+ years after going straight to med school from undergrad. Though they love medicine, I've heard both of them say on more than one occasion that they've almost become bored doing the same type of work for so many years. In fact, my mom has even said that she sometimes wishes she was a PA. I have also heard many of their MD friends in the community say they would not recommend the medical school route anymore for people looking to go into health care. Obviously med school is the right path for some people, but I think "med school = no regret" is a blanket statement and may not always be true.

Ask your folks if they would like to reimagine their lives with 50% of their salary doing exactly the same work....

 

They have worked with and know PAs, so they certainly realize this is the case. All I'm trying to say is that while you believe med school is the path of no regret, I have heard physicians from various specialties say they do not feel that med school is worth it. I know you do not agree with that emedpa, but it doesn't change the fact that there are physicians out there who feel that way. Just wanted to mention it for people to consider.

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They have worked with and know PAs, so they certainly realize this is the case. All I'm trying to say is that while you believe med school is the path of no regret, I have heard physicians from various specialties say they do not feel that med school is worth it. I know you do not agree with that emedpa, but it doesn't change the fact that there are physicians out there who feel that way. Just wanted to mention it for people to consider.

medicine isn't for everyone but if you have the ability to "go all the way" within medicine it makes more sense to be a doc than a pa.

there is no telling if your folks would be equally unhappy as PAs or not. that isn't about not liking being a doc, it's about not liking medicine.

Its hard to explain... but the first time that you walk away from a SP, after a tense disagreement about the management of a patient (you were correct) and then truly realize that your employment/livelihood is in REAL jeopardy even though you were correct...

 

Or realize that all your SP has to do is say... "I'm no longer your Supervising physician".. and send a 3.5 postcard or email to your BOM stating the same thing... and you are DONE....

 

Then you may understand the reasoning.

 

Ours is the ONLY medical profession that "serves at the pleasure of" another profession.

 

RNs are still RNs and can act as such regardless of whether or not they are employed.

Same for NPs, PT's, OT,s, Psychologists, Therapists, etc...

 

As PA's... we cannot practice unless another professional gives us the nod and signs the paper.

This makes directing one's career/livelihood at times tenous.

 

And may at times lead to some interesting ethical/moral compromises...

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