Accepted to PA school, but having second thoughts...

[pawoe]

Why is PA school a "180"? Why do you feel PA is the polar opposite of MD?

 

Your answer is within your own writings. Don't let the Internet sway you. Seek the counsel of your own gut and those humans closest to you.

 

Oh... And go to med school. PA is great but given the same opportunities when I was 22 vs 40, I would have gone the MD route too.

 

I guess "180" was a poor choice of words/numbers. I realize that both PAs and MDs allow for someone to be a great clinician, but the avenues of getting there are, to me, significantly different (mainly due to residency). Some have argued that 3 or 4 years of residency is but a drop in the bucket compared to a lifelong career, but those are long, difficult years that can make even the most enthusiastic people jaded.

 

Even with PA if you opt to do a residency, it's one year and that's it. I am not trying to argue that PA is a better option simply due to training time, but it is certainly less of a burden on one's life/feeling like they're cornered (1 yr optional commitment, 3-4 year mandatory commitment).

 

 

EDIT: I am NOT choosing PA because it is a shorter path to becoming a provider. I plan on being the best clinician I can be regardless of the letters after my name. My choice of PA is due to many other factors (just to be clear!).

[EMEDPA]

a bit of personal insight (might be TMI)...my dad was a doc and I really never saw him until I was 13 or so. I thought early on that all docs were like this and that influenced my decision in part to go pa vs md. what I figured out too late is that he was unable to balance his life and there are many docs who are able to do so, have lots of free time, as well as the resources to do a lot of fun stuff in life. most of the em docs I know take 1+ month vacations every yr to exotic places with their families. most of the PAs I know take 1-2 weeks /yr and rarely leave the u.s. or go to mexico, etc

money isn't everything. if pa and doc paid the same I would still do doc due to the difference in respect and the glass ceiling effect for pa scope of practice.

as a pa you get talked down to frequently by consultants, lab techs, etc. it gets really old really quickly having an rn tell you she won't give a febrile child tylenol based on your order without a doc cosignature( this was a power play by rn's in one dept to get rid of pa's and replace them with np's. it worked, we all quit).

[sartort]

It's obviously really difficult for people on a forum to know which profession will suit you best, but I don't think getting cold feet means you chose the wrong one when you applied to PA programs. I do agree that if you can't see yourself being happy knowing that you are referred to as an assistant, that some people will not know what you do, and that you will at several points in your career likely feel like you are looked at as being "less" by others because you didn't choose to be a physician then you really shouldn't spend the time, money, and the seat in a PA program. You chose to apply to PA schools for a reason, as you just mentioned, and they are valid. Several articles recently have shown how women in FP often have a greater net present value as a PA over an MD due to lifestyle choices after school. Personally, I chose the PA profession because I think it's one of the coolest jobs a person can have. You practice medicine, make good money, have the ability to work in a variety of areas of practice without having to start at the bottom again in a residency, don't take money from medicare while you attend residency (which some doctors have told me a large percentage of is wasted by doing irrelevant tasks over and over again) and help decrease the cost of healthcare. You get to help individuals every day while making a little impact in a bigger picture. If you want to have more authority in your practice you can choose a different setting (rural where the doc is rarely there or military, or even just a position where the SP gives you more authority). I started out wanting to be a PA and only considered MD/DO briefly. Ultimately I decided the only benefits for me were larger salaries and a title of doctor, both I feel I can live without and be very happy with my life. I feel the PA profession is incredibly special and I don't think you should just go be a doctor because you have doubts. No one knows exactly what healthcare will look like in 20 years; weighing your options just shows that you think about your future.

 

If I were you, I would go back and read my personal statements, think about my interviews, and decide if everything I said is still true. Then I would write a personal statement on why I want to be a physician. Which one feels right when you read it? Which one feels the most passionate?

[EMEDPA]

good advice above, especially about seeking out positions where you are happiest. I have gravitated towards solo and rural positions and now after 26 years working in healthcare am at a place(actually 2) where I feel appreciated and utilize my skill sets well. the first 10 yrs as a pa (for me) were filled with unpleasant experiences of being talked down to and treated poorly just because of the initials after my name. I am sure that shades my posts here and elsewhere.

[kinacat]

pawoe, I can relate to all of your concerns. I have shared and pondered over all of them. For years I too shadowed both PAs and MDs and held many hats within the medical field. Eventually, however, I realized that if the decision was this hard I would probably be happy in either. My final decision came down to how I wanted my overall life to look and when I wanted it to start. I am almost out of my twenties, which is still young, but I feel like starting medical school at this point would not foster much of a chance for a family.

The decision came rather abruptly for me after spending years struggling with the decision. My advice, like many of the previous comments, would be to take some more time to figure yourself out. Figure out what you want out of life and what you are like. Will you be bothered over not having the final say or will you be comfortable knowing that the patients' best is all that matters? (Of course there is the issue of not agreeing with the SP but that is a whole other topic of discussion).

 

Good luck to you!

[rxtechhk]

Medical school period

[ventana]

http://benbrownmd.wordpress.com/

 

 

enough said.

I find it funny that they only graph put to about 15 years on this - basically they say it costs a lot of money to become a doc. Guess what---it costs a lot of money to become a professional in any area, med school is higher cost but on average the pay off is higher too. Read some of the recent articles on the best careers to become a weathly - Physician always ranks right up there - maybe not for the super rich, but the high paying jobs are everywhere. ($150k plus per year for new grads in the lowest paying specialities with $300k per year in the higher paying new grad specialities.)

 

Physicians go far into debt, but then they make very large incomes for the majority of their careers. The debt is big the payoff is bigger. And anyone that really wants to get out of debt can do VA or NHSC or other loan forgiveness and be debt free in a few years (4-6).

 

PA's do well though, with good healthy earnings.

 

If we can uncouple from the "assistant" role and gain the professional standing that we deserve professional life would be better

 

 

Also, I own 99% of my own practice so it is not true that you can't own your own.

 

As for rather I would be a PA - a resounding YES is what i tell everyone and I am always trying to get nontraditional students to become PA's.

[Howezer]

The 'medical school period' seems a bit dismissive. I've compared the two different career options and feel becoming a PA does have many upsides, even for someone less than 25yo. PAs do work just as many hours, and do have the 'glass-ceiling'. The amount of debt MDs acquire over the 4-years of medical school, and the interest that will build upon it during residency is deterring. Grad school for PAs isn't cheap, but they can start working and saving years earlier. There are always stories of if you save half as much, but start 10 years earlier it has greater pay-off in the long-term. I'm not saying MDs don't make a good salary, but compound interest can play a big factor in finances.

 

I haven't run all the calculations on this for exact numbers, mostly because differing salaries for each specialty of medicine, and differing interest rates. I'm a person who does things based on efficiency and reason. I feel I can justify the loans and debt for 2-years of PA school, especially since I'm already on this route with pre-reqs. If I were to pursue becoming a MD it would mean another 1-1 1/2 yr of undergrad, plus the debt from medical school. The only real benefit I see to MD is the 'prestige' and not having the title of assistant. I have more than enough self-confidence (many call me cocky) that being titled an assistant won't phase me.

 

Just wanted to add my two-pence; hopefully it might help other under 25yo that truly want to become PAs, but are having second thoughts because of dismissive statements.

[discogenic]

The 'medical school period' seems a bit dismissive. I've compared the two different career options and feel becoming a PA does have many upsides, even for someone less than 25yo. PAs do work just as many hours, and do have the 'glass-ceiling'. The amount of debt MDs acquire over the 4-years of medical school, and the interest that will build upon it during residency is deterring. Grad school for PAs isn't cheap, but they can start working and saving years earlier. There are always stories of if you save half as much, but start 10 years earlier it has greater pay-off in the long-term. I'm not saying MDs don't make a good salary, but compound interest can play a big factor in finances.

 

I haven't run all the calculations on this for exact numbers, mostly because differing salaries for each specialty of medicine, and differing interest rates. I'm a person who does things based on efficiency and reason. I feel I can justify the loans and debt for 2-years of PA school, especially since I'm already on this route with pre-reqs. If I were to pursue becoming a MD it would mean another 1-1 1/2 yr of undergrad, plus the debt from medical school. The only real benefit I see to MD is the 'prestige' and not having the title of assistant. I have more than enough self-confidence (many call me cocky) that being titled an assistant won't phase me.

 

Just wanted to add my two-pence; hopefully it might help other under 25yo that truly want to become PAs, but are having second thoughts because of dismissive statements.

 

This is why you'd do well to take into consideration what those with lots of PA experience tell you.

[WanderlustPA]

I've learned as I've gotten older to not be concerned with what anyone else thinks. People who disrespect you because of your title are probably disrespectful to everyone. That's their problem, not yours. I know it is easier said than done, but you have to get past caring what people think of you, especially when they are judging you because of initials after your name and not truly knowing you, or how much knowledge you have in medicine. So with that said, the disrespect some say PA's get doesn't really bother me. It's also going to depend on where you're practicing, as well as what specialty. I've had many people tell me they prefer to see the PA over the doc because they feel the PA cares more. (Read "The Four Agreements" by don Miguel Ruiz)

 

Also, if you look at job satisfaction surveys, PA's always seem to have a higher satisfaction than doctors. Of course that doesn't mean it will be that way for YOU, but it's something to consider.

[Contrarian]

NOTICE it is the "pre" and "students" who are for some reason getting twisted about "being dscouraged" from being a PA.

Why... because they have NOT been PA's...!!!!!

 

Its all "rainbows and unicorns" from the ouside looking in.

 

I'll repeat:

 

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, within 20 steps away 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... time to pack up, sell your house, pull the kids out of school, spouse has to quit and find a new job cause you are moving out of state AGAIN...

 

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/Family Future at times tenous.

 

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

 

You could graduate, secure a job in a rural area with a GREAT SP.

You move to town, get your family started/settled and get to work being the Best, most competent and capable PA ever. 5 yrs go by and you are rolling and loved by the community.

 

You come to work monday morning to find that your SP has either died, been arrested, is getting a divorce and therefore is moving out of state, being diciplined by the BOM and likely to lose his/her license and/or be disallowed to supervise PAs, or has to spend months in drug rehab...

 

If you were a Physician... and the above occured... you would simply keep practicing.

As a PA, YOU have done nothing wrong, you have made no changes, but YOU are now unemployed...!!! Your life must now change due to the whim/decisions/actions of another.

 

So for those who say its "just about a title" or "just about prestige"... they really don't know what they are talking about because it MUCH more than that.

 

I know a PA who moved her family of 5 from Texas to Washington state for a job.

Worked it 8 months only to have her SP terminate their SP agreement with the state because "she didn't feel comfortable supervising her."

 

Basically what happened was... for 2 days the PA was caring for a newly admitted patient in a inpatient psych setting who had a looong hx of benzo and Opiate dependence. Her SP only worked 2 days a week so when the SP came in on the 3rd day, the SP abruptly discontinued the Benzo taper schedule and d/c'the opiates. Her only reason written in the chart was that the patient was known to her and was a addict.

 

The next day, the PA wrote a long chart note detailing concerns of benzo withdrawal in this patient who also needed pain control because she had actually visualized a fresh/recent and extensive 2nd degree burn. Then restarted the pain meds for the burn and the benzo taper to prevent withdrawal seizures.

 

A few weeks later, just as she is about to leave home for work... she is called at home and informed that she is no longer employed because she has no SP and no practice plan filed with the state.

 

Her SP had indeed sent a 3.5 postcard or email to the BOM stating, "She was no longer her Supervising physician"... when asked why by the administration, the SP simply stated, "I didnt feel comfortable with her practice." There was nothing else said, or needed to be said because no one can force a SP to assume responsibility (real or imagined) for a PA regardless of setting.

 

She was unemployed for another 18 weeks...

 

Hope that makes some sense.

 

 

Contrarian

[Guest Paula]

^^^^^^^ That is my worst nightmare. It is the reason why I am all for PA independence. We should be responsible for our own work, work within our scope, and be independent providers, just like the ODs and DPMs and NPs who have independence. It does not mean we forego collaboration. It is the reason why I keep writing letters to my state reps, federal gov, IHS and rural health care associations.

[emoses]

Anybody feeling the way the original poster feels should NOT be a Physician's Assistant for several reasons. Mostly because you will NOT "learn to love" your job or the profession.

 

This isn't just about becoming a PA - it's about doing anything in life. Don't make a commitment unless you really want it, and if you don't know what you want, you don't make the commitment.

 

This is a failure of the PA admissions if you ask me. They're supposed to be expert at filtering out applicants who aren't completely passionate about becoming a Physician's Assistant.

[Contrarian]

Anybody feeling the way the original poster feels should NOT be a Physician's Assistant for several reasons. Mostly because you will NOT "learn to love" your job or the profession.

 

This isn't just about becoming a PA - it's about doing anything in life. Don't make a commitment unless you really want it, and if you don't know what you want, you don't make the commitment.

 

This is a failure of the PA admissions if you ask me. They're supposed to be expert at filtering out applicants who aren't completely passionate about becoming a Physician's Assistant.

 

So should those same admission folks deny YOU entrance because you hadn't figured out that we are Physician Assistants and NOT Physician's Assitant...??

:heheh:

[Guest Paula]

^^^^ you beat me to it, C.

[sartort]

beat me to it as well

[zepoPA]

[quote name=Contrarian;383041)

 

You could graduate' date=' secure a job in a rural area with a GREAT SP.

You move to town, get your family started/settled and get to work being the Best, most competent and capable PA ever. 5 yrs go by and you are rolling and loved by the community.

 

You come to work monday morning to find that your SP has either died, been arrested, is getting a divorce and therefore is moving out of state, being diciplined by the BOM and likely to lose his/her license and/or be disallowed to supervise PAs, or has to spend months in drug rehab...

[/quote]

 

 

And if anyone out there (student or pre PA) thinks that Contrarian is exaggerating, let me share with you: this happened to me TWICE. Yes, working with an amazing Supervisor MD for 5 years, then he had a fatal MI, unexpected, unavoidable. Then after 13 years of a wonderful professional relationship with the next Supervisor MD.... Yeap, MI as well. Needless to say, I had to go through a lot of stress and changes. You have no idea how much it impacted my professional life the SUDDEN loss of my Sup.MD. Couldn't even grieve the loss of the "friend/partner at work" because I was so busy making the necessary changes to continue practicing as a PCP with minimal interruption of care (and paycheck).

[discogenic]

And if anyone out there (student or pre PA) thinks that Contrarian is exaggerating, let me share with you: this happened to me TWICE. Yes, working with an amazing Supervisor MD for 5 years, then he had a fatal MI, unexpected, unavoidable. Then after 13 years of a wonderful professional relationship with the next Supervisor MD.... Yeap, MI as well. Needless to say, I had to go through a lot of stress and changes. You have no idea how much it impacted my professional life the SUDDEN loss of my Sup.MD. Couldn't even grieve the loss of the "friend/partner at work" because I was so busy making the necessary changes to continue practicing as a PCP with minimal interruption of care (and paycheck).

 

With more practices moving away from private single-doctor set-ups to group practices, does it make it any easier for the PA whose SP dies/goes to jail/goes nuts/etc to make arrangements with another doc in the group? And make those arrangements quickly?

[Contrarian]

With more practices moving away from private single-doctor set-ups to group practices, does it make it any easier for the PA whose SP dies/goes to jail/goes nuts/etc to make arrangements with another doc in the group? And make those arrangements quickly?

 

 

Kinda/Sorta...

 

If you have allies within the group practice... one can step in.

Key word there is CAN but again... your ability to practice and feed yourself/family is still entirely dependent upon the benevolence of another...

 

Unlike Physicians... YOU can't do what you do... and have been doing... uninterrupted and unmolested by the actions of others who may/may not even consider how their actions may affect/effect you and your ability to eat.

[Teasip]

The solo practitioner can also take out a life insurance policy (term life) with you, the PA, as the beneficiary should an event such as this take place (death of SP). I've heard of this happening as well. While it leaves one out of work potentially it does provide a source of income for however long the amount of the policy covers. Again, this would be a solo practice scenario. Ventana, have you ever given thought to such a setup since you are the majority owner of your business model as per your prior statement, or are there contingency plans in place, if I may ask?

[discogenic]

Kinda/Sorta...

 

If you have allies within the group practice... one can step in.

Key word there is CAN but again... your ability to practice and feed yourself/family is still entirely dependent upon the benevolence of another...

 

Unlike Physicians... YOU can't do what you do... and have been doing... uninterrupted and unmolested by the actions of others who may/may not even consider how their actions may affect/effect you and your ability to eat.

 

What's the solution for the PA profession?

[Contrarian]

What's the solution for the PA profession?

Independence...!!!!

 

Or "REAL" PA-->MD/DO bridges...

[discogenic]

Independence...!!!!

 

Or "REAL" PA-->MD/DO bridges...

 

But is independence within the realm of possibility? The BOM already has the PA profession in a dependent position. Why would they ever give that up? It's fair to say that a significant reason that NPs seem to be gaining more independence is because they aren't under the control of the BOM; they control their own destiny, so to speak. Can PAs realistically ever spin off from MDs?

[Contrarian]

No...

Not as long as we continue to have the parade of apologists from the ole skool in the AAPA who has been ok with the Fact that the above scenarios are a reality for ALL PAs and a experience for many.

[KellyanneSD]

Pawoe: I think in your heart you know that PA school isn't what you truly want to do and that you would rather become a doctor. If you go through with PA school you will probably spend the rest of your life regretting it or eventually apply to medical school sometime after graduating anyway. And that's okay. The PA field isn't for everyone just as medical school isn't for everyone. But the only person who can truly answer the question of whether it's right for you is you. Trust your instincts and strive toward self fulfillment. Life is short and not worth agonizing over. Go for what you want. I've been working in healthcare for the past ten years and I now know that the PA field is where I want to concentrate. Everyone's path is different and I'm sure whichever decision you make, you will be good at what you do. Good luck.