Am I making a good decision in becoming a Physician Assistant? and other questions?

[sportygirl07]

I really love what PAs do and their lifestyle but I don't want to make the wrong decision. So, for you PAs out there, what are your opinions on being a PA? Would you recommend this career? Sometimes, I get doubts about becoming a PA when I hear a lot of discouraging experiences about being a PA such as not having respect from doctors and being bossed around? I have also heard people think of you as just an assistant? Is there any autonomy at all?

 

Also, PAs have to take the PANRE exam every 6 years....that seems really scary because I don't want to fail it and not have a license? All opinions and advice is greatly appreciated!!(:

 

I just hope that I'm making the right decision in becoming a PA. I have considered other careers such as physical therapy but I found being a PA to be better for me. What do you guys think? Do you love your job? What do you hate about it?

[cinntsp]

The PANRE will be every 10 years beginning with the c/o 2014 IIRC.

[EMEDPA]

I loved my first job then hated the next several. I am finally back at a couple places that treat me well and am feeling more optimistic about my choices at this point.

if I was starting over today I would go MD/DO in a heartbeat rather than put up with the flagrant disrespect I have had to tolerate for most of the last 20 years.

[Febrifuge]

I hated my first job, and love my current one (not to mention, I'm barely there, and get to be home full-time with my 3-yr-old). PA is perfect for me, because I didn't want to be a 42-yr-old EM intern. I may or may not have been ready to take on MD school when I was 24, but I don't regret not going that route.

 

Whatever reasoning you come up with, it has to be meaningful and specific, and that means it has to be personal. Nobody else can really answer a question like that. There will be times you wonder "what the CRAP am I putting myself through?" ...and you will need to have a good answer, one that convinces you.

[upperc]

I too am nervous with my decision to continue my studies toward a PA program. I am in my mid thirties, had a previous career as a police officer/paramedic and decided that medicine was what I really wanted to do. Originally thought about MD/DO, but WAY too much schooling and time away from my family, and honestly, the ability to move around (a little) from specialty to specialty is appealing to my personality.

 

Problem is that I am concerned with all of the financial outlay; will I have a career to provide for my family? I know of all of the great strides being made by PA associations on state and national level, but compared to NPs, the advancements and maintenance of roles/responsibilities seems tenuous at best. Just concerned that I will be making a bad decision.

[TThielen]

upperc- I am in the same situation as you. I was a former teacher, now in my mid 30s and start PA school in the fall, don't want to do MD school because of family and little ones and I like the versatility that the PA profession gives you. I think it just depends on who and where you work. There will always be those who disrespect the PA profession from docs to patients, but it's not much different than any other job, there are doubters in every profession. I was talking to the doc last night at the hospital I work at and he keeps trying to convince me not to go into PA. One of the nurses said something to me about school and he said, "he doesn't want to be a nurse and take orders/get bossed around, he wants to be a PA and have to take orders and be bossed around." I said, you're still trying to convince me not to go into PA school aren't you?" He said he was just picking on me, and he was but somewhere in there he was being serious. It's all about who you work for/with and how they treat you that matters.

[ryan83]

I really love what PAs do and their lifestyle but I don't want to make the wrong decision. So, for you PAs out there, what are your opinions on being a PA? Would you recommend this career? Sometimes, I get doubts about becoming a PA when I hear a lot of discouraging experiences about being a PA such as not having respect from doctors and being bossed around? I have also heard people think of you as just an assistant? Is there any autonomy at all?

 

Also, PAs have to take the PANRE exam every 6 years....that seems really scary because I don't want to fail it and not have a license? All opinions and advice is greatly appreciated!!(:

 

I just hope that I'm making the right decision in becoming a PA. I have considered other careers such as physical therapy but I found being a PA to be better for me. What do you guys think? Do you love your job? What do you hate about it?

 

 

Go to medical school, dont do PA, with obamacare NPs will have more power and will be able to own their practices while PAs still work with doctors and this will give doctors an advantage to abuse PAs , less pay and disrespect, you will then be really physician'S assistant. dont let the school put ideas in your head that you will be like doctors and will have autonomy and all that crap, its not true. The system gives doctors so much power, hospitals kiss doctors asses because they bring them patients, they have no benefit from PAs. I met awsome PAs and they know more than doctors but unfortunately doctor's ego will not let a pa in charge, also mention that most of nurses hate PAs and will do anything to show that Pas are stupid. Also patients will really disrespect you , i heard this too many times " WHERE IS THE REAL DOCTOR,I WANA SEE THE REAL DOCTOR"

no matter what you do for the patient , even if you covered everything from A to Z , they wont feel better till they see the doctor. one of my jobs , i had patients where i do everything for them but they wont feel better, then they see the doctor and i swear he orders only CBC ( blood test), no change in treatment and its like magic they are resurrected lol. DONT ever think that you will get full credit for what you do and its really discouraging. only few patients appreciate PAs.

I have a friend that works with an agency to recruit PA/NPS , i swear he showed me all the jobs available , for every 10 NP jobs which says ONLY NPs, there is 1 PA job, so if you have kids and family and a house in one area forget about being not flexible, you will be jobless.

[TThielen]

This thread is becoming depressing. :(

[upperc]

This thread is becoming depressing. :(

 

I hear you. My wife and I were smart enough to sell our house and rent well before I left my career, so I have the luxury to move as needed when I am done, but I started this venture because I thought the PA profession was on an upward tack, but as of late it seems to be on a downward slide. I work in an ED setting and the PAs that work there aren't very encouraging, nor is they system they work under (picking up patients over a certain age is discouraged, 100% chart review, no Schedule II (though that is a state law...) and to be fair the NPs in the ED are under the same system).

 

I don't know, the press releases from AAPA and others seem positive, but here and on other boards the people in the know paint a very bleak picture...

[Simplify]

I won't speak to all the doom and gloom being cast in this thread. But understand that much of this is probably regional. I attend PA school in a large city attached to a large med school/teaching hospital. I don't see any of this. The PA's are treated w/ respect and most seem to genuinely enjoy their work and their role. Furthermore, the majority of our lecturers are MD's (prestigious MD's at that), and they often tell us how important our role is and how integral we are going to be in the years ahead. Many in the classes above me have been offered jobs through their rotations, and the overall sentiment is optimism if not downright enthusiasm. I am not saying we don't need to be proactive about our profession, but this much negativity is not accurate, not for me and my classmates in our part of the country.

 

Finally, keep in mind that in the next few years something close to 30 million people are supposed to be flooding a healthcare system that is already woefully understaffed. 30 million. Honestly, when that happens it won't matter what letters are next to your name. Everyone is going to need expanded roles or people just won't be able to receive health care. period.

[TThielen]

I won't speak to all the doom and gloom being cast in this thread. But understand that much of this is probably regional. I attend PA school in a large city attached to a large med school/teaching hospital. I don't see any of this. The PA's are treated w/ respect and most seem to genuinely enjoy their work and their role. Furthermore, the majority of our lecturers are MD's (prestigious MD's at that), and they often tell us how important our role is and how integral we are going to be in the years ahead. Many in the classes above me have been offered jobs through their rotations, and the overall sentiment is optimism if not downright enthusiasm. I am not saying we don't need to be proactive about our profession, but this much negativity is not accurate, not for me and my classmates in our part of the country.

Finally, keep in mind that in the next few years something close to 30 million people are supposed to be flooding a healthcare system that is already woefully understaffed. 30 million. Honestly, when that happens it won't matter what letters are next to your name. Everyone is going to need expanded roles or people just won't be able to receive health care. period.

 

Good point! I agree, it just depends on who you work with and where you work. I feel like a much higher percentage of the PA jobs are positive experiences versus what has been posted on this thread!

[Maverick87]

Go to medical school, dont do PA, with obamacare NPs will have more power and will be able to own their practices while PAs still work with doctors and this will give doctors an advantage to abuse PAs , less pay and disrespect, you will then be really physician'S assistant. dont let the school put ideas in your head that you will be like doctors and will have autonomy and all that crap, its not true. The system gives doctors so much power, hospitals kiss doctors asses because they bring them patients, they have no benefit from PAs. I met awsome PAs and they know more than doctors but unfortunately doctor's ego will not let a pa in charge, also mention that most of nurses hate PAs and will do anything to show that Pas are stupid. Also patients will really disrespect you , i heard this too many times " WHERE IS THE REAL DOCTOR,I WANA SEE THE REAL DOCTOR"

no matter what you do for the patient , even if you covered everything from A to Z , they wont feel better till they see the doctor. one of my jobs , i had patients where i do everything for them but they wont feel better, then they see the doctor and i swear he orders only CBC ( blood test), no change in treatment and its like magic they are resurrected lol. DONT ever think that you will get full credit for what you do and its really discouraging. only few patients appreciate PAs.

I have a friend that works with an agency to recruit PA/NPS , i swear he showed me all the jobs available , for every 10 NP jobs which says ONLY NPs, there is 1 PA job, so if you have kids and family and a house in one area forget about being not flexible, you will be jobless.

 

Troll?

 

This has not been my experience or the experience of my classmates at all. We graduated from a school in NY. I went into the military right after, but my friends didn't. Most have had little trouble finding jobs as new grads. Everyone that I knew was employed by New Years and some have 2 jobs. I had friends move to the southwest. They also had no trouble getting jobs. The only people that did have trouble were people that were looking for a specific specialty at a specific location for a specific salary.....or if they failed their boards.

 

As far as the not getting respect thing, I've found that patients dont even know the difference between a doc and a PA. I get called 'doc' all the time even when I correct them on it. This is something I noticed in rotations too and my preceptorship said that that's quite common. Ryan, to be frank, it seems like you're giving patients too much credit.

[Will352ns]

Go to medical school, dont do PA, with obamacare NPs will have more power and will be able to own their practices while PAs still work with doctors and this will give doctors an advantage to abuse PAs , less pay and disrespect, you will then be really physician'S assistant. dont let the school put ideas in your head that you will be like doctors and will have autonomy and all that crap, its not true. The system gives doctors so much power, hospitals kiss doctors asses because they bring them patients, they have no benefit from PAs. I met awsome PAs and they know more than doctors but unfortunately doctor's ego will not let a pa in charge, also mention that most of nurses hate PAs and will do anything to show that Pas are stupid. Also patients will really disrespect you , i heard this too many times " WHERE IS THE REAL DOCTOR,I WANA SEE THE REAL DOCTOR"

no matter what you do for the patient , even if you covered everything from A to Z , they wont feel better till they see the doctor. one of my jobs , i had patients where i do everything for them but they wont feel better, then they see the doctor and i swear he orders only CBC ( blood test), no change in treatment and its like magic they are resurrected lol. DONT ever think that you will get full credit for what you do and its really discouraging. only few patients appreciate PAs.

I have a friend that works with an agency to recruit PA/NPS , i swear he showed me all the jobs available , for every 10 NP jobs which says ONLY NPs, there is 1 PA job, so if you have kids and family and a house in one area forget about being not flexible, you will be jobless.

 

In your last thread (first post) you came off sounding really bitter due to a bad situation...to the point it seemed like you were trolling. Now....it seems like you really are.

 

Your situation is on the extreme side. While some of the more seasoned PA's have empathized with some points of your position, they also state that it isn't the norm for it to be that bad. I know more than a few PAs in different areas of the States, and none of them have had it nearly as bad as you. Sure, it isn't all rainbows and unicorns, but overall these folks are happy.

 

Spreading an extreme example fueled by extreme bitterness doesn't really represent the norm. It isn't helpful....it is trolling.

[Timon]

This question has been asked numerous times and i always see the same variety of responses. The wide array of responses reminds me of when I was in fraternity during my undergrad years and someone explained to me the four bones.

 

Jaw bone - That person who says they're going to do a whole bunch of stuff for the organization and does nothing but flap their jaw.

 

Wish bone - That person who wishes we could do this and that but does nothing for the organization and just wishes.

 

Knucle bone - The person who knocks everyone's ideas down and offers nothing in return.

 

Back bone - The person who breaks their back for the organization and takes it upon themselves to better improve current conditions and sets up future success for the legacy to follow.

 

 

Don't listen to the knuckle bones, jaw bones, and wish bones... PAs need more back bones. If this is what you want to do then go for it. If you see a problem be apart of the solution instead of part of the problem. It's up to us new PAs to take over for the backbones that have made our profession advance this far. Lets not let them down and lets make this a better profession for those who come after us.

[Acebecker]

My experience as a PA over the past 2 years (nearly) has been extremely rewarding and delightful. Though I ask myself if I had it to do over again would I go to medical school, I don't regret what I have accomplished thus far. Our practice (in my home town - where I wanted to practice) values PAs very well, treats me with respect (aside from a couple of bad internal medicine apples), and takes care of me and mine. They want me in it for the long haul, and it shows. I will be glad to do this job for the rest of my working days. I may do some side jobs for fun, but my hope is to be here until retirement comes.

 

Everyone will have their own experiences, but remember this: it is what YOU make of it. Accept responsibility for your own happiness in whatever you choose and then your choices will make you happy.

 

Andrew

[TThielen]

Our practice (in my home town - where I wanted to practice) values PAs very well, treats me with respect (aside from a couple of bad internal medicine apples), and takes care of me and mine.

 

Andrew

 

Why does it seems like it's common for internal medicine docs to shoot down the PA profession? The internal med doc at the hospital I work at is always making jabs about how I should consider something else....even though he claims he's just "picking" on me, I know he honestly has a serious intent to his comments.

[coastalPA]

I would recommend that you not go to PA school, just go MD/DO. If the mid-level role really attracts you, then I would suggest becoming a NP -- less educational expense (this info gained from NPs I have spoken with who tell me they paid $45K-$65K for NP school), increased ability to function autonomously, generate more for primary care practices that use EMR (see below). If you are concerned with salary and desire daytime hours, I would recommend becoming a CRNA (after graduating, CRNAs can make $110K plus vs. $75K-80K as a PA, with the cost of school being about the same). Becoming an MD/DO will provide you with more freedom, respect and much better compensation and financial security. Freedom to chose where you work and how you work, without having a necessary but cumbersome SP-MD relationship. With regard to respect, this is lacking mostly from the point of hiring managers and administration. PAs are just not as important/essential as MD/DOs from a healthcare management stand point. MDs can function autonomously in every sense of the word, but PAs, having to work under the supervision of a MD/DO, will never be able to do this. I feel I have respect from patients, with most preferring to see the PA over the MD -- whether they have a "connection" with that PA, or we could see them sooner than the MD. There have been times when I have heard elderly patients demand to only see the physician, but this has been rare. I have respect from co-workers. However, I think this is in part due to my mutual respect for them and my ability to demonstrate my competence when managing patients; though during my first job in the ED, several nurses were quick to be condescending and resistant to work as a team, but I think this was mostly because I was new to the practice and had not developed that air of confidence that encourages respect from co-workers. As much as you pay for PA school (I owed $112K/minimum monthly payment of $770 at average interest of 7%), with 25-30 years of student loan debt, it is well worth it to just pursue MD school. Before PA school, what attracted me to the profession was the idea of functioning as a provider but without all of the demands on your time (working weekends, on-call responsibilities, after-hours work), the ability to work in any specialty or having to deal with the management of others. However, I am seeing a trend in the last few years that more employers expect that PAs will have the same or more responsibilities than the MD, take call overnight and weekends without compensation and are expected to manage others in the practice, so one cannot focus just on the role of being an efficient, compassionate and competent provider. I have turned down many jobs because the expectations were unreasonable and/or the pay was substandard (lowest offer $60K after 3 years of experience). For example, I left a contract position that I really enjoyed in which I had 40 hours/week but no benefits/long commute for a position with set day hours and great benefits only to find that, on day one, I was expected to be the PA, receptionist, phlebotomist, CNA/MA (I was the only employee) in an urgent care/employee health center practice where management asked me why I was not seeing more patients and why I did not give Mr./Mrs. X narcotics, antibiotics, etc. ... I do not think this would ever happen to a MD. Also, from the PAs that I have spoken with at conferences/co-workers, job satisfaction my be gender-based, with most females I speak to feeling underappreciated, overworked and underpaid; whereas male PAs feel very good about their relationship with their SPs/employer, without feeling undervalued/underpaid. I have witnessed this first-hand when a new-grad NP -- a male -- was paid significantly more (better benefits, paid salary but worked less so that average hourly rate was more) than seasoned female PAs with 2-4 years of experience at the same practice. I have been asked if I have children, do I plan to have children, how being a parent would impact my ability to be dependable with regard to my work schedule, if I was married and one interviewer even asked me about the status of my relationship with my husband (i.e., possibility of divorce) during job interviews! After asking if I planned on having children, one MD said to me, "As soon as you pop one out you will want to go part-time." I was shocked! I do not think a physician would ever say anything like this to another physician interviewing for a job. With specialty CAQs now available, the ability to be diverse and work in any specialty is getting more and more limited. Leaving me to ask: What is the point of the the PANCE/PANRE if this certification alone does not make me marketable? More employers are wanting NPs who are specifically trained in psych, and are not willing to consider PAs because we have a generalist education and cannot get the CAQ in psych without a set number of contact hours in psych -- a Catch-22. NPs are also more attractive to employers because some physicians can supervise more NPs than PAs at any one time, allowing them to expand medical services/generate revenue if that MD had NPs. Also, NPs and the practices that they work for (if primary care/IM/peds) receive financial incentive for every NP they hire that utilizes EMR. Employers DO NOT get this extra reimbursement when employing PAs (unless working in a federally funded CHC) -- see http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms/.

[Teasip]

Back in the late 80's there was one IM physician that used to be consulted frequently by my old cardiology group prior to my arrival who would refuse to allow me to write on his patient charts. I was too beneath him for him to tell me directly but he didn't mind telling my SP's. To my knowledge I was the first non-surgical PA in this large metro. hospital. Later on, this particular group at one time had up to seven PA's working for it, but last I knew they had none. All of us left for one reason or another. To my knowledge none of the other PCP's or specialists had an issue with our writing notes on their pt. charts.

 

coastalPA, you can also add to the equation those of us with a BS PA degree who won't even be considered for another PA position because we were too quick to get into the profession before MS degrees were offered. In my situation, it isn't financially advantageous to attempt an MS at this point due to my anticipated short career expectancy at my age. This is another incentive to try to meld my way into teaching at this point, even for much less money, just for the security of it. In this setting I could more easily justify at least taking graduate courses ("I'm working on an MS" wink-wink). I concur that we've potentially shot ourselves in the foot by attempting to over-specialize ourselves, but then again, back in my training days, it was all about primary care (few non-primary care PA specialists back then).

[mathwizard]

They are nasty because IM doctors are not the cream of the crop. They are usually close to the lowest scoring on the STEP 1 that is how they land in IM. Many wanted to go into Surgery and instead spend whole life miserable in IM. They think making others feel bad will make them feel better? Some get lucky and get some obscure high paying fellowship specialty but still in the end they are miserable. It is easiest to get into that’s why so many are foreign born and educated. It took them a long time to realize money doesn’t make them happy so they don’t want anyone else to be happy either? Very sad to see who is able to practice medicine nowadays?

[medman2007]

In your last thread (first post) you came off sounding really bitter due to a bad situation...to the point it seemed like you were trolling. Now....it seems like you really are.

 

Your situation is on the extreme side. While some of the more seasoned PA's have empathized with some points of your position, they also state that it isn't the norm for it to be that bad. I know more than a few PAs in different areas of the States, and none of them have had it nearly as bad as you. Sure, it isn't all rainbows and unicorns, but overall these folks are happy.

 

Spreading an extreme example fueled by extreme bitterness doesn't really represent the norm. It isn't helpful....it is trolling.

 

This x 10. Don't know what's funnier....this "Ryan" spewing the first 5 pages of the Trolling for Dummies handbook verbatim; or, the posters who actually respond seriously to him/her/it

[PM2016]

Shadow! Shadow! Shadow! You need to see first hand what you are getting yourself into. Shadow specifically in specialities you think you would be interested in. I'm shadowing an ortho pa who I always feel so bad for because she looks so over worked and exhausted. This past monday she spent a total of 18 hours in surgery! then I've also shadowed an endocrinology pa who only works from 9 to 5 with a one hour lunch break and that's it. I've shadowed 4 pa's total and all of them barely interact with they SP. most of the time their SP is not even there! I've only seen them talk to them when they are unsure of themselves.

[burnpac]

I think that becoming a PA is good advice today, and into the foreseeable future. There will be heavy demand for jobs, and PAs have the distinct advantage over other providers on length / cost of training, and we will get boots on the ground faster than physicians and NPs. The jobs will go to the people who show up.

 

There will always be pockets of the country dominated by those whose mean spirited / self-serving actions are designed to get a leg up on what they see as the "competition." I have seen plenty of this in 32 years. However, we are at critical mass, and our proven track record of caring for patients will overcome this. "Team" medicine is the model now, and autonomy and independent practice is becoming less-and-less important.

 

I can't think of a better profession for a person interested in medicine in this day and age. It is certainly much better than it was when I graduated in '81.

 

There is no reason anymore to work with people who don't respect you, or in bad environment. There are just too many good jobs out their to count.

 

I have had good jobs, and so-so jobs in my career. The good times far out-weigh the bad. Respect is earned, and I have plenty of it from my patients, colleagues and health care organizations. I see no circumstances under which the profession will decline.

[medman2007]

I would recommend that you not go to PA school, just go MD/DO. If the mid-level role really attracts you, then I would suggest becoming a NP --

 

as a combined NP/PA,that is a naive, irrational statement as there are too many specific, individual variables that must be weighed. Go and post this question in a Nsg forum (changing desire to NP), and there will be equal amount of barriers/issues, perceived lack of respect, fighting uphill battles, etc. Like mentioned 1000x on this board, things are relative location-dependent. A fact little discussed in healthcare circles are the number of NPs relegated to working as staff RNs due to lack of positions, poor pay (i.e, can make more as staff RN than APRN). Bottom line, there may be different challenges/problems to be fixed with NP vs PA vs physician, but problems nonetheless. Just several days ago, I spoke with a Nursing Clinical Mgr/Director of a large specialty group who stated to me "I prefer to hire PAs, just because I feel the PAs catch on faster and are much more time efficeint.." Is she correct, prob not...but it goes both ways

[EMEDPA]

Back in the late 80's there was one IM physician that used to be consulted frequently by my old cardiology group prior to my arrival who would refuse to allow me to write on his patient charts. I was too beneath him for him to tell me directly but he didn't mind telling my SP's. n).

we still, in 2013, have several consultants in both IM and surgery who refuse to talk to a PA on the phone about a patient. if you page them they say " have your attending evaluate the pt and have them call me" then they slam the phone on you. why is this ok? why doesn't the hospital crack down on this flagrant abuse? because they are DOCTORS and deserve respect and admiration.....

[EMEDPA]

"Team" medicine is the model now, and autonomy and independent practice is becoming less-and-less important.

 

while team medicine is an important concept and one I believe in, after almost 20 years in the profession I am seeking out positions that offer me more autonomy and the ability to be respected as as a solo clinician judged on my own abilities and training. 2 of my 3 current jobs are solo positions and the third is one at which I alternate charts with a doc from the same rack regardless of acuity. this has made me much happier professionally than I have been ever before. I'm tired of being second guessed and doubted just because I am a PA. after years working in the profession I have found that I need to either work alone or with folks who respect me. the alternative is just no longer acceptable. I recently quit a per diem job after hearing this line from a nurse manager "you can't do that(something reasonable and well within my training and scope of practice), you are just a physician's assistant". I handed her my pager and said "fine, replace me" and walked out. best choice I ever made.