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

[burnpac]

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.

 

I've met the same nurse.... :-) Great response, and you hopefully changed her behavior. Providers can be both autonomous and valuable team members.

[Teasip]

Wow! Good for you. Gee, I had forgotten about the ED on-calls who would say to have the doc call them and ask me not to call them again (especially PS) for the munchkin lacs where the parents HAVE to have PS close it when Dermabond would work just fine.

[EMEDPA]

I've met the same nurse.... :-) Great response, and you hopefully changed her behavior. .

actually she was later fired for mismanaging the dept into the ground and making it a place where no one with experience(docs or PAs) wanted to work. now they are stuck with 100% new grad PAs and docs who could not find work elsewhere.

[burnpac]

actually she was later fired for mismanaging the dept into the ground and making it a place where no one with experience(docs or PAs) wanted to work. now they are stuck with 100% new grad PAs and docs who could not find work elsewhere.

 

And you making a stand against bad behavior changed the environment and made a difference for those working there now.

[banwvd]

Finally- Thank you Acebecker and others! I agree we need more backbones, and I'll be one of them:

 

As a PA hopeful (applying this fall), I hate these threads. I come to these threads to get motivation and confirmation that I am making a great life decision and all I see is negativity. But YOU have to come up with a reason to LOVE what you have chosen. I made a 3.95 in undergrad w a double major while working 2 jobs and my professors were PISSED at me when I decided to become a high school science teacher instead of going to med school. But you know, what? I LOVE teaching. I'm applying to PA school because I miss the medical aspect, and I'm sure I'll love that, too. I would not go back and change my outcome. Also Sportygirl, I'm not sure what your life/family goals are, but I can tell you some things that make me confident in my choice:

I have had the opposite experience as some of the Negative Nancies on this post- I've had residents tell me if they were to go back, they would do PA. I've had PA's tell me they love their jobs. With a PA I shadowed, DOCS would frequently ask her if THEY were making the right call, or would ask her opinion because she was good at her job and they had too much on their plate- aka hadn't had enough time to review every patient's chart thoroughly. She was respected and it was always a team effort.

 

In my life, money is not a huge factor. I need enough to be comfortable (I'm a teacher for god's sake- clearly money is not my priority) and I need to be useful and to work with the topic of science and medicine. PA gives me all of these things.

 

I like to dabble and change my interests- PA allows me to explore many passions within the field of medicine.

 

I don't like being the main guy in charge. Not because I think I'm not competent, but because it is emotionally and physically taxing to be that person. I've heard docs say they lost a lot of sleep their first 5-7 years of working because they stressed about the calls they made at work. But some people just need to be the boss. For those people who just want to go MD because they get to be the head honcho, make tons of cash, and boss others around, they need to get an ego check and stop watching House- people's lives are in their hands. The field of medicine is too polluted with people like this already. My bf is graduating dental school and going into oral surgery, and 90% of the people are in it for money alone and talk crap about their pt's all the time. Just as in education, PA's may not be the person in charge or make the most $, but they are the professional with more time to care and the knowledge to function similarly to MDs- which means everything to the people on the other end. If/when you become a PA, don't work for an a hole like that.

 

Last thing (whew sorry so long! This just really gets me going...) remember the people on here are not dissimilar from say, something like the people who go on Justin Bieber's YouTube channel to comment that he's gay or not talented. They are unhappy and are seeking out a way to air their grievances. Do more research, shadow more PAs, but don't go off of what some Mr. Scrooge said on a forum.

 

[sportygirl07]

Is it possible or very likely for a PA to get laid off or fired? Jee, this whole thread is scaring me!

[medman2007]

Is it possible or very likely for a PA to get laid off or fired? Jee, this whole thread is scaring me!

 

No offense (really), but if this thread is scaring you then I would seriously reconsider pursuing a career in any healthcare field... You will hear and read about the chicken salad and chicken sh*t in all career paths

[d2305]

As an ER PA I got no respect. Specialist would want to talk to the doctor. Now as a FP/UC PA, I get nice letter from specialist thanking me for the referral. I've had a hell of career, and still enjoy my job, most days.

[EMEDPA]

As an ER PA I got no respect. Specialist would want to talk to the doctor. Now as a FP/UC PA, I get nice letter from specialist thanking me for the referral. I've had a hell of career, and still enjoy my job, most days.

I recently found a few er jobs that treat me the same way. I call a pcp and they say "hey, thanks for seeing Mrs. Jones, I figured it was her chf. if you could write some holding orders I will be in to see her in a few hours when I'm done with clinic. Thanks again, bye". the difference is the rural environment. they are so incredibly happy to have some extra bodies helping out that the default behavior is politeness and appreciation of your efforts.

[Timon]

Is it possible or very likely for a PA to get laid off or fired? Jee, this whole thread is scaring me!

 

And that would be different in ANY other profession? When I look at my career path and what's happened it doesn't even phase me nor should it phase you. You are the fastest projected growing profession period. Somewhere at 30% growth which is unheard of.

 

I worked in IT in the early 2000's and my job got outsourced to India.

 

I graduated with a degree in advertising in 2002. Every company was laying everyone off because the market crash due to 9/11.

 

I worked at Disneyland telling stupid jokes on the jungle cruise with a bachelors degree.. After looking for a job 10 hours a day / 5 days a week for 10 months straight before that.

 

Then I finally landed a higher paying job working customer service at a cell phone company with all the other people with high school diplomas.

 

Eventually I landed a consulting gig.

 

Then i got my MBA and started my own business in 2006... ya that failed because the economy just shat on itself.. back to work at disneyland telling stupid jokes with an MBA in my back pocket..

 

Then had a job opportunity to manage a CD/DVD company... a few years later CDs/DVDs become obsolete.

 

And you're worried about getting laid off? I don't know of a more stable industry and profession outside of PAs that let you practice with this much autonomy with two years of intense training...

 

You try working in real estate, financing, construction, engineering, manufacturing, IT, any business field, travel, transportation, sales or as a teacher and that's when you worry about getting laid off...

 

30% projected job growth, the affordable care act, and an aging baby boomer population... Getting laid off is the only thing I am not worried about.

 

What I am worried about wheni read these types of posts is who are going to be my colleagues to advance this profession who will fight for us to let us practice to our full capabilities. There is a reason why you see nurses and doctors afraid of PAs. There is a reason why they talk down to us or about us. It's not our skill or capability or training.. It's the fact they view us as a threat to take over their job roles.

[discogenic]

 

 

What I am worried about wheni read these types of posts is who are going to be my colleagues to advance this profession who will fight for us to let us practice to our full capabilities. There is a reason why you see nurses and doctors afraid of PAs. There is a reason why they talk down to us or about us. It's not our skill or capability or training.. It's the fact they view us as a threat to take over their job roles.

 

I'll admit that I don't have a good grasp on how things work in the policymaking world. But it seems there are two competing ideas that can't really exist simultaneously (or perhaps they can, I don't know). 1) PAs are a threat to take over the job roles of others, and 2) PAs are regulated by the Medical Boards (i.e., the MDs) and therefore will never get out from under the thumb of the MDs. Can PAs be regulated by MDs while at the same time taking over MD turf against the will of MDs?

[cjancay]

I finished PA school 2.5 years ago. I had 4 job offers within one month of graduation, in Philadelphia which is considered a saturated market for PAs. I took a job in general surgery at the Hosp of the Univ of Penn. It paid six figures, 4 x 12 hour shifts, no call, no weekends, no nights, 4 weeks PTO, $1600 CME. I was able to pick up per diem work in the ED at $50 per hour as well. All of my classmates had jobs within 3-4 months, most sooner.

 

I love being a PA. My best friend is a third year general surgery resident. He currently has 300k in debt, works over 100 hours per week and has missed his twenties and early thirties. I know one day he will be making excellent money and have great respect. We need people like that but for me personally it was not worth it.

 

I decided I wanted a change of weather so looked into relocating to Southern California. I was able to find a job in San Diego within a few months and now work in an urgent care setting with full autonomy. My patients love being seen by PAs. Maybe once a month I will have a patient who is not happy and requests the doc. I have to say I have great job satisfaction. I constantly get calls and emails from recruiters. I frequently check job postings just out of curiosity and even here in Southern California which some say is a tough market for PAs, there are a lot of PA job postings.

 

I see a lot of negative energy on this forum and I have to say I disagree with most of it. I feel some people tend to have a negative outlook on life and they will have negative results subjectively. I have only positive things to say about the profession. I make great money, get to help people, feel respected and appreciated, and work 3-4 days per week. I can pick up and move anywhere I want in the country and all I need is my stethoscope and a rx pad. Doesn't get much better. Do we still need MDs and DOs? Absolutely. Is NP a good field? Absolutely. I have met some good NPs and some terrible ones. I think this hold true of every profession, including PAs (I know some awful ones!). Everything has to be the right fit for the right individual.

[Timon]

Basically it's financial in most cases, but insecurity too.

[physasst]

As an ER PA I got no respect. Specialist would want to talk to the doctor. Now as a FP/UC PA, I get nice letter from specialist thanking me for the referral. I've had a hell of career, and still enjoy my job, most days.

 

I've had that. My career has been an evolution. ANYONE who has met me in person, IE; Emed, d2305, jmj11, burnpac, and several others that I am probably forgetting, knows that I have a very strong personality. I've always been in positions of leadership, from boot camp in the USN, to the fleet, to college, etc. Sometimes I have sought them out, but often I have been asked, and it's usually because of my personality.

 

My first job was in Neurosurgery, but it sucked so bad I didn't last long...100 plus hour weeks weren't my idea of fun. I still enjoyed surgery so then I moved to Minnesota and started working in Orthopedics. Stayed there for 7 years. Hated it after about 3. Mostly because while the surgeon I worked with wasn't malignant, he was very quick to remind you that you were an "assistant" and NOT a physician. Second class citizen. You couldn't have your own schedule, and while I did injections, it was only after about 4 years, and only if the resident was around. You could tell he just wasn't comfortable with it. When PAs would refer patients to him, he would try his best to find something to complain about regarding the referral. He thought of us as someone to answer phone calls, tee patients up for him, assist in the OR (IE; hold retractors), manage the postop coumadin, and help the resident. That was it. NO independent judgment, and there would be a quick, terse reminder that these were "HIS" patients. I remember once a patient scheduling surgery, and I mentioned that I would be out of town. She asked him about that. His reply: "I don't need him to be there, I am the one operating on you". I realized a change was needed.

 

Next I spent 9 years total in EM, although 3 of those were spent moonlighting in EM while still working in Ortho, and while I had more autonomy, and actually rose to a position of substantial leadership in the ED, I still could not get everything changed. Most of the attendings were cool, but some were quick to remind you that you were a PA....NOT a physician. A lesser being if you will. Trying to get procedures was tough, as the residents fought over them...Still, I didn't hate the position, but the schedule was tough. I was missing a lot of family time and a lot of my daughters school and swim stuff. Not to mention, my wife wasn't happy with me "never being around". I did get the PA scope of practice changed here. When I arrived, PAs were only allowed to see level 4 and 5 patients independently, but I managed to eventually get that changed to include ESI level 3 patients. Any admitted level 3 patients and all level 1 and 2 patients still needed to be staffed. So progress, but I wanted to include admitting privileges as well, which I was not able to accomplish. Respect was a hard issue in the ED. The attendings NEVER invited the PAs to social events, although socially, THEY were very interactive among themselves..it was little things. Just constant reminders that you are not as good as them, not to mention that as an ED provider you got NO respect from the various specialists. I remember commenting to the vice chair once regarding ongoing education in the ED, that I thought, and would like to see, that all PAs should be trained and educated to the point that they are able to function throughout the ED as a fellow, or at the very least like a senior resident just before graduation. You would have thought I had suggested that pigs fly. He looked incredulous, and said that would never happen, because "at the end of the day, you are STILL an assistant, and NOT a physician, and to suggest that you could practice at that level was ridiculous".

 

Now, I am in a good position. I work in a complicated PM&R spine practice and manage my own panel of patients. I'm the first and only PA so far, so that has helped, as there weren't many pre-conceived notions, and I have been able to have a lot more say in what I am doing and my schedule etc. I get treated more as an equal by all of the docs (save one and he's old) and they will even ask my opinion on cases and images, etc. Very interprofessional, very respectful, social, etc. I get invited to all of the physician meetings, am asked my input, and even am invited to talk and present to the physician group on research topics, etc.

 

To reply to d2305, I get the same now, internal physicians will call me and ask me what my findings were, what did I think, what were my recommendations, and then thank me for seeing them. I will get letters thanking me as well. It's a nice change.

 

It's been a nice career, and I've had a great trip so far....

[banwvd]

To person who asked can PAs and MDs survive in the same job market: I believe they can- many MDs are not going into primary care fields anymore bc after it's all said and done, time, money spent, loans that need to be repaid, malpractice insurance that needs to be paid, many physicians think something like a family practitioner is not going to be worth all the stress/$ they forked out to become a doctor. Correct me if I'm wrong, but MD is becoming more and more of a specialist degree, while I can see in the future, PA's taking a front seat in the primary care role. If PAs still choose to work in specialist areas however, I think that would be more difficult to gain autonomy and get out from under MD thumbs

[LESH]

After almost three decades as a PA, I feel it was one of the best life decisions I have ever made. It definitely was the best career move I could have ever made. I have had an opportunity to provide for my family, serve communities in need, advocate for the profession and help train generations of new PAs do the same. The PA friends I have made, PA mentors I have had, and graduations I have sat through consistently remind me that I have been blessed. Yes, there have been times when “the job” might have sucked, but then I just got another job. To the OP, I respect and appreciate your question, as well as, the many responses you have received. For me, the profession has been to quote one of my favorite Rolling Stone tunes “a gas, gas,gas…” lol. Good luck in your future PA endeavors.

[PACali]

Love being a PA. Better than a lot of jobs out there. It allows me to help people, provide answers to medical related questions for my families and friends, it allows me to travel around the world for medical missions, and of course, make a decent living. There are bad days in every profession. Same with being a MD/DO. If you think becoming a doctor will give earn you automatic respect from everybody and treating you like a god, you will be VERY VERY disappointed. I work in a large ED, most of staffs, nurse, techs, pas, docs, just want to get things done and go home enjoy their life. The techs and the nurses do not care you are a PA or a doctor, as long as you know your sh*t and don't make them work too hard. I've nurses told me they like PAs more than the docs because "we're nicer to them" i don't know what that means but I take it. Sure there are alot of a**holes out there, but they usually got issues with everybody and nobody like to deal with them anyway and that's in every profession. To the OP, I don't recommend using internet forum for questions like this one. You will often get the extreme answers. If you noticed, there is always the same 10 or so people who frequently post here. I recommend you get out to the real world, go to your state PA conference, go to AAPA, and talk to people face to face, I think you will benefit more.

[TThielen]

 

You hit the nail on the head! You want a positive outlook on life, be positive/optimistic. You want to have a depressing life, be a pessimist. It's all about your attitude!

[whoRyou]

 

 

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.

... and after US let it be THEM etc etc ... Amen brother! :wink: