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Physician's assistant career.

Discussion in 'Business, Careers & Education' started by Big Pun, Oct 6, 2011.

  1. Big Pun

    Big Pun Senior member

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    There has to be a few among us. I am interested in pursuing this career path, can anyone share what education they had, certification they received and general overview of what their job is like as a PA? Any insight is appreciated, thanks.
     
  2. Piobaire

    Piobaire Senior member

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    Not one but am very familiar with them. Generally, an undergrad degree in just about anything (I know a guy that works on an organ transplant team as a PA and was a banker prior) and then a PA program. Think they generally run two years. Tons of choices of practice, good pay, can have good to great (if you don't take an oncall position) quality of life.
     
  3. Rambo

    Rambo Senior member

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    I've never really understood this job. Why not just be a doctor? Or a Nurse Practitioner?
     
  4. HgaleK

    HgaleK Senior member

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    Less schooling (though PA school is getting to be incredibly competitive) and much more patient/professional interaction. PAs do most of the shit that doctors do, and spend most of the time with the patients. AFAIK, the only thing they can't do that a GP would normally do is prescribe meds.
     
  5. Flambeur

    Flambeur Senior member

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    Ugh, set an appointment with a new local doc, came in, get taken care of by a PA instead... After a 20 minute interaction politely ask her to leave and bring in the real doctor who then proceeds to actually address the issues and requests I had instead of the BS that the PA was giving me. So I don't really like PAs right now.
     
  6. Piobaire

    Piobaire Senior member

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    Just like NPs, PAs can prescribe. PAs are basically starting to muscle in on what NPs have been doing for years. You are correct though, much easier to be a PA vs. getting your NP.
     
  7. erdawe

    erdawe Senior member

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    PA's can prescribe under their own license. But on the same hand, are tied to the physicians license that they work under, as you might suspect given the name. It's not fair to paint all PA's equally.

    PA's education and backgrounds are somewhat variable, though most** (hence asterisk) have worked in the healthcare field traditionally in another healthcare profession before making the jump to PA school.

    Historically, a large amount have stemmed from backgrounds as military medics with a great amount of direct patient healthcare experience before making the jump to schooling for PA. Many were medics, EMT's, nurses, respiratory therapists, ect. for at least a few years before making the move to PA school. The scope of practice is generally as wide as the physicians whom the work under and the competency of their skill level. Some have been in the trenches as PA's for > 20 years and are just as capable to diagnose as the physicians they work under. It's not fair to paint all PA's under the same brush. You'll find PA's working in most any healthcare setting that a physician would from Emergency Medicine to Neurosurgery. However, you won't find (and likely never) find PA's actually doing surgery. You will find PA's who first assist in surgery however.

    Most good PA schools will absolutely require great amount of direct healthcare experience before requiring entry to the the schools and profession. The schooling is a very rigorous 2 years round master's in addition to bachelor's beforehand. The schooling is taught akin to the first 1 & 2 years of those in actual medical schools.

    What PA's lack primarily is the 3-8 year residency and fellowship training that physicians undergo for their chosen specialty. Many will refer to PA's as perpetual medical residency students. Though the delineation is more complex and nuanced.

    Many experienced PA's in non-surgical settings will be found doing similar work as the physicians next to them, but at roughly half the salary as fully licensed physcians. But, given physician's annual salaries this is still somewhat handsome. PA's CAN be sued for malpractice, but the line of fire still usually hits the overseeing physician.

    One thing to know is that the amount of PA schools offers has grown rather tremendously in the last decade or so. This has arguably lead to a trending of less and less healthcare experienced students being admitted to lower tier programs. Anecdotally, I know of a peer in the midwest whos only previous healthcare experience was a summer patient research experience at a children's hospital (NOT direct patient care) being admitted into the local state school. She was from my alma mater thus, my anecdote. She had high grades sure (>3.7). However, she did not have the realworld healthcare experience that would have traditionally been required of say a military medic of 10 years, who decided to go back to school to be a PA to further his career and knowledge base.

    The thought of new PA student right out of undergrad with only a science undergrad degree and a simple hospital internship is somewhat troubling to hear. This is a more recent phenomena from interviewing PA family members I know.

    Overall, PA schooling is still not a walk in the park, and expect 60- 70 hour weeks of studying/clincals to do well those years. Many PA's will do the grunt work physician's don't want to do to save $$$ for their practice. Some gigs depending on setting are naturally cushier than others. One thing PA's can do that physians canNOT is to switch practice specialties during their career. This is a somewhat of a benefit for the PA's, whereas physicians would usually require another residency of >3 years to do otherwise.

    Story short, some of those long standing PA's may be quite competent despite Flambeur's remarks, without knowing background it's hard to but them all into the same box.

    If Pio wants to correct I'd be happy to hear. :D
    I've only described what I've shadowed/ picked up from family members, and familial acquantances here in the U.S. Utlimately, the last word is still with the physicians and their scope of practice will be always tied to this relationship. Hope, you enjoy who you work under. :satisfied:

    BTW, no I'm not a PA, but merely a healthcare student of another profession. Still, the field is interlinked somewhat, so I've been sure to research for my own sake and future reference.

    Remember, a Quack is a Quack, despite their potential to bark 'woof'. They'll be found riddled throughout the healthcare field whether they be PA, MD (physician), or otherwise.
     
    Last edited: Oct 8, 2011
  8. Flambeur

    Flambeur Senior member

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    Yeah, nothing personal against the PA people, I've met some docs who were total quacks, and some NPs who knew more than the docs they were working with..
     
  9. HgaleK

    HgaleK Senior member

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    Thanks for the clarification, yall.
     
  10. Gibonius

    Gibonius Senior member

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    What's the % of females in the PA field? My mom is going back to school for nursing and it's damn near all women, and has a particular culture because of that.
     
  11. Big Pun

    Big Pun Senior member

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    There appears to be a lot less schooling to be a PA, and doesn't carry the stigma of being a "male nurse" ie Gaylord Focker status. (8)

    From what I've read, in the future demand will grow for PAs as it is cheaper to have 1 Dr. overlook 4 PAs than have 5 Dr.s in a clinic etc.

    I'm in the process of joining the AF, can't go to Meps yet so I don't know when or for what yet exactly, but I'm going to try to do something in the medical field. And while I'm in it I'll get my associate's degree in an applied science. So basically I'm looking at earning a Bachelor's after that then a 2 year PA course?

    And thanks for the comments. I was sort of wondering how likely it was for PA's to get sued for malpractice.
     
  12. erdawe

    erdawe Senior member

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    Lol, life's not always like the movies..
    I know you're young, but this statement is rathe naive and out of touch. [Not NP either]

    The culture aspect of nursing can be there I'm sure, but it'll vary setting to setting..


    Less likely, as hinted at above. Smaller malpractice insurance to carry.
    However, this does not give the PA free-reign from being an incompetent nitwit, and doing thing with serious laps in judgement. IE messing with potential lives on the line.
     
    Last edited: Oct 9, 2011
  13. Eason

    Eason Senior member

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    My girlfriend just started nursing school, which so far seems pretty crazy. Maybe she should go with PA?
     
  14. Michigan Planner

    Michigan Planner Senior member

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    My wife has a four or five friends who all finished PA school in the last couple of years and none of them had an issue finding a relatively well paying job (all started in the $65k+ and that was here in Metro Detroit at the height of the recession). After working here for a year, one of them decided to pick up and move to Seattle because she liked the scenery better. She had no connections and no job prospects out there but planned to get a short-term rental and rough it for a few months before giving up. She ended up with two job offers before she was even out there a week and out of her hotel that she was in waiting for her apartment to be repainted. It's stories like hers that make me realize I went into the wrong profession (not that I have any desire to work with blood or shit or broken bones or old people).
     
  15. Big Pun

    Big Pun Senior member

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    ^That's what I like to hear.

    And erdawe, the (8) at the end of my sentence is from the sarcasm meter, (10) being most sarcastic lol.

    Man I cannot wait for the future.
     
  16. Contingency Plan

    Contingency Plan Senior member

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    Dang, US healthcare professionals get paid a LOT

    - a med student in socialist Euroland.
     
  17. WhateverYouLike

    WhateverYouLike Senior member

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    We also have to pay like 200K to go to school and have much worse hours, so pick your poison.


    There's a general feeling of frustration with nurses/NPs trying to gain more autonomy and generally getting uppity. I've heard a couple physicians say they'll only be hiring PAs in their offices as a result. So perhaps that bodes well for you, Big Pun.
     
    Last edited: Oct 14, 2011
  18. Contingency Plan

    Contingency Plan Senior member

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    I imagine you have a lot more freedom over where - and especially whom - you work for though. I've pretty much got one choice of future employer: the NHS. Also, having the government decide how much you should earn (hint: it's a lot less than the market deems proper for private physicians) isn't much fun either.
     
  19. Jumbie

    Jumbie Senior member

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    When I was doing my rotations we had PA students rotating along with us in some of the core competencies. I think it's not a bad way to go. Sometimes I feel like I should have gone that route. Less schooling and "worry/responsibility" with still pretty good pay and high demand. However, I like having my autonomy and not having to work under someone (well I guess I still will have to but not nearly to as large an extent).

    Like was mentioned above, there are different levels of people in the positions (my only experience being inpatient). Some of the PAs I come into contact with are pretty good and I'll ask them questions about their specialty/field and trust their answers and others I have learned I wouldn't trust to tell me which room a patient is in. I once told a surgical PA that a patient they were seeing in the ICU needed to be anticoagulated if it was okay with the surgical team and he told me, "He's on Protonix" as he dismissed my concern. Protonix is a PPI (like Nexium) which is used for people with GERD or in certain inpatient populations as stress ulcer prophylaxis/prevention. There are interactions of this class of medication with Plavix but I was telling him about Lovenox.

    Again, there are different classes/levels of any specialty. There is a Neuro APN at my hospital who I am as comfortable with asking questions about patient management as I am the Neurologist.

    The thing is that there most certainly is a difference between a PA and an actual physician in competency. For their day to day stuff that they're used to in their comfort zone, they can be quite effective (especially the more experienced ones who quite often know more than I do about their fixed sub-specialty) but throw them in a less familiar or critical circumstance and I've seen them fall apart. I went to a rapid response on a desaturating patient just last week and a Cardio PA happened to be there who quite frankly ended up pissing me off with useless suggestions to the point where she was getting in the way of what I needed the nursing staff to do. I'm usually a pretty polite person but quite frankly I felt that the patient care was being compromised and I got tired of having to say why I didn't want certain things done. I eventually told her that if she wanted to run the show that I could leave. Not a further peep out of her.

    <--resident

    All in all, a pretty good career choice I think. Not quite a doctor but can almost sub in for one in a lot of situations with a lot less time spent in formal education.
     
  20. WhateverYouLike

    WhateverYouLike Senior member

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    I was under the impression that your medical training would allow to move around within the EU? Couldn't you move to one of the countries that has private practices as well (Poland, off the top of my head definitely has it)?

    In any case, I'm sure there are plenty of pros and cons on both sides of the pond. We have 20-40 million uninsured depending on who you ask, rampant lawsuits (some OB/GYN was successfully sued for 53 million dollars about a year ago), a lot of wasteful end-of-life care, etc etc.

    As for lifestyle - money only goes so far. I did a short stint in Cardiothoracic Surgery - 85% of the department was divorced and varying degrees of unhappy with life. Then again, CT sucks and has one of the worst lifestyles but I don't think it's nearly as bad in the EU.
     

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