Will midlevels price themselves out of market? PA-CAT? Wondering what NP/PA/MD/DO looks like in the future.

[Doctoscope]

Came across this article on Meddit: Concerning trends in primary care physician demand and compensation - The DO, and another thread on Med School reddit where apparently MSU is "synergizing" PA/DOs and have them take all the same classes (funny enough, PA exams will be held to a "different" aka easier standard) ().

With the NP/PA profession on the rise, and anecdotally exploding in popularity (a ton of pre-PAs when I went to undergrad), one can't help but wonder where this is all headed. Apparently the true objective of FPA is to equalize pay between midlevels and physicians (don't have a source for this; just some stuff I've read).

I can't see how FPA with equal pay is a possibility, because on average NPs and PAs objectively and numerically are not as well-trained as MD/DOs (NP pass rate of a watered down STEP 3 was <50% back in 2008 or 09, and they discontinued that whole thing). Why would hospital admins pay the 2 the same when one has less training/knowledge?

On the other hand, this could be a possibility: PA/NPs make less, but their hours/responsibilities are less enough that the pay is essentially the same. I've heard you're already kind of seeing this with CRNAs and gas docs in some states; the CRNA makes less than the anesthesiologist, but the hours/call burden are different enough that the pay is effectively very similar. Pay is not everything, but let's be real it's a big part of this journey.

Meanwhile, med school tuition is still expensive af, you have MSU "equalizing" curriculum between PAs and DOs, whatever the hell that means, and (anecdotally) PAs touting they learn the "exact same things as medical students, [they] just don't do a residency and learn on the job instead."

NP schools are still opening up everywhere, a lot of 99% acceptance rates. PA is a little different; looks like they might be (?) increasing admission standards even higher with the PA-CAT (Home - Exam Master PA-CAT). But it seems the PA job market is closely intertwined with the NP market, and if the NP market comes crashing down, they may inadvertently bring PAs down with them (why pay a PA more when you can find a cheaper NP?). Funnily, the PA-CAT isn't even a widely (if at all) adopted thing, but you have some pre-PA students on social media claiming it's as difficult as the MCAT (yeah, it's social media, but it's really just an outlet for what people really think).

With how grueling the premed-med-residency process is, and more and more people wanting the reward without putting in the work on the rise, one can't help wonder what this will all look like 20, 30 years down the line.

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[Princeton Medical Student]

My bet is that doctors will eventually transition to being in more supervisory roles IE CRNA model regardless of if we like it or not. I don’t see midlevel salaries rising significantly because of simply the way the job market has been for them. Doctors aren’t going anywhere though. There is still a huge amount of demand for med school and it won’t go away even with something as drastic as a 25% salary cut

 

[Med Ed]

Came across this article on Meddit: Concerning trends in primary care physician demand and compensation - The DO, and another thread on Med School reddit where apparently MSU is "synergizing" PA/DOs and have them take all the same classes (funny enough, PA exams will be held to a "different" aka easier standard)

"At the start of the program, 48% of the didactic curriculum (29 of the 60 didactic credit hours) for the PA Medicine students will be taught interprofessionally with the D.O. medical students."

With how grueling the premed-med-residency process is, and more and more people wanting the reward without putting in the work on the rise, one can't help wonder what this will all look like 20, 30 years down the line.

It will all be sorted out by liability.

 

[YCAGA]

Came across this article on Meddit: Concerning trends in primary care physician demand and compensation - The DO, and another thread on Med School reddit where apparently MSU is "synergizing" PA/DOs and have them take all the same classes

This bolded is insane...because it is wrong. You clearly did not even read the Reddit post. They are creating interprofessional education (IPE) classes for DO and PA students at MSU, since you have to have multiple professions to make it interprofessional. It never ceases to amaze me what details people will glaze over to fit a narrative.

I mean think about what you just claimed for a second. DO school is 4 years and PA school is 2 years. So the only way PA students could do all of the same classes are 1) if the DO preclinical curriculum was 1 year (literally 12 months, very very few top ranked MD schools can pull this off, they normally do it in like 15 months), and then the PA students had a year of clinicals, or 2) the PA students took an entire DO preclinical course load over 2 years with the DO, and at the same time, they did a full med student clinical rotation schedule for the 2 years. If we say med students average about 60 hours/week, PA students would need to average 120 hours/week.

A CT surgeon at my school says he worked about 110 hrs/week as a surgery intern on his worst rotations. This is a guy who comes in on the weekends for fun when he is not on call. Last time I heard him talk he had been up for 36 hours because he did a heart transplant at 3am and then had cases the next day. My point being, only the most intense doctors work 100+ hours/week and that is in short sprints. It is absolutely laughable for anyone to claim PA's will be taking the same classes as DO's, unless you think medical students work 20-30 hours/week and their curriculum could be condensed into half the time.

 

[YCAGA]

In more concise language, you are part of the problem if you think for a second that PA students could actually the same classes as DO students.

 

[Proudfather94]

In Ohio it's already happening. NPs at my hospital start at around 80 to 90 k a year. Alot of nurses with their nps are staying as bedside nurses because they can make a comparable salary with less responsibility by staying at bedside and occasionally picking up shifts.

 

[Matthew9Thirtyfive]

In Ohio it's already happening. NPs at my hospital start at around 80 to 90 k a year. Alot of nurses with their nps are staying as bedside nurses because they can make a comparable salary with less responsibility by staying at bedside and occasionally picking up shifts.

Happening for a while in CA too.

 

[YCAGA]

Happening for a while in CA too.

That makes me somewhat hopeful that the market is correcting itself a little bit. I know when I worked in the emergency room they had a ton of PAs applying for a handful of jobs, but couldn't find any nurses even from travel agencies. Obviously PA does not equal NP but similar concept of supply and demand.