Is Physician Assistant school a good investment rather than medical school?

[Shotokan487]

It's also about what you want out of your career. Both are financially secure jobs, although doctors do make more money (or even equal) compared to PAs. It's also about the status. Do you want to have the MD/DO status, where everyone calls your "DR" instead of "Mr?" Do you want to call the shots or do you want to take orders from someone else? These are the questions.[/QUOTE

Depending on the physician, many PA-Cs are working without a doctor present. The doctor has to be within so many miles of the PA-C, however. Chart reviews may not even be done on the same day that the PA-C sees the patient.

In rural areas, a PA-C may be working by himself/herself.

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[mistafab]

Thought came to me on this topic. I never see nurses or PA's at grand rounds, science lectures, research conferences, or anything like that.

If you care about research, MD/DOs will be taken seriously at research conferences and in journals. No one takes PA/NPs in research seriously and the people that go that route don't care anyway (stereotype). The nurses I know will go to nurse conferences (probably not the norm) but it is really just an excuse to meet other nurses, get some special new certificate, or look for new jobs.

 

[Sardinia]

I think it really depends on what you want to do. If you are looking to do PA vs IM or FM, then I think that is very different from deciding between PA vs Gen Surg or Rad Onc. In the former case, the PA/NP route sounds like a nice deal. In the latter, MD/DO all the way baby!

Jc what are you basing this on. Imo most lucrative option is for PAs to segue into Surg/ER for at least five to seven years before moving to another field whether they may be something like IM or FM.

 

[IAhawkeye]

Reading many of the posts makes me wonder if any of you have any healthcare experience at all. "There is such a wide knowledge gap, I would never let PAs see me" etc.

Here are some facts: many research studies have shown that PAs deliver the same quality of care, if not better, than physician counterparts in areas like family medicine.
New Study Finds Collaborative Care Teams That Include PAs Deliver Same Quality of Care as Physician-Only Teams in Cardiac Setting


https://www.aapa.org/twocolumn.aspx?id=2147486638

 

[Benjoe11]

Reading many of the posts makes me wonder if any of you have any healthcare experience at all. "There is such a wide knowledge gap, I would never let PAs see me" etc.

Here are some facts: many research studies have shown that PAs deliver the same quality of care, if not better, than physician counterparts in areas like family medicine.
New Study Finds Collaborative Care Teams That Include PAs Deliver Same Quality of Care as Physician-Only Teams in Cardiac Setting


https://www.aapa.org/twocolumn.aspx?id=2147486638

You realize that the article you linked doesn't support your claim that PAs deliver equal or better care than a physician? It says the overall quality of care is better when the team includes a PA or RN WITH a doc than only a physician. And I don't think anyone here would dispute that a PA is a valuable and needed part of a hospital team to increase overall quality of care in that setting.

 

[DKMA]

Jc what are you basing this on. Imo most lucrative option is for PAs to segue into Surg/ER for at least five to seven years before moving to another field whether they may be something like IM or FM.

If I went IM or FM as a MD, I will not be able to pay my loans off (and if I could, it would be by living on less of a take home pay than many PAs). PA and NPs in primary care also have a large scope of practice--> MD isn't worth it that route unless you absolutely want the MD

If I want surgery as a MD, it will suck and I may have to live "like a resident" 5-8yrs after residency, but I can pay it off. The job of a surgical PA and a surgeon are very different--> Worth MD. A surgeon would still likely come out ahead of a PA financially. Non-specialized IM or FM, won't.

So from an investment standpoint, MD is not worth it over PA for primary care (unless you come from money, have a very cheap state school, or get a scholarship)

 

[Mad Jack]

I think it really depends on what you want to do.

If you are looking to do PA vs IM or FM, then I think that is very different from deciding between PA vs Gen Surg or Rad Onc. In the former case, the PA/NP route sounds like a nice deal. In the latter, MD/DO all the way baby!

I dunno, 7 years of training to make double what a PA that spent 2 years training in the same field makes seems like a good deal to me. Plus all the added opportunities for side income as a physician are enormous- everything from laser hair removal clinics to medical director positions to upper-tier management spots that open up. I mean, being a PA, you really put a ceiling on your income, side-income opportunities, and upward mobility.

 

[Mad Jack]

If I went IM or FM as a MD, I will not be able to pay my loans off (and if I could, it would be by living on less of a take home pay than many PAs). PA and NPs in primary care also have a large scope of practice--> MD isn't worth it that route unless you absolutely want the MD

If I want surgery as a MD, it will suck and I may have to live "like a resident" 5-8yrs after residency, but I can pay it off. The job of a surgical PA and a surgeon are very different--> Worth MD. A surgeon would still likely come out ahead of a PA financially. Non-specialized IM or FM, won't.

So from an investment standpoint, MD is not worth it over PA for primary care (unless you come from money, have a very cheap state school, or get a scholarship)

Keep in mind that many PAs will have 100k+ in debt with a 100kish salary. You can find jobs that pay 300k in FM or IM if you're willing to relocate, which will give you around the same debt:income ratio as many PAs if your debt is in the 300k range.

http://www.indeed.com/rc/clk?jk=68b576710c8ea86d

That job, for instance, pays $140/hr for a hospitalist. At 5 12s (60 hours/week) for 48 weeks of work a year, that's enough to earn you $403,200/year, plus an additional $22,400 assuming paid vacation at 40 hours per week on your vacation weeks. That's a massive difference in earnings between PAs and IM-trained physicians.

 

[Sardinia]

If I went IM or FM as a MD, I will not be able to pay my loans off (and if I could, it would be by living on less of a take home pay than many PAs). PA and NPs in primary care also have a large scope of practice--> MD isn't worth it that route unless you absolutely want the MD If I want surgery as a MD, it will suck and I may have to live "like a resident" 5-8yrs after residency, but I can pay it off. The job of a surgical PA and a surgeon are very different--> Worth MD. A surgeon would still likely come out ahead of a PA financially. Non-specialized IM or FM, won't. So from an investment standpoint, MD is not worth it over PA for primary care (unless you come from money, have a very cheap state school, or get a scholarship)

Do PAs automatically enter into a large scope of practice right after PA school? If I'm not mistaken don't many areas prefer PAs to have experience in surgery/ER?

 

[DKMA]

Do PAs automatically enter into a large scope of practice right after PA school? If I'm not mistaken don't many areas prefer PAs to have experience in surgery/ER?

I don't know that much, but a quick internet search says no. There are optional, short PA residencies for surgery. And even if they did need to transition, they would be paid $80-90K during that time

 

[DKMA]

I am going to be applying MD and after working in insurance for a year I have become really interested in policy, but I don't really know where to start. Do you know about any of the policy opportunities for MD?

http://m.healthaffairs.org/ Tons. Lots of variety.

 

[IAhawkeye]

Do PAs automatically enter into a large scope of practice right after PA school? If I'm not mistaken don't many areas prefer PAs to have experience in surgery/ER?

A lot of places require prior experience or a completed residency. There are many ER residencies, most are 12-18 months, in which the PA is treated the same as a resident training and responsibility wise.

 

[Overthehorizen]

I know this thread is one year old but the question continues to come up over and again in another forum intended for PAs. That forum is called the PA Forum. It consists of moderators and select contributors who from the sound and style of their prose are shills for the PA profession. That is, they are employed by or tangentially benefit from relationships with the American Academy of Physician Assistants, the NCCPA (National Committee for Certification of Physician Assistants) and the more than 140 PA programs. You will see contrarian views creep into the conversation but suddenly, they are gone. Effectively, the minority report is silenced by banning them from the forum or preventing them from posting.

The primary issue that an undergraduate in college or university should weigh seriously is whether the PA profession will still be in existence in ten years. Many people reading this don't remember Alan Greenspan's famous speech where he uttered the phrase "irrational exuberance." What that means for PAs is that the growth of the PA profession will slowly wither and then fall precipitously to an end in about a decade. Two forces are behind this trend. First and most serious are the growth of Nurse Practitioners. Despite the arguments about lower quality and training pathway inferiority, they NPs are advancing toward 50 state independent practice. They have independent practice in the Department of Corrections and Department of Veteran Affairs. They have no requirement to affiliate with a Physician Supervisor ever. Their earning are growing as a result and they are opening primary care practices as well as carving out pieces of specialist practice that fit their training and experience. PAs continue to have supervision from Physicians but the medical model that once utilized teams has dissolved. Corporations now only care about the cost per order dollar. If a provider NP generates the same number of RVUs monthly that the MD/DO generates, the NP looks very nice on the spreadsheet. PAs don't have that financial benefit to the bottom line because of restrictive laws the require Physician financial overhead (supervision) that makes their cost per order dollar far higher than NPs. This is why hospital management doesn't care if an NP is smarter or dumber than a PA or an MD. IT is the cost per order dollar they NPs are the winners. PAs are the losers. Since PAs have no form of representation in lobbying state legislators, this won't change. Most of the PAs are too timid to be politically active which helps the NPs advance beyond the PA.

If you are an MD, your greatest risk is the NP. They NPs have decimated the PA profession. The game is already over but the people who know they can continue to make money from the product will still sell it. (AAPA, NCCPA and PA Programs) If I were an undergraduate, I would choose to spend cheap tuition on many state nursing programs (or community colleges). Then take a few "bridge courses" without having to get a BS or BA. Then, go into the MS for an NP. Then go for Doctorate. All of this can be done online for very inexpensive state tuition rates. Almost all PA programs require you quit your job, pay tuition on par with private medical schools and then be forced to accept lower salaries than your previous graduating class. A few years after graduation from the PA program, you will still have 200K plus in debt and discover you cannot get a job as a PA any longer. All of the jobs are going to be going to NPs. Think on this before applying to a PA program. If you are under 25 years of age, google Alan Greenspan and "irrational exuberance."