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PA more free time that MD/DO? Myth?

Discussion in 'Clinicians [ RN / NP / PA ]' started by Crookshanks, May 7, 2007.

  1. Crookshanks

    Crookshanks Juju 2+ Year Member

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    Jun 18, 2006
    Florida
    I'd post a poll if I knew how to...

    What do you guys think? Is this a myth or do PA's have more free time for family than doctors?

    I'm trying to decide what I want to pursue. I really just want to practice medicine (don't care how, PA/MD/DO). I'm 22 and I have a child, plus, I'll probably have a lot more, because I'm Roman Catholic. I would like to have time to spend with this hypothetical large family! And like I said, I've already got one little one (she's almost 3).

    Figuring out if this "time" thing is a "myth" or not would be very useful.

    I'd appreciate your feedback!

    Thanks
     
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  3. emedpa

    emedpa GlobalDoc 10+ Year Member

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    Aug 25, 2001
    Taking an Away team....
    BIG MYTH
    pa's generally work as many(or more) hrs than the docs they work with.
    In my em group of 40 docs and 12 pa's the docs work 12 eight hr shifts/month=96 hrs.
    the pa's work 16-18 ten hr shifts = 160-180 hrs .
    surgical pa's take call along with their docs so they can 1st assist in the o.r.
    they also have to do early morning hospital rounds, etc
    docs have more time in school up front (11 yrs vs 6-8 or so) but have it much easier after residency.a doc working 1/2 time makes about as much as a pa in the same specialty working full time.....
    you can always find a part time job as a pa but that comes with a part time salary as well.....
     
  4. Amgen1

    Amgen1 New Member 10+ Year Member

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    Dec 23, 2005
    Do you have anything other than anecdotal stories to back this up with? I would be careful to make such blanket statements based on your experience.

    Also EM docs are on the far end of the spectrum of docs in terms of least hrs worked. The average attending physician works 60hr per week (from the US dept of labor 2004: http://www.bls.gov/oco/ocos074.htm) and PAs work 40 per week (http://www.bls.gov/oco/ocos081.htm).

    I am sure that in both groups that there are people who lie on both ends of the spectrum (ie docs that work 36hr per week like em docs and PA that work 60hrs per week like a CT-pA). However, ON AVERAGE docs have longer hours.
     
  5. emedpa

    emedpa GlobalDoc 10+ Year Member

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    Aug 25, 2001
    Taking an Away team....
    my anecdotal evidence covers over 20 years and practice in 6 states and d.c. and interactions with hundreds of pa's. maybe I just know lots of hard working pa's and lots of slacker docs.
    I can honestly say I don't know any full time pa's who work less hrs than their physician counterparts. sure, I know lots of pa's who work part time but when you compare full time to full time the pa's always pull more hrs.
    part time docs in my dept(mostly moms) work six 8 hr shifts/mo. the least a pa can work and still retain the same benefits is 10 ten hr shifts, twice as much.
    most surveys of pa utilization only look at primary care which is 50% or less of all pa's at this point(actually 38%). in primary care there are lots of "working moms" who work 2-3 8 hr shifts/week doing outpt fp/im/peds and this drags the avg down to 40 hrs.
    the reason docs utilize pa's in their practices is to minimize the md time doing time heavy pursuits like early am rounding and taking lots of afterhrs call. surgeons love pa's because they want to maximize time in the o.r. and minimize time in clinic and rounding.
    all the surgical and ortho pa's I know arrive before the surgeons, round on pts in the early am, then spend all day in clinic or first assisting in the o.r. then pm hospital rounds while the doc is at home eating dinner. when pts have issues on the floor the pa's take 1st call, come in, eval the pt and only call the doc if the pt needs to go back to the o.r.
    difficult closed fx and dislocation reduction are done in the er by on call ortho pa's and then these same pts are followed up in clinic later by the same ortho pa's.
    the majority of hospital floor issues do not require the doc to come in and are handled quite capably by the pa. the doc hears about them the next morning at am rounds.

    recent poll at the pa forum. note this includes lots of part time folks:
    http://www.physicianassistantforum.com/forums/showthread.php?t=10649&highlight=poll+hours

    notice 40% work > 175 hrs/month with many over 200. if you take out the part time folks the avg is fairly high.
    aside from surgeons I know very few docs who work > 50 hrs/week.
    the primary care pa's I know work the same schedule as the docs they work with.
    the hospitalist and critical care pa's I know work as many or more hrs than the docs they work with.
    I worked 60 hrs this week with 1 day off.
     
  6. Amgen1

    Amgen1 New Member 10+ Year Member

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    Dec 23, 2005
    congratulations.

    However, once again n=1 is not an adequate sample size to answer the general question of how many hours docs vs pas work. You have to be able to produce more substantial data to make such statements.

    And once again, you can't use EM docs as the bench mark. They make up only 6% of the matching us seniors (http://www.nrmp.org/res_match/tables/table1_2007.pdf) and they are on the outer edges of the bell shaped curve in terms of hours worked. The average practicing physician works almost twice as many hours as an EM doc.

    You are doing people a HUGE disservice by distributing misinformation in such and "authoritative manner".
     
  7. SOUNDMAN

    SOUNDMAN Senior Member 10+ Year Member

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    May 16, 2004
    Midwest
    I would totally agree with emedpa. Unless you are doing a FP where you essentially are running your own clinic with little physician supervision in podunk midwest, then you are likely to work just as hard and just as much as your supervising physician. Why wouldn't you work as hard as your supervising physician?

    As an orthopedic PA I worked just as hard as my supervising physician and sometimes more, because I'd go do rounds in the AM or on weekends or at the transitional care unit, where he didn't like to go. I did ER coverage and would go see patients and get them going before he got there, etc. So you don't have the "freedom" like a physician would to decide your work hours and the length of them, etc.

    Being in medicine is hard, but oh so worth it.

    Oh yea returning to medical school so I can decide when I want to work and for how long. :laugh: :laugh:

    N=2 now and not just EM.
     
  8. emedpa

    emedpa GlobalDoc 10+ Year Member

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    Aug 25, 2001
    Taking an Away team....
    actually that's about n=200 as the pa's I am refering to count in the analysis.
    amgen-according to your profile you are a resident so of course you work lots of hrs. I have worked at a facility with an fp residency program as an instructor on 2 separate occassions. yes, the interns worked a lot more hrs than me but I was generally there more than the pgy 2 and 3 folks. and once they became attendings they were never seen after 5 pm again.....and hardly ever on weekends.....
    any more pa's out there want to comment on how much you work so we can make this n=203?
     
  9. Amgen1

    Amgen1 New Member 10+ Year Member

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    Dec 23, 2005
    180hrs is only 45hrs/ wk

    That is still less than 60hrs

    so 60% work less than 43.75 hrs per week. Sounds to me like the MAJORITY of PAs don’t work that many hours

    The US dept of labor link I posted states that over 1/3 docs work >60hrs per week. This is ATTENDING physicains, NOT residents. You have a VERY skewed view of how much the MAJORITY of docs have to work to earn a living.

    Do you really believe that the majority of physicians work 12hrs/wk?

    I’m just trying to give everyone a little perspective here.
     
  10. Amgen1

    Amgen1 New Member 10+ Year Member

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    Dec 23, 2005
    probably still significantly less than those in the US dept of labor data
     
  11. emedpa

    emedpa GlobalDoc 10+ Year Member

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    Taking an Away team....
    your stat of 60 hrs/week probably includes call hrs. mine does not.
    becoming a doc is definitely harder than becoming a pa. no arguement there.
    being a pa for most is more difficult than being a doc in day to day practice.
    why would docs use pa's and have them work fewer hrs than they do? makes no sense. the avg pa across the board made $84,396 last yr, higher for specialties, lower for primary care. docs aren't stupid. how many of them want to pay someone 80k+ to work less hard than they do? think about it.
    pa's do the scut work of medicine; rounds, am clinic, after hrs consults, floor call etc. we are offen refered to as perpetual residents. there is a reason for that.
     
  12. Amgen1

    Amgen1 New Member 10+ Year Member

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    Dec 23, 2005
    wow, do you honestly believe this?
     
  13. emedpa

    emedpa GlobalDoc 10+ Year Member

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    Aug 25, 2001
    Taking an Away team....
    with every fiber of my being.
    look at which pts are seen by which;
    docs- higher avg acuity pts= fewer/hr. pt are sicker and therefore more happy and appreciative with any little improvement in their conditions.
    pa's-lower avg acuity pts=more pts/hr. lower acuity pts are much more demanding than high acuity pts. they want off work notes, med refills, unneccessary studies and referals, etc. they complain more often, are more likely to be drug seeking or have a somatization d/o

    so the pa's work more hrs, seeing more demanding pts the md 's don't want to see(that's why they hired the pa in the 1st place) and get to clean up all the scut.
    the md's have the more intellectually difficult job seeing an avg higher acuity pt with a longer ddx, etc but it is intellectually more stimulating and more interesting work.
    pa's do the work docs don't want to do in the places docs don't want to work(inner city, rural, hiv clinic, etc.)-so yes, our work could be described as more difficult and less rewarding intellectually as well as financially. we all had to think of the trade offs when we decided md vs pa. if I knew then what I know now I would have gone to medschool and would currently work half as much with more interesting pts for twice as much money.
     
  14. Amgen1

    Amgen1 New Member 10+ Year Member

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    Dec 23, 2005
    emedpa you sound beat down

    I'm not going to go back and forth debating points b/c nothing is really being gained. i'm not going to change your view point and your not going to change mine

    just keep in mind that seeing those higher acuity pts has its own share of stress attached. also keep in mind that most docs don't work in the urgent care/em setting and have a responsibility to their patients after they leave the hospital. taking the calls at home, calls in the middle of the night wears on you. this continues when you are an attending.

    i will agree that increasingly more docs are doing "shift work" type work (ie hospitalist, er docs, etc). in my opinion that is bad for continuity of care and patient care in general
     
  15. emedpa

    emedpa GlobalDoc 10+ Year Member

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    Aug 25, 2001
    Taking an Away team....
    "emedpa you sound beat down"

    yup....I've spent the last 5 years transitioning into settings where I see fewer pts/shift but higher acuity. currently I cover a level 4 e.d. solo 6 night shifts/month and find this much more gratifying work than the fast track type pt population I see 12-14 shifts/mo. the level 4 ed has 24 hr pa coverage with 8 hrs of doc coverage on day shift only.
    unfortunately working solo in a small dept pays A LOT less than my regaular job as we are payed partially on a bonus structure so 30 fast track pts/shift = more money than 12 mixed acuity pts/shift.
    as I get debt payed off, pay off my mortgage, etc I am picking up more of these solo shifts and working less with fast track pts. I have increased from 2-6 shifts over the last 5 yrs and intend to go to 8 shifts as soon as possible. the rest of the group is happy to let me do this as they don't like working nights for less money seeing higher acuity.
    eventually I hope to transition entirely to solo 24 shifts and work 7-8 days/month maybe 10 years from now.
     
  16. core0

    core0 Which way is the windmill 7+ Year Member

    I would agree somewhat. It really depends on the practice. In our practice we work about 5 hours per week less than the docs. PA's 45 hours or so. Doc's around 50. They also take call and we don't. We work one weekend in 4, they work one weekend in 8. However, we get two days off before and after each weekend. They only get one day off. Of course they make a bit more than the PA's (quite a bit more actually). I have seen FP practices where the PA's work more than the MD's and the other way. I don't think that there is any real consistency.

    David Carpenter, PA-C
     
  17. Chronic Student

    Chronic Student So Fresh, So Clean 5+ Year Member

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    Feb 7, 2006
    I work 10-15% more than my doc (neurosurgery).

    Typically a minimum of 50 hours a week, 60 is more normal and we have had those bad weeks where we might work 100 hours, but those are rare. Thank god.

    If you wanted to include call time and phone calls: well, we are on call every other week and I typically take 2-3 phone calls a night.

    -Mike
     
  18. Nano

    Nano 5+ Year Member

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    Sep 14, 2006
    Virginia
    Not trying to argue with anyone. Just here to let you know how my cousine works.

    Monday and Friday: 9am-5am
    Tuesday and Thursday: 9am-8pm
    Saturday: 10am-4pm
    Wednesday and Sunday: Off

    Total Hours a week: 44 Hours
    Total a Month: 176 Hours

    --------------------
    Working Conditions: Works Alone with receptionist, a medical assistant (certified), and a PA student on rotations. Therefore, she does everything.
    Time for family: Great. She has mid weekday (wed.) off, and sunday. She doesn't mind it.
    Salary: She's happy.

    Overall: She loves it very much, and loves that she feels like she's a doctor. Her patients call her doctor, no matter HOW MANY TIMES she tells them she's a PA and to not call her a doctor.

    ------------

    I hope this helps a little.
     

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