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PA vs. family practice

Discussion in 'Pre-Medical - MD' started by Dr. Dad, Feb 2, 2002.

  1. Dr. Dad

    Dr. Dad Senior Member
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    Hey guys, I have been doing a little mind wondering lately. I know through experience that being a PA is almost identical to being a family practice physician(the more experience you have the more it becomes like a family practice physician).
    Now to become a PA, you go through four years of school (2 years premed, and then the first and third years of medical school which they combine to call PA school). Your debt would be about 20 thousand (average four year debt). There is little competition and far less stress (average accepted GPA is 2.25 and no MCAT). Then you immediately go get a job and make 70-80 thousand a year helping people. On top of that the career outlook is outstanding (even better security than a doctor). Many periodicals have rated it a one of the top five demanded professions over the next ten years (that = higher pay and more jobs available).
    Now to become a family practice physician you have four years of pre-med (20,000 debt). Then you move on to four year of medical school (average 80,000 dept). Very high competition which makes for high stress (average GPA is 3.5 and a stressful MCAT). Then you have three years minimum residency (which more than likely you are still incurring dept but we will call it even). Then you get a job making 110-120 thousand a year.
    The difference between the two, including both money spent and money earned (or not earned). Adds up to a total of 20,000 dept for the PA plus 490,000 earned income over 7 years for a net of positive $470,000 (more than enough to pay off school and live a happy life).
    The Physician spends 100,000 total debt minus $0 made while in school and residency for a total of minus $100,000. Also for the next ten years a physician will be paying around 2,000 a month for school dept.
    The difference is $570,000. The estimate of the amount of money a PA make compared to the amount of money a family practice physician makes it would take him close to 16 years to make up that $570,000 and break even with the PA.
    My question is this. Do many pre-meds think about this when they are hunting down med school. Or do they get lost in the competition and the "thrill of the hunt". We have not even talked at all about the Bureaucracy that doctors face either which is one of the main reasons for the drop in med school applications (or so I am told).
    I have thought a lot about these differences but I think the only reason I am still in "the hunt" is because helping people is not my motivator for med school (I do enjoy helping people it is just not my motivating factor). I have no interest really in family practice or PA. My interests lie more with pathology, oncology, or surgery.
    Its seems to me that its fairly obvious why med schools are getting far too many specialty doc wannabe's and not enought primary care doc wannabe's.
    I know that some people will criticise this and say that money doesn't matter and yes you are right. But the fact is that if money didn't matter at all, there would be very few people choosing family practice over PA. The few family practice docs would probably only be docs because the like the sound of "Dr. so and so". Anyone who has real experience with PA's (friends, relatives, or otherwise)knows that they are basically one in the same. Especially when it comes to the "helping people" idea.
    By the way I am not being critical or putting anyone down, I myself am a pre-med and therefore guilty of the same things that other pre-meds think about and that is money, power, skill, etc. (any pre-med who hasn't dreamed of the empowerment that comes with finding the cure for cancer is either a liar or part of the .1% of pre-meds who actually don't care). I am just asking for other people's opinions on this subject. Its seems black and white to me, but there are still so many people going into family practice or other areas of primary care. Why?

    I would love to hear your opinions.
     
  2. EMDrMoe

    EMDrMoe Senior Member
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    This is my personal opinion, as requested :) I'm a Certified Athletic Trainer now. I got my master's degree in 1996 from Western Michigan University right after my bachelor's in '95 (GPA 3.13, high GRE). Upon graduation from WMU, I applied to their PA program. I wasn't even granted an interview. That year, they had 300 applicants for 40 positions. Athletic Training was my "backup" but became my career for the past 6 years. These years have been great and have taught me more than I ever thought I could learn about myself and my love of medicine. So, when the desire to become a physician resurfaced about 2 years ago, I again contemplated PA school, especially because my husband and I were applying to med school together (which doubles the debt issue). In the end, we did not consider PA and, after MUCH deliberation, did not apply DO. We decided to try to fulfill the entire dream, not just one part of it. My husband is still strongly considering family practice. I'm leaning toward emergency medicine.

    As for the money - yes, the debt will be much higher after med school than if we had gone PA, but deep down, I don't think many people apply to med school with $ as the motivating factor any more, us included.

    As for the power - I guess being called Doctor would fall into this category, but I think the more important issue is if you're willing to "settle". IMHO, I have one chance to live this dream and I'm not going to settle for second place. I've screwed up some things in the past (see undergrad GPA above-with a few Ds and Cs in there :) ) and had to make amends there, and have no intention of having to settle for the "backup" this time(even though I think, in retrospect, that I will be a much better physician because of my ATC years). I will choose my career now, not let it choose me because I had to settle for second place.
     
  3. brandonite

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    I suppose I would say that a doctor gets a much more varied training than a PA. I mean, once you go through med school and have done your clerkships, you have a pretty good feel for all the different areas of medicine. So, especially if you're even thinking about going into a different specialty, med school would be the way to go.

    As well, family practicioners have more responsibility, I believe. I wouldn't want to be a PA, and always have a FP looking over my shoulder.

    I suppose just looking at monetary reasons, there aren't a lot of benefits to going to med school, at least if you want to be a FP/PA. But med school isn't generally a good option if you're interested in big $$ - an MBA is a far better bet.
     
  4. UCLA2000

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    Wow I'm surprised that you believe that ALL "premeds think about money, power, skill, etc."

    Money and power never really crossed my mind. My primary focus has always been serving underserved populations.

    " (any pre-med who hasn't dreamed of the empowerment that comes with finding the cure for cancer is either a liar or part of the .1% of pre-meds who actually don't care)."

    Personally I've wanted to become a physician all my life. Yeah I'd like to find a cure for cancer but it has nothing to do with gaining power from it.

    Imagine all of the pain and suffering and the hundreds of thousands of lives that could be saved (cumulatively of course) if a cure for cancer were found.

    If your primary motivation is monetary gain then I'd agree with you that becoming a PA is a much more attractive choice.

    1. PA's don't get sued for malpractice
    2. PA's don't have call...so their free time is literally their free time.
    3. PA's have 2 years less schooling.
    4. PA's make damn good money.

    Good luck in whatever you choose.
     
  5. edmadison

    edmadison 1K Member
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    Just wanted to comment on your "PAs dont get sued for malpractice"

    They certainly can get sued, you just haven't heard of it.

    Ed
     
  6. G3

    G3

    In deciding to pursue medicine a s a career, I originally focused in on becoming a DO. Due to the fact that I wish to work in a rural setting, specializing in family practice, it made sense to take a look at the PA profession. With this route, I would be able to start practicing much sooner, be more likely to support myself (there's not too much $ in nonurban areas) and my overall debt would be substantially lower; and I would be able to spend more time with my family (not on call). Being a PA though, is not for everyone, you have to not mind the oversight from an MD/DO, and there are a vast # of people who are unfamilare or untrusting of the profession. The prestige is nearly as high as a physician....but..... you get to spend a great deal more time with the patients, and hopefully have an effect on other peoples' lives.
     
  7. tBw

    tBw totally deluded
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Dr. Dad:
    <strong>
    Now to become a PA,...Your debt would be about 20 thousand (average four year debt)....you immediately go get a job and make 70-80 thousand a year ...to become a family practice physician you have four years of pre-med (20,000 debt). Then you move on to four year of medical school (average 80,000 dept).... Then you have three years minimum residency (which more than likely you are still incurring dept but we will call it even). Then you get a job making 110-120 thousand a year.
    The difference ...Adds up to a total of 20,000 dept for the PA plus 490,000 earned income over 7 years for a net of positive $470,000 ...
    The Physician spends 100,000 total debt minus $0 made while in school and residency for a total of minus $100,000. Also for the next ten years a physician will be paying around 2,000 a month for school dept.
    The difference is $570,000. The estimate of the amount of money a PA make compared to the amount of money a family practice physician makes it would take him close to 16 years to make up that $570,000 and break even with the PA.
    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Hum....you seem to enjoy math and worry a lot about money so why don't you scrap the PA/MD idea and just become an accountant!

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Dr. Dad:
    <strong>
    I have no interest really in family practice or PA. </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">So why did you post this? To annoy PAs? Or FPs?? or both!?

    Why did you do the calculations? Is math your hobby?? For the record I don't think the above calculations are all that accurate. For one you say that residents probably still incur debt but that "we'll call it even". It's true they have large loans to pay off but they are earning $32-40,000/year. I am not saying that is 'sufficient' but it's an additional $120,000 dollars income you have neglected. I have no doubt most/all of this will be used in loan repayment and cost of living but your calculations do not include those factors for the PA, who you award $80,000/year for this period, cost of living free. You are treating the loans as if they are completely interest free ie borrow 100,000, pay back 100,000. The truth is if you include interest you have to multiply the amount borrowed by a factor or 1.5-3 times. Then you take the FPs starting salary and do not adjust up (average FP salary after 3 years practice ~$150,000/year whereas PAs salary, without additional training is usually pretty flat). Even using your final figures I don't get 16 when dividing $570,000 by the difference in incomes you state ($40,000) I get 14.25

    I don't intend to be mean but I really didn't see what the point of this post was if not to be incendiary. If you were interested in becoming either a PA or a FP I would happily talk about this till the cows came home. However, you state that you are not interested in pursuing either profession. This post doesn't even serve the purpose of being valuable intellectual discussion because to qualify for that, the math on which it was based should at least make sense...
     
  8. UCLA2000

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    OK maybe I'm wrong about the malpractice thing. I was under the impression that PA's practice under the license of the M.D., and as such the M.D. that the PA practices under is legally liable for all the PA's mistakes.
    ...again I could be wrong.
     
  9. megkudos

    megkudos Senior Member
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    UCLA2000,

    I was under the same impression. One of the reasons PAs have to work under a doctor is the doctor is responsible when they mess up, including malpractice.

    And for the record--I never really thought about personally curing cancer. I'm more interested in my relationship with patients and doing good for them on a personal level.

    Thanks, Meghan
     
  10. gatepig

    gatepig Junior Member
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    PA's can get sued, but the doctor they work for usually pays for the malpractice insurance. Nurses can also get sued, but they are also usually covered by their employers. About PA's not having call-it just depends on where you work. I know plenty of PA's that do take call. The PA's at my daughter's pediatrician's office equally share call with the doctors.
     
  11. Thewonderer

    Thewonderer Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by brandonite:
    <strong>I suppose I would say that a doctor gets a much more varied training than a PA. I mean, once you go through med school and have done your clerkships, you have a pretty good feel for all the different areas of medicine. So, especially if you're even thinking about going into a different specialty, med school would be the way to go.

    As well, family practicioners have more responsibility, I believe. I wouldn't want to be a PA, and always have a FP looking over my shoulder.

    I suppose just looking at monetary reasons, there aren't a lot of benefits to going to med school, at least if you want to be a FP/PA. But med school isn't generally a good option if you're interested in big $$ - an MBA is a far better bet.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">If you want a varied experience, PA is actually better than being a doctor. PA can switch from surgery services to family practice without any additional schooling or training! Of course, it will take them a little bit of time to get used to their new service but for docs, they need to go through a whole different residency program.

    Depending on your geographical region, PA can make from 45k to 80k. It is not 80k guranteed.

    Also, for the family doc I work with, he has a PA. PA actually helps him expand his practice and bring in more income. However, PA does not equal family physician!!!!!!! That's a mistake. Oftentimes, it depends on how much responsibility the doc is willing to give you. for instance, the doc lets his PA deals with acute illnesses (cold, flu, upper respiratory infection, etc.) and well-baby/adult check. But for diabetes, coronary artery disease or other complicated, chronic problems, he sees those patients himself and would never let them have appointments with the PA. And both the PA and the doc are happy with this arrangement since the PA is not comfortable seeing these patients anyway.
     
  12. MacGyver

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    When you schedule a doctor's appointment, do some places just let a PA look at you?

    Do PAs refer to themselves as doctors? For example, does one PA say about another PA, well DR. X is a good clinician.

    Also, do they allow patients to call the PA doctor?

    Do PAs ALWAYS work under MD/DO or is that true only in certain circumstances?
     
  13. MacGyver

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    In case you cant tell yet... I am VERY concerned about who gets to call themselves a doctor.

    As far as I'm concerned, I'm going to be the real doctor and my patients better NEVER let me hear them calling some PA a doctor.

    Same thing goes for nurse practitioners, and nurses in general.
     
  14. UCLA2000

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    "I'm going to be the real doctor and my patients better NEVER let me hear them calling some PA a doctor.
    Same thing goes for nurse practitioners, and nurses in general"

    Personally it wouldn't matter to me if my patients make an error. It's not like I'm going to chastise them or something....

    ..Now a PA or Nurse that tells patients that they're a doctor would be a different matter.
     
  15. Trek

    Trek Grand Uranium Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by MacGyver:
    <strong>In case you cant tell yet... I am VERY concerned about who gets to call themselves a doctor.

    As far as I'm concerned, I'm going to be the real doctor and my patients better NEVER let me hear them calling some PA a doctor.

    Same thing goes for nurse practitioners, and nurses in general.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Heaven forbid someone of such importance as yourself be lowered to such meager levels of humanity by a patient's simple mistake. Damn, i know I gotta stop harping on this "doctors think they're better than everyone else"...but this person (term used losely) seems to truly believe it!!! --Trek
     
  16. UCLA2000

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    What about those universities that aren't accredited...if somebody mails away for a PhD from one of those...and they're a PA...is it ok to call them doctor?
     
  17. Dr. Dad

    Dr. Dad Senior Member
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    I don't understand the whole "doctors are the best people in the world" theory that some people beleive. They seem to beleive that doctors are better then nurses and PA's (to the point where they would be offended by a patients mistake in addressing who actually is the DOCTOR!). Let me say this...I have NEVER in my life met a PA, or a nurse who did not want to become a PA or a nurse. That is to say, it is not a fall back career. It is a career that someone sought out to become. I hope that by the time you (and you know who you are) become a doctor you learn to respect the people who are working around you from nurses, PA's, social workers or whatever. YOU ARE NOT BETTER THAN THEM!!!
     

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