PAs and Docs in the ER

[thebird]

Im new to the Physician Assistant Scene....but I think it might be right for me. I'm a premed or pre-PA can't decide.

What can't a PA do? Is a PAs responsibility just according to experience...or do they just do stitches and set casts?.. details?
What if any problems/greivences arise often in the ER with PA authority/control?

I've always been interested in ER medicine and I have the GPA, resume, and maturity for med school but I dont want to commit 7 years to just medicine. Im happily occupied with extracurriculars that I dont want to give up/put off. Can you go to med school blow off residency take the PA boards and practice as a PA if you dont wanna do the residency after 4 years? (doubt it, right) Im thinkn PA school now because I can always go back to Medical school right? I feel like theres a lot more good info about med school but not so much for the PA school.....Also, are the PA drop out rates like med school (low)or like law school (high)???? THX...........so many questions!

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[GeneralVeers]

Im new to the Physician Assistant Scene....but I think it might be right for me. I'm a premed or pre-PA can't decide.

What can't a PA do? Is a PAs responsibility just according to experience...or do they just do stitches and set casts?.. details?
What if any problems/greivences arise often in the ER with PA authority/control?

I've always been interested in ER medicine and I have the GPA, resume, and maturity for med school but I dont want to commit 7 years to just medicine. Im happily occupied with extracurriculars that I dont want to give up/put off. Can you go to med school blow off residency take the PA boards and practice as a PA if you dont wanna do the residency after 4 years? (doubt it, right) Im thinkn PA school now because I can always go back to Medical school right? I feel like theres a lot more good info about med school but not so much for the PA school.....Also, are the PA drop out rates like med school (low)or like law school (high)???? THX...........so many questions!

What the PA can do is depdendent mainly on what the supervising physician trusts them to do. I rotated at a hospital in Indianapolis where the ER PAs saw the patient, did the writeup, ordered any labs/meds, and discharged the patient. All the attending did was "lay eyes" upon the patient before they left and signed the chart. It's definitely a cool job, but you have to like responsibility.

 

[thebird]

Thx!
I definately want the responsibility, so thats encouraging.

 

[bartleby]

You need to do some soul searching and decide what you want out of a career in medicine, whether it is as a PA or and MD. Your desire to minimize your time being put through the ringer is understandable, as is concern about the onerus debt load one can accumulate during med school and residency.

While both career paths can lead to emergency medicine, the roles they encompass are quite different. If you envision yourself needing to be the so-called "captain of the ship" and to be regarded as an expert within your field, then you should steer yourself towards medical school. While PAs typically have a significant degree of free reign depending on the practice environment, they do not typically see the sickest patients (heart attacks, strokes, etc) and do not do the highest-risk procedures in the ED (intubation, chest tubes, central lines).

You should contact a local PA school and try to find someone to shadow a bit to find out if it's up your ally, as well as taking advantage of any physician mentoring program present at your university.

 

[corpsmanUP]

The pre-reqs and time commitment are simply too intense these days to justify going to PA school. Why would you do 7 years to be a PA when you could do 8 to be a physician? Residency pays about half of what you will make as a new PA, but you have to decide what is important. My general advice is to consider your age, your own personality traits, and your desire for the long term. As a PA, there is a serious glass ceiling that you cannot break through. I was making a comfortable 6 figures working about 50 hours per week. But there comes a time when you can't make any more, and if you decide to work any less you will not be able to afford your life any longer. As a physician, in the long run (assuming we are talking about EM), you will be able to slowly taper down the number of shifts you work per year until you are basically working as little or as much as you need to sustain the life you want. As a PA, in order to live an average existence, you will never be able to afford such a taper. Plus, as an EM doc, there is no place you cannot move or find a job if you want. There are so many places that don't use PA's, and even some places that do use PA's may decide overnight to stop using them. You are at someone else's mercy, and subsequently you may never be satisfied with your job and life. And the worst part is that you have to adjust to the attending you are working with, which basically means being a lifelong resident. Trust someone who has done both tracks......take the slightly longer road and fill in those gaps in your knowledge that will inevitably be there if you go the PA route. Just my opinion.

 

[The White Coat Investor]

Go shadow an EM PA and an EP. Then you'll know whether its worth it to you.

 

[Annette]

Go shadow an EM PA and an EP. Then you'll know whether its worth it to you.

Excellent advice! I would just add shadow SEVERAL in DIFFERENT PLACES!!!! Things you see in one situtation will not apply in another. Days and working environments vary dramatically day to day.

 

[Febrifuge]

Most of the good stuff has been said already... I would add that, at the training site where I work, the PA's are essentially like a cross between permanent 3rd-year residents and staff docs. Which is cool, except unlike actual 3rd years, the PA's don't run codes or act as "pit boss," and unlike true staff they're not faculty. PA's do some intubations, but these are uncommon.

The advantages include more human hours, and generally less administrative hassle, departmental politics, academic hoo-hah, etc. PA's can teach, if they have a niche where they're the expert... but if a staff MD should develop an interest in the same niche, the PA may or may not continue being the expert.

For me, I like the PA route, and the PA destination. But you have to like both.

 

[thebird]

(ha ha)

All these perspectives are all very helpful...THX!!