mednoob

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i got a chance to shadow a surgical PA a while ago and see the various tasks that they assist with in the OR. after a surgery was done, i asked one of the PA's about the average salary for PA's in the entire nation and he said $85K which sounded reasonable.

however i was kinda nosy and asked him around how much he was making since he's in surgery. i didnt ask him his direct salary, i just asked him to give me a rough estimate of his earnings so i can get an idea. and he told me he's making about:

$220,000 per year!!!!!!! i was like wowwwwww. he's an orthopaedic surgical PA. there also was another PA in there and he also said he's making in that range too. i seriously dont think they were joking. the surg tech that was in the OR also told me that those figures are actually right.

does anyone have any input on this? i know for sure that it's near impossible for PA's to be making that much.

one reason i was thinking of why his salary is so high is probably cause he does about 30-40% of the surgery i would say. during the operation, the surgeon sometimes just stepped aside and let the PA do some of the work. and after the surgeon was done, he left the OR and let the PA's close the incision.

and also another question: is it difficult for PA's doing surgery to make $100K + per year?
 

emedpa

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lots of surgical pa's make > 150k and the really high end ones make > 200k. keep in mind this is the upper 5% of surgical pa's and they are working for surgeons who make 600k/yr+ so it's cheaper for the surgeons to use really experienced surgical pa's than to add another surgeon at 600k+. these are not general surgery groups we're talking about here. this is only seen in c.t. surgery and ortho as far as I know. a lot of these high end guys have also done postgrad pa surgical residencies( see www.appap.org)
while the avg pa salary now hovers around 86k or so( see http://physician-assistant.advanceweb.com/editorial/content/editorial.aspx?CC=108754) many specialty pa's make > 100k without trying very hard. I think the biggest slacker in my em pa group probably makes at least 110k and the guy who really busts his butt makes around 160k. I usually hang out in the middle of the group. I think anytime you work on a production based salary you are tempted to skimp on documentation, etc in order to see more pts and make more money. I make a concentrated effort not to do this and so take a salary hit probably in the neighborhood of 25k/yr that many of my pa and md colleagues get by writing really skimpy notes. for instance when I get a phone consult I write a note in the chart detailing what was said and any recommendations. a lot of my colleagues(both md and pa) write: cards consult dr smith at 1530 hrs and nothing else.....
 

emedpa

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they probably do all the preop, the hospital admission, all the postop, the discharge, and all the clinic follow up as well as taking frequent call. this is why they make so much(in addition to excellent surgical skills). this allows the surgeon to do what they like and are best compensated for most of the time(operate) and not do what they don't like and are poorly reimbursed for(scut.)
if the doc has several pa's running around doing scut he can operate more and generate significantly more money for the practice.
I have a good friend who is an ortho pa who did the surgical residency at yale/norwalk. he takes lots of call, including 1st call to the emergency dept, does lots of hospital and clinic work, and is in the o.r. 2 full days/week. he makes around 150k/yr plus a full benefits package. he could work more and make more but he has 2 small kids so limits his work to around 50 hrs/week. there are 2 other pa's in the practice who are young single guys who operate more and take more call and make significantly more money.
 
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core0

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No, that's not why they're paid so much. Having someone do part of the procedure for you doesn't make you any more money than doing it yourself.
No but it allows you to do more surgery. There is an ortho study that the AAPA discusses in their billing class. They did an analysis of an ortho practice with and without PAs.
The PAs were bringing in about $140k per year in assist fees, office visits and procedures. Then they looked at the downstream revenue. That is the increase in the physicians income that can be attributed to having the PA there. This includes things like increases in consults because the PA is seeing follow up. Being able to do non-first assist cases because the PA is rounding etc. That revenue was more than $160k.

The other way that you can make more money is by doing the surgery faster. For example in ACLs its pretty common to have the PA prepare the graft while the surgeon sets up the tunnel and cleans up the knee. Lets say you can do an ACL in 60 minutes. If you can do one in 40 minutes by having a PA then you can do an extra surgery every two hours (increasing your income by 50%).

The real money though is in spine. Having a PA that knows your operative technique can shave hours off a big spine case. In a lot of cases that the difference between one case and two cases per day. This ignores the income for the practice from the assist fees which is 14-20% of the surgeons fees.

Consider that according to AAOS there are about 20,000 orthopedic surgeons in the US. AAPA estimates there are about between 6-7000 PAs in orthopedics. This is one of the highest Physician to PA ratios in medicine. There are more PAs doing orthopedics for example than are doing internal medicine.

Orthopedics residents are exposed to PAs during residency and for the most part residencies teach orthopedic surgeons how to properly use PAs. Most orthopedic practices have PAs which creates a group of PAs that can teach new PAs the ins and outs of orthopedics. These are advantages that other fields in medicine don't have.

David Carpenter, PA-C
 

Chronic Student

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If he really makes that much he is in the top 5% like emedpa said. Not very common, but there are a few out there.

$100,000/yr is no stretch at all in ortho/neuro/CTS, even for someone just a couple of years out of school.

Take me for instance, I cover more than my salary through assist fees which my doc was not colecting prior to me being there. You could think of it as getting a PA for free.

I make his life easier in a multitude of ways and this also factors into the equation.
 

emedpa

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some of these higher end surgical pa's get the first assist fee themselves as a part of their contract. this adds to the possibility of making 200k....
 

IcedTea

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PAs in surgery definitely can make in the high 100Ks. Like Chronic Student mentioned, ortho, neurosurg and CT surgery are the most lucrative fields. 100K + comes easy.
 
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mednoob

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thank u guys for your responses...especially to David Carpenter and emedpa as well as Chronic Student...very valuable info.

of course this thread is still open to more replies :thumbup:
 

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Starting ortho PA's in PA/NE OH is about $70-$75K plus benefits (academic hospitals) just a little FYI. I know a few that just graduated. So as long as you keep this in mind that different jobs have different pays. I know experienced ones are making alot more. I've also been told it depends on type of practice your in and what they do.
 

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Good point.

The northeast and a number of other areas are saturated with PAs and salaries are on the low side. In the west and south the salaries are above average due to the lack of us.

For instance where I'm at there are only 28 practicing PAs in an area with >300,000. There are easily 20 to 30 open jobs in this area right now.
 

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Yeah, but that wasn't the situation the OP mentioned. Stepping aside to "rest" while a PA finishes the knee scope as you stand there doesn't do anything for you.

Unless, of course, you're using a "first assist" for a scope, which strikes me as tantamount to fraud.
With most general knee scopes I did not get reimbursed as a PA, nor would any first assist. However operations like ACL's, meniscal repairs, etc I would get reimbursed, only our hospital/group that we worked for wasn't really the best in understanding how to obtain reimbursement for PA's which leads to a lot of money left on the table...frustrating.
 

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I'm no longer willing to work 60-70 hours a week, just to say I made 200K.

I suppose a ditch digger can make 100k if he's willing to work 3 jobs.

What's the point anyway ? Obama is going to close the gap on Social Security Tax ceiling anyway.

Your bosses are getting mighty rich off the deadly combination of your sweat and your ego.
 

guetzow

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I work 40 hour weeks with no call:banana:
 

Chronic Student

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Bastard;)
 

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I do 4 days on 4 days off. It's been a good deal for me, but I know one day the gravy train will end.

don't know how I'm going to cope with the return to the diaper rash circuit when the clock strikes midnight.
 
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Hey,

Nice Thread, lots of great information. Here is some more: Just out of school in the Northeast, job offered over 100k to start, willing to pay the cost to train me as well. This was in an emergency department. A classmate was offered mid 80's in a larger academic hospital, he said, "how bout 90," they replied, "how bout 79?"

There are high paying jobs right out of school if you know where to look, best place of course being your rotations where you can score the job before you graduate. Don't let these guys lowball you though, unless it's an academic location and you NEED the name for your career. You can score a job in the 90-100k range with minimal effort, ESPECIALLY in surgery. I can't believe that hospitals are offering 70-75k/year for ortho, that is criminal. Especially when you consider it is possible for a nurse anesthetist to to make over 200k, their average salary in 2012 being 157k.

You can get sued, you are responsible, you do much of the same work an MD or DO does in many cases, less surgery and specialties of course. Most of the docs I see work very hard, double booking themselves and working long hours. That is great, much respect! They will also be raking in multiples of your salary. Just don't take a nurse's salary with a doctor's responsibility. You have about 2 years before every college and university has a PA program and is flooding the market with PAs. Get in a high paying job while you can, this ship is going down sooner than we'd like to think.

Best of Luck,
PA-nothing
 
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You have about 2 years before every college and university has a PA program and is flooding the market with PAs. Get in a high paying job while you can, this ship is going down sooner than we'd like to think.

Best of Luck,
PA-nothing
dont agree with this statement. you can never have enough health care providers.
 

SouthSideSteve

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dont agree with this statement. you can never have enough health care providers.
Talk to CRNAs that have seen their salaries decrease due to market saturation.
 

Boatswain2PA

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dont agree with this statement. you can never have enough health care providers.
Unless you are paying the tab for all of those health care providers, each of whom wants to make $100K a year. Then you certainly CAN have enough, even too many.

There are areas of the country that are already saturated with PAs/NPs (Saturated = number of PAs/NPs are driving down income). This is basic, basic, basic economics which is no longer taught in school and is ignored in the media.

Great thread, I'm loving this info. Do others agree with Guy Fawkes outlook and projections? I'm looking into PA school for myself as an alternative to medical school.
PA school is a great ALTERNATIVE to medical school for brilliant young people. If you are young, and smart, then try to become a physician. If that fails, PA is a great plan B.

Back to the OP: I just updated my quickbooks last week (7/8) and found that I have already grossed $107K already this year. Not quite $220K a year, and doesn't include my expenses, but I'm pretty happy with that. Oh, have I mentioned that I typically work 3.5 days every other week?? Life is good at the lake.....
 
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Unless you are paying the tab for all of those health care providers, each of whom wants to make $100K a year. Then you certainly CAN have enough, even too many.

There are areas of the country that are already saturated with PAs/NPs (Saturated = number of PAs/NPs are driving down income). This is basic, basic, basic economics which is no longer taught in school and is ignored in the media.



PA school is a great ALTERNATIVE to medical school for brilliant young people. If you are young, and smart, then try to become a physician. If that fails, PA is a great plan B.

Back to the OP: I just updated my quickbooks last week (7/8) and found that I have already grossed $107K already this year. Not quite $220K a year, and doesn't include my expenses, but I'm pretty happy with that. Oh, have I mentioned that I typically work 3.5 days every other week?? Life is good at the lake.....
Wrong, pa school is not a plan b. If you came in to my alma mater in your pa school interview (Drexel) and said that, you would not have gotten in. PA school is either plan a, or go home and try something else. We are not a profession of med school rejects, and that is not where the profession is going. Have some pride for yourself and your profession. God bless.
 

Boatswain2PA

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Wrong, pa school is not a plan b. If you came in to my alma mater in your pa school interview (Drexel) and said that, you would not have gotten in. PA school is either plan a, or go home and try something else. We are not a profession of med school rejects, and that is not where the profession is going. Have some pride for yourself and your profession. God bless.
I wouldn't recommend anyone say that during an interview. We all know the best interview answer is "I want to serve the underserved/rural populations." But we all also know that isn't true for most applicants.

Or profession WAS based on experienced people adding education to their experience and creating a strong provider. Experienced & mature military medics, RNs, paramedics & such.

But our profession is moving toward accepting majority of 23 year old brilliant young women with virtually no life experiences other than studying very hard for the past 4-5 years.

The same cohort who apply to Med school. These people SHOULD apply to Med school, with PA as a backup.
 

pamac

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When I was in undergrad, I knew several pre PAs among those of us that were pre professional biology majors. The pre PA folks were the better students among us, and were very impressive. They all went on to go straight into PA programs wherever they wanted. I look back and can't help but think that they all could have fit in perfectly in a medical school cohort and right now would be in a really good place. But then again, they were probably making $100k really quick, and making it a lot sooner than the folks who are just now finishing residencies. With proper management of their PA wages, they could be doing well financially. And no 4 year med school and 3 year or more residency to slog through in a city they didn't want to live in. Almost no debt as well.

I always felt like having a backup plan that one can just fall into usually leads to the backup plan becoming the path that the average student will take when the going gets tough. PA school application processes are quirky enough that its harder to fall into it. The same kind of student that can't stick it out and realize how beneficial a medical school education can be is the same kind of student that doesn't want to even put in the effort on the next rung down. If its not handed to them, they aren't likely to pursue it. Frankly, I'm glad that PA school is as hard as it is to get into, because healthcare really doesn't need interlopers with the power of a prescription pad. The work is high stakes, and a lot depends on putting hurdles in there to guage commitment.
 
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MyNameWasUsed

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I wouldn't recommend anyone say that during an interview. We all know the best interview answer is "I want to serve the underserved/rural populations." But we all also know that isn't true for most applicants.

Or profession WAS based on experienced people adding education to their experience and creating a strong provider. Experienced & mature military medics, RNs, paramedics & such.

But our profession is moving toward accepting majority of 23 year old brilliant young women with virtually no life experiences other than studying very hard for the past 4-5 years.

The same cohort who apply to Med school. These people SHOULD apply to Med school, with PA as a backup.
PA school is not a back up or a plan B. Just because we're young doesn't mean we should go to medical school (that is the most flawed reasoning to go to MD/DO) . Also, the term "back up plan" is referring to an alternative option that is usually easier. Getting into PA school is not easy. It might be slightly easier to get into PA school than MD school but it is definitely harder than DO school.
 

Boatswain2PA

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PA school can be a great back-up or Plan-B for young college undergrads who are looking at medical school. Lots of brilliant young people get terrific grades in undergrad only to do average on the MCAT, and therefore can't get into medical school. The PA route is a good back-up plan for these folks.

The reasoning that YOUNG people should consider MD/DO over PA is because they have more time to offset the greater costs of the MD/DO education. Doesn't make much sense for a "traditional PA student" like myself (retired military, then went to PA school) to go to MD/DO school at 40 years old because I would only have 15-20 years to practice as a MD/DO (and therefore recover the cost of school and lost opportunity cost of going to school). Yet I have 20-25 years to practice as a PA, with much less cost of schooling.

There is no "shame" in being a PA, or in having PA as a back-up plan. My primary plan was to be a PA after I retired, my secondary plan was to become a nurse then NP. That doesn't mean nurses are somehow inferior to PAs.
 

MyNameWasUsed

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PA school can be a great back-up or Plan-B for young college undergrads who are looking at medical school. Lots of brilliant young people get terrific grades in undergrad only to do average on the MCAT, and therefore can't get into medical school. The PA route is a good back-up plan for these folks.

The reasoning that YOUNG people should consider MD/DO over PA is because they have more time to offset the greater costs of the MD/DO education. Doesn't make much sense for a "traditional PA student" like myself (retired military, then went to PA school) to go to MD/DO school at 40 years old because I would only have 15-20 years to practice as a MD/DO (and therefore recover the cost of school and lost opportunity cost of going to school). Yet I have 20-25 years to practice as a PA, with much less cost of schooling.

There is no "shame" in being a PA, or in having PA as a back-up plan. My primary plan was to be a PA after I retired, my secondary plan was to become a nurse then NP. That doesn't mean nurses are somehow inferior to PAs.
The issue isn't if one is superior to the other because that is just nonsense. Your reason is for young people to pursue Med school is basically because its financially more sounded to do that in the long run. However, you gotta ask yourself, what are you giving up for this long term financial benefit? Is it really worth your 20s and early 30s for that financial gain? Why even go into medicine if it's about money. Just get a 4 year degree in computer science or work hard during undergrad to become an investment banker.

I get the concept that people who do have a passion for medicine and in that case they should pursue the highest paying career in medicine. It's just you sacrifice so much to become a physician. You'll be in medical school and then residency for around 8-12 years all while you watch all your friends start and build their lives.

Edit: Also, go to PA school because you want to become a PA and you like what the profession has to offer. Go to medical school because you want to become a Physician and like what that profession has to offer.

Don't use PA as a back up because you're taking the spot from someone who actually wants to become a PA as their first choice.
 

Boatswain2PA

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Med school is 4 years.

Residency is 3-6 years, usually making 50-80K a year, almost comparable with what many PAs make. This is also a time when many people get married and start their families.

Then post residency the physician makes 3-4 times what the PA makes.

Having PA school as a back-up to med school is a great idea. You are not "taking the spot" from anyone. PA schools have long lists of people waiting for someone to decline.
 

MyNameWasUsed

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Residency is working 60-80 hours a week for 3-6 years at a 50k-80k salary. That might as well be $12/hour. But let's not even talk about the money because if we wanted money then we would have pursued computer science, engineering, or banking right?

Let's not even talk about taking spots from someone who actually wants to be a PA

Let's talk about how the guy with a great GPA and has everything except for the MCAT score who couldn't get into medical school so he pursued PA school as a backup because he read your post on SDN. This guy gets in PA school, graduates, and works as PA. Fast forward 20 years. He regrets not retaking the MCAT because at the time it was just easier to not retake the MCAT and instead apply to PA school. Again, its simple, if you want to be a physician, go to medical school.
 

Boatswain2PA

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Residency is working 60-80 hours a week for 3-6 years at a 50k-80k salary. That might as well be $12/hour. But let's not even talk about the money because if we wanted money then we would have pursued computer science, engineering, or banking right?...

Let's talk about how the guy with a great GPA and has everything except for the MCAT score who couldn't get into medical school so he pursued PA school as a backup because he read your post on SDN. This guy gets in PA school, graduates, and works as PA. Fast forward 20 years. He regrets not retaking the MCAT because at the time it was just easier to not retake the MCAT and instead apply to PA school. Again, its simple, if you want to be a physician, go to medical school.
But the resident is still making decent money. Yes, working like a dog, but still making money.

Yes, guy in your last paragraph should try to retake the MCAT. And if he does better, yet still for some reason can't get into medical school, then PA is a good second choice.

Now lets talk about the 22 yo who thinks that 4 years of medical school is SOOOOOO long, and SOOOOOOO hard that they choose to take the easy (ie: easier) route to PA. 10 years later they are up against a hard ceiling of income and respect, wishing they had gone to med school.
 
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MyNameWasUsed

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But the resident is still making decent money. Yes, working like a dog, but still making money.

Yes, guy in your last paragraph should try to retake the MCAT. And if he does better, yet still for some reason can't get into medical school, then PA is a good second choice.

Now lets talk about the 22 yo who thinks that 4 years of medical school is SOOOOOO long, and SOOOOOOO hard that they choose to take the easy (ie: easier) route to PA. 10 years later they are up against a hard ceiling of income and respect, wishing they had gone to med school.
If this imaginary person we're talking about can't even score a high enough MCAT to gain a DO acceptance then i highly doubt they're getting into PA school. What's the average DO MCAT score? AT Still in AZ average MCAT score was 26. That means they're accepting people with scores of 24 probably. With this said, i don't think there are any justifications for PA as a "backup plan" for medical school because if you can get into a PA program you probably can score a 24 on the MCAT (i would hope so at least). Source: http://forums.studentdoctor.net/threads/2014-2015-do-average-mcat-and-cgpa-spreadsheet.1069036/

I'm that 22 yo who decided to pursue PA instead of medical school. It's not just 4 years of medical school though. Let's say I went to med school. I would want a high paying specialty to compensate for the sacrifices i've made. I would have pursued IR rad probably. That's a 5 year residency and very competitive nonetheless. That means I have to score probably a 245+ on Step 1 and participate in numerous publications during med school. I would have to work EVEN harder than the normal med student for FOUR years. Finally, I graduate and matched with a nice 5 year IR rad residency and now I get to work 70-80hr/week for the next 5 years. Man now that I think about it, I'm gonna decline my PA acceptance and go to medical school in hopes of being IR rad. /s

As for the BIGGEST con of being a PA: hard ceiling income and respect apparently. First of all, hard ceiling income. If you graduated from PA school at age 24 and obtain a first job at 100k/year, I think you could live frugally and invest the extra money into stocks, real estate, venture capitalism, etc. Not saying that investing is easy (because it definitely isn't) but if you really wanted to make even more money then use the PA salary as a starting capital for investing. Live on 25k a year and use 75k to invest.
As for the respect thing, I really don't give a dam. You shouldn't go to MD school for respect or prestige. Those aren't the answers you give during an interview. It's just a job at the end of the day.
 

Boatswain2PA

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If this imaginary person we're talking about can't even score a high enough MCAT to gain a DO acceptance then i highly doubt they're getting into PA school. What's the average DO MCAT score? AT Still in AZ average MCAT score was 26. That means they're accepting people with scores of 24 probably. With this said, i don't think there are any justifications for PA as a "backup plan" for medical school because if you can get into a PA program you probably can score a 24 on the MCAT (i would hope so at least). Source: http://forums.studentdoctor.net/threads/2014-2015-do-average-mcat-and-cgpa-spreadsheet.1069036/
http://forums.studentdoctor.net/threads/2014-2015-do-average-mcat-and-cgpa-spreadsheet.1069036/

MCAT, inability to do well in OChem 2 or Biochem, whatever....lots of reasons why people don't make it into MD/DO school. It's a TON of work, and some people just can't make it through the whole process. And, like it or not, the process for med school is a lot more than for PA school.

I'm that 22 yo who decided to pursue PA instead of medical school. It's not just 4 years of medical school though. Let's say I went to med school. I would want a high paying specialty to compensate for the sacrifices i've made. I would have pursued IR rad probably. That's a 5 year residency and very competitive nonetheless. That means I have to score probably a 245+ on Step 1 and participate in numerous publications during med school. I would have to work EVEN harder than the normal med student for FOUR years. Finally, I graduate and matched with a nice 5 year IR rad residency and now I get to work 70-80hr/week for the next 5 years. Man now that I think about it, I'm gonna decline my PA acceptance and go to medical school in hopes of being IR rad. /s
Never woulda guessed that you are the 22 yo I'm talking about! lol.

Okay, five year residency. So as a PA you start making $100K/year at age 24. As an IR resident you start making $70K/year at age 26. By age 31 this is a $350K difference in opportunity cost, and likely a $100K difference in educational cost (4 yrs med school vs 2 yrs PA school), for a total of $450K difference. But starting at age 31, how much does that IR attending make now? $300K a year, versus $120K a year for an experienced PA? That $450 difference goes away in less than 3 years...by the time the doctor is 34 years old.

So, while you're 22 now, re-visit this discussion when you are 34 years old and are making $180K a year LESS than the IR physician that you wanted to be.

By the time you're 40, you will have lost out on over a million dollars in income being a PA versus a physician.

By the time you're 50, you will have lost out on over 2.8 million. That's a pretty damn nice retirement.

As for the BIGGEST con of being a PA: hard ceiling income and respect apparently. First of all, hard ceiling income. If you graduated from PA school at age 24 and obtain a first job at 100k/year, I think you could live frugally and invest the extra money into stocks, real estate, venture capitalism, etc. Not saying that investing is easy (because it definitely isn't) but if you really wanted to make even more money then use the PA salary as a starting capital for investing. Live on 25k a year and use 75k to invest.
As for the respect thing, I really don't give a dam. You shouldn't go to MD school for respect or prestige. Those aren't the answers you give during an interview. It's just a job at the end of the day.
Sounds like you are the type that wants to work hard at the beginning of your life (ie: "live on 25K a year and use 75K to invest") so that you can live better later. Kinda like how MD/DOs do when they "invest" in their own education early in their adult life.

And as for the respect thing....give it ten more years. When you're 32, and you've been practicing as a PA in your specialty for 8 years, and you consult a physician only to meet their "you're just a PA" attitude, questioning every single thing you did.

Then you might give a damn about the respect.
 
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MyNameWasUsed

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You are forgetting to calculate in debt and what you're giving up for that 70k a year at age 26. You work 80 hours a week for 70k a year for 5 years. What kind of lifestyle is that? If I worked 80 hours a week as a PA for those same 5 years I would make 200k+ because of overtime. Also, why are you using the salary of a primary care PA? If you're gonna use primary care PA salary you should keep it consistent with primary care physician salary which is around 180k? So that's really just a 60k difference.

I don't really see the point of debating about the financial aspects. My friend graduated from USC as an accountant last year. He works at a big 4 firm since last year making 62k/year. If he stays at that same firm for 10 years he can make partner which is a 300k salary. So if we're gonna talk about a 300k salary at age 31, why not go be an accountant. You make money throughout your 22-32 and there's no debt. You don't work like a slave and on fridays you get out early enough to for that 3pm happyhour at a downtown bar in LA.

MD/DOs give up their 20s and early 30s along with debt for their education. That kind of investment seems kind of excessive in my opinion. Especially if you go into primary care.
Well if i do end up hating being a PA so much because of the lack of respect I can always....quit. Shocking right? I feel like its easier to change careers as a PA than physician. Less investment. WHo knows? maybe i'll go into real estate in 20 years.
 

Boatswain2PA

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You are forgetting to calculate in debt and what you're giving up for that 70k a year at age 26. You work 80 hours a week for 70k a year for 5 years. What kind of lifestyle is that? If I worked 80 hours a week as a PA for those same 5 years I would make 200k+ because of overtime. Also, why are you using the salary of a primary care PA? If you're gonna use primary care PA salary you should keep it consistent with primary care physician salary which is around 180k? So that's really just a 60k difference.
Yes, they work hard. Like we discussed, smart people invest early. You suggested a PA making $100K a year live on only $25K a year while investing the rest. That is living VERY frugally so that you can live better later. Doc's do the same thing with their time....working very hard early so they can live better later.

I was using an estimated $120K pay for an IR PA to keep it commiserate with the medicine you "want" to practice.

I don't really see the point of debating about the financial aspects. My friend graduated from USC as an accountant last year. He works at a big 4 firm since last year making 62k/year. If he stays at that same firm for 10 years he can make partner which is a 300k salary. So if we're gonna talk about a 300k salary at age 31, why not go be an accountant. You make money throughout your 22-32 and there's no debt. You don't work like a slave and on fridays you get out early enough to for that 3pm happyhour at a downtown bar in LA.
Because an accountant doesn't practice medicine. I thought you were arguing against my point that PA school is a valid Plan B for those who didn't get into med school.

MD/DOs give up their 20s and early 30s along with debt for their education. That kind of investment seems kind of excessive in my opinion. Especially if you go into primary care.
Well if i do end up hating being a PA so much because of the lack of respect I can always....quit. Shocking right? I feel like its easier to change careers as a PA than physician. Less investment. WHo knows? maybe i'll go into real estate in 20 years.
I agree the investment is excessive for primary care reimbursement. However, looking at some of the specialist pay ($350/hour for EM isn't uncommon), the investment is CERTAINLY worth it!
 

MyNameWasUsed

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Yes, they work hard. Like we discussed, smart people invest early. You suggested a PA making $100K a year live on only $25K a year while investing the rest. That is living VERY frugally so that you can live better later. Doc's do the same thing with their time....working very hard early so they can live better later.

I was using an estimated $120K pay for an IR PA to keep it commiserate with the medicine you "want" to practice.



Because an accountant doesn't practice medicine. I thought you were arguing against my point that PA school is a valid Plan B for those who didn't get into med school.



I agree the investment is excessive for primary care reimbursement. However, looking at some of the specialist pay ($350/hour for EM isn't uncommon), the investment is CERTAINLY worth it!
It's subjective whether $25k/year is frugal or not. I'm living on 2.5k/month after taxes right now by working 20 hours a week for my gap year and I'm loving it. Lots of free time and I still have extra $$ left over. I see where you're coming from with doc investing in their future through medical school but you're not factoring the debt difference which isn't a big deal I guess. However, during those 5 years of residency, if a PA work 80hrs/week the PA would be making well over 200k, probably up to 250k while the resident is making 70k which seems high to me. I heard residency is more 50-60k.

I think PA school is a valid plan B for those who gave up on med school and wanted to regret later. You spoke of this yourself. Low income ceiling and lack of respect. Look, the point is if you can't score a MCAT of 24 to get into a low tier DO school then we got greater concerns. If the excuse/reasoning was "poor standardize test taking" then how the hell you gonna pass the PANCE? You gonna suddenly improve your standardize test taking abilities in two years? If you can improve your test taking skills over the 2 years WHILE in PA school in order to pass the PANCE then you can definitely improve your test taking skills in 1 year while NOT in PA school to score that sweet 24 on the MCAT. There's just no reason for PA to be a plan B. This is how you breed generations of unhappy and disgruntled mid level providers. They're gonna low back in 20 years and be like wow I should have just worked EVEN harder on studying for the MCAT to retake it. I havn't taken the MCAT so the following statement probably has no value to it, but come one... a 24..... a freaking 24 lol....

I mean I guess if you're older, like 40, you probably should go to PA school but in that case it wouldn't really be plan B in my opinion. Age is just something you can't control.

EM Residency does seem to be the most efficient investment to me. 250k salary after a 3 year residency that is not that competitive to get into. That sounds great, but you gotta be able to do ER work though. That would have been my alternative to IR rad if I went to med school. If i failed to score a high enough Step 1 score for IR rad, i would want to do EM.
 

Makati2008

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It's subjective whether $25k/year is frugal or not. I'm living on 2.5k/month after taxes right now by working 20 hours a week for my gap year and I'm loving it. Lots of free time and I still have extra $$ left over. I see where you're coming from with doc investing in their future through medical school but you're not factoring the debt difference which isn't a big deal I guess. However, during those 5 years of residency, if a PA work 80hrs/week the PA would be making well over 200k, probably up to 250k while the resident is making 70k which seems high to me. I heard residency is more 50-60k.

I think PA school is a valid plan B for those who gave up on med school and wanted to regret later. You spoke of this yourself. Low income ceiling and lack of respect. Look, the point is if you can't score a MCAT of 24 to get into a low tier DO school then we got greater concerns. If the excuse/reasoning was "poor standardize test taking" then how the hell you gonna pass the PANCE? You gonna suddenly improve your standardize test taking abilities in two years? If you can improve your test taking skills over the 2 years WHILE in PA school in order to pass the PANCE then you can definitely improve your test taking skills in 1 year while NOT in PA school to score that sweet 24 on the MCAT. There's just no reason for PA to be a plan B. This is how you breed generations of unhappy and disgruntled mid level providers. They're gonna low back in 20 years and be like wow I should have just worked EVEN harder on studying for the MCAT to retake it. I havn't taken the MCAT so the following statement probably has no value to it, but come one... a 24..... a freaking 24 lol....

I mean I guess if you're older, like 40, you probably should go to PA school but in that case it wouldn't really be plan B in my opinion. Age is just something you can't control.

EM Residency does seem to be the most efficient investment to me. 250k salary after a 3 year residency that is not that competitive to get into. That sounds great, but you gotta be able to do ER work though. That would have been my alternative to IR rad if I went to med school. If i failed to score a high enough Step 1 score for IR rad, i would want to do EM.
As someone that has done both seems like a fair bit of misinformation here.


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Boatswain2PA

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As someone that has done both seems like a fair bit of misinformation here.


Sent from my iPhone using SDN mobile app
Please, add to the discussion. I am tired of bashing my head against the wall of youthful obstinance.

BTW Makati - What's your status now? FP residency??
 

badasshairday

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If this imaginary person we're talking about can't even score a high enough MCAT to gain a DO acceptance then i highly doubt they're getting into PA school. What's the average DO MCAT score? AT Still in AZ average MCAT score was 26. That means they're accepting people with scores of 24 probably. With this said, i don't think there are any justifications for PA as a "backup plan" for medical school because if you can get into a PA program you probably can score a 24 on the MCAT (i would hope so at least). Source: http://forums.studentdoctor.net/threads/2014-2015-do-average-mcat-and-cgpa-spreadsheet.1069036/

I'm that 22 yo who decided to pursue PA instead of medical school. It's not just 4 years of medical school though. Let's say I went to med school. I would want a high paying specialty to compensate for the sacrifices i've made. I would have pursued IR rad probably. That's a 5 year residency and very competitive nonetheless. That means I have to score probably a 245+ on Step 1 and participate in numerous publications during med school. I would have to work EVEN harder than the normal med student for FOUR years. Finally, I graduate and matched with a nice 5 year IR rad residency and now I get to work 70-80hr/week for the next 5 years. Man now that I think about it, I'm gonna decline my PA acceptance and go to medical school in hopes of being IR rad. /s

As for the BIGGEST con of being a PA: hard ceiling income and respect apparently. First of all, hard ceiling income. If you graduated from PA school at age 24 and obtain a first job at 100k/year, I think you could live frugally and invest the extra money into stocks, real estate, venture capitalism, etc. Not saying that investing is easy (because it definitely isn't) but if you really wanted to make even more money then use the PA salary as a starting capital for investing. Live on 25k a year and use 75k to invest.
As for the respect thing, I really don't give a dam. You shouldn't go to MD school for respect or prestige. Those aren't the answers you give during an interview. It's just a job at the end of the day.
Ok. So I can give some perspective given that I am a radiology resident going into Intervention Radiology (IR) and my wife is a PA working in the ER. We are both 30 years old and she took 2 years off working after undergrad before starting PA school. I started med school like 6 months after finishing undergrad.

My wife makes a healthy six figure salary working 11 shifts a month (full time), with each shift being 12 hours. When she is on, the days/nights are long and by the time she is done it may b 13-15 hours. With that said she still probably works only around 40 hours a week per month when you average it out. If she wanted to make more money she could work a couple of more shifts a month, but our family is comfortable and we have a child so it is worthwhile for her to be home more often. That is definitely a pro. She may even drop down a few more shifts and do maybe 8 a month to be part time and still make a decent salary. She is lucky because her school tuition and living was around 100K, paid off by her father. A lot of our friends are physicians, and extremely rarely she feels she should have gone to med school for the respect and pay factor. She feels less professional respect as a PA, and it bothers her sometimes but she accepts it as a given aspect of being a PA. When she sees all the hoops, exams, licensing BS I have to do she is glad she went the PA route. She is overall happy with her choice as it has been more lifestyle friendly especially in the age range of starting a family and having young children.

I on the other hand did the med school route and now I am in my fourth year of residency. After 4 years of med school I accumulated around 220K of debt. As a first year resident/intern I made 54 thousand, however I worked on average 50-55 hours a week. Then in radiology residency I probably average around the same number of hours as well. My base salary is close to 60K but I also moonlight by sitting on my butt watching Netflix or studying while "babysitting" a CT scanner after hours for up to 75 dollars an hour (as much as PA makes in many specialties while grinding hard for it). This year I will probably be making 90-100 K. So I disagree that you work 80 hours a week for 5 years for low pay. Pick the right residency. My lifestyle is pretty good, although IR fellowship and my months of IR during residency will be/are more like 60-90 hours a week. IR fellowship is a year. After that you do have a relatively busy lifestyle but the pay is very good (significantly more than what you guys quoted, as partners can make more than double an ER docs pay) and vacation of 10 to 12 weeks a year is not uncommon. In the end it is worth it to me because I enjoy it.
 
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LightBox

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I have no clue why I'm reading a PA thread (maybe just for the hell of it). I respect all health care professionals for what they do, PAs included. But I do think that PAs are somewhat overpaid for their amount of education and "training" compared to nurses and primary care physicians. But I have to concede that it is an amazing gig to earn 100k after only 2 years of extra schooling after college, so I definitely understand the appeal. Personally, I could never do it because I always wanted to be my own boss, run my own practice, and be at the top of my field. Though the MD route is definitely harder and longer, the potential reward is boundless. Most eye surgeons in my particular area make in the low-7 figure territory, so there is definite financial reward at the end of some M.D.-tunnels.
 

MyNameWasUsed

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Ok. So I can give some perspective given that I am a radiology resident going into Intervention Radiology (IR) and my wife is a PA working in the ER. We are both 30 years old and she took 2 years off working after undergrad before starting PA school. I started med school like 6 months after finishing undergrad.

My wife makes a healthy six figure salary working 11 shifts a month (full time), with each shift being 12 hours. When she is on, the days/nights are long and by the time she is done it may b 13-15 hours. With that said she still probably works only around 40 hours a week per month when you average it out. If she wanted to make more money she could work a couple of more shifts a month, but our family is comfortable and we have a child so it is worthwhile for her to be home more often. That is definitely a pro. She may even drop down a few more shifts and do maybe 8 a month to be part time and still make a decent salary. She is lucky because her school tuition and living was around 100K, paid off by her father. A lot of our friends are physicians, and extremely rarely she feels she should have gone to med school for the respect and pay factor. She feels less professional respect as a PA, and it bothers her sometimes but she accepts it as a given aspect of being a PA. When she sees all the hoops, exams, licensing BS I have to do she is glad she went the PA route. She is overall happy with her choice as it has been more lifestyle friendly especially in the age range of starting a family and having young children.

I on the other hand did the med school route and now I am in my fourth year of residency. After 4 years of med school I accumulated around 220K of debt. As a first year resident/intern I made 54 thousand, however I worked on average 50-55 hours a week. Then in radiology residency I probably average around the same number of hours as well. My base salary is close to 60K but I also moonlight by sitting on my butt watching Netflix or studying while "babysitting" a CT scanner after hours for up to 75 dollars an hour (as much as PA makes in many specialties while grinding hard for it). This year I will probably be making 90-100 K. So I disagree that you work 80 hours a week for 5 years for low pay. Pick the right residency. My lifestyle is pretty good, although IR fellowship and my months of IR during residency will be/are more like 60-90 hours a week. IR fellowship is a year. After that you do have a relatively busy lifestyle but the pay is very good (significantly more than what you guys quoted, as partners can make more than double an ER docs pay) and vacation of 10 to 12 weeks a year is not uncommon. In the end it is worth it to me because I enjoy it.
Thank you for the insightful response. Are all rad residency 55 hours a week? Because that does change things. However, I still wouldn't do it. To get into a IR rad residency, you must have worked extremely hard during medical school which is hard enough by itself already.

I feel like this discussion has too centered around the financial aspects of PA vs sub specialty MD. My mother raised my brother and I on a 70k salary. I have nothing to complain about. How much money do I really need? Of course more money can't hurt, I get that.
 

Boatswain2PA

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Ok. So I can give some perspective given that I am a radiology resident going into Intervention Radiology (IR) and my wife is a PA working in the ER. We are both 30 years old and she took 2 years off working after undergrad before starting PA school. I started med school like 6 months after finishing undergrad.

My wife makes a healthy six figure salary working 11 shifts a month (full time), with each shift being 12 hours. When she is on, the days/nights are long and by the time she is done it may b 13-15 hours. With that said she still probably works only around 40 hours a week per month when you average it out. If she wanted to make more money she could work a couple of more shifts a month, but our family is comfortable and we have a child so it is worthwhile for her to be home more often. That is definitely a pro. She may even drop down a few more shifts and do maybe 8 a month to be part time and still make a decent salary. She is lucky because her school tuition and living was around 100K, paid off by her father. A lot of our friends are physicians, and extremely rarely she feels she should have gone to med school for the respect and pay factor. She feels less professional respect as a PA, and it bothers her sometimes but she accepts it as a given aspect of being a PA. When she sees all the hoops, exams, licensing BS I have to do she is glad she went the PA route. She is overall happy with her choice as it has been more lifestyle friendly especially in the age range of starting a family and having young children.

I on the other hand did the med school route and now I am in my fourth year of residency. After 4 years of med school I accumulated around 220K of debt. As a first year resident/intern I made 54 thousand, however I worked on average 50-55 hours a week. Then in radiology residency I probably average around the same number of hours as well. My base salary is close to 60K but I also moonlight by sitting on my butt watching Netflix or studying while "babysitting" a CT scanner after hours for up to 75 dollars an hour (as much as PA makes in many specialties while grinding hard for it). This year I will probably be making 90-100 K. So I disagree that you work 80 hours a week for 5 years for low pay. Pick the right residency. My lifestyle is pretty good, although IR fellowship and my months of IR during residency will be/are more like 60-90 hours a week. IR fellowship is a year. After that you do have a relatively busy lifestyle but the pay is very good (significantly more than what you guys quoted, as partners can make more than double an ER docs pay) and vacation of 10 to 12 weeks a year is not uncommon. In the end it is worth it to me because I enjoy it.
Congrats Doc, you're killing it!

I have no clue why I'm reading a PA thread (maybe just for the hell of it). I respect all health care professionals for what they do, PAs included. But I do think that PAs are somewhat overpaid for their amount of education and "training" compared to nurses and primary care physicians. But I have to concede that it is an amazing gig to earn 100k after only 2 years of extra schooling after college, so I definitely understand the appeal. Personally, I could never do it because I always wanted to be my own boss, run my own practice, and be at the top of my field. Though the MD route is definitely harder and longer, the potential reward is boundless. Most eye surgeons in my particular area make in the low-7 figure territory, so there is definite financial reward at the end of some M.D.-tunnels.
Maybe you are just coming across wrong here, but your post certainly doesn't sound like you "respect all health care professionals for what they do." Sorry you had to come here to the slums, but it's funny that you infer that you are going to make a 7 figure income while focusing all of your efforts onto one very small part of the body, yet slam PAs for being "overpaid for their amount of education and 'training' compared to nurses and primary care physicians."

Instead of just focusing on one small (albeit important) organ, I take the totally undifferentiated patient, determine whether they are sick or not sick, begin resuscitation, diagnose, and then send them to the right specialists. Here are a few I dealt with in a recent shift:

G3P2, 25 weeks along, high fever, tachy to 130s, moderately hypotensive, back pain, n/v, and contracting.

10 week old (+ preemie), unimmunized, febrile to 38.5, somnolent, persistent vomiting X 4 hours.

Young adult DKA with pH of 6.9

Severe asthmatic with hx of multiple intubations

Blast injury with multiple shrapnel wounds from propane tank being in fire pit.

This is including the many chest pains, belly pains, headaches, back pains, schizophrenic, orthopedic injuries, etc.

So while you are doing your 10th surgery of the day on the same organ, try to remember the last time you had to care for one of these types of people. Then come back and tell me that I'm overpaid at $200K a year. Oh, by the way, I'm single coverage in most of the places I work, and I'm a million miles away from tertiary care (well, it feels like it sometimes anyway).


Thank you for the insightful response. Are all rad residency 55 hours a week? Because that does change things. However, I still wouldn't do it. To get into a IR rad residency, you must have worked extremely hard during medical school which is hard enough by itself already.

I feel like this discussion has too centered around the financial aspects of PA vs sub specialty MD. My mother raised my brother and I on a 70k salary. I have nothing to complain about. How much money do I really need? Of course more money can't hurt, I get that.
The discussion has gone several directions (like normal for discussions), but what you and I have disagreed on was whether PA is a valid back-up plan for people trying to get into medical school. Maybe Dr. Badass can give his opinion if he thinks PA would have been a good choice for if he had been unable to get into med school.
 
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emedpa

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So while you are doing your 10th surgery of the day on the same organ, try to remember the last time you had to care for one of these types of people. Then come back and tell me that I'm overpaid at $200K a year. Oh, by the way, I'm single coverage in most of the places I work, and I'm a million miles away from tertiary care (well, it feels like it sometimes anyway).
Good post Boats. As you know, we are frequently in the same boat with single coverage issues/high acuity/etc. wouldn't have it any other way.
my last shift I resuscitated a stemi that coded in the field, gave TPA and had ROSC before flying them. At the same time I was managing an 88 yr old with new onset aflutter and chest pain. at 2/3 rds what they pay an FP doc to staff the place when I am not here I am a bargain for almost 30 yrs of em experience when compared to someone who was an fp resident in clinic last year. when there are codes at shift change most of the FP docs ASK me to run them because they know this is what I do. some of them are honestly scared when high acuity rolls through the door. I don't make 200k, but I am in the top 1% of em pas nationally in terms of scope of practice and pay. I think it is disingenuous when folks describe PA as "just 2 years after college" as this discounts any prior HCE we bring to the table. I was in ems for almost 10 years at the point that I became a PA. those years as a medic in busy systems brought with them a wealth of experience. EM PAs are not EM docs, but we are the next best thing and the reason many rural hospitals are able to stay open.
 

LightBox

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Congrats Doc, you're killing it!

Maybe you are just coming across wrong here, but your post certainly doesn't sound like you "respect all health care professionals for what they do." Sorry you had to come here to the slums, but it's funny that you infer that you are going to make a 7 figure income while focusing all of your efforts onto one very small part of the body, yet slam PAs for being "overpaid for their amount of education and 'training' compared to nurses and primary care physicians."

Instead of just focusing on one small (albeit important) organ, I take the totally undifferentiated patient, determine whether they are sick or not sick, begin resuscitation, diagnose, and then send them to the right specialists. Here are a few I dealt with in a recent shift:

G3P2, 25 weeks along, high fever, tachy to 130s, moderately hypotensive, back pain, n/v, and contracting.

10 week old (+ preemie), unimmunized, febrile to 38.5, somnolent, persistent vomiting X 4 hours.

Young adult DKA with pH of 6.9

Severe asthmatic with hx of multiple intubations

Blast injury with multiple shrapnel wounds from propane tank being in fire pit.

This is including the many chest pains, belly pains, headaches, back pains, schizophrenic, orthopedic injuries, etc.

So while you are doing your 10th surgery of the day on the same organ, try to remember the last time you had to care for one of these types of people. Then come back and tell me that I'm overpaid at $200K a year. Oh, by the way, I'm single coverage in most of the places I work, and I'm a million miles away from tertiary care (well, it feels like it sometimes anyway).

The discussion has gone several directions (like normal for discussions), but what you and I have disagreed on was whether PA is a valid back-up plan for people trying to get into medical school. Maybe Dr. Badass can give his opinion if he thinks PA would have been a good choice for if he had been unable to get into med school.

I just don't think that the starting salaries for a PA should be equivalent to the starting salary of an Internal Medicine grad. The latter has 7 years of education/training while the former has only 2 years. But again, I guess that is why PA school is so popular. Just my opinion. The PAs that I've run across in my community don't know very much beyond just referring everything out. So maybe that taints my view of your profession.

Eventually, your PA schools will become greedy and oversaturate the market with newbie PAs that drive down salaries. That is the only drawback of a field where the barrier to entry is very low.
 

badasshairday

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I have no clue why I'm reading a PA thread (maybe just for the hell of it). I respect all health care professionals for what they do, PAs included. But I do think that PAs are somewhat overpaid for their amount of education and "training" compared to nurses and primary care physicians. But I have to concede that it is an amazing gig to earn 100k after only 2 years of extra schooling after college, so I definitely understand the appeal. Personally, I could never do it because I always wanted to be my own boss, run my own practice, and be at the top of my field.
I disagree with your statement about PA's being underpaid. They are paid fairly, and sometimes I think underpaid for the amount of work and responsibility they have. See emedpa's post I quoted at the end.

I do agree with you about the own boss and being the top of your field sentiment.


Thank you for the insightful response. Are all rad residency 55 hours a week? Because that does change things. However, I still wouldn't do it. To get into a IR rad residency, you must have worked extremely hard during medical school which is hard enough by itself already.

I feel like this discussion has too centered around the financial aspects of PA vs sub specialty MD. My mother raised my brother and I on a 70k salary. I have nothing to complain about. How much money do I really need? Of course more money can't hurt, I get that.
Most radiology residencies range between 40-80 hours a week, with you only being close to 80 hours on a few rotations (i.e. Nights or busy IR call). Typically in radiology residency you will be working About 50 hours a week. A lot of radiology residency programs have moonlighting options and some residents I know are clearing 100K. Other programs don't have that option.

The discussion has gone several directions (like normal for discussions), but what you and I have disagreed on was whether PA is a valid back-up plan for people trying to get into medical school. Maybe Dr. Badass can give his opinion if he thinks PA would have been a good choice for if he had been unable to get into med school.
I don't know. I have thought about it rarely. Sometimes I think it would have been nice since there is less BS when you train to becomes a PA, however most of the time I am glad to be where I am.

Good post Boats. As you know, we are frequently in the same boat with single coverage issues/high acuity/etc. wouldn't have it any other way.
my last shift I resuscitated a stemi that coded in the field, gave TPA and had ROSC before flying them. At the same time I was managing an 88 yr old with new onset aflutter and chest pain. at 2/3 rds what they pay an FP doc to staff the place when I am not here I am a bargain for almost 30 yrs of em experience when compared to someone who was an fp resident in clinic last year. when there are codes at shift change most of the FP docs ASK me to run them because they know this is what I do. ... EM PAs are not EM docs, but we are the next best thing and the reason many rural hosp.
This is why I think PA's earn there keep.
 

badasshairday

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IM doc's make significantly more than PA's while working less hours... like double. The only PA's making 200K+ are working there tails off, like 75-90 hours a week and usually in things like CT surgery, Ortho, ER (taking tons of extra shifts). IM doc's doing outpatient only make high 100's to low 200's in many place. Hospitalists, working half the year make mid 200's. Starting salaries for PA's are 75-110K depending on specialty. So it isn't even close.
 

emedpa

GlobalDoc
10+ Year Member
15+ Year Member
Aug 25, 2001
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Taking an Away team....
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Post Doc
to make 200k/yr I would have to work almost 3000 hrs/yr.
typical em pas make 90-110k. Senior folks like Boats and myself make 125-150k or so without too much overtime. most I have ever made, working really hard was 170k one year I did LOTS of O.T.