Pharmacy or PA?

[Potential123]

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I have debated the future of pharmacy on these threads for a long time. I'm sorry if I'm getting repetitive. I just don't have anyone whose looking at the facts. They're just telling me to stop making excuses and do it. However, I have to take in the job market and the new graduates coming in. I already come from a disadvantaged background, only child, and just don't want to put myself in a situation where I can't get a job once I graduate with about > 120k debt and virtually wasting four years of my life. I'm trying to be smart and I want to do something in health care. Is PA a good substitute for pharmacy and how are the job prospects?

 

[AlPacino]

I have debated the future of pharmacy on these threads for a long time. I'm sorry if I'm getting repetitive. I just don't have anyone whose looking at the facts. They're just telling me to stop making excuses and do it. However, I have to take in the job market and the new graduates coming in. I already come from a disadvantaged background, only child, and just don't want to put myself in a situation where I can't get a job once I graduate with about > 120k debt and virtually wasting four years of my life. I'm trying to be smart and I want to do something in health care. is PA a good substitute for pharmacy and how are the job prospects?

The job outlook for physician assistant is much brighter then pharmacy. I've had a couple of my professors actually ask me "Have you thought about PA?" If you are looking for a health care career with jobs being handed to you right out of school and low debt, then better start looking somewhere else, because you will be one unhappy pharmacist.

 

[oogin]

Couple pharmacists I shadowed also recommended PA to me. One said the job outlook for PA is especially good because retail stores will offer drop-by PA services (one step down from going to the hospital to see a doctor) and will need lots of PAs to fill that spot.

 

[Starshipp]

PA is the way to go. 2-3 years of school. Lower debt. No malpractice insurance. You can prescribe, under a supervision of a doc of course. More fun than a retail pharmacist. And in my opinion, less stress. The pay will balance out in a year or two. PA isn't too shabby.

 

[Pharmdmba1978]

I am currently a pharmacist (8 years of experience) and I say go to PA school, not Pharmacy school. Full disclosure, I am currently in the process of applying to podiatry and osteopathic medical schools... Trying to get out...

 

[Skrumpy]

Each has their pros and cons. I suggest actually talking to some real pharmacists and real PAs. Not come around and ask the Internet for real advice.

 

[Rouelle]

It is important to realize that these two professions are incredibly different. Sure, in the respective schools both PAs and pharmacists learn some overlapping information: basic science, some pathophys, medications, and current clinical practice guidelines. But in professional practice there are few similarities. PA's typically diagnose and prescribe. Although clinical pharmacists do exist, the vast majority of pharmacists serve in a dispensing role.

My wife is a practicing PA and I am a pharmacy student who interns at a community pharmacy. I would hate to have her job and I'm pretty sure pharmacy would bore her to tears.

Like others have mentioned, do some shadowing and get some experience with each to determine which you would enjoy more. Of course, if you are looking solely at ease of finding a job, PA is definitely the way to go...at least at this time.

 

[Skrumpy]

True.. it is much easier in the scheme of things to open a PA school than a pharmacy school. They are already set to explode in terms of number of new PA schools in the beginning stages and planned to open, soon it will be saturated like pharmacy. The only difference is that NP >>> PA as NPs can actually be fully autonomous in some states and may even open their own clinics. PAs must always be under the direct supervision of a practicing physician (though often there is a high level of autonomy). Thus PA salary will always be tied to that of NPs and NP salary will never go higher or approach the level of physician salary. If PAs had the autonomy of NPs, I probably would have leaned more towards PA over Pharmacy. Prior to applying to pharmacy school, I shadowed two different PAs in our hospital. Here PAs work physician hours (on call w/pager) and get paid PA salary (as a salaried not hourly employee so not paid for all the massive amts of OT they work). So basically you are a grunt bitch that they take advantage of. It's no doubt different in other settings but I would have preferred working in a hospital and not a clinic. I spoke with a couple that really disliked having new grad physicians that "don't know anything" coming in and "bossing them" around. So like I said before.. pros and cons to each profession. Personally, I like the idea of being fully autonomous (hence pharmacy).

 

[AlPacino]

True.. it is much easier in the scheme of things to open a PA school than a pharmacy school. They are already set to explode in terms of number of new PA schools in the beginning stages and planned to open, soon it will be saturated like pharmacy. The only difference is that NP >>> PA as NPs can actually be fully autonomous in some states and may even open their own clinics. PAs must always be under the direct supervision of a practicing physician (though often there is a high level of autonomy). Thus PA salary will always be tied to that of NPs and NP salary will never go higher or approach the level of physician salary. If PAs had the autonomy of NPs, I probably would have leaned more towards PA over Pharmacy. Prior to applying to pharmacy school, I shadowed two different PAs and in our hospital. Here PAs work physician hours (on call w/pager) and get paid PA salary (as a salaried not hourly employee so not paid for all the massive amts of OT they work). So basically you are a grunt bitch that they take advantage of. It's no doubt different in other settings but I would have preferred working in a hospital and not a clinic. I spoke with a couple that really disliked having new grad physicians that "don't know anything" coming in and "bossing them" around. So like I said before.. pros and cons to each profession. Personally, I like the idea of being fully autonomous (hence pharmacy).

PAs have more autonomy then you think. I spoke to one that is in charge of a clinic. The building is operated and consists of nothing but PAs(and receptionists of course). The doctor doesnt even have to be in the area. They just need that DEA/license number, and he can stay at home. He said that the MD visits the clinic once biweekly to check on things and the rest of time, the PAs are in charge. I understand the autonomy reason. Being bossed around and told what to do by somebody who doesnt know better would drive me crazy. PA is a great profession with job growth(for the moment), but I couldnt do it because I would always have that "what could have been" thought if I went the MD track instead.

 

[Skrumpy]

PAs have more autonomy then you think. I spoke to one that is in charge of a clinic. The building is operated and consists of nothing but PAs(and receptionists of course). The doctor doesnt even have to be in the area. They just need that DEA/license number, and he can stay at home. He said that the MD visits the clinic once biweekly to check on things and the rest of time, the PAs are in charge. I understand the autonomy reason. Being bossed around and told what to do by somebody who doesnt know better would drive me crazy. PA is a great profession with job growth(for the moment), but I couldnt do it because I would always have that "what could have been" thought if I went the MD track instead.

As I stated it is different in clinics and under different situations. The "doctor doesn't even have to be in the area" depends highly on the state. I can only wait until someone dies due to a misdiagnosis and the entire model changes to become more strict. It already seems rife for some sort of issue to arise. The MD is in charge though, the PA that oversees the clinic is their immediate boss but they will never be fully autonomous as NPs can be. NPs in some states can actually own and operate their own clinic, a PA cannot in any state and most likely never will be able to. Subservience is built into their title.. Physician ASSISTANT. I also think PA isn't bad at all for the schooling required. It's the same amount of school as pharmacy (if you only do 2 years of undergrad) for only a bit less money. You will work more and put in more effort on the job, but some people like that aspect of it. The overall salary cap is less than pharmacy because as I mentioned PAs will not earn as much as NPs who have more autonomy, somewhat more expanded duties, more options for specialty, and are also limited by physician salary. I'm much in the same boat as you though, if I was going to do PA I probably would have just gone MD instead. Financially, for someone who just wants to get out into a well paid HC career ASAP, PA isn't a bad path at all (NP takes a bit longer and is more costly).

 

[rxtech2012]

I am currently a pharmacist (8 years of experience) and I say go to PA school, not Pharmacy school. Full disclosure, I am currently in the process of applying to podiatry and osteopathic medical schools... Trying to get out...

Just curious how much pharm exp you had before becoming a pharmacist?

 

[nyc76]

I'm currently a prepharm student, in the middle of a career change, prepping for the pcat and I struggled with the PA vs. Pharm vs. AA (anesthesiologist assistant). From what I read, of the three PA is the one that paid the least and based on the requirements it seemed that you might as well go MD because its almost the same. Like others already said, there is a built in "bitch title" with the word assistant, you don't have much autonomy based on where you work, the hours are almost like MD but you're not an MD and you're not paid like one. AA is similar except they get paid much better but then the limited scope of where you can work and always being subservient to fresh out of med school doctors who might not know as much as you would drive me crazy too.

That is why I went the pharm route because the pay is better, you have more autonomy and it just seems to me all the work it takes to get there becomes worth it and you aren't thinking the rest of your life what would've been had you gone the higher route...ie PA vs. MD.

 

[Pharmdmba1978]

I worked as a pharmacy tech from 2000-2001. Then I worked as a pharmacy intern from 2001-2005. I then worked full-time at a hospital and part-time at walgreens from 2005-2006. I have worked full-tme at walgreens since 2006. Things are not the same now as they were when I started pharmacy school. Back then there was a huge demand for pharmacists. People were graduating and getting large sign on bonuses, being promoted to management directly after graduating, and jobs were abundent. Also, tution was much lower, salaries were increasing, and there was only half the amount of pharmacy schools back then compared to today. I know the grass is not greener on the other side (i.e. podiatry/ osteopathic medical schools); However, I enjoy learning and I have enough money saved to pursue my dream of becoming a physician. Thats my situation in a nutshell..

 

[Pharmdmba1978]

Just curious how much pharm exp you had before becoming a pharmacist?

I worked as a pharmacy tech from 2000-2001. Then I worked as a pharmacy intern from 2001-2005. I then worked full-time at a hospital and part-time at walgreens from 2005-2006. I have worked full-tme at walgreens since 2006. Things are not the same now as they were when I started pharmacy school. Back then there was a huge demand for pharmacists. People were graduating and getting large sign on bonuses, being promoted to management directly after graduating, and jobs were abundent. Also, tution was much lower, salaries were increasing, and there was only half the amount of pharmacy schools back then compared to today. I know the grass is not greener on the other side (i.e. podiatry/ osteopathic medical schools); However, I enjoy learning and I have enough money saved to pursue my dream of becoming a physician. Thats my situation in a nutshell..

 

[Pharmdmba1978]

That is why I went the pharm route because the pay is better, you have more autonomy and it just seems to me all the work it takes to get there becomes worth it and you aren't thinking the rest of your life what would've been had you gone the higher route...ie PA vs. MD.[/QUOTE]

No offense but as a pharmacist you have NOOOOOOOOOOOOOOOOOOO autonomy!!!!! I am a pharmacist and I am telling you that if you think you will graduate and work as a clincal pharmacist and have any autonomy you are sadly mistaken. Physcians are always in charge. If you change an order without consulting the Doctor you will be chewed out everywhich way from Sunday. Even when there is a protocol in place to change orders (i.e. IV levaquin to PO levaquin) some physcians will still try to argue with you if you dont consult them first before making the switch in the chart. If you want some autonomy go be a mid-level, if you want complete autonomy become a physician, if you want to be told how to do your job become a pharmacist!!!

 

[nyc76]

No offense but as a pharmacist you have NOOOOOOOOOOOOOOOOOOO autonomy!!!!! I am a pharmacist and I am telling you that if you think you will graduate and work as a clincal pharmacist and have any autonomy you are sadly mistaken. Physcians are always in charge. If you change an order without consulting the Doctor you will be chewed out everywhich way from Sunday. Even when there is a protocol in place to change orders (i.e. IV levaquin to PO levaquin) some physcians will still try to argue with you if you dont consult them first before making the switch in the chart. If you want some autonomy go be a mid-level, if you want complete autonomy become a physician, if you want to be told how to do your job become a pharmacist!!!

Oh right I just meant in terms of career options. Pharmacists, it seems to me I may be wrong, but from what I read can work in a variety of different environments or even own their own small town pharmacy. PA's I think are only PA's and thats pretty much it.

I've seen the pharmacists get chewed out. I actually got a cold sweat cuz one that I know of got into trouble because he was told by the doctor to substitute a different IV for a baby cuz the one he asked for they didn't have. The pharmacist had to do a conversion of the calcium concentration and pretty much messed that up. The baby got double the dosage and died. That scared me quite a bit. 😱

 

[Skrumpy]

No offense but as a pharmacist you have NOOOOOOOOOOOOOOOOOOO autonomy!!!!! I am a pharmacist and I am telling you that if you think you will graduate and work as a clincal pharmacist and have any autonomy you are sadly mistaken. Physcians are always in charge. If you change an order without consulting the Doctor you will be chewed out everywhich way from Sunday. Even when there is a protocol in place to change orders (i.e. IV levaquin to PO levaquin) some physcians will still try to argue with you if you dont consult them first before making the switch in the chart. If you want some autonomy go be a mid-level, if you want complete autonomy become a physician, if you want to be told how to do your job become a pharmacist!!!

I think you are taking it to the extreme there a bit. The amount of pharmacist - physician contact in our hospital is relatively nil except when they are doing rounds together. When they do rounds the pharmacist gives therapeutic recommendations for each disease state. It is more of a team atmosphere that also includes other health professionals. I see this every day in our hospital. At least one pharmacist is part of every rounding team. Aside from that you don't have physicians popping in telling the pharmacists what to do. The pharmacists must check/verify every order that comes through, thus, they have to check the work of the physician. Nothing gets through without a pharmacist's verification. It's rare, but I've seen pharmacists refuse to go through with an order they believed was detrimental to a patient, even at the behest of the physician. The med didn't get filled and it gets escalated to administration to work it out. Either way the goal is not who is in charge of whom because physicians aren't in charge of pharmacists and pharmacists aren't in charge of physicians. I feel sorry for the people that sit there and try to engage in some sort of power struggle (yes these people exist) when the goal should be to provide the most optimal plan for patient recovery. If you truly believe that pharmacists have no autonomy, then perhaps you should have followed your dreams of being a podiatrist earlier.

 

[Potential123]

PA's make more than retail pharmacists?

 

[Skrumpy]

PA's make more than retail pharmacists?

Not that I've seen. In my area retail pharmacist vs PA is a 30-40k/year difference. I'm sure it varies from area to area, but I'd be surprised to see a PA making more than a pharmacist if both had equal amount of experience in the field. As I stated previously, PA salary is limited to what NPs make. NPs are more desirable, in terms of flexibility, PAs are more desired because they get paid a bit less (less overall schooling than a NP). Both compete for many of the same jobs.

 

[NYCGuy86]

Oh right I just meant in terms of career options. Pharmacists, it seems to me I may be wrong, but from what I read can work in a variety of different environments or even own their own small town pharmacy. PA's I think are only PA's and thats pretty much it.

PAs can also work in a variety of different environments. PAs are in all of the medical specialties except anesthesia (at least as an anesthesia provider). They work in hospitals, private practice offices, specialty clinics, etc. Wherever you find a physician, a PA can also work there.

 

[Stilltrying1288]

I worked as a pharmacy tech from 2000-2001. Then I worked as a pharmacy intern from 2001-2005. I then worked full-time at a hospital and part-time at walgreens from 2005-2006. I have worked full-tme at walgreens since 2006. Things are not the same now as they were when I started pharmacy school. Back then there was a huge demand for pharmacists. People were graduating and getting large sign on bonuses, being promoted to management directly after graduating, and jobs were abundent. Also, tution was much lower, salaries were increasing, and there was only half the amount of pharmacy schools back then compared to today. I know the grass is not greener on the other side (i.e. podiatry/ osteopathic medical schools); However, I enjoy learning and I have enough money saved to pursue my dream of becoming a physician. Thats my situation in a nutshell..

I don't think being promoted to management right after graduation is something that has changed. If anything I've been seeing recent grads get stuck with management jobs in stores other pharmacist don't want.

 

[Pharmdmba1978]

I think you are taking it to the extreme there a bit. The amount of pharmacist - physician contact in our hospital is relatively nil except when they are doing rounds together. When they do rounds the pharmacist gives therapeutic recommendations for each disease state. It is more of a team atmosphere that also includes other health professionals. I see this every day in our hospital. At least one pharmacist is part of every rounding team. Aside from that you don't have physicians popping in telling the pharmacists what to do. The pharmacists must check/verify every order that comes through, thus, they have to check the work of the physician. Nothing gets through without a pharmacist's verification. It's rare, but I've seen pharmacists refuse to go through with an order they believed was detrimental to a patient, even at the behest of the physician. The med didn't get filled and it gets escalated to administration to work it out. Either way the goal is not who is in charge of whom because physicians aren't in charge of pharmacists and pharmacists aren't in charge of physicians. I feel sorry for the people that sit there and try to engage in some sort of power struggle (yes these people exist) when the goal should be to provide the most optimal plan for patient recovery. If you truly believe that pharmacists have no autonomy, then perhaps you should have followed your dreams of being a podiatrist earlier.

The ultimate goal is to enhance patient outcomes. I am not saying that physicians are popping in and telling pharmacists how to do their job; however, if you try to change a med order without consulting the physician you are going to get chewed out. The only time a pharmacist can change an order is if there is a protocol in place or they consult the attending. I have refused to fill plenty of orders that I felt would hurt the patient, that's not my point. My point was that as a pharmacist you can only change or start therapy by first consulting with the attending, unless there is a protocol already in place. Even when there is a protocol you will still run into physicians that want to be consulted prior to changing an order.
Also, are you a pharmacist???? If you are not a pharmacist then you do not understand what it means to be a pharmacist. I have been a tech, an intern, and a pharmacist and I know what each job entails. I also thought I knew what it was to be a pharmacist as an intern, but you do not know what it is like until you are in licensed. My point was that if you are interested in having autonomy to make decisions on your own regarding patient care then you should consider becoming a PA, NP, or physician.

P.S. the physician is always in charge of patient care. You can consult and make recommendations, but never forget that the pecking order is physician then pharmacist..

 

[Skrumpy]

My input in bold:

The ultimate goal is to enhance patient outcomes.

Agreed.

I am not saying that physicians are popping in and telling pharmacists how to do their job;

You said as a pharmacist you have "NOOOOOOOOOOOOOOOOOO autonomy!!!" Which is incorrect. Perhaps you need to familiarize yourself with the word: freedom to determine one's own actions, behavior, etc. Pharmacists are in charge of the pharmacies, they help develop the protocols, decide the formulary used, manage technicians, advise physicians, counsel patients, etc. Are physicians involved? Of course. There are also discussions with nursing, techs, etc. Nothing happens in a bubble. To claim that there is no autonomy is rather ridiculous. Do pharmacists have free reign to do whatever they please? No and neither do physicians. Everyone is beholden to someone. Interns to their attending, the attending to the department chairman, the chairman to the chief of staff, then the medical director, then the CEO, President, Board, etc, ad nauseum.. If you can't deal with being "managed" by someone else then I hope you are the person in Florida who just won the 600 million powerball because that is the only way that is happening.

If you try to change a med order without consulting the physician you are going to get chewed out. The only time a pharmacist can change an order is if there is a protocol in place or they consult the attending. I have refused to fill plenty of orders that I felt would hurt the patient, that's not my point. My point was that as a pharmacist you can only change or start therapy by first consulting with the attending, unless there is a protocol already in place. Even when there is a protocol you will still run into physicians that want to be consulted prior to changing an order.

I have seen this happen maybe once in the nearly 20,000 hours I've worked in a hospital pharmacy. Maybe it is different since we are a teaching hospital and have more communication at every level of patient care? Our pharmacists are the ones who directly enter the medication orders on COWs (Computers on Wheels) while they are on rounds with the multidisciplinary team. The physicians ask them what meds they should go with and whether or not they should stop/continue a med. Everyone gets input, including the nurse handling that patient. They often will also ask pharmacy and med interns, who are usually present on rounds, for their opinions as well (more so of course to engage them). Our decentral pharmacists sit in the same rooms as the physicians (in multidiciplinary rooms) on each floor so there is no need for a physician to call a pharmacist up and "yell" at them as they just need to look to their left/right and see them sitting right there next to them.

Also, are you a pharmacist???? If you are not a pharmacist then you do not understand what it means to be a pharmacist. I have been a tech, an intern, and a pharmacist and I know what each job entails. I also thought I knew what it was to be a pharmacist as an intern, but you do not know what it is like until you are in licensed. My point was that if you are interested in having autonomy to make decisions on your own regarding patient care then you should consider becoming a PA, NP, or physician.

Yes, yes, I'm also not a black man, a woman, or a gay white male and therefore will never be able to understand their plights either. I've been in pharmacy for 15 years now and while I never will claim that I know everything, I feel that I have a fairly good insight as to its inner workings. Not only that, I have a great knowledge base in the 50 pharmacists I work with currently and in those I have worked with in the past. Prior to applying (and getting into) pharmacy school I asked questions regarding that aspect of the job. Either you are grossly over exaggerating it on your end, or our hospital and sister hospitals are really that much different from yours (a distinct possibility). You claim only pharmacists can know what it is like to be a pharmacist yet are rather free with your commentary on how much autonomy PAs and NPs have when you are neither a NP or PA. I've shadowed a hospital PA and the amount of autonomy they have amounts to close to nil, you are quite literally the physician's grunt worker. I know this is different in some clinics and probably different in other hospitals, but that is my personal experience.


P.S. the physician is always in charge of patient care. You can consult and make recommendations, but never forget that the pecking order is physician then pharmacist..

Maybe you've been out of school for awhile and lost touch on the direction things are moving now.. or maybe our state is alone in the direction they are moving with healthcare. At our University, pharmacy and med students have some of the same courses together and med students interact/work with nursing students early on in their curriculum. This is to reinforce the team aspect that is utilized throughout our hospital system (which is associated with the school). As far as work flow, I'm not going to argue that there isn't a physician who acts as the "team leader" but if this person went rogue and tried to go against the recommendations of the other physicians, pharmacists, nurses, etc, on the team.. they wouldn't be working at our hospital for very long. The egos do exist (we all have one after all) as do the occasional office politics, but as I said before I do not see the dire situation you so vividly paint as everyday hospital life.

 

[Pharmdmba1978]

My input in bold:

After you have become a pharmacist we will continue this discussion..

 

[Skrumpy]

After you have become a pharmacist we will continue this discussion..

Nice deflection! Bravo. Honestly, did not see that coming at all. Well done.

 

[Pharmdmba1978]

Nice deflection! Bravo. Honestly, did not see that coming at all. Well done.

The point of this thread was to answer a question regarding becoming a PA or pharmacist. Our argument was not accomplishing anything. We will have to agree to disagree. On a side note congratulations on your acceptance to pharmacy school. I believe that you will find pharmacy school both challeging and rewarding.

 

[Skrumpy]

The point of this thread was to answer a question regarding becoming a PA or pharmacist. Our argument was not accomplishing anything. We will have to agree to disagree. On a side note congratulations on your acceptance to pharmacy school. I believe that you will find pharmacy school both challeging and rewarding.

My question is what benefit are you gleaning from becoming a DPM? From some very cursory research, I've found that they get paid only slightly more than pharmacists and you are going to incur quite a bit more debt in the process. Also orthopedic surgeons can do the same surgeries some DPMs can, yet will get paid 2-3 times more. Just curious, on your choice and what prompted the switch (besides your obvious disdain for the treatment of pharmacists)?