what do PA's do when they start getting older?

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Lawgiver

Lawgiver

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How many 60 year old male PA's are there running around the hospital? My main issue with PA route is the well, the title. Sucks but if you all think im alone in feeling this way you are very wrong.

one example: http://www.afppa.org/index.php?opti...to-associate&catid=3:general-public&Itemid=11

It just seems like too much of an ego hit. Also, im already in my early 30's so part of me thinks going the full med route, probably DO is the only option my future 60 year self will approve of.

But part of me thinks PA is great and I shouldn't let title stop me.
 
go DO. better long term options if you are just starting out.
I'm not 60, but work with several PAs who are. These guys are highly respected( they don't stick around at places that don't treat them well). A few are basically treated as attendings because after 40 years working in EM they have "been there, done that" a lot of the time when newer docs have not. I aspire to be one of these guys in time and am working my way into jobs that will treat me that way.
PS: I NEVER use the word "assistant". It's not on anything that identifies me including my CV, scripts, business cards, etc. They all say " Emergency Medicine PA"
 
If the title bothers you, you have bigger issues with the profession than worrying about what you'll be doing at 60.
 
primadonna22274 said:
I decided at 35 that I could not continue to be a dependent provider at 50. Graduated med school at 40. Poorer but happier.
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I decided at 40 that I didn't want to be treated like a dependent provider so switched jobs to places that let me work alone and/or didn't treat me like one...🙂
 
They regret they became PAs
 
Interesting thoughts. I've had "60-year old" physicians encourage me to become a PA over MD/DO. They tell me had the PA's role looked back when they were in training the way it does now, they would have become PA's. The reason I transitioned my AAMCAS application to CASPA this cycle was because of this, and the third year FM resident who told me he would do anything he could to talk me out of going to medical school because, "Clinically, PA's can and do everything I do."

I've been quite surprised to see just how many people on these forums take issue with not having the prestige and "respect" that physicians do--or worry about not having that. That is such a #firstworldproblem. For me, if I get to go to my first choice PA program, I will finish training in two years, with <$40,000 in debt, and will take a job making $90,000+ out of the gate (I could go and work with a hospital CEO buddy of mine where he is paying his PA's $130,000 with 8 weeks PTO). That's pretty-damn-great, if I do say so myself.

But it's not for everyone. For me, embracing the reality of just how good this is was how I made the decision to apply to PA programs over medical schools. I think my 60-year-old self will look back and appreciate how wise that decision was.
 
Lawgiver said:
I did some digging:

Age Group Number Percent (2013, Certified PAs)
<30 16,710 17.5%
30-39 34,757 36.4%
40-49 22,173 23.2%
50-59 14,687 15.4%
60+ 7,256 7.6%
TOTAL 95,583 100.0%

http://www.nccpa.net/Upload/PDFs/20...sicianAssistants-AnAnnualReportoftheNCCPA.pdf (page 9)


Contrast that with Physicians (2012, Active License) :

<40, 22.2%
40-49, 24.6%
50-59, 24.5%
60+, 26.3%

https://www.fsmb.org/Media/Default/PDF/Census/census.pdf (page 16)

Sort of what I expected. PA is not an old persons game.
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the reason there aren't a lot of PAs > 60 yrs of age is that there were not a lot of pa programs 40 years ago. when I went to PA school in the early 90s there were only 52 programs. now there are >180. 20 years from now today's 40-49 yr olds will be > 20% of all PAs. the profession is still so new that > 50% of PAs have been in practice less than 10 years.
 
Good perspective. Thx.
 
Agree with E, and consider the first PAs (all 3 of them) graduated from Duke in 1967. The profession didn't really take off until the 80s and exploded in the 90s. It's a young profession.
Part and parcel of the growing pains of this young profession is to figure out how to grow up as PAs. I grew out of being a PA and am grateful I went back to med school--but most can't and won't do that. I would like to see an avenue for these folks to grow into an expanded role--but I didn't want to wait around for one myself.
 
I'm about 10 years older so the idea of switching later on is not an option. If I was 22 I would likely do pa as there would be plenty of time to switch later if not happy. If now there was option I was guaranteed a spot in med school after successfully graduating and say working a minimum of 1 year as pa I'd jump on that too.
 
My advice, as someone who's done both, is that if you suspect you will be unfulfilled as a PA and wish you had just sucked it up later and gone to med school you should do that. I didn't go to med school in my 20s, mostly because I didn't know that I could. I had no mentors. I had nobody encouraging me that I was smart enough. There were no doctors in my family. And quite frankly the whole process seemed daunting without somebody offering wise guidance. It wasn't until I was 2 wk into my first PA job when my supervising physician sat me down and said "you're wasting your talent--you need to go to med school"--that I seriously started to contemplate it. It took me 14 years but she sat very proudly with my family at my med school graduation. I will always be grateful to her for seeing what I could not see.
You gotta make your own decision, but really, it's not as easy as a financial balance sheet or a friend's wistful recollection of what he or she would do now if he or she could do it all over again.
 
Lawgiver said:
How many 60 year old male PA's are there running around the hospital? My main issue with PA route is the well, the title. Sucks but if you all think im alone in feeling this way you are very wrong.

one example: http://www.afppa.org/index.php?opti...to-associate&catid=3:general-public&Itemid=11

It just seems like too much of an ego hit. Also, im already in my early 30's so part of me thinks going the full med route, probably DO is the only option my future 60 year self will approve of.

But part of me thinks PA is great and I shouldn't let title stop me.
Click to expand...
I think PA is great for someone who wants to treat patients and get compensated well... Most patients don't mind that you are a PA, but you occasionally get some who want to be seen by physicians. It's a weird feeling... I have seen that a few times... PA/NPs were ready to examine patients and patients said NO once they know you are NP/PA... Very awkward stuff! That was one of the reasons I decided to go MD/DO after being a RT for a few years... Also, I want to be the expert on whatever specialty I am going into.
 
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didymus said:
Interesting thoughts. I've had "60-year old" physicians encourage me to become a PA over MD/DO. They tell me had the PA's role looked back when they were in training the way it does now, they would have become PA's. The reason I transitioned my AAMCAS application to CASPA this cycle was because of this, and the third year FM resident who told me he would do anything he could to talk me out of going to medical school because, "Clinically, PA's can and do everything I do."

I've been quite surprised to see just how many people on these forums take issue with not having the prestige and "respect" that physicians do--or worry about not having that. That is such a #firstworldproblem. For me, if I get to go to my first choice PA program, I will finish training in two years, with <$40,000 in debt, and will take a job making $90,000+ out of the gate (I could go and work with a hospital CEO buddy of mine where he is paying his PA's $130,000 with 8 weeks PTO). That's pretty-damn-great, if I do say so myself.

But it's not for everyone. For me, embracing the reality of just how good this is was how I made the decision to apply to PA programs over medical schools. I think my 60-year-old self will look back and appreciate how wise that decision was.
Click to expand...
Your debt will be so low because you might be going to do your PA in a state school. However, most PA schools are private and they are as expensive as med school except it's 2(1/2) years... Also, most PA don't start out making 100k+ -- it's more like 70K. Also, one thing people should pay attention to is PA school expansion--it's getting crazy!
 
most new grads start in the 78-85k range. the avg pa with at least 1 year of experience makes around 91k as of the last aapa salary survey with folks in derm, ortho, neurosurg, CT surg, and emergency medicine making considerably more. we just hired a bunch of new grads with significant prior experience(navy corpsman, ER techs, etc) at > 100k/yr in em
 
didymus said:
Interesting thoughts. I've had "60-year old" physicians encourage me to become a PA over MD/DO. They tell me had the PA's role looked back when they were in training the way it does now, they would have become PA's. The reason I transitioned my AAMCAS application to CASPA this cycle was because of this, and the third year FM resident who told me he would do anything he could to talk me out of going to medical school because, "Clinically, PA's can and do everything I do."

I've been quite surprised to see just how many people on these forums take issue with not having the prestige and "respect" that physicians do--or worry about not having that. That is such a #firstworldproblem. For me, if I get to go to my first choice PA program, I will finish training in two years, with <$40,000 in debt, and will take a job making $90,000+ out of the gate (I could go and work with a hospital CEO buddy of mine where he is paying his PA's $130,000 with 8 weeks PTO). That's pretty-damn-great, if I do say so myself.

But it's not for everyone. For me, embracing the reality of just how good this is was how I made the decision to apply to PA programs over medical schools. I think my 60-year-old self will look back and appreciate how wise that decision was.
Click to expand...

I will just say that your post is a good one but the resident that told you a PA can do EVERYTHING clinically they can is a bit off the mark unless he is one of the timid( can't think of a better word) FPs that tend to over consult, scared of full scope fm etc...

I am not bashing your friend but I know what a good full scope FP is worth. That's like me saying I could do everything as an EM PA that my EM docs could do. I could do a lot but I won't say everything.
 
Makati2008 said:
I will just say that your post is a good one but the resident that told you a PA can do EVERYTHING clinically they can is a bit off the mark unless he is one of the timid( can't think of a better word) FPs that tend to over consult, scared of full scope fm etc...

I am not bashing your friend but I know what a good full scope FP is worth. That's like me saying I could do everything as an EM PA that my EM docs could do. I could do a lot but I won't say everything.
Click to expand...

He is a bit timid, you're right--and I'm not naive enough to think a PA can do everything a physician can do in any setting. I'm married to a FM doc and I worked as an executive-level administrator in a primary care setting, so I have a good idea as to the scope of both; mostly I was highlighting that what he offered as his opinion contributed to tipping me over the edge in switching last minute to apply PA instead of MD/DO. I think what was compelling to me about what he said was the point that--in his opinion--there wasn't a substantial enough difference between a primary care PA and a primary care physician to justify the extra training and debt incurred to become an MD/DO (he happens to be a DO).

That said, the buddy I mentioned before who is a hospital CEO in a smaller regional community has his PA's doing a ton of stuff. They are staffing the ER independently (docs on call in case of major trauma coming through), assisting with deliveries, working inpatient and outpatient, and seeing patients in longterm care. The scope in that setting--as well as the salary and benefits--is incredible for PA's. Since that is the setting I am interested in (along with overseas healthcare delivery), training as a PA was an expeditious and pragmatic choice.

I won't claim everyone is in the same situation I am, or has the same aspirations; for others, then, being a physician is the only route that will suffice. I'm cool with that.
 
primadonna22274 said:
First world programs like respect and scope of practice do tend to grate on you after several years of PA practice. But hey, there are plenty of happy PAs out there. Hope you can be one of them.
Click to expand...

You are absolutely correct. I'm not there myself, so I cannot comment on how that feels, but I can imagine it to be quite demoralizing. All paths come pre-packaged with their own unique challenges (and some common ones, too), and we must each decide what we are willing to put up with and for how long. Not like it matters, but I think it's pretty awesome that you made a big sacrifice, leaving your career of a number of years, went to and finished medical school. Seriously, that rocks!
 
Makati2008 said:
Keep it professional. Further comments such as these will lead to infractions.
Click to expand...

Now, why was that an unprofessional comment? It certainly could be true that they could regret becoming PAs at that age.
 
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As an experienced RN, I am frequently asked why not NP/PA. Scope, independence, and the desire for the most rigorous clinical education available to me so that I can offer the most to my patients. That is not to disrespect the valuable role of the NP/PA in the least. But having worked this long in a profession dependent upon another, I've found that I don't like it one bit and I can't see going back to school just to stay in the same situation.

Many physicians see the greener grass on the PA side, but if they actually were able to cross that fence, they would be pining for the MD/DO instead. The grass is greener where you water it. The physician has the option to change their conditions of practice so that they do have less money and more time... and if they were sincere in their preference for PA, they would. Rather, it is a nice thing to talk about wistfully while continuing to work themselves silly. They can't cut back on their responsibilities, not because that option isn't available to them, but because they aren't constitutionally suited to do so. It is just more comfortable to outsource that blame to externalities.

As for why there are fewer 60+ PAs than MD/DOs, recall that posessing a license is not the same as practicing. A physician is more likely to teach or do research well into retirement from clinical practice, and may wish to retain their licensure purely for reasons of pride, long after they stop seeing patients. I would think that PA's are more likely to stop paying licensure fees after retirement... and to be able to afford to retire early enough that the 60+ group would shrink pretty quickly.
 
Promethean said:
As an experienced RN, I am frequently asked why not NP/PA. Scope, independence, and the desire for the most rigorous clinical education available to me so that I can offer the most to my patients. That is not to disrespect the valuable role of the NP/PA in the least. But having worked this long in a profession dependent upon another, I've found that I don't like it one bit and I can't see going back to school just to stay in the same situation.

Many physicians see the greener grass on the PA side, but if they actually were able to cross that fence, they would be pining for the MD/DO instead. The grass is greener where you water it. The physician has the option to change their conditions of practice so that they do have less money and more time... and if they were sincere in their preference for PA, they would. Rather, it is a nice thing to talk about wistfully while continuing to work themselves silly. They can't cut back on their responsibilities, not because that option isn't available to them, but because they aren't constitutionally suited to do so. It is just more comfortable to outsource that blame to externalities.

As for why there are fewer 60+ PAs than MD/DOs, recall that posessing a license is not the same as practicing. A physician is more likely to teach or do research well into retirement from clinical practice, and may wish to retain their licensure purely for reasons of pride, long after they stop seeing patients. I would think that PA's are more likely to stop paying licensure fees after retirement... and to be able to afford to retire early enough that the 60+ group would shrink pretty quickly.
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You explain it a lot better than I could... As a RT, I did not see myself going back to school and do something that will not give me widest scope of practice passible.
 
In reference to few of the responses thus far.

Earning starting out at that stipulated figure not a given. It's specialty dependent. Often time, it's base on years of experience until the salary glass ceiling hit.

The competition has double. The rising tuition and cost of attending is something to consider. Graduating at <40K debt, becoming very unlikely. A salary glass ceiling exist in the field unlike MD or DO.
 
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The PA salary glass ceiling obviously refers to normal hours. If you are willing to work crazy hours you can make bank. I work with a couple EM PAs who consistently work 60+ hrs/week and make over 200k/yr. I just don't want to work that hard all the time. I occasionally work crazy hours( this month right at 240 hrs), but prefer 180ish when I can manage it based on "the needs of the dept". Ideally I would be at 35-45 hrs/week, which would still have me working more than the vast majority of docs I work with who max out around 140 hrs/mo.
 
emedpa said:
The PA salary glass ceiling obviously refers to normal hours. If you are willing to work crazy hours you can make bank. I work with a couple EM PAs who consistently work 60+ hrs/week and make over 200k/yr. I just don't want to work that hard all the time. I occasionally work crazy hours( this month right at 240 hrs), but prefer 180ish when I can manage it based on "the needs of the dept". Ideally I would be at 35-45 hrs/week, which would still have me working more than the vast majority of docs I work with who max out around 140 hrs/mo.
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How is your salary compare to a doc's salary?
 
W19 said:
How is your salary compare to a doc's salary?
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Depends on setting and scope of practice. A residency trained/boarded EM doc makes 2-3x what an em pa can per hr.
An EMPA can make good money when working solo in small rural depts. $70-100/hr is the going rate for experienced EMPAs in these settings. A PA right out of school makes a lot less than that, more like $38-45/hr at most places.
At my first job after 10 years I was making a few bucks more/hr than the new FP docs right out of residency they hired to do the same work. after 3 yrs though, the docs became partners and quickly started making a lot more than even the senior PAs.
 
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