Where is the PA career going

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Tkirchme

Tkirchme
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Hello, I have a question not asked to often. I have not been able to stir up to much info so, here it goes. Where do you see the P.A. career field going in the future? And to clarrify, lets say in terms of practice abilities, such as, autonomy. I know the NPN are able to parctice seperate of a physician. Does any one with any knowledge on this subject see P.A.'s some day doing the same. I know the are now starting to intigrate doctorate P.A. programs, and they are obtaining more prescriptive authority in more and more states. Please any knowledgable response appreciated.

P.S. If I spelt anything wrong dont comment.

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pa's already have prescriptive rights in all 50 states and sch 2(same as md) in most..
there are only 2 doctorate pa programs now(if you don't count pa/pharmd of which there are 5 or 6). 1 is a military residency in conjunction with baylor, the other is a medical scientist research pa/phd program.(wake forest). pa will never go to an entry level doctorate although there will probably be more doctorate level residencies over the next decade.
pa is a top 3 job for the next decade on every forecast out there. the avg pa salary goes up every yr. when I entered the profession we thought 40k was a fair entry level salary. now it is around 80k+ in most fields with more in some.
pa autonomy is both earned and geographical. some states have great practice laws, some don't. a pa in NC needs to have a 30 min mtg with an md every 6 months. that is pretty close to independent practice.many states (including mine) allow pa's to staff er's without an md present and allow minimal to no chart review. my state requires an md have an "ongoing understanding of pa practice patterns". what this amounts to is the doc who relieves me in the morning asks how my solo night shift went. I don't see pa's ever completely disassociating themselves from md mentoring and collaboration. that is one thing(of many...) that sets us apart from np's- we work with md groups and don't compete directly with them like the np's do. even a pa who owns his own practice has to hire an md to meet the minimal supervision requirements.
any pa related issue is better asked at the pa forum www.physicianassistantforum.com where it will be seen by 20,000 pa's instead of the 10 who frequent here.
 
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I wonder what will happen to PA salary in the future if health care reform starts dropping MD salary. It is unlikely that a PA would make more than a physician in the same field because why would any hospital pay more for a PA if they could get a board certified MD for the same amount. Nothing against PAs but when the healthcare system starts squeezing salaries to cut costs PAs are going to get squeezed too.
 
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I wonder what will happen to PA salary in the future if health care reform starts dropping MD salary. It is unlikely that a PA would make more than a physician in the same field because why would any hospital pay more for a PA if they could get a board certified MD for the same amount. Nothing against PAs but when the healthcare system starts squeezing salaries to cut costs PAs are going to get squeezed too.
yes, a doc will always make more than a pa in the same field but when some administrator realizes 1 doc can supervise 4 pa's for the price of 3 docs total(including the 1 md) guess who gets laid off...not the pa's.....job security comes with a price...and that price is a lower salary....I have seen it happen....I used to work for a group that stopped using moonlighting residents and hired about a dozen full time pa's because we were cheaper and more efficient than a new resident every shift....at the time the residents were getting 60/hr and the pa's got around 30/hr.
at my current job we stopped staffing docs on nights and now only staff pa's at night...same reasoning....we staff pa's 24/7 and only have docs on days...good lifestyle for the remaining docs but we lost several docs in the process...
 
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pa autonomy is both earned and geographical. some states have great practice laws, some don't. a pa in NC needs to have a 30 min mtg with an md every 6 months. that is pretty close to independent practice.many states (including mine) allow pa's to staff er's without an md present and allow minimal to no chart review. my state requires an md have an "ongoing understanding of pa practice patterns". what this amounts to is the doc who relieves me in the morning asks how my solo night shift went. I don't see pa's ever completely disassociating themselves from md mentoring and collaboration. that is one thing(of many...)

"my state requires an md have an "ongoing understanding of pa practice patterns". what this amounts to is the doc who relieves me in the morning asks how my solo night shift went."

&

"a pa in NC needs to have a 30 min mtg with an md every 6 months"

don't really seem like PAs are associating themselves with MD mentoring and collaboration.

that sets us apart from np's- we work with md groups and don't compete directly with them like the np's do. even a pa who owns his own practice has to hire an md to meet the minimal supervision requirements.

"when some administrator realizes 1 doc can supervise 4 pa's for the price of 3 docs total(including the 1 md) guess who gets laid off...not the pa's.....job security comes with a price"

&

"at my current job we stopped staffing docs on nights and now only staff pa's at night...same reasoning....we staff pa's 24/7 and only have docs on days...good lifestyle for the remaining docs but we lost several docs in the process..."

I guess PAs do compete with MDs.

Why hire 5 MDs, when they can hire one MD to provide superficial supervision on 5 PAs?

yes, a doc will always make more than a pa in the same field but when some administrator realizes 1 doc can supervise 4 pa's for the price of 3 docs total(including the 1 md) guess who gets laid off...not the pa's.....job security comes with a price...and that price is a lower salary....I have seen it happen....I used to work for a group that stopped using moonlighting residents and hired about a dozen full time pa's because we were cheaper and more efficient than a new resident every shift....at the time the residents were getting 60/hr and the pa's got around 30/hr.
at my current job we stopped staffing docs on nights and now only staff pa's at night...same reasoning....we staff pa's 24/7 and only have docs on days...good lifestyle for the remaining docs but we lost several docs in the process...

Some physicians prefer NPs because they're of less liability to them due to the whole "independence" and "collaboration" approach. NPs can help physicians make a lot of money too.

If PA screws up big time and the supervising physician doesn't notice, guess who's career is on the line? Maybe both?
 
^^^ This is why I rarely visit SDN. Every thread turns into a PA/NP/DO/MD pissing match.
 
"I guess PAs do compete with MDs. "-dnpdr



actually pa's make md lead groups run more efficiently. it wasn't the pa's who decided to replace docs with pa's...it was other docs....docs who knew how to save money without changing pt outcomes....and no one was fired...when docs left they were simply replaced with pa's.
 
pa is a top 3 job for the next decade on every forecast out there. the avg pa salary goes up every yr. when I entered the profession we thought 40k was a fair entry level salary. now it is around 80k+ in most fields with more in some.

That should be cause for ALARM for any student. Saturation seems to be the theme for healthcare professions in general lately. Ask anyone if they think nursing (for instance) is a wide-open job and they'll probably say yes. Ask a nurse who is trying to FIND a job and they'll laugh in your face. Same for pharmacists, optometrists, etc. In tough economic times people look for those "top careers" and then fill them the heck up. It's not that the need stops existing, either...it's a combination of more students entering a given profession plus cutbacks in who will hire new grads (or more expensive, experienced people) in a crappy economy.
 
That should be cause for ALARM for any student. Saturation seems to be the theme for healthcare professions in general lately. Ask anyone if they think nursing (for instance) is a wide-open job and they'll probably say yes. Ask a nurse who is trying to FIND a job and they'll laugh in your face. Same for pharmacists, optometrists, etc. In tough economic times people look for those "top careers" and then fill them the heck up. It's not that the need stops existing, either...it's a combination of more students entering a given profession plus cutbacks in who will hire new grads (or more expensive, experienced people) in a crappy economy.

The thing that keeps the market saturation in check is not the number of people applying, it is the slots available per program. It does not matter if everyone in your city has "taken all thier pre-reqs" and applying, the number of slots is what you get. For instance the waitlist for the nursing program in my state is about 18 months on average, AFTER you finish your 2 years of pre-reqs... open the floodgate of people willing to hop on the health care ban wagon... it wont matter.
 
The thing that keeps the market saturation in check is not the number of people applying, it is the slots available per program. It does not matter if everyone in your city has "taken all thier pre-reqs" and applying, the number of slots is what you get. For instance the waitlist for the nursing program in my state is about 18 months on average, AFTER you finish your 2 years of pre-reqs... open the floodgate of people willing to hop on the health care ban wagon... it wont matter.

http://www.arc-pa.org/acc_programs/

I went down the list and counted 19 programs that have opened since 2004 (using the "Date first accredited" column)...and don't forget that PAs compete directly with NPs for many spots, and NP programs with lesser standards are blossoming all over the place. Both programs that require an RN and direct entry programs.

I'm not a PA so maybe I'm talking out of my arse here, but I'd still be wary of the numbers if I were the OP. Especially if this recession lingers. The erroneous assumption that healthcare jobs are "recession-proof" is SO prevelant. And if there are people applying, more programs will open. Everyone sees dollar signs.
 
I'm not a PA so maybe I'm talking out of my arse here, but I'd still be wary of the numbers if I were the OP. Especially if this recession lingers. The erroneous assumption that healthcare jobs are "recession-proof" is SO prevelant. And if there are people applying, more programs will open. Everyone sees dollar signs.


I know it worries me. PA schools are cropping up right and left. Still, I think it'll be a decade or two before we see true saturation so I guess I'd better save my pennies now.
 
Hey Morning! I would worry if the population of the earth would remain constant, if the baby boomers would stop aging and take thier vitamins, ...and if the diabetes / obesity epidemic will be cured by "Wii Fit". On top of all listed above (that isn't going to happen) we are still facing a shortage in providers. In my state there are less than 2 Physicians per 100 people. Not to mention the MD/DO private practices that are turning down medicare / medicaid recipients. Maybe there are certain areas that will be saturated, like Florida... but on a whole you will be able to practice somewhere. If you are just dead set on getting that Florida tan... then buy a timeshare and a tanning bed using the bonus you get from practicing in an underserved area. There are places in my state where there is no medical providers at all, and they would welcome any one who would practice there. If you think the PA profession is on shaky ground and may take a financial dive, then maybe it is not for you. The original PA's that fought for our salary rights made around 16,000 a year back in the 70's... if you think after 40+ years of steady gain that it will just dwindle to EMT salary because there are "too many programs" then so be it... all the people following the dollars will leave and the market will correct itself. I will still be practicing whether I make 60 and hour or 20 an hour.
 
Hey Morning! I would worry if the population of the earth would remain constant, if the baby boomers would stop aging and take thier vitamins, ...and if the diabetes / obesity epidemic will be cured by "Wii Fit". On top of all listed above (that isn't going to happen) we are still facing a shortage in providers. In my state there are less than 2 Physicians per 100 people. Not to mention the MD/DO private practices that are turning down medicare / medicaid recipients. Maybe there are certain areas that will be saturated, like Florida... but on a whole you will be able to practice somewhere. If you are just dead set on getting that Florida tan... then buy a timeshare and a tanning bed using the bonus you get from practicing in an underserved area. There are places in my state where there is no medical providers at all, and they would welcome any one who would practice there. If you think the PA profession is on shaky ground and may take a financial dive, then maybe it is not for you. The original PA's that fought for our salary rights made around 16,000 a year back in the 70's... if you think after 40+ years of steady gain that it will just dwindle to EMT salary because there are "too many programs" then so be it... all the people following the dollars will leave and the market will correct itself. I will still be practicing whether I make 60 and hour or 20 an hour.

The bold is correct. It is going to be quite a long time before this country has enough health professionals to deal with the spike of our population that will be over 65.

Morning- As far as the nursing "shortage." Your right that some parts of the country have enough nurses. However, other parts are dying for them, and overall, we still need them.

I think it would take quite a few more PA schools to open up before they are no longer needed.
 
Hey Morning! I would worry if the population of the earth would remain constant, if the baby boomers would stop aging and take thier vitamins, ...and if the diabetes / obesity epidemic will be cured by "Wii Fit". On top of all listed above (that isn't going to happen) we are still facing a shortage in providers. In my state there are less than 2 Physicians per 100 people. Not to mention the MD/DO private practices that are turning down medicare / medicaid recipients. Maybe there are certain areas that will be saturated, like Florida... but on a whole you will be able to practice somewhere. If you are just dead set on getting that Florida tan... then buy a timeshare and a tanning bed using the bonus you get from practicing in an underserved area. There are places in my state where there is no medical providers at all, and they would welcome any one who would practice there. If you think the PA profession is on shaky ground and may take a financial dive, then maybe it is not for you. The original PA's that fought for our salary rights made around 16,000 a year back in the 70's... if you think after 40+ years of steady gain that it will just dwindle to EMT salary because there are "too many programs" then so be it... all the people following the dollars will leave and the market will correct itself. I will still be practicing whether I make 60 and hour or 20 an hour.

I certainly hope that the PA market DOESN'T become saturated, but you're still competing with NPs and they are opening new programs like crazy.

I also don't want to diminish the ability of PAs to fight for their salaries, but 16k in 1975 is equal to 65k now. Still a very good increase!

In 1975, schoolteachers made 12k a year... http://www.jstor.org/pss/20298648
 
At the last AMA meeting, in a poll asking whether practicing physicians would rather hire a PA or NP, the PAs won something like 98% to 2%. The physician assistant profesion is here to stay and market is nowhere near saturated.

PAs are seeing good representation in every specialty but the ability to move from specialty to specialty is a huge selling point for PA. I have three PAs in my vascular surgery practice and will likely hire a couple more (would never consider NPs) once my research lab is up and running as the PAs who work with us (the attendings) give us more time to teach residents and medical students along with more time for our research.
 
This is all personal opinion here but if I was very ill and needed to see a health professional I would want to see them in this order:

MD/DO, PA, NP, RN

This is based on my own personal patient experience over the years with the various medical problems I have had. Nurse Practitioners are nice and I can see following up with them, but I just don't think they have the know how and medical science understanding to diagnosis and treat properly like a PA and to a even greater extent, MD/DO do.

Just my two cents!

I am seriously thinking of going to PA school in 3 or 4 years from now, once I get my spine troubles fixed and possibly improve my GPA by doing a post-bac or more undergraduate courses.
 
there are some smart np's out there and some not so smart pa's. A LOT of it depends on the individual. I work with an np who does infectious dz who I would see over most docs if I had a problem in their area of expertise.
 
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