Why do people recommend PA to medical students and premeds?

[libertyyne]

The few studies I’ve read have shown that they order more tests, consult more, and in some cases prescribe more abx (though I’ve seen some studies that don’t show that last one). I’ve seen a few that show equivalent care is only there when compared to physicians with higher acuity and larger patient loads.

Anecdotally, I have seen midlevels perform well when patients are relatively straightforward, but they typically find themselves out of their element when things get more complicated or atypical. Which makes sense given the gap in knowledge.

I really just don’t get how anyone would trust someone with a quarter of the training to do the same job independently.

23 states have. If you are an NP opening up shop in any of those states you do not need to have supervision. I would see some adverse outcomes if what you say is true, insurers would be pissed that they are paying more for unnecessary tests and not contract with NPs, malpractice rates would go through the roof for them. Hasnt happened, not a peep.

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[Matthew9Thirtyfive]

23 states have. If you are an NP opening up shop in any of those states you do not need to have supervision. I would see some adverse outcomes if what you say is true, insurers would be pissed that they are paying more malpractice rates would go through the roof for them.

Just because something is allowed to occur doesn’t mean it should. I know midlevels have independent practice in some states. I’ve worked with them in one of those states. It is scary having seen how quickly they can be overwhelmed and knowing there is not a physician safety net. And this is coming from someone with that experience (not that that means anything, but I do know what it feels like to have that knowledge gap but have to care for patients).

 

[W19]

Even if they arent very good, People should be able to do good studies now considering complete autonomy in many states over the past decade. Plus if the effect size is soo large it should become obvious even in not great studies.

That has happened in rural hospitals and I am yet to see any studies indicating that they are killing people left and right.

Plus insurance premiums should also going through the roof for NPs if this was truely the case. We have too many checkpoints with little to show at this point in terms of superiority besides pointing towards training. But does the training even matter if there are no outcome differences.

For outpatient FM, that might be the case... I don't think you want NP/PA managing inpatient patients in ICU, telemetry etc... with multiple comorbidities... There are some studies that show they order a lot more test.

 

[libertyyne]

Just because something is allowed to occur doesn’t mean it should. I know midlevels have independent practice in some states. I’ve worked with them in one of those states. It is scary having seen how quickly they can be overwhelmed and knowing there is not a physician safety net. And this is coming from someone with that experience.

I am not arguing if it is right or not. You would think that such incidents would lead to statistically significant poorer outcomes and be able to be shown.

 

[Matthew9Thirtyfive]

For outpatient FM, that might be the case... I don't think you want NP/PA managing inpatient patients in ICU, telemetry etc... with multiple comorbidities... There are studies that show they order a lot more test.

I don’t want a midlevel managing anything more than sick call type stuff.

 

[libertyyne]

I don’t want a midlevel managing anything more than sick call type stuff.

I agree, but thats not the reality we live in. The cat is out of the bag. Need to show clear superiority in outcomes if any headway is to made in stuffing it back in place.

 

[Matthew9Thirtyfive]

I am not arguing if it is right or not. You would think that such incidents would lead to statistically significant poorer outcomes and be able to be shown.

In some cases they are, but unfortunately mistakes made in managing chronic conditions may not have long term consequences if caught early enough, or at all if they are fixed.

 

[libertyyne]

In some cases they are, but unfortunately mistakes made in managing chronic conditions may not have long term consequences if caught early enough, or at all if they are fixed.

These things should be able to be shown. Insurer's and malpractice insurers are not completely stupid. If excess testing, disability, or claims were being made the would refuse to contract with them.

 

[Matthew9Thirtyfive]

I agree, but thats not the reality we live in. The cat is out of the bag. Need to show clear superiority in outcomes if any headway is to made in stuffing it back in place.

It’s not likely to be going back in. And unfortunately, the differences are really only going to be immediately noticeable in a minority of cases, which the nursing lobby will just brush under the rug as zebras that shouldn’t take away from their ability to practice independently.

 

[Matthew9Thirtyfive]

These things should be able to be shown. Insurer's and malpractice insurers are not completely stupid. If excess testing, disability, or claims were being made the would refuse to contract with them.

Don’t they only reimburse midlevels like 85%? I’m betting that compensates. And while I’m sure they have power, obviously the nursing lobby has it too.

 

[rlbk]

What PA school takes failed out medical students?

Because any PA school that is accredited (not new, probationary etc)

When i left medical school i contacted all the PA schools and they all said the same thing SORRY

Plus most PA schools need a GRE score and will NOT take my passing Step 1 score

So PA schools want me to take the MCAT despite passing Step 1, is that a joke?

Talk about defeat? Let's talk about being realistic. Even 1 year BSN nursing programs wont even LOOK at my Step 1 score as part of my application.

Also speaking about a job, i worked as a vet tech at two different hospitals because of the MUCH higher pay than EMT/Scribe work. That's how i supported myself.

Also I failed out in 2008 and took time off, went to the Carribean AND THEN passed Step 1 in 2018 ten years later. That is also a huge problem with my application according to the countless advisors I have spoken with. That is a HUGE issue as all my science courses were taken when I was in my first two years of undergrad (transferred tons of credits from night classes i took in high school and from AP classes). Many PA/Accelerated BSN/Pharm schools want me to retake basic bio, ochem, physics, and even calculus. Ive proven my knowledge in medicine with my passing Step 1 score yet this is ignored.

The only schools that would even consider me are the non-accredited brand new schools or those schools under probationary accred.

I am scared to put tons of money into PA school and then not be allowed to take the board exam or be forced to apply for a job from a school that no longer is accredited or even no longer accepts any new PA students.

Please suggest to me some schools that take failed medical students, if you dont want to say what school you go to please pm me

I am dead serious if it is an option and i can find a school that would take me I will do it.

I am not some bum I have been working my butt off to pay off my loans and refuse to study for the MCAT because Step 1 trumps the MCAT in all aspects. People that take the MCAT aspire to go to medical school, pass M1 and M2 AND THEN pass step 1.

Thanks

I can't speak for much of the country, but the PA programs in my state would absolutely not be eager to take a failed medical student. They don't really care that you got into med school in the first place. To them, it will look like you couldn't handle med school and in their eyes, there's a risk you wouldn't be able to handle PA school either. Plus, they typically prioritize their seats to students who WANT to be a PA. That was a huuuuge thing that was stressed in my interview. Spots are pretty competitive, at least where I'm from. Each program only has like 30-50 slots and the number of applicants per year is increasing at a high rate. Not to say you still couldn't get into PA school after failing med school, it could happen. I feel like you'd likely be on the wait list though. May also depend on if the PA program is within the same school as your MD/DO program. I could more likely see a PA program take a failed med student who was within the same university. (my university my PA program is part of does not have a med school, the university the med school in our area is from does not have a PA program)

 

[libertyyne]

It’s not likely to be going back in. And unfortunately, the differences are really only going to be immediately noticeable in a minority of cases, which the nursing lobby will just brush under the rug as zebras that shouldn’t take away from their ability to practice independently.

If that is the case, medical education should be blown up. Why does a PCP need 7 years when society says an NP can do it in 3 without rigorous science.

Don’t they only reimburse midlevels like 85%? I’m betting that compensates. And while I’m sure they have power, obviously the nursing lobby has it too.

this is not going to be true forever. They have been lobbying hard for 100% reimbursement.

 

[Matthew9Thirtyfive]

If that is the case, medical education should be blown up. Why does a PCP need 7 years when society says an NP can do it in 3

Because they can do it in 3 when things are simple. The extra 4 are for when they are not. I’ve seen the difference. Three years is not enough to practice independently.

this is not going to be true forever. They have been lobbying hard for 100% reimbursement.

I’m betting (hoping?) that for multiple reasons, if that happens, the midlevel expansion will implode.

 

[libertyyne]

Because they can do it in 3 when things are simple. The extra 4 are for when they are not. I’ve seen the difference. Three years is not enough to practice independently.



I’m betting (hoping?) that for multiple reasons, if that happens, the midlevel expansion will implode.

Yeah, but society doesnt care, and there is no clear data on the value add of the additional years.
I would like to think you are right, but it seems to be like they are aiming to switch all MSN programs to DNP by 2020 and peddle to the metal hard. They are creating one year residencies as well.

Why pay a doctor more when you can get one of the dozens of NPs now available for half the salary?

 

[rlbk]

I worked with PAs and docs both when I was scribing in the ED. You're absolutely right, that with experienced PAs, the docs trusted them to make the right decisions and usually only laid eyes on a PA patients once or twice in a shift - usually when the PA asked for another opinion and talked through the patient with the doc. However, the reason that it worked was because there are 2 very important categories of decisions that the PAs were being trusted to make, that you are leaving out: the decision of which patients to see, and the decision, rarely made but always important, of when the patient would benefit from having care transferred to the doc. Throw in 'when to double check a decision with the doc' for good measure.

When a fresh-out-of-school PA started training in our ED, the docs would look over her patients constantly, reading almost every chart at first. The learning curve for her was...steep, and at the beginning, she absolutely could not be trusted to make the right decisions, on any level. Same as people partway through their medical training, only ostensibly she was ready for practice, having finished PA requirements.

PAs are valuable and competent providers. However, they do not have all of the expertise of the docs and part of what makes a good PA is learning to recognize their strengths and limitations and where they best fit into the workflow of any given practice. You claim to recognize the difference between docs and PAs, but you speak as if ignoring that difference is what makes a good PA. It's not. It's accepting it. I'd advise working on that.

No I'm not ignoring that at all, I agree with what you said completely. As a newly graduated PA, I do not expect to be trusted to make the right decisions. I wouldn't feel confident in my own self enough at all! Not right away. I know docs will be keeping a close eye on my patients and I'd like that while I'm still new and still learning.
I'm referring to PAs who have at least a year of experience in said area under their belt. I have acknowledged this in previous posts if you've been following closely. I have also acknowledged several times now that PAs are trained to know damn well they won't have all of the expertise of their physician they're working with. It really isn't that difficult to understand. There will always be exceptions to the case in anything in life, that's a given. If there are some PAs out there that think they know just as much as the physician they work with, that speaks less about PAs as a profession and more about that person's own level of cockiness and delusions of grandeur lol.

Don't worry, I'm with ya.

 

[DO2015CA]

Even if they arent very good, People should be able to do good studies now considering complete autonomy in many states over the past decade. Plus if the effect size is soo large it should become obvious even in not great studies.

That has happened in rural hospitals and I am yet to see any studies indicating that they are killing people left and right.

Plus insurance premiums should also going through the roof for NPs if this was truely the case. We have too many checkpoints with little to show at this point in terms of superiority besides pointing towards training. But does the training even matter if there are no outcome differences.

Insurance companies are only going to increase the premium if midlevels are being sued. As of right now, their collaborators are the ones being sued because they are the bigger fish to fry. Once solo practitioners start getting sued, thats when you will see the insurance companies raise the rates.

"Congrats! they lived" shouldn't be the standard of care. Killing people isnt the only metric we should be using to establish competence. Referral patterns, imaging, tests ordered should all be factored in. If we can see this all equal then we can support expansion of their autonomy.

 

[libertyyne]

Insurance companies are only going to increase the premium if midlevels are being sued. As of right now, their collaborators are the ones being sued because they are the bigger fish to fry. Once solo practitioners start getting sued, thats when you will see the insurance companies raise the rates.

"Congrats! they lived" shouldn't be the standard of care. Killing people isnt the only metric we should be using to establish competence. Referral patterns, imaging, tests ordered should all be factored in. If we can see this all equal then we can support expansion of their autonomy.

You seem to be missing the point. They are practicing without collaborative agreements. This should result in the issues you are describing if the care was substandard.

Payors should be able to discern if independent NPs are in fact ordering excess testing and would have the option to not contract with them. If it is soo eggregious.

Congrats they lived is one metric, I would settle for any metric where superiority was shown in physicians. I am a pessimist so lets for a second assume that long term studies show up no superiority in physican vs midlevel outcomes for PCP, what then? Shouldnt we be blowing up our training model if no real benefit to patients is being derived from all the extra training ? Its not like the physicians are the only ones being screwed , we as a society are paying for residencies and subsidizing public medical schools and education.

 

[BorntobeDO?]

What PA school takes failed out medical students?

Because any PA school that is accredited (not new, probationary etc)

When i left medical school i contacted all the PA schools and they all said the same thing SORRY

Plus most PA schools need a GRE score and will NOT take my passing Step 1 score

So PA schools want me to take the MCAT despite passing Step 1, is that a joke?

Talk about defeat? Let's talk about being realistic. Even 1 year BSN nursing programs wont even LOOK at my Step 1 score as part of my application.

Also speaking about a job, i worked as a vet tech at two different hospitals because of the MUCH higher pay than EMT/Scribe work. That's how i supported myself.

Also I failed out in 2008 and took time off, went to the Carribean AND THEN passed Step 1 in 2018 ten years later. That is also a huge problem with my application according to the countless advisors I have spoken with. That is a HUGE issue as all my science courses were taken when I was in my first two years of undergrad (transferred tons of credits from night classes i took in high school and from AP classes). Many PA/Accelerated BSN/Pharm schools want me to retake basic bio, ochem, physics, and even calculus. Ive proven my knowledge in medicine with my passing Step 1 score yet this is ignored.

The only schools that would even consider me are the non-accredited brand new schools or those schools under probationary accred.

I am scared to put tons of money into PA school and then not be allowed to take the board exam or be forced to apply for a job from a school that no longer is accredited or even no longer accepts any new PA students.

Please suggest to me some schools that take failed medical students, if you dont want to say what school you go to please pm me

I am dead serious if it is an option and i can find a school that would take me I will do it.

I am not some bum I have been working my butt off to pay off my loans and refuse to study for the MCAT because Step 1 trumps the MCAT in all aspects. People that take the MCAT aspire to go to medical school, pass M1 and M2 AND THEN pass step 1.

Thanks

Dude the GRE is easy, just take it and kill it. Seriously why do you care whether they recognize step or not. And I guess I need to clarify whether you 'failed out' or withdrew. Because I am talking about students that withdrew. So you never took the MCAT either?

Why do you think these schools owe it to you to let you continue. Your attitude is the issue here over everything else IMO. You need to approach this from a whole new perspective. You should be saying things like 'I realize that while I enjoy medicine and want to practice it at some level, that at my age/life situation/w/e I feel that PA is a better fit. Also you should say 'I am not a person who needs the 'ego boost/recognition' that medical school provide, I just want to take care of people.'

But based on your posts here I don't think you can be helped till you change your attitude.

 

[rlbk]

No ones making up facts here bud. I said 3.4-3.5 which includes 3.40-3.59 if i wasnt clear enough. DO would be 3.50-3.69. There is overlap but how can you even compare PA and MD/DO admission. MD/DO requires more pre-reqs (usually additional upper-level sciences to be considered competitive with some schools even requiring this additional coursework), higher GPAs, and the MCAT (just this exam alone craps on PA admissions and makes attempting to even compare the rigor of the two admissions as equals completely laughable).

this is not entirely true.... after just comparing the pre-reqs for the MD school in my city, they have approximately 6 required courses. The PA school I attend has 11 required courses. The pre-reqs for PA school are notorious for being numerous and also having great variation from school to school.

You also need a pretty damn high GPA. Half of the students in my class (including myself) had a 4.0. There are a lot of highly intelligent students choosing PA school over med school in recent years, so even though a PA program may say they will accept you with a 3.4, you don't have a good chance. We don't have the MCAT or anything comparable to it. The biggest thing PA schools care about is your GPA because that's their only way to gauge your medical knowledge--how well you did in your medical/science-based courses. Patient care hours are important too, most schools require 1000+.

Overall, yeah applying to MD/DO is a more intense process because of the MCAT and that being the most important aspect of your application. Takes a **** ton of studying and prep. I give props to all of you who went through that stress lol.

 

[rlbk]

Dude the GRE is easy, just take it and kill it. Seriously why do you care whether they recognize step or not. And I guess I need to clarify whether you 'failed out' or withdrew. Because I am talking about students that withdrew. So you never took the MCAT either?

Why do you think these schools owe it to you to let you continue. Your attitude is the issue here over everything else IMO. You need to approach this from a whole new perspective. You should be saying things like 'I realize that while I enjoy medicine and want to practice it at some level, that at my age/life situation/w/e I feel that PA is a better fit. Also you should say 'I am not a person who needs the 'ego boost/recognition' that medical school provide, I just want to take care of people.'

But based on your posts here I don't think you can be helped till you change your attitude.

Agreed, the GRE is VERY easy. I didn't even prep for it at all and I did very well on it. Also having a high score doesn't even give you an edge because the GRE is just a technicality. As long as you get above whatever threshold a school requires that's really all you need.

Also I second BorntobeDO's statement. Your attitude and the way you choose to look at things is SO important and makes such a difference.

 

[W19]

You also need a pretty damn high GPA. Half of the students in my class (including myself) had a 4.0. There are a lot of highly intelligent students choosing PA school over med school in recent years, so even though a PA program may say they will accept you with a 3.4, you don't have a good chance. We don't have the MCAT or anything comparable to it. The biggest thing PA schools care about is your GPA because that's their only way to gauge your medical knowledge--how well you did in your medical/science-based courses. Patient care hours are important too, most schools require 1000+.

Overall, yeah applying to MD/DO is a more intense process because of the MCAT and that being the most important aspect of your application. Takes a **** ton of studying and prep. I give props to all of you who went through that stress lol.

You could have done it and your career prospect would have been much better. There are MD/DO who work 4o hrs/wk, make $$$ and have a life outside of medicine.

In all honesty, young people who do PA because it's shorter are ill advised IMO. You can work PA hrs as a MD/DO while making twice... A PA is kind of a resident forever who just make more $$$....

 

[Matthew9Thirtyfive]

Why pay a doctor more when you can get one of the dozens of NPs now available for half the salary?

Except they are already demanding equal reimbursement. Why would you pay the same for an inferior product? Why would you pay the same for someone with half the training?

 

[libertyyne]

Except they are already demanding equal reimbursement. Why would you pay the same for an inferior product? Why would you pay the same for someone with half the training?

They are asking for equal billing privledges from medicare.Employers are free to pay whatever. If that occurs why would I hire an MD for 250k when I can hire 2.5 NPs willing to work for that .

 

[rlbk]

You could have done it and your career prospect would have been much better. There are MD/DO who work 4o hrs/wk, make $$$ and have a life outside of medicine.

In all honesty, young people who do PA because it's shorter are ill advised IMO. You can work PA hrs as a MD/DO while making twice... A PA is kind of a resident forever who just make more $$$....

Yeah I considered it, as a college senior I had a good friend who was a 3rd year med student who kept trying to persuade me into applying for med school. I looked into schools and researched quite a bit, but in the end felt like PA was a better fit for me and I'd be happier overall. I couldn't commit to that many years of my life. Having a massive salary, getting the final say, calling all the shots, etc isn't all that important to me. I feel like to make that commitment worth it, you have to realllllly want it.

 

[DO2015CA]

You seem to be missing the point. They are practicing without collaborative agreements. This should result in the issues you are describing if the care was substandard.

Payors should be able to discern if independent NPs are in fact ordering excess testing and would have the option to not contract with them. If it is soo eggregious.

Congrats they lived is one metric, I would settle for any metric where superiority was shown in physicians. I am a pessimist so lets for a second assume that long term studies show up no superiority in physican vs midlevel outcomes for PCP, what then? Shouldnt we be blowing up our training model if no real benefit to patients is being derived from all the extra training ? Its not like the physicians are the only ones being screwed , we as a society are paying for residencies and subsidizing public medical schools and education.

The point is not lost on me. Have the no back up providers been around long enough to get actual numbers? Malpractice rates would take at least a couple years to catch up and long term outcomes would take decades.

I would 100% agree if there are decent reliable studies showing no difference then medical education needs a massive revamp. There are no reliable studies that have be produced anytime this conversation occurs.

 

[W19]

Yeah I considered it, as a college senior I had a good friend who was a 3rd year med student who kept trying to persuade me into applying for med school. I looked into schools and researched quite a bit, but in the end felt like PA was a better fit for me and I'd be happier overall. I couldn't commit to that many years of my life. Having a massive salary, getting the final say, calling all the shots, etc isn't all that important to me. I feel like to make that commitment worth it, you have to realllllly want it.

Remember this conversation and see how you think 10+ years from now...

 

[Matthew9Thirtyfive]

They are asking for equal billing privledges from medicare.Employers are free to pay whatever. If that occurs why would I hire an MD for 250k when I can hire 2.5 NPs willing to work for that .

Right. I’m just saying if they are already pushing for equal reimbursement, they are going to start demanding equal salaries.

 

[rlbk]

Remember this conversation and see how you think 10+ years from now...

Hahah yeah I could potentially regret it, who knows. There are pros and cons for the decision to do each, it could go either way. Heck, I know a handful of physicians who have personally told me they wish they had chosen PA school over pursuing their MD/DO. Guess I'll find out how I feel in 10+ years

 

[DO2015CA]

Hahah yeah I could potentially regret it, who knows. There are pros and cons for the decision to do each, it could go either way. Heck, I know a handful of physicians who have personally told me they wish they had chosen PA school over pursuing their MD/DO. Guess I'll find out how I feel in 10+ years

Remember this conversation and see how you think 10+ years from now...

All depends on your view on life. If you want to work your 40 and enjoy your coin then it’s a decent gig. 10 years from now I bet some physicians will be regretting that they wasted their 20s going through all this training

 

[libertyyne]

Right. I’m just saying if they are already pushing for equal reimbursement, they are going to start demanding equal salaries.

its probably going to drive down PCP salaries in those areas. Maybe, depends on the volume of NPs available they have been proliferating like crazy. I can see a world where NPs are competing with FM Docs driving salaries down.

 

[Matthew9Thirtyfive]

its probably going to drive down PCP salaries in those areas. Maybe, depends on the volume of NPs available they have been proliferating like crazy. I can see a world where NPs are competing with FM Docs driving salaries down.

And then we are back to my question: why would you pay the same for someone with half the training?

 

[W19]

All depends on your view on life. If you want to work your 40 and enjoy your coin then it’s a decent gig. 10 years from now I bet some physicians will be regretting that they wasted their 20s going through all this training

I started med school in my 30s, and my life at 20s is no different than it is right now... Most people in their 20s are working 50-60 hrs/wk trying to make ends meet. They aren't in Las Vegas every weekend doing what we see on TV.

My classmates party every 2 wks after exam and they go on vacations more than most middle class individuals I know

 

[libertyyne]

And then we are back to my question: why would you pay the same for someone with half the training?

because the services provided have no difference in outcomes.

You wouldnt pay more for an NP , but you would probably not be willing to pay more for an MD at that point.

 

[DO2015CA]

I started med school in my 30s, and my life at 20s is no different than it is right now... Most people in their 20s are working 50-60 hrs/wk trying to make ends meet. They aren't in Las Vegas every weekend doing what we see on TV.

My classmates party ever 2 wks after exam and they go on vacations more than most middle class individuals I know

I agree but grass is always greener

 

[Matthew9Thirtyfive]

because the services provided have no difference in outcomes.

You wouldnt pay more for an NP , but you would probably not be willing to pay more for an MD at that point.

That’s not the situation. If they have driven down salaries to where they are essentially equivalent, why would you hire an NP with half the training when you can hire an MD for the same amount?

 

[rlbk]

I started med school in my 30s, and my life at 20s is no different than it is right now... Most people in their 20s are working 50-60 hrs/wk trying to make ends meet. They aren't in Las Vegas every weekend doing what we see on TV.

My classmates party ever 2 wks after exam and they go on vacations more than most middle class individuals I know

The speciality you choose as a physician can make a huge difference on your lifestyle though, and you're pretty much stuck with it. Let's say you're in your early 20s and you are highly ambitious, full of energy, and want to go into cardiothoracic surgery. For quite some time you love it but eventually feel worn out and want to slow down. That's harder to do.

For me personally, many of the specialties I want to be a PA in are extremely demanding, labor intensive, lots of funky hours, etc. I'm young and have the energy for it and find it thrilling and exciting. 10-20 years down the road....probably won't feel the same way. I like knowing that I can spend x amount of years working in trauma surgery or something and then decide to slow down and switch to like dermatology or something if I'm over it or if I have kids and want more time for them.

Maybe that's why ROAD specialties are so popular amongst med students though lol

 

[libertyyne]

That’s not the situation. If they have driven down salaries to where they are essentially equivalent, why would you hire an NP with half the training when you can hire an MD for the same amount?

If x number of people can do the job with similar outcomes.
Now there are 3x number of people for the same job. What do you think will happen to salaries ?

 

[Deecee2DO]

If x number of people can do the job with similar outcomes.
Now there are 3x number of people for the same job. What do you think will happen to salaries ?

This is just ridiculous to say. A PA will not be paid as much as an MD/DO. It won't happen. I don't care if its an FM, IM or Peds MD/DO which typically have the lowest salaries of all specialties with Peds being the absolute lowest overall, a PA caps out and won't ever make as much as them and they shouldn't, they went through less than half of the training (General Peds/FM/IM is all 7 years after undergrad which is more than double the length of time to become a PA). @Matthew9Thirtyfive has a good point.

 

[libertyyne]

This is just ridiculous to say. A PA will not be paid as much as an MD/DO. It won't happen. I don't care if its an FM, IM or Peds MD/DO which typically have the lowest salaries of all specialties with Peds being the absolute lowest overall, a PA caps out and won't ever make as much as them and they shouldn't, they went through less than half of the training (General Peds/FM/IM is all 7 years after undergrad which is more than half of the length of time to become a PA). @Matthew9Thirtyfive has a good point.

Have you met a recent law graduate? Oversupply drove down salaries for entry level lawyers. Software reduced demand. I would never say never. Employers dont care what credentials you have behind your name as long as you can do the job.

 

[Deecee2DO]

Have you met a recent law graduate? Oversupply drove down salaries for entry level lawyers. Software reduced demand. I would never say never. Employers dont care what credentials you have behind your name as long as you can do the job.

For entry level lawyers, you're comparing apples to apples (they are all entry level lawyers applying for the same jobs with the same degree). When you compare Physicians to Physician ASSISTANTs you are comparing apples to oranges. That would be like comparing a paralegals salary to an attorneys: two totally different degrees with different salary caps just as with MD/DOs and PAs. An MD/DO if they look hard enough won't have to compete with a job for the same pay as a PA. PAs on avg make between 80K-110K. Sure there are outliers, but I can tell you that less than 1% of PAs are making more than 130K per year. Even at worst most if not all MD/DOs are making 150K or higher regardless of specialty. Even then, if a physician is making only 150K then he got robbed. Sadly, some pediatricians right out of residency are making this. Depending on location, many PCP MD/DOs make around high 100K to low 200K (~180K-210K). To say that a PA would ever be making that much would not be accurate.

 

[Matthew9Thirtyfive]

Have you met a recent law graduate? Oversupply drove down salaries for entry level lawyers. Software reduced demand. I would never say never. Employers dont care what credentials you have behind your name as long as you can do the job.

@Deecee2DO makes a good point. You are not comparing apples to apples when you discuss midlevels to physicians. Equivalency studies are showing equivalency in only limited circumstances (eg, when only measuring systolic bp of pts on meds), and the training isn’t even close. You’re not paying the same for equal products.

 

[libertyyne]

For entry level lawyers, you're comparing apples to apples (they are all entry level lawyers applying for the same jobs with the same degree). When you compare Physicians to Physician ASSISTANTs you are comparing apples to oranges. That would be like comparing a paralegals salary to an attorneys: two totally different degrees with different salary caps just as with MD/DOs and PAs. An MD/DO if they look hard enough won't have to compete with a job for the same pay as a PA. PAs on avg make between 80K-110K. Sure there are outliers, but I can tell you that less than 1% of PAs are making more than 130K per year. Even at worst most if not all MD/DOs are making 150K or higher regardless of specialty. Even then, if a physician is making only 150K then he got robbed. Sadly, some pediatricians right out of residency are making this. Depending on location, many PCP MD/DOs make around high 100K to low 200K (~180K-210K). To say that a PA would ever be making that much would not be accurate.

Apples and oranges analogy makes sense if the outcomes are different. If paralegals got to practice law to the full extent that lawyers do we would be looking at a similar example. Look to any other industry like call centers , IT support, all of these were disrupted by cheaper lower quality labor (outsourcing) and were completely decimated. There are already psych NPs making close to 200k.

 

[Deecee2DO]

Apples and oranges analogy makes sense if the outcomes are different. If paralegals got to practice law to the full extent that lawyers do we would be looking at a similar example. Look to any other industry like call centers , IT support, all of these were disrupted by cheaper lower quality labor (outsourcing) and were completely decimated. There are already psych NPs making close to 200k.

Psych NPs making close to 200 are outliers. PAs and NPs don't get to practice medicine "to the full extent" as MD/DOs do. Are you a PA student or something? Must be. Why do you care so much?

 

[libertyyne]

Psych NPs making close to 200 are outliers. PAs and NPs don't get to practice medicine "to the full extent" as MD/DOs do. Are you a PA student or something? Must be. Why do you care so much?

Not really . They are a dime a dozen 150+
Psychiatric Nurse Practitioner $150,000 Jobs, Employment | Indeed.com

What would you call NPs practicing Medicine without physician oversight or agreements? I would suggest doing a quick google search before having strong opinions about something you know nothing about.

Lol. Yeah, I am totally an NP. thats why I care so much. lol.

 

[rlbk]

Apples and oranges analogy makes sense if the outcomes are different. If paralegals got to practice law to the full extent that lawyers do we would be looking at a similar example. Look to any other industry like call centers , IT support, all of these were disrupted by cheaper lower quality labor (outsourcing) and were completely decimated. There are already psych NPs making close to 200k.

I imagine psych NPs are making that much just because of how ridiculously underserved it is as a field of medicine.

 

[mehc012]

No I'm not ignoring that at all, I agree with what you said completely. As a newly graduated PA, I do not expect to be trusted to make the right decisions. I wouldn't feel confident in my own self enough at all! Not right away. I know docs will be keeping a close eye on my patients and I'd like that while I'm still new and still learning.
I'm referring to PAs who have at least a year of experience in said area under their belt. I have acknowledged this in previous posts if you've been following closely. I have also acknowledged several times now that PAs are trained to know damn well they won't have all of the expertise of their physician they're working with. It really isn't that difficult to understand. There will always be exceptions to the case in anything in life, that's a given. If there are some PAs out there that think they know just as much as the physician they work with, that speaks less about PAs as a profession and more about that person's own level of cockiness and delusions of grandeur lol.

Don't worry, I'm with ya.

You're not with me, because a) a year isn't enough, and b) nothing about your posts indicates that you would actually know your limits or pass things off when you reached them. It's like you think that a year after graduation, PAs don't actually need supervision. You've still got to check the ego a bit.

 

[Deecee2DO]

Not really . They are a dime a dozen 150+
Psychiatric Nurse Practitioner $150,000 Jobs, Employment | Indeed.com

What would you call NPs practicing Medicine without physician oversight or agreements? I would suggest doing a quick google search before having strong opinions about something you know nothing about.

Lol. Yeah, I am totally an NP. thats why I care so much. lol.

"I would suggest doing a quick google search before having strong opinions about something you know nothing about." Exactly my point when you state your strong opinions about Chiros in past posts (something you know absolutely nothing about at all). Now you see what its like from the other side.Also, if an NP makes as much and has the same scope of practice as an MD/DO why did you switch careers and attend medical school? Most NPs and PAs I can still tell you are not making ~200K like many MD/DO PCPs however. I have a very intelligent friend who is in NP school and she says she can't stand it because all of the info is just way too superficial for her, that is why she wants to go to medical school after her NP. If NP and MD/DO are doing the same job for the same pay why is there such drastic differences in knowledge-base. I just don't understand.

 

[HelpMeFailedStep1]

Podiatry school bro. They are thirsty for applicants, and the career is actually pretty cool

@GypsyHummus

.

 

[Matthew9Thirtyfive]

"I would suggest doing a quick google search before having strong opinions about something you know nothing about." Exactly my point when you state your strong opinions about Chiros in past posts (something you know absolutely nothing about at all). Now you see what its like from the other side.Also, if an NP makes as much and has the same scope of practice as an MD/DO why did you switch careers and attend medical school? Most NPs and PAs I can still tell you are not making ~200K like many MD/DO PCPs however. I have a very intelligent friend who is in NP school and she says she can't stand it because all of the info is just way too superficial for her, that is why she wants to go to medical school after her NP. If NP and MD/DO are doing the same job for the same pay why is there such drastic differences in knowledge-base. I just don't understand.

Not sure if this is what you are referring to, but there are numerous studies showing chiro is not effective except in very few circumstances, not to mention that subluxation does not exist. That chiro schools continue to teach it and chiros continue to offer treatment that don’t work based on pseudoscience is snake oil. You don’t have to be a chiro to see that.

That said, I agree with you wrt NPs and MDs. I have a couple friends who quit jobs where they had very little supervision and full autonomy because they felt unqualified to provide that kind of care with no supervision. And these people graduated from reputable programs with decent admissions standards.

 

[rlbk]

You're not with me, because a) a year isn't enough, and b) nothing about your posts indicates that you would actually know your limits or pass things off when you reached them. It's like you think that a year after graduation, PAs don't actually need supervision. You've still got to check the ego a bit.

LOL you're right, I am absolutely not with you. No, I don't think that PAs after a year can work with little supervision, I KNOW many PAs who are working in the field as we speak who are relatively new (like a year or two) who are working with little supervision. Of course, this depends on the specialty, as well as the state you live in because PA laws are highly variable across the country. I never said that all of them can work fairly independently after a year, but it does happen a LOT. Does this mean that they are at the level of expertise as that of the doctor? Of course not!

I truly have no idea who the hell you think you are. Just because you're one med student, resident, whatever, does in no way indicate that you're able to speak on behalf of every doctor/PA relationship in the country. Your assumptions indicate that you're the one who needs their ego checked.