Why PA?

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PA Week is an annual celebration taking place October 6 – 12th that honors Physician Assistants all around the globe – bringing recognition and improved understanding to the fifty-two year profession. Multiple initiatives take place during this important week to educate and raise awareness, namely hosted by the American Academy of Physician Assistants, the 246 current PA programs in the U.S., as well as hospital systems and large groups that employ PAs as part of the team-based healthcare approach.


I’ve always seen PA Week as a tremendous opportunity to explain to others why I chose the PA profession and why now, 20 years later, I still think it was the best decision that I’ve ever made.


Educational Timeline


Most PA programs are typically 23-28 months, granting a Master’s degree after an initial didactic year, then a clinical allocation leading to the National Commission on Certification of Physician Assistants exam (PANCE). Although wildly rigorous, the PA educational timeline is rather short in comparison to that of an MD or DO, which was an ideal option for me. I wanted to minimize debt, start a family in my late 20's / early 30's, and pursue entrepreneurial interests. I was an unusually young PA graduate in 1999, entering PA school at age 23 and graduating at 25. The competition was so extreme at that time as most applicants were medics, RNs or had significant healthcare experience prior to applying to PA school. I was lucky enough to receive acceptance from an inner-city PA program in Queens, NY where I would have the opportunity to choose additional electives in Emergency Medicine (EM).


Versatility


I have PA colleagues that work in every specialty in existence. Emergency Medicine, OB-GYN, Ortho, Dermatology, Family Practice, Urgent Care, Pediatrics, Oncology, Pain Management, Interventional Radiology, Cardiothoracic Surgery, etc. In most cases when they felt burned out or ready for a change, they simply transitioned to another specialty more challenging or appealing. At that point, the knowledge that they bring to the table benefits everyone - the practice and the patient. Still, to this day I think the versatility component is a notable advantage for PAs. Ironically, I stuck around in EM for nine years before switching to Urgent Care.


It is truly is incredible that a PA is not glued to a certain specialty upon graduation and certification.


Stability


I never wanted to have to stress about finding a job and was highly attracted to a profession with such a positive long-term employment outlook. I’ve seen consistently similar statistics regarding the demand for PAs over the 20 years since graduation. The AAPA most recently stated last that the PA profession is projected to increase 37% from 2016 to 2026, significantly more than average for almost all occupations. Now that is some extraordinary job security.


Autonomy


The PA profession offers a level of autonomy that is ideally suited to my personality. Prior to shadowing multiple PAs before school, I only knew that I wanted to work in medicine but struggled to find a profession in which I could be a clinical decision maker and be a part of a high-level team. I felt best about my contributions in a fast-paced environment which required quick decisions. The partnership model in which PAs are specifically hired by a physician or physician group to see their own patients, perform high level procedures, first assist in the OR, evaluate labs / x-rays / other studies, manage and prescribe medications, and follow patients long-term provided a level of autonomy that I also enjoyed. I was able to recognize my limitations, prove that I was there to grow (quickly), and thrive knowing that my decision making skills are needed and valued.


Salary


The current median, across all PA specialties according to the AAPA is $107,500. Surgical sub-specialties including Dermatology, Plastic Surgery, Emergency Medicine and Orthopedics are well known for paying far more, with bonus structures and other incentives built into some contracts. I was lucky to hit this number early in my career by working overtime and differential hours (plus bonus), even in an inner-city EM setting, thanks to tremendous PA leadership and physician support within our department.


Reputation


The role of PAs has changed dramatically over time, since Eugene A. Stead, MD founded the first PA program at Duke University in 1965. Stead recognized a shortage of primary care physicians in rural areas of the U.S. and repurposed the fast-track principles of training medics and corpsmen in WWII and Vietnam to develop the initial curriculum. Dr. Stead successfully graduated the first class of six PAs in October, 1967. He required that all PAs had mentoring relationships with physicians to ensure access to a larger body of medical knowledge, which rings true today in all specialties. More and more physicians choose to hire PAs to navigate in a highly productive partnership through the trenches of modern medicine. I should also mention that the reputation of PAs among physicians has benefited by our training model, as the medical model is seen as effective and relatable.


Job Satisfaction


US News & World Report 2019 lists the Physician Assistant profession as #1 for best health care jobs, #3 for 100 best jobs, and #3 for best STEM jobs. And this is the typical statistical profile, year after year. The explanation is based on the combined highlights I’ve listed, among others. Personally speaking, between the designated 3-4 weekly shifts, the entertaining nature of working with genius colleagues and fellow night owls, the opportunity to gain trust from patients in record timing through demeanor and knowledge base, the ability to perform complex procedures, and the allowance to attend top CME conferences in a continual quest for growth, I’ll wholeheartedly agree that the PA profession deserves its position at #1.


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