Physician Assistant Medicine: 11 Misconceptions
Posted By: Kubin | What its like being a PA?
There are plenty of misconceptions about the physician assistant field. If you’ve never met a physician assistant or been treated by one, you’re left to guess what PAs do, and sometimes these guesses — though understandable — are just plain wrong. What follows is a list of the 11 most common misconceptions about physician assistants. It should help you if you are doing initial research on the field or if you know about it already. If you have others, please let me know.
Misconceptions About The Physician Assistant Field
- “Physician Assistants are assistants to doctors.” With the poorly chosen name that our field has lived with for nearly 50 years, this one is easy to understand. It turns out that PAs are only truly assistants to doctors in the area of surgery. PAs are the lead assistants in surgery, even before other surgeons. Surgical PAs do plenty of work on their own though. They round on patients before and after surgery, do bedside like chest tubes and central lines, and see patients in the office. The majority of non-surgical PAs work nearly independently, and consult with their supervising doctor when they feel they need to.
- “Physician Assistants don’t prescribe.” False. State regulations vary, but for the most part, PAs prescribe medications as any doctor does. In some states the term is “furnish,” or “dispense,” but these are minor distinctions. You should know, however that when a PA writes a prescription, he/she does so as an agent of the supervising physician. In most states the physician’s name must appear on the prescription form too. Still, the PA makes the decision to prescribe, including what to prescribe, how much, etc.
- “Physician Assistants don’t prescribe narcotics.” Taking #2 a step further, PAs can prescribe oxycodone, morphine, and Fentanyl and others just like physicians. In most states the PA must obtain a separate DEA registration to do so. Some choose to practice without it, which means that they can’t prescribe these types of drugs. But the majority of PAs choose to maintain their own DEA registration number.
- Physician Assistants work under the doctor’s license. Actually, PAs are certified nationally, and licensed by the state in which they practice. What’s the difference? A license is a credential that allows one to practice (effectively) permanently, so long as one pays the professional fees and does regular continuing education. PA certification is a more temporary credential that must be renewed by retesting. Physician assistant certifications must now be renewed every 10 years. This means that every ten years, a PA must pass a recertification exam (the Physician Assistant National Recertifying Examination, or PANRE) that proves he/she is still proficient. There are also certification exams for different PA specialties. This is all in addition to paying annual professional fees and performing continuing medical education (CMEs). In California, for example, PAs must do 100 hours of CMEs every two years. Though it’s a hassle, the recertification process is a good thing. It lends credibility to the field as a whole. PAs must keep their knowledge up, or they can’t practice.
- Physician assistants don’t specialize. Cue the buzzer – false again. PAs specialize in pretty much every area of medicine. About 36% of PAs work in primary care, with the other 64% working in surgical, ER, and subspecialty areas, such as dermatology or rheumatology.
- “Physician assistants don’t order or interpret labs or imaging studies.” Actually, PAs order and interpret labs and imaging studies (x-ray/CT/MRI etc.) just as any physician does.
- Physician assistants provide inferior care compared to physicians. This is hard to measure experimentally, but the research shows that PAs aren’t sued for malpractice any more often than physicians, and the judgments from lawsuits against PAs aren’t any larger than those against physicians. In terms of patient outcomes, the research shows us consistently that PAs, NPs, and MDs are all about equal.
- Physician assistant isn’t a satisfying job. Actually, the vast majority of PAs say that they are very satisfied with their work, such as their pay, feeling that they matter, and liking what they do. The one area where they consistently show somewhat lower satisfaction is their workload, much like physicians. The satisfaction scores are higher for PAs in the area of workload than for doctors, however.
- Physician‘s Assistant. It’s physician assistant – no apostrophe-s!
- Physician Assistants don’t get sued for malpractice. In any malpractice lawsuit, the plaintiff usually sues everyone who was involved with the patient’s allegedly improper care. This is no less true for physician assistants. Rarely, physicians can prove that they gave good supervision, despite the PAs negligence, and therefore escape the malpractice judgment. But most often, if a PA is named in a lawsuit, the PA and the supervising MD usually either win or lose together.
- Physician assistants all wish they could be doctors. Sorry, but it just aint so. Of course, there are some who would prefer to become physicians. But the vast majority chose to be PAs because that’s what they wanted to be. They might have wanted more life balance, more time with patients, or less school debt. Or a hundred other reasons. Don’t believe me? Go talk to a few PAs, and you will.
There are plenty more misconceptions about physician assistants. Can you think of one we’ve missed? Leave a comment to let us know.
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Hey Paul,
Regarding #4 above, I’m confused. Don’t individual states issue “licenses”? Because a PA does not HAVE TO do the PANRE every 6 years and stay “certified”, but then, from what I understand, they are not able to switch between states, and they are a PA, not a PA-C. Anymore insight into this?
One small correction. PAs do get licensed, just like all other professions. I have a license on my wall for many years. Licensing is by the state. Certification is by the NCCPA and or/ other professional boards usually connected to organizations. A state could opt to require certification to practice as all states do the initial NCCPA exam. Many states to not mandate re-certification, although employers do.
Dave
Yes, Aaron and Dave, you are absolutely correct. I’ve made the change – thanks for catching that!
The one I hate the most is that most or many PAs would have preferred to go to medical school if they had had the chance. Even my cardiologist dad, who is extremely supportive of me, is still a little baffled by my choice.
I agree Laurelin!! PAs do not want to be physicians!! That’s why they’re PAs <3
As a respiratory therapist in a teaching hospital, I’ve met several residents who’ve said if they could do it all again, they’d go to PA school!
This was extremely helpful. I love this entire website. It’s so difficult to find credible information about the PA profession because of the many misconceptions and misunderstandings about the profession. Thanks for posting this!
I have two more years of pre-requisite coursework before I can apply to P.A. school, but I must say that I am sold on being a P.A. I have interviewed several P.A.’s and Physicians, and the most job satisfaction I’ve heard is from P.A.’s. I have also spoken with several medical school students, and almost all of them have warned me away from medical school, saying if they could do it again, they would’ve gone P.A.
It depends on your personality, I think. But the % of people who fit the personality of becoming MDs and being willing to sacrifice as much as they do to get through is much smaller than the rest. I love my work, am respected, make a difference in people’s lives, and I earn a very good living. What more could I want?
Hi all,
Thanks for this post, I hope many people read this and understand who PAs really are. I an currently in my final year of PA school on my 7th rotation. Recently, I’ve encountered really bitter PAs who have discouraged me and advised me to even try and go to medical school. I’ve truly fallen in love with this field and very sad to see how some of these PAs are miserable. I just wanted to know does any one else out there feel they should have went to med school? I’m fairly young, only 22 years old and everyone is telling me why not med school…I’m very torn at this point. How do you deal with the people that push you to med school and discourage you from the goals you’ve set for yourself? And how do you prove to these people that it’s not because you’re lazy or afraid of the workload med students/residents go through? But simply found PA to be a far better choice. How many of you are really happy with what you do? And What should I be looking for once I’m on the search for a job? Any advice??
Okay, Natasha, get ready for a soap box performance from yours truly, because this question is really important to me…
I think in some ways you are answering your own question. Who are you becoming a PA for? I know the answer is YOU. So I think you may need to reorient your brain: don’t try to convince others of anything – you’re doing this for YOU, not for them.
I haven’t run into many bitter PAs, but you need to realize that there are those people in any field. The bitter PAs I have run across didn’t seem to be bitter because they were PAs. In most cases they were bitter because they had continued to work for a doctor/company/hospital that was not treating them well, and/or that they were over-worked or didn’t seem to apply themselves much to their work. You can also find this in any profession. When you feel this way IN ANY CAREER, YOU NEED TO MAKE SOME CHANGES, MAN! Get a new job. Learn something new. Try some new approaches to the problems you work with. Learn in more detail the things that you already know about. Help your patients understand what is going on EVEN BETTER (believe me, as much as you explain, they will never get it all – there’s just too much). Explore a new specialty. Examine from where you derive the most personal satisfaction in your job. Are you putting as much into it as you expect out of it?
I AM A STRONG BELIEVER THAT MOST PEOPLE WHO ARE UNHAPPY WITH THEIR CAREERS (NOT THEIR JOBS) ARE UNHAPPY BECAUSE THEY DON’T PUT ENOUGH OF INTO IT, AS IN “YOU GET OUT OF IT WHAT YOU PUT INTO IT.”
James Allen said “As you think, so shall you be.” If you think you’re miserable and hopeless, then you’re right. If you think you’re a medical badass with a stimulating and challenging job that requires you to stretch yourself every day, then you’re right. Most unhappy people aren’t stretching themselves. Some of them cool their heels after graduation and somehow expect the job to entertain them like a little home movie watched from a recliner.
I received an email from one of those bitter PAs you are describing early on in my blogging. He said essentially, “I’m 28, I’ve been a PA for 6 years. I’ve worked in different specialties and learned it all. And I’m unfulfilled.”
Really? If you do it right, you could spend three lifetimes learning to be great at one specialty. As I read it, all I could think was, man, this guy is missing the point. He thinks the job should make his life happy. How much sense does that make? ZERO. The job doesn’t make you happy; you make you happy.
To look at it another way, have you seen the other side? Have you been to a PA conference? I strongly recommend you splurge and attend an AAPA annual conference – they are a blast. You will run across more people who are motivated and LOVE their work than you have ever seen in your life. You will learn and play and dine with people who are totally enthusiastic about being PAs!
Every now and then I have a patient who doesn’t know much about PAs (there seem to be remarkably few of those in my area) who will ask me “So when are you going to become a doctor?” I tell them flatly: “I’m not. I’m a PA, and I love it.”
What goes through my head?
-this person has no idea what I do, and that’s not his/her fault.
-this person has no idea what it’s really like to be a doctor either, and it’s not his/her fault.
-They have no idea how much time/energy/commitment it takes to be a PA (OR A DOCTOR, FOR THAT MATTER).
-If I love what I’m doing (and I truly do), why would I care about what they think I should do? It’s just noise to me.
It’s an interesting topic, and I’m guessing I need to write more on it. Thanks for the question.
You live your life for yourself. Never forget that. It’s very easy for someone to tell you their opinion. Opinions are like a-holes; everyone has one. Do what you are happy with and take what people tell you with a grain of salt. I leave my job every day realizing how happy and fortunate I am and how miserable others are around me. (They’re not miserable because of me by the way)
i have been a PA for 9 years and have never regretted the decision. I originally planned on going to med school but happened to walk by the PA school bulletin board at my undergrad and stopped to read, went in for a chat with the staff, and never turned back! I love it and can’t imagine anything else. I don’t think any of us would say we chose to be PA’s because it’s the “easy” route- the school is rigorous (I’ve had medical students state “you did 4 years of med school crammed in 2 years!”) and we are constantly learning. Many of us chose this because we want a little shorter schooling, maybe less debt, more time with family etc for similar benefits of medical school since we get to do many of the same things. But as a PA, I get to help people every day get better from whatever their issue is, help their families, counsel them, and I leave with a smile on my face!
Paul! Your words are absolutely amazing, so inspiring. Today after reading your reply, I went to my rotation smiling because I thought a lot about it and spoke to many people…and I regained my power, recollected my thoughts and my original feeling about why I chose to be come a PA and I felt great! Stronger than ever! It really is true you get back exactly what you put in. I went in determined not to let them discourage me anymore and scrubbed in on a few cases and didn’t let anyone intimidate me!
Thank you so much!!
I’m so glad! Make your career, baby.
So glad I found this website. My youngest daughter is on her way to becoming a PA and I have been hearing from other people that she can’t write narc scripts. I was told she could do everything as a Dr could, just had to work under a supervising one. Thanks for confirming what I already knew.
It does depend to a certain extent on the state where she will practice and the practice in which she works. But yes, in general, PAs can write for narcs. In CA, there is a special one-day class that is required of PAs over and above their certificate in order to prescribe scheduled (controlled or “narcotic”) medications.
I am so glad I came across this site! I have dreamed of becoming a Pediatrician or OBGYN for as long as I can remember, but now that I am 22, and about to graduate with my Bachelor’s Degree in Biology, I have seriously considered going to PA school rather than Med school. I feared that I would ultimately regret my choice, but after reading a few of the posts on this site and the comments that follow, I am now confident that I would love to pursue a PA degree. Less time, less debt, and just as much responsibility as a MD? How could I go wrong? Thank you, Paul, for your insight!
Thanks for your kind words, Hannah. Neither career is for everybody, but I do think that too many people assume that the “traditional” path of MD is for them, when a day spent with medical students will help you to see that it clearly is not. The same could be said about PA, of course. The point is that you’re ACTUALLY trying to determine which is best for you, and not assuming. Bravo!
Thanks for this website. I am a Physical Therapy Asst, who has a Bachelors in Sociology. It’s been 21 years since I’ve been a PTA so I have to take my science courses all over again which is fine. I am so looking forward to finishing my pre reqs so that I can apply and start my new journey as a PA. I had always wanted to be a surgeon since I was 4 years old but, circumstances didn’t allow that to happen. Recently my husband had encouraged me to go for it and become that doctor that I’d always wanted to be but, after careful thought I felt that PA was the way to go for me. I’m excited about the new direction that my life is about to take. I have a few college friends who are PA’s and they’ve been helpful in helping me make this transition. Glad that I found this site. One question that I have for you is this. Is it a common thing to see PA’s advance in their careers? If so, to what degree?
I’m so excited for you! You’re going to love this field!
There are all kinds of ways that PAs progress. They learn to know and do more. They progress through jobs with higher levels of responsibility. They can enter leadership roles within medicine, such as running or owning a clinic, doing research, and getting better and better with patients. When I did my cardiothoracic surgery rotation, I met several PAs who told the residents what they should do. They had such skill and confidence that they were respected and valued members of the care team that included surgeons.
I should interject here, that now at age 45, I see that everyone (myself included, sometimes) has a tendency to continuously reach and lean on their ambition. Spending time in a field isn’t just about rising up some ladder. It is about getting better at what you do and loving it more as you do.
I totally agree with you that being in a field that you love is far more rewarding than rising up the ladder of success. I guess that I was thinking more on the lines of being able to do as you’ve said, run my own office one day or even go on mission trips to places that need medical assistance. But, now I see that I cam do just that..thanks
Hello,
I am glad I found this website. I am currently an Occupational Therapist working with a variety of different diagnoses but When I first began my career I instantly fell in love with orthopedic. But I am limited as an OT to what I can do with ortho patients. I love working with ortho patients. However I have always wanted to be the one to be in the OR to do the surgery. After careful consideration, I said I was going to go to med school however the amount of loans I already have I cannot imagine doubling that amount. Which is what led me to consider PA school; less time in school and less money. I’m not sure if this is the right path for me to take because of course of financial reasons. But I know I would be. Wry happy being a PA. I have worked with several PAs and I love what they do. I spoke to family and friends and they said why don’t I just go to medical school instead of going to PA school. But I feel like PA is better suited for me. How soon after PA school can you start being in the Or working alongside doctors performing surgery?
If you get a surgical job right out of school, then right away. We had plenty of people in my class working in surgery right out of school. Sometimes you need another job first, but not usually.
Sasha,
Thanks for asking thay question. I’m in PT and I’m planning on changing careers too to PA. I’ve always wanted to be a surgeon but, I became a mom whilr in undergrad school so that tabled that. I’m so happy that PA’s are assisting in surgeries and im so excited to be apart of that.
Paul, you stated that having a job prior or in lue of workong with a surgeon might be necessary. Is it your advice to keep my therapy license current since I may still have to work in that field?
Hi Carnetta,
I’m so glad I’m not in this alone because most people are asking me why would I want to make such a drastic change which made me think maybe that I shouldn’t go for it.
Sasha,
It’s been my experience that you have to do what makes you happy. Sometimes you have to keep your dreams and goals to yourself because some folks just won’t get the bigger picture. So, you keeping forging ahead with your plans, your goals and your dreams. Be real to the woman that you are now and are becoming..
Thank you all for this post. I have many years in corporate America and I am tired of it. I started thinking about a total career change where I will have job security and love my work and earn good money in the process. I have a BS in mngt and HR which means I took zero science courses and have no hands on patient experience. I am excited to take my nine prerequisites starting in January.
Everyine has been helpful — thank you for sharing your journey. I would like to hear from someone who had to leave a decent paying career to go to school fulltime and make a drastic change. I am a 36 year old wife and mother of four. My husband is supportive. I am excited and just want to make sure I finish. I want to specialize in either internal medicine or psy. Feed back please…
Dee — have you visited Inside PA Training’s Forum? There you can talk with others who are interested in the PA profession and maybe get some of the feedback you are seeking. Try it out!
Can PA’s contribute to research or become involved in research projects? Similar to how physicians can conduct their own funded research.
They can, but it is less common than for physicians. My workplace does clinical trials, but my part in it is minor. If you are heavily interested in research, then MD might be a better way to go.
Krystal- we sure can. I work at a medical school that is involved in a lot of research projects that I am also getting involved in, everything from skin substitutes (we work in plastics/burns) to new types of catheters to decrease UTI’s to… You name it!! As a PA I am not only involved in signing up patients for trial but collecting data and organizing as well as helping write papers.
I’ve been a urology PA for almost 4 years now. I started in surgery right after I graduated and can’t imagine myself in a different profession or field. I have never regretted my decision to not go to medical school.
I like almost everything on this post except #11 has a slightly misleading statement. I’ve heard since graduation that “I get more time with patients” and I can tell you that is only true if I take it out of my lunch, the end of my day, or some other time that doesn’t exist. I also don’t do less paperwork than my physician colleagues. I work in an Internal Medicine practice and my schedule and workload really isn’t different than that of my colleagues.
Good article and will be sharing with my pre-PA students. Did want to offer a few corrections though. 1. PAs are moved to a 10 year recertification cycle (like MDs), not 6 year. 2. CME requirement is actually 100 hours every 2 years in the state of California.
Thanks for sharing info!
Thanks for letting me know — these have been corrected.
You are right on both counts. The first has been updated — it was 6 years at the time that this was written. I obviously spaced on the second one.
Another myth: Physician Assistants are residents-in-training or still in limbo waiting to become MDs. Not so.
Myth #12: That I tried to get into med school, and I couldn’t, so I became a PA instead. Truth: If I wanted to apply to med school, I would have.
Myth #13: PAs are just like nurse practitioners. Truth: PAs and NPs perform very similar tasks, but the rules vary within each state regarding what a PA and and NP can and cannot do. The rules also vary with regard to credentialing.
Myth #14: Patients won’t respect me like they would respect a doctor. Truth: Many of my patients prefer my care over my supervising physicians’ care because I spend more time with the patient and answer the questions in terms he or she can understand.
Hi to all,
I am a physician assistant working in india. I practice in surgical side. I read in the web regarding the NCEPA exam. But i waa not able to apply for it as they state, only uk and us University are eligible to apply for the exam. Can any one help me out in sorting out this problem. If any national level exam i am eligible to attend, please let me know
If you can’t take the PANCE then you will need to start PA school in the US from the start. I’m sure this sounds horrible. It’s only two years, but it’s a lot of money. I would contact the NCCPA and AAPA to ask them about other options.
Yes, i have gone through the web sites of the AAPA and NCCPA. I even tried to get a post graduation course, but due to the registration problem i was not able to do so. Even though I am still trying to get into post graduation. If you can recommend any?
when I was thinking about going back to school, every Doctor told me to go PA. They said given the choice again the would choose PA over med school.
Hey Paul Thanx again for this website! Is#4 saying that you don’t have to work under a doctor? If you have to work under a dr. And want to open your own office how much do you lose?
A quick – and maybe tangential – question about the debt aspect, Paul. I’m considering schools with quite varied tuition costs: $120K on the high end (a program I’m in love with, mostly because I’m married with two young children, and it’s the most life-balance friendly that I’ve encountered; it’s also a well-known and well-regarded school) and $66K on the low end (quite a bit less excited about this one; it’s not prestigious, but it would get the job of becoming a PA done). There are a few others in the middle, but, hypothetically, if I’m offered the choice between these two, do you have any insight to offer as to the cost/benefit analysis? It’s difficult to think about giving up on the dream school, but I also feel nervous about shouldering that amount of debt. (BTW, thanks for the generosity you always show in answering these sorts of life-situation questions; you site has been one of my most valuable resources as I’ve pursued career changing and becoming a PA!)
Rachel,
I just finished PA school and interacted with PA students from at least 10 different schools during rotations (from no-name schools to top-ten). Every program will suck up your time about equally. The prestigious school you have your eye on will chew you up and spit you out just like the cheaper one. I’m not saying this to discourage you – I’m SO happy I went through it! But you may as well save your money, because in my humble opinion, $60K is a big deal. That’s probably your take-home pay for your first year of work. Regardless of the school you choose, you won’t be spending much time with your kids when school’s in session, so you may as well be able to afford a family vacation or something when you finish.
Also, from a purely academic standpoint – accreditation is pretty strict for PA programs. The more prestigious school may be ever so slightly better academically, but it’s not going to make a big difference in the grand scheme of things.
Best of luck.
Hi,
I am a urology PA and love my job. I was doing research in Boston before PA school and was making a relatively good living in an expensive city, but with very little debt from my state school undergrad education. Traveling a ton and going out and to dinner with friends with rent equal to my current mortgage. Then I went to PA school and I am completely money savvy and chose the best(#11 at the time), but cheapest Master’s program in the country, but still came out with living and schooling costs for a 24-month program $78,000 in debt (Program actually cost less than living expenses). Now I was prepared for the debt, but having finished undergrad in 2003 during a different financial time what I didn’t know or predict was how high grad school loan interest rates are… up to over 9%!!! And those are not personal loans. Those are federal loan programs, so even with consolidation the interest rate is 7.25%. This is more than double my mortgage interest rate. So what I didn’t anticipate was setting me up for 30 year repayment that would give the government almost half a million dollars of my earnings over that time period if you do the calculation. So I paid over $1000/month for 24 months out of school before buying our first home, but then with a mortgage, my husband’s Grad loans, car payments, house renovations that was no longer possible, but I still pay $500/month, which is no still no small feat. After paying off renovations I will be upping my payment yet again, but every time I look that I still have 20 years left to be paying this much it is overwhelming. I have looked into consolidating with credit unions, etc, but either the rate is no different or they won’t even give a loan large enough and then you lose the security of government loans in case a huge life crisis occurs. So recently I have been looking into the income-based repayment and pay as you earn options, which coming out of school noone really counseled me on. And being money savvy I saw that you payed more interest over time and scrolled right by. My husband has been in this repayment plan since graduation and works with disabled individuals and actually can apply for Public Service Loan Forgiveness, which was a program that started in 2007 after paying your loan for 120 on time payments. And something we both just learned about, but were happy to have done some research to learn we will be more financially free in six years when he will be eligible for forgiveness. I only wish my school had given a session in different payment options and legislation that is out there. Because now I am not sure my current job will apply as it is certain tax form rules for your employer to qualify and this may have helped me choose to work for a nonprofit hospital or the VA right out of school. But no matter what in those low payment options you4 loans are forgiven in 20-25 years no matter what. I had no idea about any of this. Basically… I know I am on my soapbox, but many days recently when the cost of everything has risen so fast and our salaries have not followed suit that I wonder if I made the right financial decision. Anytime you are taking out loans above or near your AGI you need to be very careful. So I would say you will be a good PA no matter what program you choose, so it is super important to make a good financial decision, as well.
And just take a look at this link, because Georgetown Law School basically has an inservice to teach their students who graduate with $150,000 in debt how to use these low pay options to their advantage. For example, had I chosen income based or contingent my payment would’ve been between 150-250/month for the past four years and could’ve used that extra 250-1000/month to out into my retirement, investments or savings and things might look very different right now. I wish I had known, because now unless I qualify for the 10 year forgiveness it won’t make sense to switch into these other payment options, because I have already over paid for so long….
http://www.edcentral.org/beware-savvy-borrowers-using-income-based-repayment/
I found a pay stub of my fathers right before their divorce in 1991 and have always kept it. My mom was a stay at home and my father at that time made $15,000 less a year than I do now and we had a car, a van, a boat and went on two one-two week long vacations per year with a family of four. Now we make nearly double what he made with our combined incomes, but we struggle to go on one week long vacation unless my half is paid for with a conference and I only get to half relax…
I am very passionate about making Washington make changes in student loan interest and the cost of education in general. Make sure your local representatives know how you might feel about this as well. It is not ok for big banks to get loans at 1.5% and then have students and the future of America try to pick up the slack. End rant.
Can a PA be referred as a doctor by his staff? And If the patients address him as doctor should he correct them and informed them that he is not a doctor but a Physician Assistant?
PAs are not doctors, and the proper way to refer to them is by their name — in most cases, their first name. Some more formal PAs may prefer to be referred to as Mr./Ms. So-and-so.
I get called “Dr. Paul” and “Dr. Kubin” all the time. The first time this happens, I always explain to them that I’m not a doctor and that they may call me Paul. After that, if they call me doctor, I just let it go. If I didn’t I’d be correcting people all day. A few refuse to call me anything other than doctor, telling me, “I know, I know — you’re a PA. But you’re Dr. Paul to me.”
I’m certainly not going to get into a conflict over it!
I will say that I much prefer to be called by my first name — I work hard to develop a close rapport with my patients and it feels much more true to our relationship than doctor.
I hold a doctorate and according to state law, there is nothing that says I cannot be called doctor in the clinic. Ethically, I am bound to not imply to patients that I am a physician, therefore I introduce myself as PA Crosby. I no longer correct my co-workers and patients when they call me doctor, since it is a title I have earned.
Remember, that doctor is an academic title.
Great point. I always correct my patients the first time I meet them, and then intermittently if they continue to call me Dr. After that, I let it go. Many of my patients say things like “I don’t care what you say — you’re Dr. Paul to me!” And I’m not going to argue THAT point.
Hi Paul,
I’ve been reading this post and your replies so I figured I would ask you directly. I just graduated with my B.S. in communication disorders and have been accepted to SLP graduate school… But truthfully, I’ve never been passionate about the field and have had the mindset of “get in, get out” as far as college goes… which is why I never changed my major despite this uncertainty (plus I chose this path at 17 and am soon turning 21). I was unaware of what a physician assistant does or the schooling required until more recently. I am wondering if taking a different route to apply to PA school which would require getting my prereqs and hours, etc. would be worth it (and also dropping out of SLP grad school before it even begins this August). Is salary a lot worse for a SLP in a healthcare setting that it is for a PA? Admittedly, pay is of great importance to me in a future career.
Hi, Rachel — I’m sorry it took me so long to get to your message. Hopefully you’ve figured out what you should do. Here are my thoughts:
1) Life is too short for graduate study in anything that you don’t love.
2) PA school is a different path, and it doesn’t sound like you have enough information to choose that one way or the other yet.
3) Make the decisions independently.
I suggest you first decide about SLP. If you don’t go through with it, then take some time and do a whole mess of soul searching and research before you commit to another one.
What about if you are a Psychologist? Can you be called “doctor”. With that in mind would it lesson the amount of training time.
Regards,
Teresa (Teresa Torres, Psy.D)
If I’m understanding your question, you’re wondering if being a PhD in something (such as psychology) would reduce the amount of training to become a PA. If that’s the case, the answer is no. A doctor of philosophy is called Dr., but that doesn’t translate to medicine. Even for physicians from other countries, to be a PA in the US, they have to go through the entirety of a PA program. That is, your work won’t transfer.
Hi, I was preparing for a PA school interview. Can you please give me some tips on answering the PA vs MD question? What would you say if you were asked that question? Also, any other tips for preparing for the interview are welcome. Thank you in advance.
By PA vs MD, I assume you mean “Why have you chosen to become a PA, instead of a physician.” If that’s correct, I would ask you just that. What appeals to you about the PA profession that you wouldn’t get from training/working as a physician. It’s not a trick question – just be honest.
However, if the answer truthfully has to do with PA requiring less time/work and/or lower grades, you would do well to give other reasons. In my opinion, PA school is not as hard as medical school, but it’s definitely very hard. You also have less time for each topic.
Hello everyone,
I am 18 years old and just about finished my first year of community college. I volunteer at a hospital, in a couple medical clubs, and very interested in the medical field! I’m looking for a career which can be flexible for me, not be in debt, and to still be able to have my personal life going. I know I don’t want to be a nurse of any kind because I simply feel I can go beyond that to pursue something greater like becoming a PA. One thing that drives me to become a PA is definitely the option to always improve and go beyond in your career. I guess my question happens to be is how can I make sure this is what I want to pursue throughout my time being. what are some ways I can possibly talk/interview PA’s and see what they think? Also, what kinds of difficulties along the way to becoming a PA, have you dealt with and made you think that this kind of pathway may not have been for you? thank you.
I think you answered your question. It’s not an official requirement, but i think you should be sure to shadow a PA. We have articles on that.(click). You might start by asking your primary care doc if you can shadow him/her and if he/she knows a PA you can shadow.
At first I worried that PA might be “too easy,” or “not enough” for me, but that’s a laugh these days. This job will give you more to learn than you can learn in three lifetimes. I worried about not having prestige, but I seem to get more than enough of that. I don’t know if it’s me, or the long white coat, or what, but people treat me like a doctor. They even call me doctor, though I tell them I’m a PA and they should call me Paul. Most are fine with that. I have a few who insist on calling me Dr. Paul. “I don’t care what you say,” they tell me, “you’re Dr. Paul to me.”
Both of these depend on the setting, your clinic, and your supervising MD. But in general, this job is all I could ask for.
Apparently some PJA-C’s shouldn’t be allowed to prescribe narcotics. My elderly mother had chronic heart disease, and was not able to swallow pills. She had a growth on her hip that was misdiagnosed at the same office, which became hideously large and painful. I requested some form of pain medication in a patch, and she was given Fentanyl 5mg. After receiving her second dose, which was given every 3 days, she left walking and talking to her day care. At the end of that day, she had to be carried in a wheelchair, and never regained consciousness, and stopped breathing on the 5th day of treatment. She had never been on any pain med except OTC pain relief. According to the pharmacist, and the internet, she should never have been given the narcotic.
Dear Donna,
I’m so sorry to hear about your mother. There are providers of all kinds out there (PAs, MDs, DOs, DDSs, NPs, etc) who shouldn’t be working, let alone prescribing narcotics. 5 mcg Duragesic is a very very low dose. But you don’t give a long-acting narcotic to a patient who is what we call “opiate naive,” because if they don’t tolerate it, you can’t withdraw it quickly. Narcotics can work very well with the elderly, but they take an experienced clinician to prescribe properly, and even then sometimes are just the wrong type of medication.
I hope you family can find some peace with it.
Sincerely,
Paul
Hello all,
So I know you’ve already addressed the research aspect of a Physician Assistant, but I was wondering if I wanted to become a PA and go into research what would be the best way to do that? I’m really interested in the brain and nervous system and I’m currently majoring in Biopsychology but every where I look it looks like it’s getting harder and harder to do research without getting a PhD or masters. I’m willing to go through the schooling it’s just the fact that I won’t be able to afford it and will need a job before hand. Really what I’m looking for is a way to be able to get a job out of undergraduate school that involves research, the brain, or nervous system. Thanks!
I’m not clear on your goal. Do you want to be a PA, a researcher, or get a job out of undergraduate school that involves research, the brain, or the nervous system? Be sure you’re clear on what you are after. If you’re doing PA because you want to go into medical research on people, I might discourage you. There are PAs who work in research, but it doesn’t pay the bills, and it’s hard to find. If you want a job that involves the brain, etc. out of undergrad, then have you considered working in neurology as a medical assistant, EEG tech, or something like that? If you REALLY want to do research, PhD is the way to go, but only if you’re 100% sure NOW, because it’s a long haul to get there, and it’s financially costly. If you’re less sure, then you might benefit from getting incrementally closer to it through jobs until you’re more sure.
Despite 50 years as a profession, many patients still ask when we will be a doctor!
My biggest pet peeve is related to #11. I abhor physicians that say, “if you wanted to practice medicine, you should have gone to medical school.” My two PA diplomas are from a Health Science Center and a state medical center.
I understand. I get asked that from time to time. For me, it only stings if for some reason I’d rather be a physician, and as much as I revere my Dad who was one, I don’t have much desire to be one. Seems more a matter of the public not understanding how much goes into both fields. They also don’t get that (totally my opinion here) physicians are scientists first, and care providers second, and PAs are the other way around.
Hi guys. Great informative website. But I have to add my two cents as a 4th yr med student, but only ab the bit/comment that PA school is med school crammed into 2…and honestly no disrespect but that’s the one bit I disagree with. Yes there are a few med students who say that but that’s prob what SOME of them say so as not to seem like they look down on PAs or devalue their work in medicine. Maybe I’m wrong in that, but I doubt I am. Cuz honestly if the amount of work that we do in med school could be crammed into two it prob would. Given The amount of classes and information we have/learn per semester, people would drop out more if it was crammed into two years Bcs we wouldn’t be able to handle it. Again, no disrespect to your guys field, and I realize all the misconception yall have had to put up with but let’s do that without throwing us under the bus and downplaying the amount of work that’s put into becoming an MD or DO :) yes it’s a lot of work and I’m sure there are many of us who prob would’ve gone to PA school if they could supposedly do it over, but that’s prob Bcs they went into medical school for all the wrong reasons in the first place. Anything worth it is hard work so those people prob wouldn’t have been happy as PAs either.
Thank you for making the point so eloquently, Kim. I agree — PA school isn’t the same as med school, even if you take into account the difference between 2 and 4 years. It is hard, but it’s a pretty different curriculum. I have great respect for what med students go through. That said, I’ve spent a lot of time talking with residents and physicians, and they mostly agree that after graduating med school, much of what they studied and learned goes the way of a year-old memorized grocery shopping list — much of it is lost and replaced with the practicalities of what they learn in their own specialty and use every day. If you doubt me, ask an orthopedist to tell you what they know about ophthalmolgy or a Dermatologist what they know about cardiology. I promise you’ll get a laugh! But in general, having it all in the first place gives a more complete background to medicine, so it’s not a waste at all IMHO. Hear me well: you’re right. PA school is not a 2-year med school — but I think you’re responding to a comment, because that wasn’t anything I claimed in the article. Thanks for your thoughts.
Oh, and re: physician’s are scientists first; I respectfully disagree esp since I can speak from experience. As much science as I’ve learned between graduating undergrad and med school, I’ll never consider myself mostly a scientist or a scientist first. In fact I was an Enlgish major and studio art minor in undergrad…and actually as a former dancer who then naturally transitioned to a consistent yoga practice when I couldn’t dance anymore, I came into medicine by way of a yogastudy for cancer patients. You’d be surprised how many doctors have a similar background. It may not be a whopping bunch but still, we exist. And for those who weren’t “other majors” like myself, they def have way more layers to them than just science. During my first and second year of med school I was the president of the Artists in Medicine club, and we not only had a lot of members but a full committee. So, again, while I love medicine, esp infectious diseases, I don’t consider myself a scientist first. I’m def equal parts scientist, AND caring doctor. Just wanted to add that bit ;)
Point taken. I didn’t mean to say that physicians aren’t an artistic and sensitive bunch. At UCD they do a service at the end of the first year in memoriam for those who gave their remains to the anatomy class for dissection. They invite family members (who have expressed an interest) and I’m told it’s extremely touching for all involved. There are performances of music, singing, etc. from the med students, and they are supposed to be a very talented bunch. The entire event is solemn and heartfelt. My point is that as a field, (I feel) like doctors are judged (by their peers) FIRST by their technical/clinical/scientific ability, and SECOND by their humanity. My dad was a doc and he told me many times that when he was in school (UCSF) they really beat into the students that they were scientists. There was also a degree of humiliation, which I know has for the most part changed. My dad really disliked his time in med school and turned out to be an extremely warm clinician, despite the focus on science. But that’s only one doctor, and he’s not here anymore to correct me if I got his opinion wrong, so again, point taken. Doctors are very much people too!
Hey Paul! This website is absolutely amazing. I am so glad found out about physician assistant as a career. I’m 18 right now and still considering what i want to do. I was wondering how much of a workload is it? Is it as much work as a physicians? Is there relatively less stressful work than the practicing physicians? Also, from experience, would you be able to tell me what the work schedule for PAs usually are. How many hours and days a week do they work. Do they get holidays and vacations off?
Thanks for your kind words!
It all depends what you specialize in and where you work. If you work in the ER, you will probably work 8 or 12 hour shifts, and they could be any time of day or night. 10-6AM, 6-2AM and 2-10AM are common shifts, as well as 8 AM – 8 PM and 8 PM to 8 AM. If you work in a clinic, you’re likely 9-5 or 10-6. So it depends a lot on what you do.
PA work, in my opinion, is just about as busy and stressful as MD work WHILE YOU’RE WORKING. Outside of work, I think PAs have more balance. I work 8-6 4 days per week (40 hours), I never take call, and I don’t work weekends or Mondays. When I leave work, I do not get called, need to do rounds or more paperwork, etc. Some PA jobs do require taking call (most surgical ones, for example), and you are usually paid a base rate at home that is lower, and your usual rate when you come in, or perhaps more. PAs can own/run their own clinics, but it’s not as common — they usually work for an MD who is the business owner, so they don’t need to worry as much about that piece. But when I work, I see as many patients as my supervising MD, and medically, they are all the same kinds of patients that he sees. We do a lot of work comp, so he has specialization in this area, and therefore has to see a lot of more legally complicated cases than I do. He is certified to make determinations about how disabled a person is, etc., so he writes many many letters to attorneys and participates in depositions. I don’t have to do any of that. I say have to, because that part of the work interests me zero. In some clinics the PAs are overworked and undervalued. In some they are treated with great deference and respect. I’ve worked with cardiothoracic PAs who told residents what to do because they were sharp and more experienced, and the residents trusted their judgment. So it depends on:
1) your specialty
2) your place of work (clinic, hospital, government office, etc)
3) Who is your supervising MD
4) How important you are to your employer’s success
5) How you carry yourself and what you are willing to put up with.
I hope that helps!
Thanks so much for this! I’ve learned a lot. I’m a 19 year old freshmen in college in an Allied Health major for PA. Based on your experience, what specialties offer the best hours and I was also wondering how a PA would open up their own clinic if they need to be supervised by an MD. I am also interested in surgery and I read that PA can perform minor surgical procedures. I was wondering what kind of minor surgical procedures they are referring to.
Thanks for your compliment!
Specialties that have the most reliable and “easy” hours tend to be clinic specialties, as opposed to hospital ones. Family practice is usually fairly 9-5. Others that don’t involve acute care are as well: dermatology, psychiatry, allergy, etc. Opening your own shop can be done, but the regulations depend on which state. The AAPA (AAPA.org) has done articles on it, so it would be worth calling them. California allows PAs to own as long as they don’t own the majority, for example, the PA could own 49% of the practice if a doc or more than one doc owned 51%. In family practice we do things like suturing lacerations (simple and complex), skin biopsy, joint injections, incision and drainage of abscesses, toenail removals, etc. Surgery PAs assist in the OR, usually before another MD. They have lots of responsibility, and often open and close the surgery without the MD present.
As a patient, what can I expect what expertise could I expect from an MD but not a PA?
That’s a tough question. PAs obviously do much of what physicians do, and it depends a lot on which doctor and which PA we’re talking about. MDs in general will be able to take you farther when things are complex or atypical. I realize that that’s pretty vague. Part of a PAs training is knowing when to call in their supervising MD to advise, and next, when to take over. I will say that I can go a week or more without asking a question of my supervising MD. On some days I have several questions, usually on the order of “Here’s what’s going on, here’s what I’m thinking, am I missing anything? And occasionally “Here’s what’s going on — how do I handle this?”
In general, you can expect a PA to be honest about what he/she does and does not know, and to include the supervising physician when there is any doubt.
Hi Paul,
I’ve been doing some research and I noticed that many pursue the PA profession because they “spend more time” with patients. Is this still true? I’ve seen on many other threads of forums that physicians and PAs spend the same amount. Also, one more question: do you work in the ER? If so, do you take your work home with you to complete charting? Do PAs generally take their work home or go “overtime” to finish their charting. I noticed that is an issue with physicians, but I was wondering if it also an issue with PAs. I’m deciding between PA and MD. Thank you very much for all this! We appreciate it!
It’s a good question. I think largely PAs do spend at least a little more time with patients. That’s what all my patient’s tell me at least (and not just about ME). That’s not because anyone says to do that, but MDs typically have other non-patient activities that they are needing to do — maintaining a business, hospital administrative stuff, etc. But in many cases, the time spent is the same.
In my clinic, there is no one faster than the doc, and it’s because it’s about his income! Patients like him, but they often prefer to be seen by one of the PAs, who generally have more time. I work in a free-standing urgent care clinic (that also does primary care). I never bring my paperwork home with me. Sometimes I’m late leaving the office because I have charting left over from a busy day. Some providers tend to go patient-chart-patient-chart, but I usually find I can get the patients out (and happier) by going patient-patient-patient-chart-chart-chart, or sometimes p-p-p-p-p-p-p-c-c-c-c-c-c, etc! Lol. I am never on call when I’m not at work, unless there’s something I forgot to do, at which point they call me and I need to get it done ASAP. I have been to the clinic for an hour or two on my day off, maybe 5x in 4 years. In general, I try to be off when I’m off.
Some clinicians take call. Some also do documentation from home, usually by an EMR (electronic medical record) system that syncs in the cloud. I would rather have a root canal than to do so myself.
Can a PA overrule a medical doctors decision?
A PA can’t “overrule,” but he or she can argue/discuss with the supervising physician to try to get the MD to see it their way. It’s one of the challenges of the job that sometimes your doc will disagree. But generally they do so for good reason. If you really think their decision is dangerous, there are things you can do.
Can PAs practice in any state regardless of where they had their education?
Yes. They are nationally certified, and then licensed in the state(s) where they will practice. So if you went to school in New York, you would pass the national certifying exam (the PANCE), then go to the state where you want to practice, and apply for licensure. Licensure is pretty much paperwork, background check, fingerprinting, pay fees, and do the required number of continuing education units for that state. Then you can practice there. And yes, you can license in more than one state. But it can become a hassle. Most people maintain one license at a time.