3 Other Reasons for Wanting to Be a PA Worth Exploring More Thoughtfully|Be a Physician Assistant (2023)

In investigating whether the PA profession is right for you, some key features may pull you toward the PA career (and away from other options in the medical field).

But, as presented, some of these often mentioned “perks” of being a PA, while true, may also be overly simplified.If you hope to have an accurate picture of these PA-career-specific characteristics, it’s necessary to examine how they function for real-world PAs.

Last week, we explored one of the most common of these “reasons,” PA career flexibility. And now, we’ll walk through some of the other frequently cited drivers for pursuing the PA path.

Additionally, we’ll cover sample questions you might ask real-world PAs to shed light on how these characteristics might show up in practice and fluctuate between one PA role and the next.

In conversations centered around reasons to be a PA, the idea of having “more time” with patients is a common theme. What’s often unsaid, or perhaps reluctantly described after a bit of probing, is what “more” is being compared against.

Generally, the supposition is that PAs spend more time with patients than their physician counterparts. Or there’s a suggestion that PAs have a lighter patient load than physicians and, therefore, have the time to spend.

When I encounter this impression, I’m always left wondering where these utopias of PA practice might exist. I’m sure there are places where APPs (advanced practice providers = PAs and NPs) see fewer patients or have more time to spare than the physicians they work with.

But after 15 years and four PA positions, I haven’t found one.

In both of my prior outpatient oncology roles, I saw far more patients than the physicians I worked alongside. (And not because I only saw the simple cases, we’ll get there in a bit.)

In my part-time role in internal medicine, my collaborating physician saw zero patients and acted only as a resource to review my work as needed to meet state regulations. In my current role with inpatient hospital medicine, our physicians see patients once within 24 hours of admission; otherwise, the encounters are all mine.

My experience is not unique among PAs. And I think this “reason why” for wanting to be a PA is close to being accurate, but it requires some reframing to get there.

PAs don’t necessarily spend more time or have more time to spend with patients in prolonged visits. But compared to physicians, they often (not always, but often) spend more oftheir timefocused on patient care. While their collaborating physicians may devote a greater portion of their week to administrative or research work, PAs can more often concentrate the majority of their efforts on direct patient care.

While PAs don’t often spend more time per visit than other providers, PAs usually contribute more oftheircollective time to patients. If your goal as an aspiring PA is to focus primarily on patient care, then this altered “reason” should align with what you’re hoping to accomplish.

You might ask a practicing PA:

  • How much of your week is focused on direct patient care? Is that a different proportion than the physicians you work with?

  • What other roles or duties do your collaborating physicians have that you don’t?

  • Do you have any duties outside of direct patient care? What do those involve?

Whenever the PA profession is being discussed, you’ll inevitably hear about the “good work-life balance” it provides. The often silent comparison is to the more stressful or involved career of a physician.

And that can be true of the early career years. As a PA, you can train in roughly two years and be out and practicing after that. Compared to a physician track that involves med school, then a residency and a potential fellowship, PAs can often achieve a reasonable balance earlier simply by finishing their training and, consequently, being in greater control of their time.

However, most practicing PAs know that finding “balance” once in the professional phase of their career has less to do with a particular role and relies more on where and how they practice.

In practice, the burnout rates of PAs mirror those of physicians. Some specialties, including critical care, emergency medicine, and oncology, have consistently higher rates of burnout among providers. If you work in a higher stress practice, your role as a PA won’t protect you against the demands of the position.

While training to become a PA offers some early advantages, the role does not guard against a schedule or patient population or acuity level that might be more than you can or want to handle. So, as a PA, if you hope to find a good “work-life balance,”youhave to work to achieve it.

You might ask a practicing PA:

  • What is the most stressful part of your role (now or in the past)?

  • When you were a brand-new PA, what helped you to find balance when adjusting to practice?

  • Have you ever changed roles or adapted your schedule to make your workload more manageable?

Team-based practice is a prominent feature of the PA role and allows for significant career-long learning and growth.

But a pre-PA’s understanding of this team dynamic, and especially the PA-MD relationship, is often oriented around their early career days without incorporating longer-term insight. In describing the value of this relationship within essays and interview responses, many future PAs reference ideas like “not having the final decision” or “knowing my work would be reviewed” as reassuring.

Some future PA descriptions of the collaborative relationship suggest that PAs see more straightforward cases while the more complicated patients are left for the physician to manage. In my experience as a PA, I have managed very complex patients throughout my years.

In my oncology days, I saw everyone from those with routine post-treatment checkups to chemo evaluations to worsening disease to hospice candidates. Certainly, some cases warranted more collaboration and physician input than others, but there weren’t patients I “saved” for my collaborating physician because their issues were beyond my capabilities.

The ability to practice as a team is real, and it’s valuable. But PAs also have a lot of autonomy, especially as they gain more experience. PAs need to be confident in their ability to manage patients. No matter your level of experience in practice, a physician will not oversee everything you do.

As a PA school candidate, programs will want to know that you’re capable of handling this responsibility and not looking to operate in a “forever trainee” mode. And as a practicing PA, you’llwantmore responsibility as you gain experience and skills.

You might ask a practicing PA:

  • At what point in practice did you start to feel more comfortable in managing patients without physician input?

  • How has your PA-physician relationship changed over time?

  • How has your team dynamic shifted as you’ve gained more experience with your patient population?

As the PA profession has grown, public awareness of our training, abilities, and career attributes has likewise increased.

But as an aspiring PA, if you hope to understand these “reasons why” beyond the typical talking points, you’ll need to dig a little deeper to learn how practicing PAs utilize them.

Once you do, you’ll be able to capture a fuller, more accurate picture of what you might be able to create through both the early days and your longer-term PA career.

Have you been catching the weekly Blog Bonus videos? In the most recent, I walk you through how you might frame questions to PAs to foster more comprehensive, helpful responses that you can use to craft a solid pre-PA plan. Find it here.

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