Why Become a PA? (When I Could Have Been a Mime)

so, off my sugar, but i'm doing ok so far. i don't have much time to eat in the hospital anyway, so i just kind of grab what i can, when i can. i have eaten something like 1500 free bagels from the residents' lounge in the last 2 weeks. and even if they're stale and the cream cheese might have turned, they're FREE, so they're delectable.

it's come to my attention recently that maybe i should 'splain the role of the PA in the medical world. it's a relatively new medical profession and lots of people still aren't sure what we do. if you haven't already at some point been treated by a PA, you will- since we are taking over the world. (mwah hah hah). i've never really talked about why i chose the PA profession or what PA's do among the other health professionals and some of you out there might be curious. maybe, with some clarification, you can share these insights with your friends. perhaps it will make for good party conversation or an excellent diversion when stuck in an elevator. if you have a lot of interest or are thinking about pursuing a PA degree yourself, or are shopping for a PA to use as your primary care practitioner, go to the national organization- aapa.org. tell them i sent you.

what a PA is: a licensed health care professional, practicing underneath the supervision of an MD. as a patient, you would never really tell a difference between an MD and a PA as far as what they do for patients- PA's do physical exams and diagnose and treat illness and injuries, order and interpret tests, assist in surgery, perform many procedures (casting, suturing, joint injections, etc, etc), and write orders and prescriptions (PA's have their own prescriber's ID, and the script also includes the MD's name and ID). PA's practice in many settings- they may work closely w/ their MD in a hospital/clinic, or may work autonomously (especially in rural settings) and just have an MD in the vicinity officially sign off for them. the exact scope of practice and prescribing rights varies state to state, but all 50 states do now have practicing PA's. a PA is similar (but not identical) to a nurse practitioner. NP's have been around longer and more people are familiar with them. they have a bit more independence than PA's do, but practice from the nursing model of medicine rather than the physician model, and have to have a bachelor's in nursing background instead of the varied backgrounds you find in PA's.

what a PA is not: not a doctor, not a nurse, not a nurse practitioner, not a medical assistant (an "MA" takes vital signs, gives shots, does filing/billing- it's 6 months of training without an undergraduate degree- totally different from a PA), not a scullery maid.

what is the training and what to call PA's: historically, the PA degree was a 4 year degree. now it's a master's, so it's 2-3 years in addition to an undergraduate degree. there are PA residency programs available post graduation, but most people don't do them. many patients have issue with not calling their PA "doctor" (many will do it anyway, no matter how many times we explain the difference). most PA's just go by their first name or by Ms./Mr. eventually, there will be a PhD upgrade option for PA's, which will make the whole confusion even more confusing. i think i will just have my patients call me "Paddy" for "practically-a-doctor"-dy. that should clear up everything. or maybe i'll get myself knighted by the queen so i can have the title "dame..."

what is the history of the PA: the PA role came about in the 1960's when practitioners were needed quickly to keep up with the patient demand. the first PA's were predominantly military personnel who had already been trained/worked in the field during Vietnam as medical corpsmen, and wanted to practice medicine upon return to civilian life w/o going through all of medical school.

why i chose to be a PA instead of an MD or a mime: in my previous career, i was already practicing in a hospital and didn't want to leave patient care long enough to go to med school (7-9 years of med school versus 2-3 of PA school). and i liked that PA's seem to have more time with patients, more opportunity to educate and care for them and don't have to worry so much about cost efficient practice as MD's do. also, the training is very practical- very nuts and bolts, daily practice stuff, and less germ theory and genetics and all the hard science stuff that MD's have to learn. and as far as job satisfaction- PA's are some very happy people. there is less liability, overall better hours and more flexibility as a PA than an MD. and good money for not all that much schooling. and i knew i could handle always ultimately answering to someone. i don't have an ego that needs total autonomy. and i decided not to pursue miming because, while i'm ok w/ hitting a glass ceiling, i didn't really want to be struggling to get out of an invisible box the rest of my life.

hope that helps!