OldPreMeds Podcast
OldPreMeds Podcast
Jun 21, 2017
79: MD or DO vs PA? How Should I Decide Which is Best?
Play • 13 min

Session 79

A common question among stressed out premeds – which do I choose, physician or PA? In this episode, I am sharing some insights into the differences between a physician and a PA as well as how to best choose between the two.

[01:18] OldPreMeds Question of the Week:

"I'm a new OPM (old premed), 31-year-old single, no kids. After taking a detour from the very traditional path, during my original undergrad 3.47 GPA in Biology, never took the MCAT, I figured out that I wasn't ready for medical school and started pursuing other interests outside of health care."

* As a nontraditional student, you're allowed to go pursue other things. If you think you're not ready, maybe you're a little burnt out from the premed path (all of us are a little bit), go and explore some other interests which is what this person did.

"Nearly a decade later, I am more convinced than ever that becoming a health care provider is the right career for me but I'm struggling with the decision of MD/DO versus PA. I don't have the requisite health care experience that would make me competitive for most PA programs but I'm going to have to spend one to two years full-time refreshing postbac coursework, taking the MCAT, etc. to go to medical school. So I could just easily spend the time working full-time as an EMT, CNA, or whatever. the problem is can't do both so I need to figure out which path I want to pursue sooner rather than later.

I've read some compelling statistics about PA that appeal me - 90% job satisfaction, two times the patient interaction time, 42-hour work week, etc. But those tend to come from sources that seem incredibly biased towards PA over MD. Furthermore, I am not 100% sure I'd be happy long term with the relatively diminished status of PA and/or whether I could do the type of international work as part of my life plan. Any thoughts, feedback, etc. from the OPM community especially from those who have explored decision for themselves would be most appreciated."

Here are my thoughts:

[03:50] Don't Base It on Job Satisfaction or Work Hours!

Deciding between being a physician and a PA -  the problem with this at that high level where you're just comparing work hours and patient interaction time and job satisfaction, that means nothing. Go look at somebody who has the best job satisfaction who's only working 40 hours a week and has great interaction with their clients. You can't choose your career based on job satisfaction, ratings, work hours per week, or patient interaction. If that's how you're going to choose your career then you're not going to be happy in the long run depending on if you made the right choice or not.

[05:15] A Huge Difference Between PA and Physician

Unfortunately, it's not talked about enough but there's a huge difference between being a physician and being a PA. The PA world will tell you there's not that big of a difference and the physician world will say there is. I am a little biased as I'm a physician. But in practice, depending on what you're doing and on what state you're in considering states have different laws regarding PA's, the work around what a PA can do can vary drastically.

I've talked to PA's who want to go on to medical school and I've helped some of them get into medical school and the reason always comes back to not having enough knowledge to be able to treat the patients they want to treat. The physicians would usually tell PA's it's the doctor's job while they go take care of the minor stuff. So there's a huge difference in the types of patients you'll be able to see because your knowledge base is limited, your scope of practice is limited. The role of the PA was created to fill in more of the mundane, easier things that could be algorithmically handed over to a "mid-level" provider. There's a lot of rate around the term "mid-level' but we'll just call it that because that's the terms that's been thrown around for a long time and that's the term that I always use.

The PA and NP are trained to take care of easier things. You can't go through PA or NP school and have the same depth of knowledge as a physician to be able to treat the sort of diseases that you would see that a physician treats. You can't. So if you are okay regardless of job satisfaction, hours per week, or any of that stuff, get rid of that. If you are okay working and treating patients who have the sniffles or aches and pains, it's going to be a lot of repetitive things. Medicine in general is repetitive even for physicians. But if you're okay with treating some of the lower acuity things then great, go be a PA. If you're okay not having the full knowledge base to be able to take care of your patients then be a PA.

[08:17] How Should You Choose Between a Physician and PA

We need PA's and there are plenty of people out there that want to be PA's. They have that mentality, personality, and goals in life that fit with being a PA. But my point here is do not choose physician versus PA based on job satisfaction, patient interaction, and hours per week. Don't base it on years of schooling. Choose physician or PA based on the scope of practice you want and the level of knowledge you want and go from there. The only way you're going to find our is by shadowing a physician or shadowing a PA. Shadow many physicians in different specialties in different areas or shadow PA's in different specialties in different areas and talk to a lot of people. Find out what they like and what they don't like about their job. This is the best way to go about it.

[09:23] International Work

I'm going to assume that a PA degree is not recognized throughout the whole world. If you're interested in doing international work as a PA, you may want to look into this. For instance, DO or the osteopathic medicine degree started here in the U.S. and it's most recognized here in the U.S. Now the American Osteopathic Association is working on getting more countries to recognize the DO degree and they're doing well. So now as a DO, you can practice in more and more countries but there is a limitation there. Whereas an MD can practice everywhere. So if you are truly interested in international work then really look into the recognition of a PA degree and what privileges and credentials you would have in another setting.

[10:36] Final Thoughts

Don't look at hours of work or patient interaction or at job satisfaction. Find out what you want based on the depth of knowledge, the skills you learn as a physician versus a PA. Look at everything else in there and you can only do that by shadowing enough. That's how you should choose between a physician or a PA.


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