Over time, in most jobs, employees expect the opportunity to rise up the totem pole at work. They assume eventually they could have their boss’s job, if they pursue it. However, the medical field is structured differently. As a physician assistant, no matter how much experience you get, no matter how fantastic you are at your job, you will not be a supervising physician unless you go back to school. That means you must go to medical school (3-4 years), go through a residency program (3+ years) and maybe even a fellowship (1+ years). Yikes! That’s a minimum of 6 years of your life, a huge initial pay cut and hundreds of thousands of dollars of loans to get a promotion! Thanks, but no thanks.
Does this mean we’re not ambitious? Does this mean we’re stuck being someone’s assistant for the rest of our lives? Are we oppressed? Of course not. Power to the PAs!
When you start out in the field, you might think it’s nice that someone else holds your hand through decision making and takes all of the responsibility for what you do. However, when you start kicking butt at your job, it’s annoying to still have the tricycles on. Hello. I can ride a big kid bike with no hands at this point, why do I still have a tricycle? No one is going to hand you autonomy on a silver platter. You have to advocate for yourself and earn trust. Keep in mind, we are operating under a physician’s license, so if we mess up big time, they get sued. This makes physicians very anxious. So when you start getting micromanaged, it is up to you to let it be known you can handle the situation. If I have questions, I look the protocol online or in a book before speaking with my supervising physician. This way when I ask a question, I already know what I want to do and I am just confirming it with them, instead of looking clueless. Imagine the difference- “This patient has such and such problem, what should I do?” vs. “My patient has such and such problem, according to the research, I should do (insert plan here). She also has this comorbidity, so I was planning on starting this medication at this dose. Sound good?” Boom! In the first example, you didn’t take ownership over the patient and you had no clue where to start. In the second scenario, you already took ownership and came up with a feasible plan, but asked for confirmation. This tells your supervising physician, you are competent, thorough and confident and you recognize you are operating under their license so you respect their input. Over time, you will be rewarded for your efforts. When you treat physicians this way, they will reward you with more autonomy and respect. Treat them as an equal and should will do the same. Asking for confirmation is not a sign of weakness; physicians ask me for confirmation of their medical decisions this same way. No one knows everything all the time. If you think you do, you are far too arrogant and will eventually fall on your face. If after all of your efforts to get respect and autonomy, your supervising physician still cannot help but micromanage you, it is time to find a new place to work. As a physician assistant, you can get a job anywhere, in any field, anytime. When you leave, you’ll be missed dearly, so remember you have way more power than it might seem.
Do you care about how you are perceived by the physicians in the community? There are absolutely physicians out there that think we’re fantastic ( which we are) and treat us as equals! Do your best to surround yourself with these types of doctors. I work with a doctor who believes in me more than I believe in myself sometimes and I couldn’t be happier to work with her. When I am drawing a blank, instead of micromanaging me, she says, “Lauren, it’s your patient, you figure it out.” These words are magical to me- instant confidence and determination to solve the problem. We should all work with physicians like this. Of course, unfortunately, there are physicians who think we are inferior. Sometimes, they think we are their personal assistant. To some degree we are assisting, as in we are helping them by taking some of the patient load and taking care of them ourselves. However, we are not mere assistants; we are awesome licensed medical practioners. Let’s put ourselves in their shoes for a minute. Imagine you went to a four year medical school, you did a residency and possibly a fellowship and someone else got the same job as you after only doing a 2 year PA program ( or 1 extra year of school in the case of the 5 year PA programs). You’d be pissed! You justify your life choice by thinking the other person is only an assistant, you obviously know more. So before you get offended by any condescending comments, remember that. My personal favorite are the condescending comments that are supposed to be compliments like “You know, you would probably get into medical school if you tried”Really? No kidding. If I wanted to do that I would have done that. Or “You are as good as some doctors!” Well, duh. I’m a fairly intelligent person and I know how to do my job. Haha. Okay, sometimes people forget we don’t idolize them; we actually love ourselves. Hey remember though, “No one can make you feel inferior without your consent.” These are wonderful words by a wonderful lady, Eleanor Roosevelt. Do not let yourself get upset. It’s foolish. Keep in mind, there is a line between being sensitive and being mistreated, so know your limits and keep your eye on the job listings if you think your conditions are intolerable. If you really idolize the respect physicians get enough to go back to school, knock yourself out! If you do not, keep in mind your self-worth and remember what the rest of the world thinks of you.
How are physician assistants perceived by the general public? Exciting news-almost everyone thinks we are awesome! Every time I tell someone I am a physician assistant (and they actually know what that means), they tell me a story about a physician assistant they went to that was great. First of all, thank you to my fellow physician assistants for being incredible at your jobs; you make me look so good. I love that we all raise each other up. One great thing about PA school being so hard to get into and get through, is that the people who graduate are the cream of the crop. I love calling these people my colleagues. Patients trust us! We write prescriptions! We order and interpret tests! We have the ability to affect patient’s life and quality of life. It is so humbling and wonderful. Ya, ya, sure, you get a sour apple every once in a while, but 9 times out of 10, this is a difficult patient that you really did not want to deal with anyways. “Oh you want to see the doctor only? Great! Not my problem. I’ll go see the patients that love me.”
Let’s talk about advancement possibilities that do not require a lifetime of education and cost your left arm and first born. First of all, you can teach! Look at part time positions or opportunities to give lectures at universities. You can start your own or join up with a medical community. I know NPAE is always looking for bright, motivated PAs to join our team! You can get on the NCCPA board and actually make a difference for the physician assistant career at large. There are even physician assistants that own their own practices! There are countless other ideas that did not just quickly pop into my head that you can do to take a leadership role in the community. You are a physician assistant and the world is your oyster.