Here's an interview witha PA who works in Neurosurgery.
1) Why did you become a PA?
I became a PA in a roundabout way. I suppose the same way a lot of people do. I already had a Master's degree in Anthropology and was burnt out on academics. I knew I wanted to do something practical with my training and experience. Initially, I was taking pre-med prerequisites thinking I'd become a physician, but I met someone who was applying to PA school who was taking a class with me. I did some investigating and realized that becoming a PA would be a better fit for me over all. I wasn't wrong.
2) How did you pick BCM? What was your application and interview process like?
I lived in Louisiana at the time I applied to Baylor College of Medicine in Houston. Louisiana only had one PA school available and it was a Bachelor's program. Baylor was relatively close to home and I didn't have to meet any residency requirements to go to Baylor. I loved it there. Great school and amazing experiences at the Medical Center there. The application process was easy. This was 1998-99 so I think it was an individual application process, not a centralized process. The application process was enjoyable actually. We all toured the campus and part of the Med Center. We were assigned to interview with PAs and MDs. It was pretty relaxed overall even though we were all stressed out.
3) What was your strategy for succeeding in the didactic phase? How did that change in clinicals?
I learn visually and I just remember reading and re-reading and re-reading and talking things through with classmates. For me, re-writing my notes was really helpful. Clinical phase was markedly different. You learn on your feet, helping take care of patients and then reinforcing what you saw and learned by reading more whenever possible.
4) What do you do as a neuro PA? What does a normal day/week look like for you?
As a neurosurgery PA I see patient's in my own clinic, assist my physician in his clinics, order and interpret tests, assist in surgeries in hospitals and in our surgery center. I also take call after hours and round on the weekends as needed. I also field phone calls from patient's and deal with disability paperwork and refill requests. I also see patients in pre-op clinic and discuss their upcoming surgery and answer their questions. A normal day starts at its earliest around 7 am and ends around 4:30-5. I work Monday through Friday and, if on call, round on Saturdays and Sundays. Occasionally, we do have emergency surgeries that happen after hours. Occasionally we have to see patients in the hospital in consultation after hours too.
5) How did you get connected to your current practice? Have you worked in other areas of practice?
I actually interviewed with my current employer 9 years ago but accepted another job offer. I was looking for a new position several months ago and answered an advertisement for a Neurosurgical PA on the TAPA website. I have also worked in general orthopedics, neurology, orthopaedic spine and orthopaedic trauma surgery.
6) I've heard that the critical component of any PA position is the relationship with your supervising physician. What do you look for in that relationship?
Finding the right "fit" with your supervising physician is very important. You have to mesh well intellectually and emotionally. Working with surgeons means that you have to respect and appreciate that your employer may do things differently from other surgeons, but your employer's way is THE right way when you work for him/her. You are second fiddle to your boss. If you can't accept that, don't become a PA! For me, I need to work with someone who is respectful of me, my life and my opinions, and is honest about the expectations. Some employers will try to win you over with money and benefits but then have no respect for your time outside of work. I can take working long hours as long as I know that's what is expected of me. I've been led down primrose paths before thinking that I would work "normal" hours (ie, 9-5) only to be in clinic until 8pm routinely and in the operating room until 11pm all too often. With no extra compensation for all that time mind you. If your employer works as hard as you do that's the exception to the rule. That's how things are for me now. Not always. I used to work with ones who took their dedicated time off during the week but expected you to work your 40 hours and more.
7) You've been practicing for 10 years now [ed: I think I remember that from our conversation, feel free to correct me] How has the role of a PA evolved in that time?
I have been a PA in practice since 2002. Medicine has changed drastically. I think that US medicine is evolving towards a more centralized system. Not necessarily toward government centralized but more towards hospital centralized care. I see more and more private practices having real difficulties because they're competing with other providers who are employed by hospitals. Imagine that you work for yourself and have employees. All the income you generate is because of your great reputation and hard work. Then, right next to your name in the insurance directory is a provider who provides, by appearances at least, all the service you offer but their salary is paid for by a hospital system and that provider is expected to keep all their referrals and testing within that system. That's what we're going to see more and more of. Your boss may be a surgeon who is competing with other surgeons who provide the same services, but your boss gets paid based on the work that your practice performs. A hospital employed surgeon gets paid no matter how much work he/she does because they get a salary from their employers - a hospital. Your boss may need to do 40 surgeries a month to keep the business going, but that hospital employed surgeon....I'm not sure how hard that surgeon would work since they would get a salary no matter what. I feel that this trend will affect PAs and NPs and more hospitals will employ mid levels directly. Might not be a bad direction to consider.
8) Any advice for aspiring PAs?
Study hard. Ask lots of questions. Listen to the nurses. They can teach you a LOT. Don't take things personally if people look at you like you're "just a PA" and "not a doctor." I'm amazed daily how few people know what PAs are and what we do. Don't stop learning. Most patients just want someone who actually listens to them. Try to really listen to people rather than just waiting for your time to talk. Do what you enjoy and enjoy what you do.
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