Hey guys, thanks for checking out this episode. Today we’re going to talk about five PA career misconceptions that either I believed when I was a paramedic or I’ve heard from other paramedics and EMTs, kind of just things that they think about the PA profession that aren’t necessarily true. And the first one is that a PA is just a doctor’s assistant. Unfortunately assistant is in the name. So this is something you’re going to have to explain a thousand times when you become a physician assistant is no, I’m not a medical assistant. I’m not just here to assist a doctor. I’m a fully functioning medical provider. But that is something that you have to be aware of if you’re going to be a physician assistant is a lot of people are going to confuse you for a medical assistant, you know, will have to explain this to patients as well as people that just don’t understand the career as much.
It is very similar to being a paramedic. Paramedics have to work under a medical director. They have standard protocols or guidelines that they’re allowed to operate under, but they can’t operate individual of that or they’re going to be more liable if they start to go outside of those guidelines. A physician assistant’s very similar. We have to have a supervising physician and while they don’t hand us guidelines or protocols that we have to follow, we still cannot operate individual of that supervising physician. We still have to have somebody that has signed on to take that role for us. So one question that kind of comes up is do you have a lot of autonomy as a PA and paramedics are seen as very autonomous. When you’re out in the field, you’re not calling and asking permission to do a lot of things and being a PA is very similar.
I’m not asking permission to do a lot of stuff. I still feel very autonomous even though I’m still operating under a supervising physician. So if you think a paramedic’s autonomous, a pa, you will also have a feeling of autonomy even though knowing that you’re working with a physician. Similar to being a paramedic though, is especially when you’re a new ER provider or a new pa, you have to understand your limits and when you’re kind of in over your head, if a patient presents very benign initially or low acuity, you need to know if something comes back on that patient that now kind of upgrades their level of care. If a patient comes back with a weird imaging finding or lab work that you don’t know how to interpret, you need to know when to involve a physician. They’ve had a lot more training. They’ve had four years of medical school, they’ve had three or four years of ER residency.
They’ll be able to answer your questions. A lot of times because PA schools a couple of years, two to three years of education, a lot of times you don’t get a residency. So you have to understand the limits of your own abilities and your own experience level and know when you need to bring an imaging finding or lab work finding to a physician to kind of help get guidance. And that’s similar to being a paramedic. When you feel like you don’t know the right answer in a question, you can call medical direction or you should have somebody that you can turn to, even if it’s another more experienced paramedic, to ask them a question to kind of get some guidance. So it’s very, very similar in that regard as well. One thing I saw when I was a paramedic that kind of made me think that a PA was a doctor’s assistant was I would be giving handoff report and the doctor would do all the questions.
They would start asking the patient questions, they would do the physical exam and the advanced practice provider, the PA would kind of stand there and wouldn’t be super actively involved. And I’ve come to see on the other side of that, of the 20 plus patients we’re seeing, I probably go see a lot of those independent of the physician and they go in separate from me. A lot of ’em we see as a team but just because I’m not the one asking the questions doesn’t mean I’m not actively involved. I’m probably going to do a lot of consulting on that patient. I’m going to talk to the specialists place their orders, potentially discharge them or get them admitted. So that’s just a very tiny piece of the puzzle as the initial history taking. So just because you see a, not being the one to take the lead when you give report doesn’t mean they’re not actively involved.
It’s probably that they’re just allowing the physician to take the lead on that particular patient. And you’ll see it both ways. It could be PA took the lead on the prior ambulance that came in or saw the prior ambulance by themselves, and so they’re happy to step aside and let the physician get the history on this particular patient. But that doesn’t mean that they’re not taking an active role in the patient’s care. It’s they’re not getting the history on that particular patient. The second big misconception that I see about PAs is that they are seen as just a paramedic in the hospital. That’s something I kind of thought when I was a paramedic although that changes, I kind of did shadowing and kind of, but it’s definitely a misconception. A PA is much more than just a paramedic in the hospital. The amount of education that a PA goes through is a couple years of them basically teaching you everything you don’t know and that the world of medicine is much more broad than you think 50 years ago or more.
A primary family physician could do a lot of medical care now there’s a specialist for every subspecialty in medicine. And knowing when to involve those specialists and how to articulate a medical problem to those specialists is a huge part of the job and a huge part of the learning curve that I had to climb over the last couple of years, and I’ve discussed this with other paramedics that have become PAs. It’s that part of paramedic culture is to take the lead. Even if you don’t know, always have all the answers. Cardiology and a lot of pulmonology topics in PA school will be familiar to you as a paramedic and you will have a leg leg up on a lot of your classmates, especially in cardiology and EKG interpretation. But there’s so much more to learn in topics like GI and renal and even now with a couple years of experience and having gotten through school, there’s still so much to learn on those topics that I learn more every single day.
And a lot of becoming a PA from a paramedic is understanding all that you have to learn and knowing when to reach out for help and when to consult specialists to get further help in guidance in treating a patient. Sometimes I don’t know if a patient’s okay to go home and I need to talk to a specialist to see if they’re okay with the patient following up in their clinic or if they’re more concerned about something and they want the patient to stay in the hospital so they can see them more urgently. Adding to that the ability to prescribe medications especially medications that you’re not intimately familiar on. The ambulance, I was super familiar with every single medication that I would give. I mean paramedic school hammers all of ’em into you. The mechanisms of actions of every single medication, what they interact with, exactly what they do, going to being a pa, where you’re prescribing medications that you’re not intimately familiar with.
And so you have to learn about these medications on the fly, learn how to prescribe them, learn how to properly dose them. And that’s another topic that really just begins to make you realize that being a PA is very different from being a paramedic and really does require a lot of knowledge that you have to gain and makes it very different from just being a paramedic in the er. Another big misconception that I see is that PAs only see the low acuity patients and that’s not the case in most systems. Now, some places you might work, PAs are going to see a lot of the low acuity patients, but only seeing the low acuity patients is certainly a misconception. One thing I like about the system I work in is that we see a lot of patients in collaboration with the physicians as a team.
And so I’m taking care of critical patients, lower acuity patients and everything in between which is something that’s really fun about the job especially when you’re new. It’s great to be able to see higher acuity patients in combination with a physician that can help you when you’re not sure what to do, especially when you gain more experience and the physicians start to trust you more. You’ll be doing all the high acuity stuff that attracted you to paramedicine in the first place and things like central lines, lumbar punctures, innovations, chest tubes, you’ll be doing all the fun high acuity procedures that you enjoyed doing as a paramedic, as a pa, especially as you gain more experience, you will be seeing those high acuity patients that really need emergent interventions. That’s not to say that we don’t see the low acuity patients. We certainly do. I’ll go in and see a patient that’s very low acuity and discharge ’em to save the physician some time and keep the department moving and they’ll pay me back the same favor if they go into a room before I do see a low acuity patient, they can discharge that patient and I don’t have to go spend my time seeing them.
And so it’s a very much team mentality. The ER especially a busy ER is about efficiency and so if I can save some physician time by seeing and discharging a low acuity patient, I will. And they’ll do the same for me. If they get into a room, they’ll discharge a low acuity patient too. It’s not expected in a lot of places that you just go see all the low acuity. Certainly there’s different care units in different hospitals where they put lower acuity patients and a lot of times those are run by advanced practice providers, be it PA or nurse practitioners, but that’s only one shift. A lot of times if you have different departments and different shifts, you’re going to get a good variety of patients. And I think a lot of people will use that as an excuse not to go to PA schools.
I don’t want to go and see a bunch of low acuity patients. I still want to see critical patients, but don’t use that as an excuse because of course nobody wants to spend two years of your life and a bunch of money to only see low acuity patients. That wouldn’t be motivating at all, but don’t use that as an excuse because you will be able to see a large variety of patients depending on where you work. The fourth big misconception that I see is that I don’t have a lot to learn. If I went to PA school, and I touched on this before, but PA school really is two to three years of them teaching you everything you don’t know. And it’s very humbling to kind of broaden your view of medicine in general emergency medicine’s, its own kind of little thing, but there’s lots of other different types of medicine to practice and you get a brief glimpse of all of that in PA school.
And learning how to longer term manage patients is a skill all of its own as well. And that might be something that actually attracts you to a different type of medicine instead of emergency medicine. A lot of paramedics go to PA school and find that maybe emergency medicine isn’t that attractive to ’em and they go into a different specialty and that just means that there’s a whole new world that you have to learn. One example I can give of that is really just abdominal anatomy. I think my physical exam, especially when it came to the abdomen as a paramedic was pretty poor. And maybe I just wasn’t a very good paramedic when it came to abdomen exams. But where you push and where the pain is is very pertinent to what tests you want to order. So a good exam is super important. And knowing what you’re looking for, be it pancreatitis, cholecystitis, appendicitis, all these things really matter where the patients tender and that’s all that anatomy and what tests you want to order is something I had to learn in PA school that I really had no idea when I was a paramedic.
And a lot of that’s just because it doesn’t matter to you as a paramedic, you know, care if they’re having abdominal pain, you care if that’s their chief complaint, but you’re not thinking about the further tests that you need to order imaging wise or lab work wise. The fifth and final misconception I hear about the PA career field is that it is a step you want to take when you are done with all the excitement and kind of want to retire. It’s paramedic retirement, which is really not the case. And if you watch the episode where I talked to Brian San Felipe, who’s NPA school, we go into a lot of depth about how hard it is to get into PA school, just the competitiveness and how bad you really need to want it. So it’s not something you want to consider later in life because it’s not something that’s easy.
It’s a huge sacrifice both financially and time wise. It’s not something you want to consider just when you’re done being a paramedic. It’s something you act have to actively pursue and sacrifice to get there. My personal journey to get to PA school started in I think 2011 when I was in paramedic school. I went to a information session for PA school and decided that was for me. And I slowly worked on getting all those classes done over the course of several years, about six years of getting prerequisites done, getting my bachelor’s degree before I actually got accepted in 2017. And so it was something I had to actively pursue. It wasn’t an afterthought. I sacrificed a lot of free time and a lot of money to get that education under my belt so that I could be a strong applicant. And even working in the ER as a PA with a paramedic background, the learning curve is still extremely steep and it’s not something you want to do later in life because the learning curve is something that has to be grasped quickly.
You have to be a very quick learner, and the older you get, your ability to learn things quickly starts to deteriorate. So it’s not something I would want you to do when you’re considering yourself closer to retirement because it’s a huge endeavor to understand this new level of education and understand this new level of emergency medicine. So my encouragement to you is if you wanna be a PA or you have that inkling, start now. Start now looking at prerequisites. Figure out what you need to do. If you need to improve your gpa, if you need to get volunteer hours, whatever you need to do to be a strong applicant, I would start now because it’s a very long and arduous process and not something to be put off just because it does take so long. So if you wanna be a PA and you think that’s the next step for you, I would encourage you to start those steps now and not wait, not wait until you’re tired of being a paramedic.
I still had a very long career as a paramedic. I was actively practicing for I think between eight and 10 years as a paramedic. And most of that time I was working on prerequisites for PA school. So you can still have a very long career as a paramedic while simultaneously working on getting into PA school. All right, guys. I hope that this episode was valuable for you. I hope that some of these misconceptions were a little bit set right, and hopefully gives you a little bit better perspective of what the PA career field looks like. Check out some of the other episodes I have and it’ll hopefully help you determine if the PA career path is for you or not. If you did find this episode valuable, please subscribe, like, share it, comment, let me know if there’s things that I could be doing better or things that you like. And the more you guys can do that stuff, the more I can take these episodes and produce content that is actually valuable for you and understand where you guys are coming from. And just remember that there’s very few professions where you can actually save somebody’s life. And just know that while that opportunity doesn’t happen every day, there’s always an opportunity coming. So go out there and be the best provider that you can be and be ready to take those opportunities.
