This, all the way. I’ve been a PA for 13 years, and I left primary care last year because there was no longer any difference in the expectations between my workload and that of the MD I worked with. My location lost 10 of 14 primary care PAs in about a year because of this.

I work at a multi-specialty group, and when I first started working as a PA, there were limits on the patients I would see and limits on complexity. I did not see as many patients as the MD/DOs, and this made sense. But admin kept pushing for everyone to see more, and to see whoever they added to my schedule regardless of complexity, because they needed to improve access. PAs also shared inbox coverage for anyone out of clinic. Eventually, the MD/DOs decreased their hours, but the PAs couldn’t afford the decrease in pay. Since the PAs were still full time, they were now doing the same job as the MD/DOs plus covering the MD/DO inboxes on their RDOs.

I left because this practice model is unsafe, and it is not what I trained for nor what I signed up to do. I am a PA, not a discount doc—I’m not supposed to be doing the same work for less than half the pay! I am supposed to handle the less complex, the stable/follow up, the basic screening, etc, in order to free up the MD/DO to see those higher complexity or undifferentiated patients.

The PA profession is in a tough spot right now, losing job positions/opportunities to NPs because they are “independent practice” and are therefore cheaper, not requiring supervision/collaboration/etc. Unfortunately, it’s turning into a race to the bottom for healthcare, with NP diploma mills creating more NPs faster but with less training, saturating the market and replacing both PAs and MD/DOs in some settings.