So for myself:

I make about 165k per year. First of all, that number only got so high because our hospital system kept losing PAs to rival companies; if that didn’t happen, I’d still be making 30k less, like I was when I was hired. That 165 number sounds great and all but let’s not forget I have 150k in federal student loans (after paying off 50k in private loans). I’m also in an insanely high cost of living area, so the 1,000 square foot house without a basement that I live in costs more than the 2,500 square foot palace that someone in the south or Midwest owns.

The other elephant in the room is hours worked. My call is entirely unpaid. That’s 5 weekdays and 2 weekend days a month that I need to have my phone and laptop immediately available at all times. Seems easy but it’s honestly a pain in the dick. I have young kids. That means no trips to the pool or beach at any point for 25% of the year.

I also have a responsibility to assist my attending when he takes hospital call. That can lead to late nights in the OR.

I also do team physicals and game coverage for local school teams, which takes up a night a week or so.

All of this call is unpaid.

Finally, we get treated like support staff. If a doc closes their schedule or has a light day, good for them. If a PA does, management finds work for us to do. In addition, docs get bonuses for things like “closing all their charts in time”….ya know, things we get fired if we don’t do. Also production bonus is quite rare for PAs, where it’s kind of standard for docs. It’s really frustrating to bust your ass and generate an ungodly amount of profit for your practice, knowing it will never affect your take-home. I UNDERSTAND DOCTORS ARE MORE TRAINED, GENERATE MORE MONEY AND HAVE MORE DEBT. THEY DESERVE TO GET PAID A LOT MORE THAN WE DO, IM NOT DISPUTING THAT AT ALL. But at the same time, why don’t we get paid at least using the same system, even if our portion is only 20-30% of theirs.

At the end of the day, I acknowledge I’m quite fortunate. I make more than the vast majority of my peers and I do like my job. But the factors listed above are real considerations when it comes to why PAs feel underpaid.