u/ExcitementOk5728

Have a question for Derm PAs!!

I am a PA without derm experience, and have been wanting to break into Derm for a long time. Most places won’t take me without experience. One practice I applied to is willing to take me on but suggested that I keep my current PA job and come train with them one day a week being paid as an MA/scribe but in “training” then after 1-2 years I would transition to being a provider.

Any thoughts on the 2 years MA/in training? It seems to be a common thing.

Hi! PA of about 4 years here. Looking for some career advice from someone who has potentially been in my shoes or has some insight.

I have only ever worked in big academic hospitals and in surgical specialty roles. Right now I’m working in academic hospital in outpatient surgery which is a pretty cushiony job. Pay is great, PTO is great, benefits are great, and my schedule is SUPER nice with some charting days and half days a week. On paper the job truly can’t be beat. The thing that I am really struggling with is the way that the PAs and NPs are utilized. They operate with a “shared” billing model and you are essentially working as a scribe for a surgeon on half your clinic days. Some of the scheduling staff in this clinic don’t even know what APPs do and have no idea we are independent practitioners. The surgeons sometimes treat the APPs as students (go in get a history, present to me, then we will see the patient together and you write my note) or as RNs (gather supplies and room this patient) and you are often referred to as “Dr. X’s PA or Dr. X’s assistant” because that is the role you play. I struggle with this not because I think that there isn’t a really important role to be had as a physician extender or assisting the surgeon, but because I wonder what I went to school for if this is something that could be done by someone with half my education.

I just applied to a private practice dermatology job (something I have been interested in for a while) that is interested in hiring and training me, after training I would be functioning as a fully independent provider, seeing my own patients, making my own schedule, billing for my patients and making a percentage of collections.

Anyone that switched from academic hospital to private practice do you regret it? Assuming pay stays the same, I would essentially be giving up good benefits, super chill schedule, structured PTO in a very reputable academic institution in exchange for autonomy and hopefully more pride in my work, pride in my career as a PA and sense of ownership for the medicine that I am practicing. Would love to hear thoughts!!