What Kind of PAs Are We Turning Out?

By Dana Sayre-Stanhope, EdD, PA-C
President Elect

This message is reaching you just after the elections in our states and local communities and, depending on your inclination, you may have awaited the outcome with excitement or with trepidation. Here in Missouri negative ads flooded the airwaves and demonized candidates of all parties. My message also coincides with a special election being conducted within our Association. Fortunately, our Association elections are much more civilized and allow us to explore our issues, address our concerns, and select our leadership in a spirit of cooperation. More importantly for the Association, we are seeing more and more talented faculty members stepping forward and indicating their interest in advancing the work of the group. I am particularly struck by this, given the enormous and often stress-inducing workload of PA faculty. Their dedication to our mission and our students transcends the all-too-human desire to hunker down out of the way and speaks volumes about the kind of folks who are educating the next generation of PAs. I can’t help but contrast that with a comment I heard from a new graduate who was offered a position in a very busy internal medicine practice and who said to me, “I don’t want to work that hard.” Huh?

More than 40 years ago, when the first PAs appeared on the scene, they were drawn from the ranks of those who had a vocation to care for patients but were unable to attend traditional medical school. They were driven to care for patients and were willing to take a chance on a new profession in order to do so. Over the years I have seen that “fire in the belly” in many of our students, who relied on it to get them through tough years of study. I see it in some of our foreign medical graduates who don’t care what their title will be — they care only about getting back to the patient’s bedside. I see it in some of our older students who have worked hard to get back into the classroom. And I see it in some of our younger students whose lives have prepared them for service.

But I also hear the other mantra — or variations of it — from many of our students these days. They choose to become PAs because they can work at a slower pace, have more time with their patients, or work in practices that do not require evenings, weekends, or call. They choose to become PAs to ensure that they will have adequate time for their families, and they choose to become PAs because physicians must devote too much time and attention to the business of medical practice. Of course, most importantly, they choose to become PAs because they want to care for patients, and that is what we work hard to prepare them to do.

This issue, of students not wanting to work as hard, isn’t unique to the PA student population — I hear it echoed by my colleagues in medical school with regularity — but I fear that our profession is uniquely vulnerable to the charge of a diminished work ethic. In a world where PAs are still judged by the least of us, where work ethic variations are ascribed to a population rather than an individual, I am worried that I will hear from physicians trying to hire PAs what I heard from the doc who offered the job to the new graduate, “What kind of PAs are you turning out?”

This is a good question for all of us: What kind of PAs are we turning out? How do we identify those with a fire in the belly who understand the depth of commitment necessary to care for patients in today’s society? How do we ensure that while balance is an admirable goal, patients' needs must always take precedence? I wrestle with this question every admission season, and I don’t have an answer; but I am comforted by the students who rise to the challenge of rigorous curricula and demanding clinical rotations. What kind of PAs are we turning out? With all their reasons to choose our profession, the most important is the desire to care for patients and that is what really matters.