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Hi, 

I saw on the news a segment about PA's not getting pandemic pay by Ontario Government. 

https://globalnews.ca/video/6887853/some-ontario-front-line-workers-left-behind-on-pay-premiums-during-pandemic

As someone looking into both MD and PA as a potential career, I worry about this. Does this mean going into the PA field could be a risk.  I read some online forms and people are saying that the PA career will not grow because the government likes NPs better. And after doing some more reading I am kind of wonder if there is a need for PA's when we have NP's.

Personally if I am doing the same work as doctors as a PA I would want to be paid fairly and it dosn't look like PA's have a decent salary, security or the government's support. 

 

Any thought on this as I might have to choose between PA and MD this year. 

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1 minute ago, swoman said:

LOL neither residents nor physicians fall under this wage increase either. The OHIP billing system isn't even accepting certain billing codes for telehealth and physicians are not getting any support from the Ontario government for their small businesses

Oh wow I didn't know that either. Then why were PA's featured on this new segment if also doctors were not recognized. 

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3 hours ago, med1234med said:

Do you think PA's are over paid? Just wondering I am just starting to learn about PA's and its sound kind of nice but not alot of support for them. 

There is more to this. In Ontario, PAs are not regulated and face stern opposition from the nursing union and other allied health professionals (sometimes physicians). PAs are under-utilized and underpaid compared to Manitoba and vastly underpaid/under-utilized compared to the US. It's a good field but in Canada, there is more advocacy required. For years, people have said they'll be recognized and regulated but there has been minimal, if any progress for Ontario. Physicians are currently dealing with their own billing issues with the government but PAs are having their funding pulled and reallocated to ER/urgent care settings for the time being. Really consider yourself being in this field, I keep reading encouraging articles from the association that PAs will grow and they continue to advocate but I don't see governments being ready to even entertain regulation or progress for PAs. I'd look into PA in the US if you really want to be in the profession, they're killing it over there. Otherwise if you want to be in Canada, consider med as a more stable option

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3 hours ago, VivaColombia said:

There is more to this. In Ontario, PAs are not regulated and face stern opposition from the nursing union and other allied health professionals (sometimes physicians). PAs are under-utilized and underpaid compared to Manitoba and vastly underpaid/under-utilized compared to the US. It's a good field but in Canada, there is more advocacy required. For years, people have said they'll be recognized and regulated but there has been minimal, if any progress for Ontario. Physicians are currently dealing with their own billing issues with the government but PAs are having their funding pulled and reallocated to ER/urgent care settings for the time being. Really consider yourself being in this field, I keep reading encouraging articles from the association that PAs will grow and they continue to advocate but I don't see governments being ready to even entertain regulation or progress for PAs. I'd look into PA in the US if you really want to be in the profession, they're killing it over there. Otherwise if you want to be in Canada, consider med as a more stable option

do you think PA's will stay where they are now, or potentially all be out of jobs? 

I didn't know things were so unstable, why would they keep the programs going and have students graduate every year. 

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24 minutes ago, med1234med said:

I didn't know things were so unstable, why would they keep the programs going and have students graduate every year. 

Because the university's primary interest is collecting your tuition dollars and the government funding that comes along with it. At the end of the day universities are a business in addition to being educational institutions and research facilities (they are in the business of education). That's why you can take a multitude of degrees at University that are difficult at best to find jobs in - because people will pay to pursue a degree that is a passion project (I have at least one of them! It was a super interesting degree, I enjoyed it, but it's not employable in the least). It's also one of the reasons why universities don't like being gatekeepers to professions beyond purely academic measures of competence and want professional registration bodies to do the gatekeeping in regards to fitness for practice. That's why every year there are at least a few graduating students who have passed all their courses yet still find themselves caught in an administrative nightmare after sending in their registration papers and being told they have to pay for a bunch of additional monitoring in order to practice that they were not told prior to entering their degree that this would be an issue on graduation. It's really unfortunate but it's also not an easy problem to solve. 

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As other users have mentioned, a LOT of professions were excluded. But the profession is not doing as poorly as some people seem to think here. Currently, there are more jobs than new grads to fill them every year. Salaries range from 75k-130k ish here in Ontario. If you see jobs posted for less than that, they likely never will get filled or the post was mislabeled since the professional title is not protected. As a current student, I am not worried and I expect things to keep improving. 

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1 hour ago, med1234med said:

do you think PA's will stay where they are now, or potentially all be out of jobs? 

I didn't know things were so unstable, why would they keep the programs going and have students graduate every year. 

PAs will have jobs once covid passes, I'm just not sure if they'll be good stable jobs. The PA field is interesting, they are extremely useful for the healthcare system (as demonstrated in Manitoba and Ontario to an extent but more so in the US) yet there is a lot of opposition to their expansion. NPs are being utilized far greater than PAs in Canada, my opinion is due to the pull of the nursing community/union. Until the government recognizes and regulates PAs in more provinces, this topic will keep being discussed. I've read about PAs trying to get recognized for a decade in Ontario but no progress whatsoever is being seen. Alberta has some progress but it's still stalled there. At the end of the day, it is a business as mentioned by MSWschnoodle and universities will gladly take tuition to fund students hope of a great PA utilization in Canada. Look into this more and talk to PA students and practicing PAs to get more than one perspective about it. I'm pro-PA but only in the states since they have more stability, get paid really well and have more scope in their practicing ability. Heck, you can even open your own primary care practice as a PA with limited oversight from a physician in the US, lots of autonomy present there. 

55 minutes ago, green987 said:

As other users have mentioned, a LOT of professions were excluded. But the profession is not doing as poorly as some people seem to think here. Currently, there are more jobs than new grads to fill them every year. Salaries range from 75k-130k ish here in Ontario. If you see jobs posted for less than that, they likely never will get filled or the post was mislabeled since the professional title is not protected. As a current student, I am not worried and I expect things to keep improving. 

I'm not a PA student nor a PA but when I was looking into the field, those jobs are only filled for what 1-2 years? If there isn't funding, you lose them and have to find someone else to take you on. You have to be flexible to move and it's not a stable job. And getting autonomy for medical directives without regulation is a pain from what I've heard from practicing PAs. Until regulation doesn't come, people deciding to become a PA should take this into consideration and know there is not much job stability present (unless moving to Manitoba or rural ON is an option). I saw on social media recently that a PA in Ontario working in primary care has changed her job 2 times since the supervising physician either left or could not keep them due to funding issues. And covid made this person unemployed again, placing them in a position to still advocate for the profession and look for employment. PAs should definitely be unionized and have more flexibility/stability in Ontario but heres to keep waiting.

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8 minutes ago, VivaColombia said:

 PAs should definitely be unionized and have more flexibility/stability in Ontario but heres to keep waiting.

Thank you for your opinion. I have started reading more into the profession, it does like their growth is paused and that they havn't done much in a decade. I am guessing if given the choice between PA or MD, MD is the better choice.

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Hello! I’m a current PA student and thought I would chip in. I think I might be the only one commenting here so far, so I’m going to acknowledge my bias as I’m obviously a huge supporter and advocate for the profession’s growth in Ontario and Canada as a whole. 

 

It’s funny how there is radio silence on this forum until something remotely controversial happens and people start talking - I recognize that is good though, seeing conversations happen among students and professionals outside of the PA sphere. 

 

I am in support of PAs receiving pandemic pay, full stop. It is complicated by the lack of a stable funding model. Physicians (and NPs I believe) are able to bill for their services, whereas PAs tend to be employed by a physician/group of physicians, family health teams, by a hospital, the list goes on. So, this immediately complicates WHO exactly would provide the pandemic pay for PAs because there are a lot of different parties involved depending on the PAs position. So, the way I see it, pushing for pandemic pay is a means of advocating for the profession in of itself by making sure the government and the ministry can see us, and know that we are working. 

 

In my circles, which consist of current PAs and students, I have not heard much about people losing their jobs to COVID. I am sure it’s possible, based on some of the other comments above, but I have mostly heard of PAs being relocated from family med clinics to EDs & ICUs.

 

It is important that PAs get compensated fairly during this time, but there are numerous challenges associated with that. For those of us in the PA sphere we know these issues quite well and have good people in leadership positions doing their best to advocate and move us forward.

 

In regards to some of the other comments/questions you made:

-Is there a need for PAs when we have NPs? I would say yes, if NPs are providing care under a nursing model and PAs are providing care under a medical model. That leads into your next point.

-If a PA is doing the same work as an MD, why aren’t they compensated the same? PAs also work in medicine, and provide care to patients but MDs should generally be viewed as specialists who have undergone extensive training to practice independently where PAs should be viewed as generalists who work in collaboration with MDs (and other members of the healthcare team) with a fair degree of autonomy but ultimately deferring the final say to the MD (in most cases). With that being said, it makes sense why MDs make more. However, for only going to school for 2 years and then entering the workforce to be lifelong learners and providers, the median PA income in Canada  is still around 81k (and that’s good if you ask me). 

 

In my opinion, PAs are here to stay. Last year there was about 70-80 new jobs for about 50 grads in Ontario. I was told that everyone in the class above me found jobs except one person who wanted a job in a speciality that was not hiring. Once again, funding models are where we lack stability, but to my knowledge most people keep their job. 

 

-Finally, of course MD is a more stable choice. It’s been around forever! In the next 10 years it’s hard to predict what the landscape will look like for the profession, and what new and ongoing challenges we may have then, but I am confident that we are in this for the long term, even if it might not seem like that on your end. 

 

Our program heads have always been very open with us since day 1 about the very real challenges associated with being in a growing profession. None of us are leaving this program blind about the potential challenges we may face but we are doing the best we can in these uncertain times. 
 

One final story: our program head and other faculty members were in the first graduating class of PAs and told us that they got jobs after graduating only for them to be cut several years later. At the time they were cut, it was mostly due to funding I believe, but there may have been other reasons. Several years later, that same hospital began to rehire PAs because they realized the critical role they played in continuity of care  and actually keeping the flow of patients steady and moving. Today, one of them is working in subspecialty medicine and has been for several years. She says her supervising physicians see her as more of a colleague, and she has a great job teaching for the program as well. The other is in a very high position of leadership for the program and continues to practice part-time on the side. 

 

If you have concerns, trust me, we have them too. We are working hard to make sure people never worry about us in the future! Feel free to DM me if you have any more questions. 

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Regulation is an interesting topic. A lot of supervising physicians and PAs are actually against regulation of the profession, its a much more complex situation than I once thought. Due to this, I do not believe I can do the topic justice but just know its not as linear as regulation = stability in this case. I don't think PAs should practice independently as mentioned above, PAs in the states are getting a lot of back lash. Once again, if you want to practice independently become an MD. 

Im not sure where this notion of PAs disappearing is coming from, just recently a new pilot project started and NS and there is huge support to integrate them there. 

As for unstable jobs, that was much more common years ago. The ones that only last 1-2 years are career start jobs. Those normally turn into permanent positions. Most students are now able to find permanent jobs right out of graduation without that funding though. Here in Ontario, that one example that keeps getting brought up about a person being laid off twice is the only one I've heard in recent years. There definitely could be more but I have met so many practicing PAs who have not had any issues at all.

I agree with the points mentioned above by a fellow PA student. MD is definitely a more stable field and it always will be I think :). The best advice I can give is to talk to practicing MDs, PAs and whatever other options you are picking.

In conclusion: Whichever you choose, put your heart into it! Each profession has strengths and weaknesses so it's very important to do some soul searching before deciding.

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1 hour ago, swoman said:

2 years of school and then a 6 figure job or 4 years of school then 2-6 years of residency plus grad school and fellowships if you want to work in an academic center/subspecialize?? 

Stonks, wish I did PA or NP

Just a friendly reminder that a lot of PAs are also encouraged to participate in research and be able to practice evidence-based medicine so many will either have their masters/PhD before entering PA school (1/4 of my class) and many will go on to complete graduate education after to keep research and teaching opportunities open to them :) However, many of us do admire the amount of time MDs have spent training and feel reassured in their supervision of us and as mentors! 

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I am a PA working in family medicine and have been for some years. Most if not all of the people in my graduating year are still working and have very stable jobs. However I did hear about some PAs losing their jobs after funding was over because they weren’t able to come up with a feasible model to pay their salary, or because of issues with medical directives. There are a lot of very valid points for PAs that are raised here, as well as equally valid concerns. I think overall the profession is fairly stable and will slowly gain traction and stability, but the nurses union holds way too much pull and they have no interest in giving PAs more authority. The sad but hard truth in life is that it all comes down to $$$. Money rules everything. NPs and nurses will make arguments that PAs only have 2 years of school, aren’t as well educated, and don’t have the medical knowledge to be regulated. The reality is it’s a poor argument and if the nursing union really cared about wait times, increasing access to health care, and a more integrated health care model, they would want PAs to work with them in hospitals and clinics. The cold hard truth is that they perceive  PAs as a threat to their jobs and their paychecks. Thankfully for me I don’t have to worry about hospital politics and the threat of losing my job over inadequate hospital funding/budget cuts.

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PAs have prior healthcare experiences (RNs, SLPs, Dieticians, Social Workers) so definitely not just 2 years of education...

The fact that PAs come from unique healthcare backgrounds make the profession much more versatile and they can fill the gaps in many areas of practice

I know many MDs that prefer working with PAs that are trained under the medicine model and are able to effectively carry out the medical duties!

 

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Current PA-S2 here, I can echo the sentiment provided by the people here. The nursing union is really preventing the use of PAs in Ontario and its concerning that the government doesn't recognize the work of PAs even during the pandemic. There have been issues with funding but most people are doing okay in their respective positions. Not sure how long it'll last though, since most of the people in ER/ICU are employed but fam med and subspecialties are seeing drawbacks (endocrinology PAs have been let go where I was on placement, possible other specialties too but not sure about others). Its not necessarily stable but not unstable either if that makes sense? Funding gets pulled quite easily and its difficult to get funding in new hospital areas. The biggest challenge is explaining your role in the healthcare system and why PAs are necessary to help reduce wait times and improve efficiency. The PAs I've worked with state that there are occasions where nurses, NPs, physicians question the role of PAs and see them as a threat to their income/jobs. It's going to be over a decade since PAs last tried to be regulated in 2022 so the fact that we're still discussing this is concerning for the profession. The work we do is exceptional and we have life experiences prior to entering this field, as well as on the job training that prepares us to handle a variety of situations independently, as well as part of the healthcare team alongside physicians. South of the border, it's quite different and I wish we could adopt the US model here to have the maximal impact of PAs in the healthcare system. For those still looking to go into the profession, make an informed decision and know the field is great if you have employment but its not something thats remotely stable compared to MDs.

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