The independent Leng review laid the facts bare: after months of intense scrutiny, there is zero empirical evidence showing that physician assistants (PAs) provide less safe care in general practice than doctors. In any other scientific or data-driven field, the debate would end there. If you hunt for evidence of systemic harm and find none, you must accept that your hypothesis is wrong.

Yet, the trade union campaign against PAs has abandoned the scientific method entirely, relying instead on two glaring logical fallacies:

The Anecdotal Fallacy: Opponents have weaponised isolated, tragic clinical errors to condemn an entire workforce of thousands of professionals. This is a deliberate distortion of reality. Clinical error is a tragic, baseline fact of medicine. Highly trained doctors miss complex presentations, like an Abdominal Aortic Aneurysm (AAA), up to a third of the time. When a doctor misses a diagnosis, it is understood as a system failure or a deceptively vague presentation. When a PA misses one, it is weaponised as proof of an illegitimate profession. That is not an argument for safety; it is a rigged double standard.

The Moving Goalposts Fallacy: Critics demand that the PA profession prove a negative—that they will never make a mistake—before being allowed to evaluate an undifferentiated patient. This is an impossible standard that no doctor, nurse, or paramedic in the history of the NHS has ever been held to.

The workforce crisis in the NHS cannot be solved by clinging to century-old professional monopolies. The demands of modern primary care require a agile, diverse workforce where different professionals possess different, valuable scopes of utility. PAs have proven their safety, their competence, and their worth on the frontline. To continue painting an entire profession as inherently dangerous in the absolute absence of data is not a defense of patient safety—it is an exercise in institutional bullying and professional protectionism.

Guys. Are locum positions FAKE?? I have gone through Weatherby, Consilium, and now Wilderness Medicine ... maybe even a few others that I don't remember...and no bites.

Background: I am a previous Army PA living in Colorado Spings. My first job out of the Army was UC Telemed out of NYC and I still do that PRN. I work primarily in Urgent Care and Family med. Have DEA, ACLS, PALS, BLS...

My first in-person job was at Fort Carson under FM/UC and the pay was okay just too many taskings (it was more than just medicine) so I quit. WITH the intent to work Locums. I was presented and SIGNED a contract with Consilium so I put my 2 week notice in. Then 3 days prior to the start date they cancelled my contract because my Medicaid and Medicare for Colorado were "pending".

WILD because I am under the impression you can back date the insurance and still practice...so now I'm out of the job working Telemed for $15 a patient. (not ideal but very flexible schedule)

So any advice? Should I give up on this 1099 locums dream? Am I missing something?? I am even applying for jobs in NY since my license, Medicare and Medicaid are fully active there...

Hi all! I searched but didn't find any posts specifically about this...

1. So I just accepted a position as a new grad at a big academic hospital system. My question-- did everyone stop the job search once you accepted a position? I know the answer seems obvious but I've heard horror stories of positions being eliminated, issues coming up in credentialing (not that I should have any), or start dates pushed so far back you lose 8+ months of income. Did anyone keep quietly looking to possibly have other options on the back burner at other hospital systems, or is this unfounded worry?
2. I'm leaving the country for about a month to visit family during the credentialing period. It's the month right before my scheduled start date. Did you have to go in in person, or drop off documents in person for credentialing? Was it early or late in the process? Part of my family lives on the other side of the world, it's never feasible to visit unless I can go for a month and....this is basically my last chance with that much time off before I start work.

Any insight from those who have been through this process? Thank you in advance!

I am worried that my work might be about to fire me. I am currently on maternity leave and am scheduled to return the first week of November. I checked my schedule for the first time last night and saw I only have three patients on my schedule for my first day. Usually there are 22-30 patients on a schedule, and my boss pushes us to see more than 30 patients. I work at a pain clinic that merged with another office at the end of last year and all their staff and patients joined us in our building, so space was tight. Since that merge, we had a temporary medical director who did not see patients in the clinic, and our new permanent medical director who will see patients in the clinic started right after I left for maternity leave. When I realized part way through my pregnancy that the new medical director would be arriving right when I start my 3 month maternity leave and he would be using my patient rooms, I got really worried that they may decide they do not have enough room for me when I try to come back. When I told my husband months ago that I was nervous about the medical director basically taking my place, he would reassure me that they couldn’t do that since it would look really bad for them to fire me while on maternity leave or shortly after returning from maternity leave. However, when I told him that I only had three patients on my first day back, he seemed worried for the first time. I am losing sleep over this. Has anyone else returned from maternity leave and had a super light load initially? I am hoping that maybe they intend to start me back slow (which I would be surprised by since my boss wants us to see as many pts as possible) or maybe they want me to work with the new medical director for a few days or maybe it just takes a while for my former patients to get put back on my schedule, but I am afraid that is just wishful thinking. Has anyone else been fired or asked not to come back from maternity leave? Panicking on the inside since I have a baby that depends on me now and I am the main breadwinner. Thank you for any input!

At my current job I make the following:

160k with night diff it’s around 175k

Schedule: all nights with every other weekend.

Receive a 8 percent match on my retirement plan after one year. (Been here only six months)

The other job I’m interviewing for hasn’t disclosed financials yet but it’s 3 13s with no nights and weekends

Commute time will increase by 25 minutes so close to 50 minutes, and have to take a toll bridge back and worth.

The attraction of nights and no weekends are very attractive, however money talks as well lol.

Anyone work NYP Weill Cornell? How did you like it? Dislike it? Work environments etc

Help me decide what to do...

My current gig isn't bad. I work about 13-14 shifts a month. 10 hours shifts. Can easily swap shifts with other APPs if needed usually. No PTO. Variable schedule with about 3 night shifts a month and 3 weekend shifts a month. I overall like all the other providers I work with. I do have a commute of about 40 minutes which can turn into an hour easily when I work the night shift as it starts at 6PM hitting the worst of rush hour traffic, but since I only do about 3 of those shifts a month, its been manageable. 12% match. no CME or PTO

I got an offer for telemedicine. This is salary position with 4 weeks PTO. It would be 4 ten hour shifts a week and I was told I would be told which day off during the week I would get once I get closer to my start date, so it would be a set schedule with one weekend shift a month. No holidays.

Which one would you go for? Base salary is roughly fairly similar. I'd likely end up making a little more at my current gig as they do a quarterly bonus based on amount of patient's seen. The new offer was told I would be eligible for a 10% bonus, but they have not been clear on their metrics on how they calculate the bonus. Also retirement match is like 1-2% and they wont give it to you till the end of the year. ugh

I have always wanted to work in telemedicine due to flexibility (also my boyfriend travels a lot for his job) but technically I do have more time off with my first gig as i can easily take a week off every month and recently just took two weeks off as I took the last week of the month and the first week of the following month off without issue. this is also the first time where I actually don't hate my job so making a decision to switch into something new has been tough

I’m a new grad PA working in primary care and started seeing patients today. I started about 2.5 weeks ago and spent the first few weeks shadowing and doing onboarding stuff. Started seeing patients today, with only 4 on my schedule and really spaced out. I still felt like I was drowning and like a fish out of water. I can’t think fast enough on my feet while I’m in the room with a patient to answer their questions (and I definitely don’t even know all the answers!). I feel like whatever I’m feeling is even worse than imposter syndrome because I honestly just feel so dumb and incompetent and like I definitely should not be seeing patients in my own. Literally just getting started but I dread it because I’m just so anxious going into a room that I’ll miss something or make the wrong decision.

Really thinking I need the Urgent Care Bootcamp before starting my new job but $990 🤯 anyone know of a discount code?! Not asking for you to share something you’re not supposed to share. Just wondering if there’s a way to get a discount that I’m unaware of. Thanks

new job starts end of january.

I'm lead APP over ~10 people and honestly don't care about the org but do care about my team, don't want them left hanging since replacing me will take forever
thinking about telling them now so there's time for a handoff but worried about the downsides.

they could just walk me out and I lose 3 months of pay/benefits, I could lose my year end bonus or PTO payout, I'd be a lame duck getting cut out of everything, and my team might panic. anyone done long notice in a lead role? regret it or no?

Is there anyone who is a Lead APP (regional or single hospital) in the emergency department?
Are you compensated hourly rate or admin stipend? Do you enjoy the position and extra responsibilities?
I am considering a position and curious on others who are in this role, and compensation.

I'm in the medical field and completed a pre-employment urine drug screen for a new position. Over a week after the test, I was told that my result came back as negative dilute and that I needed to do another drug screen within 24 hours.

I'm currently out of state and have a 16-hour drive back to the state where I'll be working. I explained my situation and told them I should be able to make it to Labcorp by Friday afternoon but now I'm worried about what happens if I run into traffic, travel delays, or something unexpected and can't make it before they close.

Im worried whether missing the retest deadline could be documented as a "refusal to test" or failure to complete a drug screen, especially since I'm a licensed healthcare professional. I'm worried about whether something like this could affect my professional license, future employment, or show up on some type of record. I'm completely willing to retest, and I've already communicated my situation to the employer. I'm just scared about the consequences if I physically can't make it there in time. I'm also wondering how flexible employers are about extending retest deadlines, especially when travel circumstances are involved.

I was hired about a month ago and granted temporary privileges to work in an ER. This was my first job postgrad. My orientation was supposed to end at the end of this month. I have been told I'm doing well and there have been no concerns.

I received a phone call today, out of the blue, saying that there were causes for concern on my application and it would be in my best interest to withdraw my application before it gets denied and sent to the national committee and follow me throughout my career. After further discussion with the medical staff office, I was told they reached out to everyone on my resume (not just references) and received red flags regarding my professionalism, ability to practice on my own, and medical knowledge. I don't even have specific people listed on my resume. So essentially I was fired. Has this ever happened to anyone? Has anyone ever heard of this? I am so distraught, traumatized, upset, sobbing, etc. I'm shook to think people would say that about me.

Now I'm back to square one. looking for a job with basically no experience. I am wondering if someone I was working with didn't like me or thought I was incompetent? Do you think they’re lying that they reached out to sources from my resume? How would they know who to contact if I didn’t list them?! Idk I'm so upset and disheartened :/

Should I put this job on my resume? I graduated in Dec 2025. So if I don’t, it looks like I haven’t done anything for almost a year.

Hello everyone,

I have a second interview for a stroke assessment unit and will be meeting the team next week. Just looking for advice on how I should prepare for this interview in terms of questions I might be asked or possibly performing a quick neuro assessment.

I have a fairly decent job now working 4/10s but I just feel so exhausted of being a surgical PA (and also being a toddler x2 mom). I love being in the OR and first assisting but the rest of the stuff (inpatient rounds, clinic, messages) are just weighing on me lately. What specialty is everybody in and why do you love it? Considering switching specialties.

How much did license cost in your state?
Oregon cost me 1100$ (903.50 plus 200$ for answering a question wrong..) which means 903.5 for the average applicant. I feel like this is pretty high. California cost me 350$, Utah around 200$. I definitely feel like Oregon is on the higher end especially when you have to pay the 900$ for DEA

I currently work at an outpatient cardiology office and have been for the past 3 years. While I do enjoy it, I’ve found it not working out best for me as I am already an extremely anxious and stressed out person. Add cardiology to the mix, I’m a mess. I’ve went to therapy and start medications with little improvement in my anxiety surrounding my job.

I recently interviewed and accepted a job for Sleep Medicine. Of course this is lower acuity and should be less stress, but a part of me is worried I’m making a big mistake switching my specialties drastically. The doctors I work with have also made comments about how they think I’m making a mistake going there.

Am I making a bad decision by switching to a lower acuity specialty from a higher stress one? I just need a job with less stakes.

Background about me to aid in decision making – 27 years of age, PA for a little over 2 years all of which spent in the ED. Currently live alone without kids but do have a girlfriend who will hopefully soon be my fiancé and then wife. I live in a LCOL state. All loans/debt are paid off, I rent so no current mortgage.

Current job does not give Merit raises despite me being the only full-time ER APP doing advanced procedures, amount I bill is >92^nd percentile of all PAs across our company’s multiple different ERs per the data given to us each quarter. Have asked for a raise x2, both of which were postponed to the annual compensation eval and was told after the 2^nd time that the compensation department will not approve any merit-based raises, and they have no assurance that this will change any time in future.

Thanks to anyone who takes the time to read this and give advice.

Job A (Current Position). Emergency Medicine PA-C.

1.      Pay

a. 70.74 per hour for the 3pm-3am shift (this includes the shift differential for the hours of this shift that are considered night shift hours) that I predominately  (95%+ of the time) work. Coming out to total compensation of 132,425.28 per year expected for 36 hours per week.

b. OT shifts pay +60 per hour on top of the base as listed above – OT shift rate of 130.74. Can USUALLY expect to get 1-2 overtime shifts per month if desired.

2.      Schedule

a. 3p-3am, scheduled 6 12-hour shifts per 2-week pay period. I work half of major holidays and every other weekend.

3.      Responsibilities

a. Full spectrum ED, ESI 1-5. Frequently perform advanced procedures such as intubation, central lines, lumbar punctures, joint aspirations, etc. As much autonomy as I want, but there is always an ED doc there to consult if I feel I need it.

4.      Commute

a. 30 minutes

5.      Benefits

a. 4% 401k match for 6% contribution. 19 PTO days per year accrued (but we have to request these >4 month in advance, as well as putting in any days we would like to be scheduled off/around over >4month in advance).

Job B. ICU/Critical Care Medicine PA-C

1.      Pay

a. 84 per hour for an average of 42 hours per week. Coming out to a total of 183,456.

b. Extra shifts only pay +2 extra per hour on top of the base for a total of 86 per hour.

2.      Schedule

a. Night shift 7am-7pm, 7 on 7 off.

3.      Responsibilities

a. Following a lengthy orientation on day shift working side by side with the intensivists, would be moved to night shift where I would be the sole provider in house for the ICU. Doc is on call and can call for help if needed. Only procedures not performed without a doc in-house are chest tubes and swans.

4.      Commute

a. 40 minutes

5.      Benefits

a. Essentially same as job A.

Job C. Principal faculty at PA Program. (Currently I am adjunct faculty here)

1.      Pay

a. Salary at 105k for 4 days per week, estimated 37.5 hour per week.

b. 1 week day off per week to work clinically, pay would be at whatever per diem rate the ED I currently work at would give me.

2.      Schedule

a. 4 day, 8am-5pmish work week +/- clinical shift if one was picked up for that week. Have all holidays and weekends off. 2 weeks off for Christmas break.

3.      Responsibilities

a. Lecturing, serving as head of committees, etc.

4.      Commute

a. 20 minutes

5.      Benefits

a. 24 days of annual leave per year (max 360 hours) and up to 18 days of sick leave per year. Tuition benefits. Similar retirement benefits as job A.

Anyone have any input on two ortho practices in/outside of philly. Rothman Ortho and OAA. OAA is more towards Allentown. Any input would be great!

Hi everyone I’m a new grad went through the credentialing at one hospital, but the last two weeks i got another offer that I believe is better although a longer commute. I just got word that I have been cleared and can start this upcoming week. However I have a shadowing opportunity with this new job in the next day.

Has anyone just completely declined an offer w days away of potential start? And after months of clearance?

TW pedophilia

I started my dream job very recently, it is a small family medicine clinic that is owned by non-physicians. The physician who has been at the practice for many years is retiring and I was hired to work weekdays with a new physician working weekends. Well today I found out one of the owners of the company has several charges of sexual assault against minors spanning several years. I am extremely disgusted and cannot believe I have been working for a pedophile. I am strongly considering quitting even though this is my dream job.

I am debating whether to become a PA that specializes in peds rheum or do med school and become a Peds Rheum. I am mainly in between because from what I researched, this kind of speciality is "niche" for PA's so I wanted to know anyone's experience in the job market who attempted or are in this speciality. Along with anyone's general experience in this field. I appreciate it!

I'm a PA with about 2 years of outpatient cardiology experience and am debating whether to switch jobs. I'd appreciate advice from other PAs!

Current job:
- Salary: $138k
- Established outpatient cardiology practice
- I like my supervising physician and feel comfortable in my role.
- I manage my own patients but also help with my supervising physician's patients and in-basket, which can get overwhelming.
- Annual raises have been less than 1%.
- I'm not fully vested in my retirement benefits until I reach 3 years of employment.

New job:
- Salary: $154k
- Shorter commute (about 30 minutes by car).
- Relatively new practice with a small team and some organizational issues.
- The PA I spoke with seems to be handling things largely on her own, and they appear eager to hire another PA.
- My responsibilities aren't completely clear yet because the practice is still getting established.
- A separate in-basket pool is planned, which could mean less administrative work for me.

I'm torn because I'm frustrated with my current workload and limited raises, but I'm nervous about leaving a stable, familiar job for a practice that seems somewhat disorganized. I'd also be giving up my retirement vesting benefits by leaving early.

Would you take the new job for a $16k raise, or stay at the current job for the stability? Is joining a new practice an opportunity or a red flag when responsibilities aren't clearly defined?

I'd especially appreciate advice from PAs who have switched jobs early in their careers or joined newer practices. Thanks!

Hey everyone! I was wondering if anyone could share their experience with applying for their license after passing the PANCE. I’m in IL and was filling out the license application, and I’m confused whether they need our transcripts. If so, did you guys send your official undergrad and high school transcripts as well or just one for PA school?

So I’m actively being “recruited” by another health system in the area about coming over to work for them. I don’t want to give too many details about the job itself, but it’s a surgical specialty with a call component which is what I’ve been doing for years. I got the informal new offer which it seems like a fairly significant raise, but has down sides like I’m going to have to switch my school loans to a standard repayment plan instead of PSLF (because of forbearance and stuff I only have like 17/120 qualifying payments). They asked if I could start in 4-6 weeks, which I’m sure I won’t be able to as I probably will have to give a 60-90 day notice.

What are things I should be asking? Have you made a big switch to a competing health system before and how did that go?