Specialty versus Primary Care Practice for Your First PA Job

New Physician Assistant graduates face a unique career dilemma when it comes to choosing what area of medicine they will work in. While the lure of specialty care may be tempting, this may not be the best option for a new graduate.‌ To help evaluate what the best career path may be for you, consider the pros and cons of specialty versus Primary Care practice.

Physician Assistants working in today's healthcare system have a broad range of medical specialties to choose from. Each specialty offers a unique practice experience that is filled with both career advantages and disadvantages.

Specialty Practice

Pros:

  •  Higher Pay & More Perks Some PA's working in specialty care demand upwards of $23,000 more a year in take-home pay than those working in Primary Care 1. This increased income isn't taking into account frequently added perks and benefits like call coverage, productivity, annual or signing bonuses, which can total up to an additional $15,000 a year 2.
  • A More Focused Practice Working in a specialty allows you to focus on one specialty instead of all issues related to patient care from the cradle to grave.
  • A Feeling of Mastery in Your Specialty Focusing on specialty practice allows you to keep abreast of new and relevant changes in your field, while also increasing your depth of familiarity with its pathology.

Cons:

  • Increased Competition for Fewer Positions Healthcare shortages are driving increased demand for Primary Care more than specialty care Providers.
  • Specialized Practice Can Limit Later Career Changes Being too focused on one specialty makes it harder to change to other specialties down the road due to having limited skillsets.
  • Repetitive Patient Care with Less Variety Seeing the same patients with similar pathology every day can become monotonous and less fulfilling with time.

Primary Care Practice

Pros:

  • Solidifies Your Foundation in General Medicine Primary Care provides PA's an opportunity to treat patients from the cradle-to-grave suffering from a large variety of issues. This comprehensive practice will reinforce what you have learned in school, remember the old adage "use it or lose it".
  • More Job Opportunities with Less Competition Only 22% of new grad PA's work in Primary Care Medicine as opposed to specialty care*. This leaves the market ripe for you to capitalize and select from a multitude of job opportunities.
  • Loan Repayment Options Due to Primary Care Provider shortages, there are more employer, state and federal options available to help PA's with their student loans. According to the 2017 Statistical Profile of Recently Certified Physician Assistants, around 2% of new graduates participate in state or federal loan repayment programs like the National Health Service Corp.
  • Increased Ease Making Later Career Changes Working in Primary Care makes you a jack-of-all-trades and attractive to employers in specialty care looking for PA's with a solid foundation in medicine.

Cons:

  • Increased Stress This can be especially true for PA's working in rural or medically underserved areas with increase patient census, fewer Practitioner colleagues and less supervision.
  • Lower Salaries Mean salaries for PA's working in Primary Care average around $105,000 a year, putting this practice area on the lower spectrum of the earning scale 1.