I still remember the first time I shadowed a PA. It was in an orthopedic clinic, and I wasn’t sure what to expect. I didn’t know if she was going to be following around an MD and “helping out”, or what. Within the first hour, she was seeing surgical follow up cases, injecting a bursa, and working with small child with a cast on his arm — all before lunch.
That day flipped the script for me. Physician Assistants (or Physician Associates, depending on how progressive you are) are legit medical providers. They diagnose, treat, prescribe meds, assist in surgery, and work in nearly every medical specialty you can think of — from emergency medicine to dermatology, psychiatry to orthopedics. I mean, I’ve met PAs who’ve worked in trauma surgery and others who help manage ICU ventilators. They work in all corners of medicine.
Now, let me break it down for anyone trying to figure out what exactly a PA does on a daily basis. First off, PAs are trained under the medical model — just like doctors — which means they’re taught to think in terms of pathology, diagnosis, and systems-based treatment. After a science-heavy bachelor’s and anywhere from 500 to 2,000 hours of clinical experience (I did mine as a Medical Assistant in Dermatologic Surgery, by the way — mostly helping bandage surgical patients), you jump into a 24+ month accredited PA program. It’s intense. Think gross anatomy, pharmacology, clinical rotations, and enough acronyms to make your brain melt.
But once you’re out, the work? It’s diverse. On any given day, you could be doing physical exams, interpreting labs, suturing wounds, counseling diabetic patients, assisting in orthopedic surgeries, or managing chronic illnesses. The scope of practice can vary depending on your state and your supervising physician, but in most places, PAs can prescribe meds — even controlled substances — and practice pretty independently. The teamwork part is real, though. We collaborate with MDs, nurses, therapists, and social workers. You learn real fast how crucial communication is, especially in high-stakes settings like the ER.
I used to think PAs were kind of in the shadow of doctors, but the truth is, in many clinics and hospitals, we’re the frontline. There’s a reason patients consistently report over 94% satisfaction with PAs. We’re accessible, we take time to listen (seriously, it’s half the job), and because we’re trained to be generalists, we can pivot fast. That’s one of the coolest things — you don’t have to commit to one specialty forever. You could be in family med for five years and then jump to ortho or psych. Many folks go into surgical subspecialties without ever setting foot in a formal residency.
Of course, there’s still a lot of confusion out there. People mix us up with medical assistants (not even close), or assume we’re just a stepping stone to becoming a doctor. But most of us are exactly where we want to be. The autonomy, flexibility, and the fact that we get to really help people every single day? Totally worth the hard work.
If you’re on the fence about pursuing this career, my advice is: go shadow a PA. Ask the tough questions. Get in the trenches. That’s when you’ll really see what it’s about. And maybe, just maybe, you’ll find your place in this wild, wonderful mess of modern healthcare.