Leigha Barbieri [0:00 - 1:05]: So, you want to work in healthcare, but you're not sure where to start. I'm Leigha, your host of this podcast, and I'm bringing you the inside scoop on healthcare professions. From doctors to pas, to healthcare administrators and crnas. My goal is to let professionals tell their stories and give honest reviews of the careers they have chosen. So, whether you're considering a job in healthcare or you simply have an interest in what we do, this show is for you. Me, me, me, me. Welcome back to the so you want to work in Healthcare podcast bonus episode edition. I am back with Heather Struhl, aka Heather the injector. Hey. Hey. Today we're gonna break down the top ten highest paying physician assistant specialties. Hopefully, you guys will find this helpful, especially if you're planning on becoming a PA. Heather and I are both pas, and we can weigh in on some of these. Cause I think both of our specialties might be on here. But first, we are gonna start our episode with the pop medicine moment of the week.
Heather Struhl [1:05 - 1:06]: Is that what it's called?
Leigha Barbieri [1:06 - 1:10]: Is that what we said last time? Yeah, I think that's what we call pop medicine.
Heather Struhl [1:10 - 1:11]: Pop medicine moment.
Leigha Barbieri [1:11 - 1:15]: The pop medicine moment. So, Heather, what do you got for us this week?
Heather Struhl [1:15 - 1:41]: All right, so more than just a pinch, patients are filming their expressions getting IUD's. This is all over TikTok, and it has been for many years. But for whatever reason, there's been a surge in these videos. And basically, doctors note that there aren't clear guidelines for managing pain or discomfort during IUD insertion. And it really is very painful. So I do think that there should be more of a guideline set for controlling pain.
Leigha Barbieri [1:41 - 2:03]: Yeah. As someone who has had an IUD, yes. I would have loved two things. Number one, for someone to tell me how much it was going to hurt. And number two, maybe a little bit of lidocaine or something that could have helped with the pain. They did, I think, tell me to take, like, advil beforehand, but, dude, that was not enough. That shit hurt.
Heather Struhl [2:03 - 2:26]: No, that's not going to cover it. Like, that's definitely not enough. And they need to mentally prepare you for what to expect. During my Ob gyn rotation as a PA student, we placed a lot of these. And women are strong human beings, let me say. They can endure a lot, but there is no reason that someone shouldn't have more of pain control during this. No one needs to be in a lot of pain, feeling tortured. No.
Leigha Barbieri [2:26 - 3:09]: Just to get some birth control. And these videos are kind of funny. But the best part about these videos is that it's bringing awareness to this subject, and you're seeing, like, just how painful it is to insert an IUD. I will say, though, the removal of an IUD was, like, no big deal, and the placement. The pain lasted for the first day was, like, awful. Was, like the worst cramps I've ever felt in my life. And then those lingered for a couple days. I will say, though, I had the copper IUD, and they say that the pain can be a little bit worse with that one, I think. So. I'm not quite sure. I'm sure everybody's experience is different.
Heather Struhl [3:09 - 3:19]: I've heard the same thing. And also, I mean, you can have a heavier period on it, potentially, and other. Other side effects that differ from the hormone IUD's, like progesterone.
Leigha Barbieri [3:19 - 3:54]: I'm going to be real open here and just tell everyone that my periods were twice as heavy and twice as long when I had the IUD, and painful. And I'm. I'm someone who's lucky enough to not really have painful periods. I know I am very lucky there, but my. I also have very short periods normally, so, yeah, it's not fun. But I will say it beats having to take a pill every day, and it beats having the mental and emotional effects that birth control by mouth gave me. So I would get an IUD still any day over having to take hormones. Yeah.
Heather Struhl [3:54 - 4:00]: And the copper ones, if your OBGYN feels that you're a suitable candidate, is a really good option if they don't want you to have any hormones.
Leigha Barbieri [4:00 - 4:27]: Yeah. Let's get started with our top ten list of highest paying specialties for physician assistants or physician associates. Number ten is my specialty, orthopedic surgery. The total compensation or salary is 120,000 a year. I guess that's average. This salary has increased a bit in the. In the last year or so. I think last year, the median base salary was 120,000.
Heather Struhl [4:27 - 4:31]: And they list the bonus as well. Yeah, 7750.
Leigha Barbieri [4:31 - 5:08]: Yeah, I'd say that makes sense now. 128,000 a year for an orthopedic surgery pa. I think, obviously, they are taking the average throughout the country, but keep in mind that in places like New York City, where we are in California, that salary is most likely going to be quite a bit higher just for cost of living purposes. So if you're depending on where you live, like, don't let that salary bum you out, because it also depends on the type of job you have. Right. Like a hospital based ortho pa is probably going to make a little less than, like, a private practice pa.
Heather Struhl [5:08 - 5:16]: In most cases, they have more flexibility in the private practice, where they can typically raise your salary a little bit more. But I'm shocked that it's number ten.
Leigha Barbieri [5:16 - 5:20]: Yeah, I know. I can't wait to see what's next. What's the top nine?
Heather Struhl [5:21 - 5:37]: Exactly. But one thing that I wanted to comment is, I am ancient, and I know that, but when I started in orthopedic surgery prior to working in aesthetics, what I'm currently doing now, I believe the total compensation was a lot lower. So it really has grown a lot, as I'm sure all the specialties have.
Leigha Barbieri [5:37 - 5:52]: Yes, yes, it was a lot lower, and they have come a long way. Even places in New York were really low. I was like, what is happening here? But it's going up. And I think we deserve it because it's a great specialty.
Heather Struhl [5:52 - 5:59]: We absolutely deserve it. And also, the dollar isn't really worth anything anymore, so it really needs to go up.
Leigha Barbieri [5:59 - 6:01]: Yeah. All right, you want to tell us, number nine?
Heather Struhl [6:01 - 6:16]: All right. Number nine is urgent care, and the total compensation is, oh, $128,980. And it says approximately 6.2% of pas are working within urgent care, and they have about six years of experience.
Leigha Barbieri [6:16 - 6:19]: Okay. I think that's pretty solid.
Heather Struhl [6:20 - 6:31]: For my friends that work in urgent care and that do share their compensation with me, I think that's pretty appropriate. And I know there is a lot of room for bonuses and also working overtime.
Leigha Barbieri [6:31 - 6:32]: Right.
Heather Struhl [6:32 - 6:48]: Working extra shifts, which is a really nice part of it. And lastly, my other comment, which I think urgent care is also so great, and it's a great lifestyle, is because I have a very good friend who works in urgent care, and they have full control of their schedule.
Leigha Barbieri [6:48 - 6:50]: And if they want to work two.
Heather Struhl [6:50 - 6:53]: Weeks straight and then have a week and a half off to travel, they can.
Leigha Barbieri [6:53 - 7:29]: Oh, that's awesome. And I just also want to point out that the median hours, amount of hours worked for orthopa was 45 hours a week, and urgent care was 39 hours a week. So even though the salaries aren't that different, it was only different by, like, not even a time worked versus those salaries I think we need to pay attention to, because, you know, you could be making $250,000 a year, but you're working 60 hours a week, you know, so the hours for me really play into it.
Heather Struhl [7:29 - 7:56]: Oh, absolutely. And also, I think urgent cares hours are a bit more predictable than that of orthopedic surgery, because occasionally, back in the day, we were stuck in the or till very late hours, you know, get home at 11:00 p.m. That didn't happen often, but we don't get overtime, or at least, right. That's what I'm familiar with. Maybe some other institutions do. So it's just something to keep in mind. Whereas urgent care is more of a set schedule shift.
Leigha Barbieri [7:56 - 7:59]: Yeah. I was in the OR till, like, 10:00 p.m. A couple weeks ago.
Heather Struhl [7:59 - 7:59]: Happens.
Leigha Barbieri [7:59 - 8:16]: It happened. All right. Number eight is neurosurgery. Total compensation is 129,000 a year. Only 2.7% of pas are currently working in neurosurgery. The median number of hours is also 45 a week.
Heather Struhl [8:16 - 8:29]: I think neurosurgery is an incredible subspecialty, and the neurosurgery pas that I know are badass. They have so much knowledge, and they are such an integral part of their team that I think their salary should be even higher than this.
Leigha Barbieri [8:29 - 8:37]: Oh, yeah. I mean, I think neurosurgeons are some of the highest paid surgeons. So I agree. I mean, it's serious stuff.
Heather Struhl [8:37 - 8:53]: It's not as full of fun and games like, we have an orthopedic surgery, and it's a bit more serious. So I definitely think with that territory, it should really be closer to number one, in my opinion. And I think back in the day, it was really when. Yeah. When I actually, we started out at the same time.
Leigha Barbieri [8:53 - 8:53]: Yeah.
Heather Struhl [8:54 - 8:55]: But it used to be in the top five.
Leigha Barbieri [8:55 - 9:09]: Okay. I believe I should still be in the top five. And mostly also because not just the hours are kind of long, but it's probably one of the most unpredictable schedules, if I had to guess. Yeah. Give us number seven.
Heather Struhl [9:10 - 9:21]: Psychiatry total compensation, $130,000. And approximately 2.7% of pas are working within psychiatry with a median experience of five years.
Leigha Barbieri [9:22 - 9:23]: Huh. Interesting. Yeah.
Heather Struhl [9:23 - 9:34]: And they work about a median of 40 hours per week. So I think we need more pas working in psychiatry. More pas, more NP's, doctors, everybody.
Leigha Barbieri [9:34 - 9:34]: Yes.
Heather Struhl [9:35 - 9:39]: I just think they are so understaffed, and it's a difficult job. Raise the salary.
Leigha Barbieri [9:39 - 9:43]: Raise the salary for everybody. I like that psychiatry's on this list, though.
Heather Struhl [9:43 - 9:46]: Yeah, that's pretty cool. I don't remember that in the past when we started out.
Leigha Barbieri [9:47 - 10:11]: It's great. Great. Number six is kind of a cop out. Surgical subspecialties slash other, like, weird. But the total compensation is 130,000 a year. Only 1.3% of pas are working in other surgical specialties. The examples they give are oral maxillofacial surgery, podiatric surgery, and, like, ob gyn, basically.
Heather Struhl [10:11 - 10:12]: Very interesting.
Leigha Barbieri [10:12 - 10:20]: Yeah. The average bonus is 6000 a year. They work 40 hours per week on average and they have a median of seven years experience.
Heather Struhl [10:21 - 10:24]: So does every specialty, like, does everyone get a bonus?
Leigha Barbieri [10:24 - 10:32]: Because I know, I guess a lot of people get bonuses, which is good, but I don't know.
Heather Struhl [10:32 - 10:40]: In my prior life when I was in orthopedic surgery, I don't recall getting a bonus until I was a private Pa. Yeah, same.
Leigha Barbieri [10:40 - 10:41]: Is that. That's correct.
Heather Struhl [10:41 - 10:41]: Okay.
Leigha Barbieri [10:41 - 10:43]: Yeah. I don't think the hospital pas get bonuses.
Heather Struhl [10:43 - 10:49]: Yeah, I think there's the annual percentage increase to keep up with inflation.
Leigha Barbieri [10:49 - 10:50]: Yes.
Heather Struhl [10:50 - 10:53]: But I never received a bonus until working privately.
Leigha Barbieri [10:53 - 10:56]: Number four, hit us with it.
Heather Struhl [10:56 - 10:57]: I think we skipped five.
Leigha Barbieri [10:57 - 11:00]: Oh, did I skip it? Oh, sorry. Number five.
Heather Struhl [11:02 - 11:31]: Okay. Number five. Critical care. Total compensation, $133,000 and approximately 2.3% of pas are working within critical hair. Critical hair critical care. And they have a median of five years of experience and they work a median of 40 hours per week. And that was as per 2022, actually. And interestingly enough, 48.4% received a bonus. I want to know more about these bonuses.
Leigha Barbieri [11:31 - 12:10]: I know, I know. I mean, I think everyone should receive a bonus even if it's just based on your performance. Right. But I think that if anyone is paid more, it should probably be critical care pas because I just actually interviewed a critical care PA and that episode is probably coming out in maybe two months. The things that he is responsible for is like way over my head. You have to have so much knowledge. If I needed to, like, play who wants to be a millionaire and like, phone a friend and it was like medically related, it would be a critical care PA, I'm pretty sure.
Heather Struhl [12:10 - 12:12]: Oh, well, 100%. That's who I'm calling too.
Leigha Barbieri [12:12 - 12:13]: Yeah.
Heather Struhl [12:13 - 12:19]: The level of stress, when we were talking about stress before that job is. Was so intense.
Leigha Barbieri [12:19 - 12:20]: So intense.
Heather Struhl [12:20 - 12:51]: Some of the smartest pas that I know work in critical care. And back when I did my PA surgical residency program, I did, I think it was two or three months in the ICU. The amount of information and you need to be on it. And these are seriously sick patients. It is so stressful and the room is full of brilliant people. It's really incredible. And there was a PA there at the time that was working critical care for 30 years. This person was a wealth of knowledge and they taught me so much. So I think incredibly highly of them.
Leigha Barbieri [12:51 - 13:15]: Yeah. My best professor, most knowledgeable professor in prea school was an ICUPA. And he's just like a freaking encyclopedia of medical knowledge. And it was incredible to watch him work. And I just commend anyone who wants to go into critical care. Good for you, because I'm in the dumb part of medicine. I just fix bones and stuff.
Heather Struhl [13:15 - 13:56]: So back when I was doing my surgical residency program, I actually knew towards the end of that residency that I was going to work in ortho. I got offered a job and when I. One of the critical care pas at the time was a little upset, they felt like I was a cop out. They literally said I was wasting my brain. So I took that. That was very flattering that they thought I could have been smart enough to work alongside them. But I just really enjoyed orthopedic surgery and went that route and I was trying not to feel too guilty about it because you do have to be absolutely brilliant and know your anatomy to work in orthopedics too, in every subspecialty. Yeah, you're going to get the same comment where you go, whoever you talk to.
Leigha Barbieri [13:56 - 14:00]: Listen, we may be wasting our brains, but we are having fun doing it.
Heather Struhl [14:00 - 14:07]: Oh, yeah, we're laughing a lot. While we're a lot. We're keeping it light because we are also your therapy dogs.
Leigha Barbieri [14:07 - 14:08]: Correct.
Heather Struhl [14:08 - 14:09]: We digress.
Leigha Barbieri [14:09 - 14:25]: I'll let you move on. All right, number four. I don't even know what this is, but it's occupational medicine. Total compensation, 133,000 a year. Only 1.1% of pas are currently working in occupational medicine. They have a median of 13 years of experience.
Heather Struhl [14:26 - 14:31]: I didn't even know. I didn't even know Pa's. This is really bad. I didn't know Pa's worked in occupational medicine.
Leigha Barbieri [14:31 - 14:38]: I know. I just said, like, I don't even know what this is. And I feel bad saying that. I need to obviously do some research.
Heather Struhl [14:39 - 14:41]: I'm googling it right now.
Leigha Barbieri [14:41 - 14:53]: Okay, google it for us, Heather. The median amount of hours worked per week in 2022 was 40 hours and the median bonus was 5000 a year. Oh, okay. I just didn't, you know.
Heather Struhl [14:53 - 15:01]: Okay, what does an occupational medicine physician assistant do? They specialize in the health assessment of employees and the treatment of injuries sustained in the workplace.
Leigha Barbieri [15:01 - 15:04]: Oh, okay.
Heather Struhl [15:04 - 15:05]: That makes sense.
Leigha Barbieri [15:05 - 15:06]: Interesting.
Heather Struhl [15:06 - 15:19]: Just didn't know they called it that. Yeah. So they'll order blood work, x rays and other tests, diagnose illnesses and perform examinations, and they can also prescribe medications and evaluate patient progress. So.
Leigha Barbieri [15:19 - 15:28]: Okay, makes sense. And sounds like it could potentially be a very nice job for lifestyle wise, if I had to guess. I agree.
Heather Struhl [15:28 - 15:30]: And probably consistent hours.
Leigha Barbieri [15:30 - 15:36]: Any occupational medicine pas out there, please send us a message and let us know how you like your job.
Heather Struhl [15:36 - 15:44]: I knew an occupational medicine NP, and they loved their job. Now that I know what it is, what they do, the term.
Leigha Barbieri [15:45 - 15:50]: Sorry, guys. You know, I wanted this to be as genuine as possible.
Heather Struhl [15:51 - 15:54]: Well, this is the real deal you're getting from us.
Leigha Barbieri [15:55 - 15:59]: All right, let's move on to number two. Did I skip one again?
Heather Struhl [15:59 - 15:59]: About three?
Leigha Barbieri [16:00 - 16:01]: Oh, no, sorry.
Heather Struhl [16:01 - 16:03]: I'm just keeping you on track here.
Leigha Barbieri [16:04 - 16:07]: Let's move on to Leah had a.
Heather Struhl [16:07 - 16:11]: Day and it is monsooning in New York, and she made it home.
Leigha Barbieri [16:11 - 16:19]: I had to take three subways. One of them I had to go backwards on, and it was just insane. So. All right, let's move on to number three. Heather.
Heather Struhl [16:19 - 16:37]: Emergency medicine. Total comp, $133,990. And approximately 7.2% of pas are working within emergency medicine with a median of six years of experience. And their hourly wage is actually $73 if you break it down, with a median bonus of $6,000.
Leigha Barbieri [16:37 - 16:38]: Nice.
Heather Struhl [16:38 - 16:42]: And they work slightly less than some of the other specialties. 38 hours per week.
Leigha Barbieri [16:42 - 16:43]: Yeah.
Heather Struhl [16:43 - 16:44]: And that's expected with shift work.
Leigha Barbieri [16:44 - 16:44]: Right.
Heather Struhl [16:45 - 16:48]: And honestly, if they have to work overnight shifts and their schedule is constantly.
Leigha Barbieri [16:48 - 16:52]: Changing, it should be that. Yeah, I think that's fair. Yeah. Yeah.
Heather Struhl [16:52 - 16:56]: Cause it's tough. It's tough to change your sleep schedule. Totally.
Leigha Barbieri [16:56 - 17:01]: So tough. It never gets. It never got easy for me to do an overnight shift.
Heather Struhl [17:01 - 17:18]: No, I mean, that's like, all I did as a PA student. They had us do during our first year of PA school, didactic year. We had to do a certain amount of hours in the ER, and everyone had to experience at least one overnight shift. They gave me three out of five.
Leigha Barbieri [17:18 - 17:19]: Oh, no.
Heather Struhl [17:19 - 17:25]: Which was fine, but, yeah, I felt like a zombie the next day. When you're not used to it, that's.
Leigha Barbieri [17:25 - 17:33]: Interesting that they did that to you guys. I guess it's a good thing. So you just know what you're getting into. Oh, yeah.
Heather Struhl [17:33 - 17:44]: It was a really good experience. But my very first shift, there was one patient in the ER, and it was a homeless person that just wanted a sandwich. So that was my first experience. It's like no one's here. Actually, my shift started at midnight.
Leigha Barbieri [17:44 - 17:46]: Aw. Did you just hang out with them?
Heather Struhl [17:46 - 17:55]: I hung out with the residents at the time, and the chief resident let me put an iv in him just because they were equally as bored. And, yeah, extra practice.
Leigha Barbieri [17:55 - 18:46]: Perfect. Good. Yeah. Okay, number two. That's a number we're on. Right? Dermatology, total comp, $145,000. A year. 3.2% of pas are working in dermatology. They have a median of six years experience, and the median bonus was $20,000. Wow. With a median hour of 40 hours week worked in 2022. This is why it's so hard to get into dermatology. I mean, I don't know if you've experienced this, but you're in a similar field, I guess. But like everyone I talked to who's in Durham, they said they either got very lucky getting a position, the timing just worked out, or it took them years to get into derm.
Heather Struhl [18:46 - 18:54]: Oh, absolutely. I think it's one of the most difficult specialties to get into. And everyone wants to hire someone with a minimum of one year of experience of dermatology.
Leigha Barbieri [18:54 - 18:59]: Right. So then how do you get that if you can't?
Heather Struhl [18:59 - 19:26]: I think if you can get a rotation in PA school where you're working at a dermatology office and you can get that experience, and they know you, they might be more willing to train a grad, but it is definitely difficult. But you really can make a lot of money in this field. There's procedures. Depending on your work agreement, you can make, you know, whether it's a procedure, percentage of your gross or net income, and yes, the bonuses, which are super high here.
Leigha Barbieri [19:27 - 19:28]: Yeah, super high.
Heather Struhl [19:28 - 19:38]: And one of my close dermatology friends does really well. It's a great lifestyle. They have the most beautiful skin also. So, yes, always the nice bonus.
Leigha Barbieri [19:38 - 19:57]: And if you guys listening want to know more about the life of a dermatology PA, listen to episode number two. You can also watch it on YouTube with Savannah from the PA platform. She goes into how she got her job. A lot of it is just about who you know. And like you said, having a rotation in dermatology in PA school is clutch.
Heather Struhl [19:57 - 20:00]: Networking is huge, and that's how I started in ortho.
Leigha Barbieri [20:00 - 20:06]: Same heather. Bring it home. What is the number one highest paying job for physician assistants?
Heather Struhl [20:07 - 20:34]: Cardiovascular cardiothoracic surgery, with a total compensation of $152,500. And approximately 2.3% of pas are working within the specialty with a median of nine years of experience. And 48.7% received a bonus. And their base salary was 145,000. Bonus was 7500. And they work a median of 48 hours per week. And they really do have long shifts.
Leigha Barbieri [20:34 - 20:53]: Yeah, yeah. Just to point out, this was the highest of the top ten median hours worked per week. I think the next one was. Was ortho at 45 hours. So you're working a little longer, but you're being compensated for it, it seems.
Heather Struhl [20:53 - 21:38]: And I agree that this should be the highest paying specialty because the level of expertise and the hours and the care, it is incredibly difficult. And you have to really be a specialist. You have to be on your game. And the pas can play central lines. They're part of the surgeries, harvesting grafts. And I was fortuitous enough to be part of the cardiothoracic surgery rotation during my residency, and I learned so much on it. And really, the pas are incredible. They run, you know, depending on the hospital, they help run the department, and they work so integrally with the surgeons that the team can't survive without them.
Leigha Barbieri [21:39 - 22:04]: I didn't honestly get very much experience. I actually wanted a cardiothoracic rotation, but I was unable to get it. So I was kind of bummed that I didn't get to, like, experience that. But I think I ended up in the right field for me either way. But, yeah, it's. It's not an easy job from what I've heard, and. But luckily, you're being compensated for it. So number one is cardiovascular cardiothoracic surgery.
Heather Struhl [22:04 - 22:05]: Well deserved.
Leigha Barbieri [22:05 - 23:00]: Ooh. That list came straight from the AAPA. So if anybody wants to look into that further, you can go to the AAPA website and check it out. Well, that about wraps it up for this bonus episode. Thanks so much for tuning in. I have already interviewed a lot of pas and physicians in the specialties mentioned today, so look through the list of episodes and if you're interested in any of them, you might find some, some good little pearls of information that you can use. Also, if you haven't subscribed yet, don't forget to subscribe on YouTube. And please give us a five star review on whichever listening platform you're listening on. Whether that's Apple podcasts or Spotify or somewhere else, you can find me at. Hello, I'm the psych on social media and Heather. Heathertheinjector NYC on social media. Feel free to send us a DM. Let us know what you want to hear about. Send us questions. If you do leave us a review, we will shout you out on the next episode.
Heather Struhl [23:00 - 23:01]: Thanks for joining.
Leigha Barbieri [23:01 - 23:05]: Thank you everyone for joining. See you guys in two weeks.
Heather Struhl [23:06 - 23:07]: Bye bye.
Leigha Barbieri [23:11 - 23:18]: This is the so you want to work in healthcare podcasts with new episodes every month. Don't forget to subscribe to stay up to date on the latest releases.
