Thanks for all the replies.
The bottom line is I have been struggling with staying as a pa or going to medical school. But it seems senseless to acquire the debt if I could make similar income without the degree. As far as autonomy let me describe my current position. As a hospitalist PA I ask a physician to review a patient with me perhaps once or twice a month. I consult with specialty consultants as needed. I am very comfortable managing non icu patients and my supervising physician/s are comfortable with my skill. With no element of ego, I will say I am on the brighter end of mid-levels, the primary reason for this is I self educate with evidence based literature relentlessly, long after the day is over. I know there are those of you will cannot believe, do not want to believe that my knowledge could possibly equivocate an MD,s but there are many MDs in our group that I have to correct their errors, and I wonder how they could NOT know some fairly basic tenets of internal medicine.
You don't know me and if you've had a negative experience with midlevels you are bound to be suspect. I know my husband has a fairly poor view of many midlevels from experience, both NPs and PAs, and many NPs and pas probably should not be autonomous. But there is a subset of us that, through experience and intellect can and do practice autonomously despite what the title denotes because it is a WASTE of (billable) time to babysit us. I didn't come to this conclusion on my own, many many physicians have expressed this to both some of my brighter colleagues and myself. Both fortunately and unfortunately my husband and I have a better intellectual/collegial relationship than romantic, we constantly review our interesting, difficult cases at the end of the day and often come up with better differentials for the next time. I would not work side by side with him or be directly supervised, but I assure you I do not fear asking a question when a difficult case arises and clearly there will be a learning curve for me on peds and OB patients. He will bounce things off of me as much as I off him, I have years of IM experience over him. This wasn't a supervision debate but I felt I needed to say my piece despite the flame war that will undoubtedly ensue.
My question remains the same, I wonder how lucrative it would be for us to be in practice together, but other than a few of the responses above that addressed that question I think we'll just have to do it and see.
