at one of the older and more respected programs that as I mentioned above trains PA and MD students side by side. I chose to go into medicine later in life when I already had two kids and yes because I didn’t want to be overly involved with training for ten years and miss out on their childhood I chose the PA route. I knew this would sacrifice some prestige, knowledge base, opportunities, and a lot of $, but it’s also given me flexibility and the time with my family.

I feel both confident in what I know, and daily nervous about what I might not know. Taking care of people’s health is a huge responsibility (let alone risk, and yes we bear the risk too). So if someone needs an ER consult because I believe it’s an emergency I’m not going to hesitate, but you can bet I’m going to see that person first and work it up, or at least have a good knowledge of their medical history before h the they are sent. I have no problem getting STAT imaging ordered or EKGs in clinic. Sure it’s a pain when you have 20+ people to see but it can be done. I also have no problem asking a colleague what they think of a questionable case. I don’t want to hurt them, I don’t want them to pay for ER unnecessarily, and I don’t want them or the other providers to lose confidence in me. But, again, if you’re frustrated maybe you need to communicate back about your frustrations because shaming people for making referrals to the ER is also dangerous to patient care IMO.