The Associated Financial Costs of Practicing as a Physician Assistant

Did you know that working as a PA comes with costs, some of which are pretty obvious, while others are more subtle or even somewhat hidden? You may think that all of the income you earn through work can be spent in your personal life; however, there are actually profession specific costs and general underlying costs to going to work to earn a paycheck! Let’s start by reviewing some profession specific costs that come with working in the PA profession. 

Profession Specific Costs of Working as a PA

Many of these professional costs may be fully or partially covered by your employer, or could potentially be negotiated as part of your benefits during the negotiation process. 

PANCE and PANRE Certifications: PANCE (Physician Assistant National Certifying Exam) is the initial certification examination to become a PA-C, and PANRE (Physician Assistant National Recertifying Exam) is the recertification examination currently needed every 10 years to remain a PA-C. (Although there is an alternative to PANRE being piloted.) Currently as of May 2021, PANCE costs $475, and PANRE costs $350. 

NCCPA: NCCPA stands for National Commission on Certification of Physician Assistants. This is the organization that you certify and re-certify as a PA through. However, not all states require you to be a certified PA (PA-C) to work as a PA in their state. You also log your CMEs through the NCCPA website. As of May 2021, the cost for my certification maintenance fee through NCCPA due in 2022 is listed at $180, which is a fee that occurs every 2 year CME certification cycle, and appears to have been increasing by $20 – $30 every 2 years the past few cycles. 

CME: CME stands for Continuing Medical Education. Currently, certified PAs need to complete and report 100 CMEs every 2 year cycle through NCCPA. The cost of CMEs is quite variable, and your CME budget that your employer likely provides for you as a part of your benefits package can be variable as well. (Pro tip: try to negotiate your CME budget, because even one to a few thousand dollars does not go very far after paying the costs of the conference fee, flights, hotel, and food!) There are so many great options for CME courses, but you can also obtain free CMEs in a variety of ways, one of the primary ways being using UpToDate to research topics and record those CMEs that you earn by doing so. If your company pays for UpToDate for you, then this would be a free way to earn CME credits. Another way to earn free CMEs is to join AAPA discussed below and take advantage of free CMEs that they offer. 

DEA License: DEA stands for Drug Enforcement Administration. A DEA license is a required license for medical professionals to be able to prescribe and administer controlled substances. Currently as of May 2021, the cost to renew your DEA license for 3 years is $731, but this often increases over time as well. Many employers cover the DEA fee, but again, if they initially say they don’t, try to negotiate this!

State License: This is a required license to be able to practice as a PA in the state that you are seeing patients. Cost can vary by state. 

AAPA: AAPA stands for American Academy of Physician Assistants. This in the national professional society for PAs. As of May 2021, the membership fee for practicing PAs is $295 yearly. There are several benefits to being a member including access to free CMEs as previously mentioned, as well as the free salary report, among others. Additionally, this is the national organization that advocates for the PA profession, so it’s great to support them. One of my employers covered the cost of this membership, and another had me use my CME funds to cover the cost as I had wanted to continue my membership.  

Your State PA Society: As AAPA is the national professional society for PAs, your state also has a professional society for PAs. Cost can vary by state. Your state PA society likely is advocating for the PA profession at a more local level, so again, it’s great to maintain a membership through them. My state PA society also will post a variety of PA job openings, which may help you find a job as a new grad or even as an experienced PA. Again, some employers may cover the membership cost for you, or this may be able to be negotiated. 

Resources: Depending on your specialty as a PA, you likely will have a variety of professional resources that are handy to utilize. For example, UpToDate is a very commonly used resource in the medical community to research almost any topic or disease in medicine. My employers have provided this resource to me for free, but I have heard of other PAs needing to purchase their own UpToDate subscription. 

Stethoscope: You may have to pay for your own stethoscope, though I have heard that some employers allow you to use your CME budget for this or may cover the cost for you.

General Costs of Working as a PA 

Commuting: Unless you fully work in telemedicine as a PA from the comfort of your home, you likely commute to work. Even if you have to commute, the cost could be free if you are able to walk to work or if you bike to work with a bicycle that has been paid off. However, commuting to work often costs PAs some money, whether that includes taking public transportation, or driving a vehicle or motorized scooter or something else to work. If you drive something to work, it costs money for the gas or the electricity / battery that operates the vehicle. There are also maintenance costs. I would venture to say that most PAs drive some type of vehicle to their job, and if so, try to keep the costs low by considering driving a vehicle that is a few years old and paid for vs. a newly bought or a leased vehicle. 

Work attire: Depending on your specialty and your employer, you may have to pay for your work clothes, whether they are business casual or scrubs. Some hospitals provide scrubs for you, but many PA positions require you to wear your own clothes that you have had to pay for. Don’t forget the cost of shoes as well, whether they are some comfy clogs like Danskos, or comfy tennis shoes like New Balance or HOKA shoes, or fancy heels or other dress shoes, they all can be a pretty penny. 

Lunches: You can keep the cost of lunch low by bringing a packed lunch, but if you instead go out to lunch with your coworkers or order a delivered lunch many days in a week, the cost can drastically add up over time. 

Daycare / Childcare: If you are going to work as a PA, and don’t have a spouse or other family member that is able to watch your kiddos for free, then there is likely a cost for their daycare / childcare that needs to be factored in, depending on their ages. 

We just reviewed some examples of profession specific costs and general costs that are associated with working as a PA. This list was not all-inclusive as there are a variety of costs that may occur due to working. If you do choose to pursue financial independence (FI) and are thinking that you may retire early (RE), then take into consideration how much continuing to work is actually costing you. These are just the financial costs with working as a PA, as we did not cover the other life costs such as possibly missing out on spending time with your family or even some of your kiddo’s activities as they grow up. Additionally, depending on your specialty and work environment, the stress of working may have some underlying mental health costs as well. The time of your commute is also a cost that is not a financial cost, but rather the cost of you spending your precious time away from family and friends heading to and from your job. The point of this post certainly is not meant to make you feel overwhelmed or guilty about working as a PA, but rather to bring awareness that the cost of work needs to be factored into your finances for a more complete picture. 

I hope you have decided to join me in pursuing financial independence as a PA to allow more options to open up, along with the flexibility and freedom that FI provides! 

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