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Overcoming Difficulty and Rejection as a Physician Assistant

The practice of medicine demands not only intellectual prowess and technical skill but also intimate awareness of one’s inadequacies. 

The goal is always an unwavering dedication to patient-centered care. Physician assistants, known once again as Physician Associates or PAs, play a vital role in healthcare systems across the globe. PAs are operational in 15 nations, to be exact, and “their acceptance appears successful and satisfaction with their care largely indistinguishable from physicians.” 

The journey of a PA is not without its challenges, however. From the demanding nature of medical education itself to the complexities of patient interactions and the politics of medicine, PAs often face difficulties and experience rejection. 

How do PAs deal with adversity in the practice of medicine? Let’s talk about the importance of resilience, self-reflection, and seeking support.

The Pursuit of Medicine and Inevitable Obstacles 

Becoming a PA requires years of rigorous education, training, and a neverending quest to stay abreast of best practices. PAs study the most important elements of medical practice, a 3-year curriculum often condensed into 2 years. 

From grueling coursework to intense clinical rotations, becoming a competent healthcare provider is arduous for any practitioner, regardless of credentials. 

Along that arduous path come many obstacles. It’s crucial to understand that encountering obstacles is not a sign of inadequacy but rather an inherent part of the journey. By reframing setbacks as opportunities for growth, PAs can develop resilience and adaptability, essential traits for success in the medical field.

The Weight of Responsibility and Rejection

As a PA, you bear the weight of immense responsibility for patient well-being. The idea that physicians carry a heavier burden could not be farther from the truth. We all make life-and-death decisions every day.  However, despite our best efforts, we will be rejected eventually. Sometimes by patients, sometimes by co-workers.

Patients will express dissatisfaction, some will choose to seek care elsewhere. Others will leave negative reviews online for all to see. Colleagues, who ought to be mentors and friends, may be antagonistic or even predatory.

Recognize that rejection does not define your abilities as a healthcare professional and certainly not your value as a human being. Instead, view rejection as an opportunity to define your values and refine your skills. Remember, medicine is a collaborative process, a team sport and most of us get along just fine

The Power of Self-Reflection

Dealing with difficulty and rejection requires introspection. But before one can be introspective, one must be humble. Engaging in self-reflection allows PAs to identify areas for improvement, gain insight into their strengths and weaknesses, and refine their clinical practice. By fostering a growth mindset, PAs can transform setbacks into learning opportunities and drive personal and professional development.

Building Resilience

Resilience is an indispensable quality for practicing PAs. It involves adapting to stress, bouncing back from setbacks, and maintaining emotional well-being to prevent burnout

To enhance resilience, PAs ought to cultivate healthy coping mechanisms, such as mindfulness, regular exercise, and maintaining a support network of colleagues, mentors, and loved ones. Seeking support from like-minded individuals can provide invaluable perspective and reassurance during challenging times.

Consider how you define yourself. Are you a PA or do you only work as one? We don’t have to own the shortcomings of our profession. It’s noble work that provides for our families–that can be enough.  

Embracing Continuous Learning

Medicine is an ever-evolving field, and PAs must embrace a lifelong commitment to learning. Those who oppose PAs taking a larger role in our ailing healthcare system often quote the oblique argument of “7 years to train a physician and 2 to train a PA”. While this is accurate on the surface it’s an unfair comparison. Yes, 7 is more than 2. But 7 equals 7. A PA with 5 years of experience is a better comparison to the new physician.  

Starting from a point of disadvantage, PAs are voracious learners. We learn to never gamble wholly on what we were taught in school. We seek the latest evidence, and the most authoritative guidelines and strive for best practices. We have no choice. It’s essential to our survival. 

By staying abreast of the latest clinical evidence, attending conferences, and engaging in continuing education, PAs are lifelong learners. Continuous learning not only equips PAs with the tools to navigate difficulties but also instills a sense of confidence and competence. After all, trained is trained. 

Cultivating Empathy and Compassion

The practice of medicine is inherently rooted in empathy and compassion. Whether PA or MD, we must put patients before our egos. 

PAs must strive to understand the perspectives and experiences of their patients. By cultivating empathy and compassion, PAs can treat their patients in a way no medicine or surgery ever can.

Empathy is an attempt to understand how others feel. Compassion is born of empathy and drives us to lift and care for others. 

Empathy and compassion will help to establish strong patient-provider relationships, and alleviate distress and suffering in addition to minimizing the potential for rejection. More importantly, a kind and compassionate heart will bear rejection well.

Every patient encounter is an opportunity to make a positive impact on another human, regardless of the outcome.

Wherever the art of medicine is loved, there is also a love of humanity.


The practice of medicine as a PA is an extraordinary and rewarding journey that is not without its share of hardship and frustration, perhaps more so than other healthcare workers. Nurse practitioners share some of the idiosyncrasies of life as an advanced practice provider, but nurses far outnumber Physician Associates.

By embracing these challenges as opportunities for growth, fostering self-reflection, cultivating resilience, and prioritizing continuous learning, PAs can navigate the turbulence and emerge as confident, compassionate, and skilled healthcare providers. 

2 thoughts on “Overcoming Difficulty and Rejection as a Physician Assistant

  • It’s horrific and I’d never recommend anyone be a PA. Period.

  • Hayduke lives!

    I agree that it can be pretty horrific from time to time and I know that I have had my fair share of colleagues who have been less than cordial. In my chosen area we do a majority of the overall work and the “supervisors” sit around and work on vacation plans or watch movies/sports on their smart devices. There are several who also wear ear pods and get upset when they are required to see patients. Almost everyone of them commits fraud by putting an attestation on the chart that they did their own medical exam and were responsible for the decision making. Needless to say the burnout rate is high especially after the high numbers of patients using the ER as primary care since COVID. The question of being a PA or working as one is a good thought that should also be given to some other providers.

    Would I recommend the field to others? Probably not given my experiences of the “better” trained folks. Long hours, countless charting/documenting, rude and violent patients along with the hospital administration culture that seeks only to increase its numbers while breaking the backs of its employees. In short…the light at the end of the tunnel seems to be dimming every day.


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