JAAPA Podcast – Episode Summary: “Career Flexibility”

Published: July 12, 2024
Host: Kim (JAAPA Podcast)
Guests: Eliana, Claire Kriakos, Jay Navoa

Episode Overview

This episode of the JAAPA Podcast explores the theme of career flexibility within the Physician Assistant (PA) profession. The hosts discuss recently published research (in JAAPA) examining how PAs transition between specialties, the unique adaptability of the PA role, and the experience from both the providers’ and the hiring managers’ perspectives. The conversation includes personal journeys, research methodology, industry insights, and practical advice for PA students and practitioners contemplating or navigating specialty switches.

Guest Introductions and Personal Journeys (01:18 – 06:30)

Key Points:

• Each guest shares their unconventional path to the PA profession, highlighting career pivots and the draw of flexibility.
• Guests discuss alternative career interests outside of the PA field, underscoring the multidimensional interests of PAs.

Notable Quotes:

• “I originally studied physics and computer science...then worked as a management consultant...then I discovered the existence of the PA profession...[and] everyone I talked to was so happy with their career decision.” – Eliana (01:18)
• “I was thinking originally I would go through the physician route, but after meeting [a PA]...I thought it was an awesome job to look into.” – Jay Navoa (02:53)
• “I started my career in clinical practice, but...was one of the first PAs on my first team...and those leadership opportunities inspired me to continue in healthcare administration.” – Claire Kriakos (04:29)

The Value and Importance of Career Flexibility for PAs (06:30 – 09:12)

Key Points:

• Career flexibility is a primary draw for many entering the PA profession.
• A study cited found 75% of PAs switch specialties at least once; over 90% value this ability.
• Research into specialty switching is limited, sparking the need for more comprehensive studies.

Notable Quote:

• “The flexibility to change specialties was often top of the list of advantages of being a PA over other healthcare professions.” – Eliana (07:09)

The Research: Inspirations, Methods, and Participant Perspectives (09:12 – 16:49)

Key Points:

• The researchers interviewed both PAs and hiring managers for a dual-perspective.
• The team explored prior studies on Advanced Practice Registered Nurse (APRN) specialty switching to inform their approach.
• Data was gathered through interviews aimed at both the practical and personal dimensions of transitioning specialties.

Methodology Segment:

• Sample: Contacted 225 PAs and 60 team leaders; interviewed 11 PAs and 7 hiring managers.
• Why Both Sides?: To understand both the hiring process and the lived provider experience.
  (14:37 – 15:25)

Notable Quotes:

• “We were really interested in both the perspective from the hiring managers...but then also the perspective from the people who've gone through this process.” – Eliana (15:25)
• “What makes you more interested in that candidate or less interested in that candidate?...How do you make onboarding smooth compared to new grads or same specialty hires?” – Eliana (15:25)

Memorable Insight:

• Organizational onboarding strategies from outside healthcare, such as tech companies, may be more advanced at integrating employees from various backgrounds (17:56).

Challenges in Onboarding and Managing Expectations (17:56 – 23:30)

Key Points:

• There is a recognized gap in formalized onboarding for experienced PAs moving into new specialties; most organizations are still developing standard practices.
• Disparity exists in manager expectations regarding prior experience—some prefer seasoned providers, some prefer blank slates.
• Team capacity and organizational needs often shape hiring and onboarding decisions.

Notable Quotes:

• “Almost everyone I talked to was just not thinking at that level...the app world is still pretty nascent in its process of really thinking about onboarding.” – Eliana (17:56)
• “From the hiring managers, it’s multifactorial—not only about orientation, but the bandwidth to train a newer provider...Those are things you have to take into consideration.” – Jay Navoa (20:58)
• “I talked to hiring managers on totally different places in that spectrum...some far prefer to hire somebody who knows how to talk to patients...others said they’d take a new grad any day.” – Eliana (22:04)

The Role of Networking and Internal Mobility (23:30 – 27:23)

Key Points:

• Networking—both informal and through structured events—significantly aids transitions between specialties.
• Internal networking fosters referrals and awareness of available positions, improving job matches and team satisfaction.
• Organizations must balance fostering internal movement with addressing avoidable turnover, ensuring changes align with passion and life stage, not just extrinsic motivators.

Notable Quotes:

• “Being a PA gave them these networking opportunities to meet people who work in other specialties, to find out about job openings, to have those relationships.” – Eliana (23:55)
• “We’re all in the business of trying to make sure the patients are cared for in the best way...when you have an engaged provider...we’re all more than happy to say, ‘hey, I believe this PA would be great on your service.’” – Jay Navoa (24:55)
• “Organizations should look at equitable standards...so you don’t have people jumping specialties for extrinsic motivating factors.” – Claire (26:11)

Comfort Timeline: When Do PAs Settle Into Their New Roles? (27:23 – 31:59)

Key Points:

• There is often a mismatch in expectations between PAs and managers about the pace of acclimation when changing specialties.
• The timeline to reach comfort varies by similarity between specialties, institutional memory, and individual experience.
• Clear expectation-setting and mutual support are vital.
• The transition from “novice” to “proficient” or “expert” can take up to five years, echoing Patricia Benner’s theory.

Notable Quotes:

• “One of the things we found...people talked about not having expectations for how long it was going to take...that causing a lot of tension.” – Eliana (28:00)
• “Setting expectations is probably what is key...you’re not going to know everything after a year; keep wanting to learn.” – Jay Navoa (29:59)
• “In some programs...we’ve used five years as our minimum expectation for proficiency.” – Claire (31:02)

Trends in Specialty Switching and Onboarding Practices (31:59 – 37:59)

Key Points:

• Historically, onboarding for experienced PAs re-entering or changing specialties has lacked structure; a spectrum now exists, with growing awareness of tailored onboarding needs.
• Comfort with new roles often depends on acuity and setting, not just the overlap in knowledge between specialties.

Notable Quotes:

• “It would be great...to work with your hiring manager and have a more structured program to highlight the strengths you bring from your past expertise, but then also fill the gaps.” – Eliana (35:08)
• “More recently I’ve noticed that it’s based on acuity as a similar theme...learning the medicine in that specialty is one thing, but knowing how to treat in the hospital, working up different things, is important as well.” – Jay Navoa (37:16)

Advice for PA Students and Early Career PAs (37:59 – 42:38)

Key Points:

• Keep an open mind; the first job may not define your whole career.
• Focus on settings and environments that align with your strengths and life stage.
• Flexibility is inherent to the PA profession; embrace risk, persist, and leverage networks and references.
• There is no single recipe for successful specialty switching.

Notable Quotes:

• “One of the beauties of being a PA is you have that opportunity and flexibility to change specialties if needed, but sometimes you have to take that initial risk and choose the specialty based on your passion.” – Claire (38:19)
• “There wasn’t only one recipe that you have to follow if you want to switch specialties…if you’re persistent, pay attention to what you’re interested in, and you network...you will end up getting that job.” – Eliana (39:18)
• “Don’t think that you’re going to be in your final job right away...keep an open mind and be willing to take that jump if you feel that it’s time to do so.” – Jay Navoa (41:13)

Memorable Moments

1. Direct Comparison with Tech Industry Onboarding:
   Eliana draws from her background in tech to highlight gaps and emphasize the potential for healthcare to adapt cross-industry best practices in onboarding.
   (17:56)

2. Personal Vulnerability Around Switching Specialties:
   The host shares candidly the challenges and emotions faced with career shifts, adding relatability and reinforcing research findings.
   (31:59 – 35:08)

Key Timestamps

• [01:18] – Guest introductions and backgrounds
• [06:30] – The draw and statistics behind PA career flexibility
• [09:12] – Inspiration and design for the research
• [14:37] – Rationale and framework for interviewing managers as well as PAs
• [17:56] – Surprises in research and onboarding practices
• [22:04] – Hiring managers’ perspectives on prior experience
• [23:55] – The importance of networking for specialty transitions
• [28:00] – Timeline and expectations for acclimation in new roles
• [31:02] – The timeline from novice to expert
• [35:08] – The spectrum of onboarding practices and shifting expectations
• [38:19] – Advice to PA students and early-career PAs
• [41:13] – Reassurance for being open to change throughout one’s career

Conclusion

This episode offers a comprehensive, empathetic, and practical exploration of career flexibility among PAs—examining not only the value and frequency of specialty switching, but also the structural, practical, and emotional challenges of doing so. The guests underscore the need for better onboarding processes, more intentional networking, and dynamic, individualized approaches to hiring and training. Their advice to future PAs is clear: embrace flexibility, keep an open mind, persist in your interests, and connect with your community.

For CME credit, visit cme.aapa.org.
For more on PA career journeys, follow JAAPA on social media and catch upcoming episodes.