PA + NP side gigs: The role of the Pharmaceutical Industry

Being a healthcare provider is a full-time job. It requires long hours in the classroom, endless studying and all those extra hours during clinical rotations. Nearing graduation, you must find time to apply for jobs, interview, freshen up your CV and LinkedIn profile. Don’t forget about studying for the boards! Finding out how to transition your career into a healthcare provider (HCP) is not an easy task.

Then, you start your first job. Talk about being green! Generally speaking, PA and NP school do a great job preparing their students for the real world. As it turns out, the real world is a convoluted mess! There are rarely textbook patient presentations and finding your spot in the ever-changing hierarchy of healthcare can be quite challenging. It takes several years to begin to feel comfortable and become a proficient provider. After that, you made it! You have achieved your goal and are making a difference in your patients’ lives! What else could you possible need in your career?

The Massive Raise

Your new salary, anywhere between $75,000 - $120,000, suddenly isn’t enough! It begins with staying late for a little overtime. Then you begin picking up weekend shifts once or twice per month. Before you realize there is a problem, your perfect 40/week job turned into 60 hour/week with evenings, weekends, on-call, holidays, AND YOU ARE STRESSED! We told ourselves a 40 hour/week job making $130,000 per year would be all that we ever needed! Remember saying that to yourself? Why are we always looking for more?

PAs and NPs constantly strive to achieve the ideal work/life balance. Working hard, providing quality care to patients, and standing out among your peers is the goal. An hourly rate of $62.50 sounds pretty good. $62.50/hr x 40 hours/week x 52 weeks = $130,000 per year. Why would you need to work evenings, weekends, holidays or be on-call when the average salary is around $115,000? Oh, that’s right…STUDENT LOANS! And, what about the $60,000 Ford Bronco you bought three months after graduation? Oh, and what about your condo payment of $2,000/month? Don’t forget about all the vacations put on your credit card(s). How much have you been trying to "fit in" with your new colleagues and workplace? How much does that cost you per month? Realistically, your income pays for your fixed expenses and loans, but NOT your lifestyle or savings!

Stress

Burnout begins to set in. Your life is now consumed by work. Patients have become annoying. Your boss continues to expect you to work harder and longer than your peers. There is a building need to “get away” or make a big purchase because you “work too hard” and “deserve it”. The cycle continues and you begin searching for non-clinical ways to make more money. Quickly, your passion for healthcare dwindles and you question whether you made the right career choice. Many of your PA/NP colleagues and friends are considering a doctorate or already have one. You find those rapidly advancing in their health system or the pharmaceutical industry have other advanced degrees (i.e., MBA, MHA, MPH), all of which require more money, and ultimately more STUDENT LOANS! What about the Instagram influencers touting their ability to make smart financial choices? How much about any of these people do you really know? Since when do high-level professionals lean to a stranger on their phone screen for advice? How much do these toxic comments on Facebook get to you?

The Non-Clinical Search

You begin searching for ways to make more money without being stuck seeing patients any more than you have too. Social media platforms are telling you about the wonderful lifestyle you can achieve by starting a side gig/hustle. For new graduates or those within the first 3-5 years of their career, here are some side gigs commonly discussed:

· Botox/Filers

· Freelance writing

· Health coach

· Real estate investing

· YouTube channel

· Stock day trading

· eBay

· Photography

· Cosmetic products

· Podcast

· Drive for Uber/Lyft

The list goes on. A side gig SHOULD be more of a hobby or passion that brings you joy and provides extra income. It should not feel like work! Ideally, it turns into enough income to decrease the burden to pay for your expensive lifestyle and improve career satisfaction. When it truly comes to making money, (referencing the list above) most of the side gigs result in less than the hourly rate of your PA or NP job. But that’s ok! A fulfilling life does not necessarily equate to spending every waking hour on the clock and maximizing every opportunity to make money. Happiness is hard to put a value on...

What about the Pharmaceutical Industry

In many areas of medicine, we are inundated with innovative treatments and technologies to better care for patients. The mechanism of action (MOA) of these novel medications brings out our desire to learn more. Whether it be oncology, dermatology, neurology, hematology, or rheumatology, there are multiple biologic medications available for specific conditions.

For a moment, let’s talk about Dermatology. Psoriasis and Atopic Dermatitis have many biologic medications available. While the class of medication and MOA are not the exactly the same, understanding the immunological process of forming plaque psoriasis or dermatitis is integral as a prescriber. A comprehensive understanding of these disease processes, will help you better take care of patients. Atopic Dermatitis is a disease that plagues millions of people and is now getting more attention. As HCPs, collectively, we need to better utilize the resources offered by those in the pharmaceutical industry to make the optimal informed decisions. Here are the most frequent encountered positions HCPs interact with in industry:

• Pharmaceutical sales representatives are part of the commercial team and key players to get information in our hands. In certain specialties, it often seems like we are getting bombarded by these individuals. The truth is, it is their job to let us know what is new with their medication and provide resources to help us make informed decisions and the most appropriate pharmacologic choice for individualized patient care. Patient access is an ongoing struggle, and we need their help to get the medication in the patient’s hand.

• Medical Science Liaisons (MSLs) do work with the sales team but function much differently within medical affairs. They provide in-depth scientific information on biologic medications and can offer unbranded data as well. If you have not taken advantage of working with MSLs, you are missing out on a HUGE resource! Your sales rep can easily connect you with them. Most of the time, they are willing to work around your schedule to meet virtually or in person. Check out the podcast, MSL Talk and the MSL Societyfor high level MSL discussion topics and learn more about how important MSLs are!

• Pharmaceutical Company Speakers offer lunch and dinner programs to help inform clinicians on a specific medication or therapy. Being a key opinion leader (KOL) is an amazing opportunity that gives HCPs the ability to have scientific discussions with their peers and offer sound, nonbiased data on specific disease states and treatment options. Life is busy but be sure to attend a few of these sessions per year.

By the way, did you know PAs and NPs prescribe more biologic medications than physicians? Reason? Appropriate medication decision making and comprehensive ability to provide the highest standard of care for patients. The pharmaceutical industry recognizes who is most commonly prescribing most biologics and improving medication access. Are you ready to take the next step?

The Mental Transition – Realizing what the pharmaceutical company can do for you

Going from being a PA or NP 60 hours/week to 40 hours/week and doing something you enjoy 5 hours per week sounds great! No one ever said seeing patients wasn’t enjoyable. Rather, diversifying your time and income sounds more attractive. Imagine seeing patients 3-4 days per week and doing something you love 1 day per week and still making the same amount of money, or even more money? What about being able to expand your reach and offering your experience to help other HCPs better manage patient?

Making the switch isn’t easy for most. Your friends, family and colleagues question why you are stepping away from medicine (or adding this into your already busy schedule) and working in pharmaceuticals. Here is a list of the most common ways HCPs work in the pharmaceutical industry:

• Speaker: Working in a specialty, having enough knowledge and experience managing certain diseases is necessary to become an expert on a topic. Whether it be a medication, diagnostic or prognostic tool, several years of experience in the field is crucial before being able to become a speaker. Being a speaker provides a lot of career satisfaction. Not only is it lucrative, but it allows you to potentially expand your ability to help patients. If you have 10 HCPs attending your dinner program, think how many patients each of them sees a week, month, or year? What an effective way to make a difference in patients’ lives!

• Advisory Board: Pharmaceutical companies want your opinion and “advise” for their current plan or to assist development of their future “vision”. You have the chance to help develop the way these MASSIVE companies’ market and develop their science! During these events, you will have the opportunity to network with your colleagues from other states and work towards common goals. Bouncing ideas and difficult cases off one another is a great bonus at these events! Advisory boards are infrequent compared to speaking events but offer a wonderful experience, provide meaningful career satisfaction, and pay well.

• Medical Science Liaison (MSL): More and more PAs and NPs are leaving patient care and becoming MSLs. THIS IS A FULL-TIME POSITION! Working from a home office and going out in the field to clinics and health systems offering scientific resources is attractive to many. Pharmaceutical companies, specifically the medical affairs team, seek out those are all experts in the field and have experience dealing with sales reps, MSLs and speakers. One of your main roles as an MSL is establishing relationships with KOLs and developing their ability to demonstrate the importance of their medication. It is COMPLETELY different than seeing patients for a living. Check out the MSL Society, MSL Talk and network with MSLs on LinkedIn to get more information on the role.

What Is Your Why

Before any major changes occur in your life, ask yourself this question, “Why am I doing this”? It sounds so simple, but people rarely do it. It is typically easy to come up with reasons for your decision making. But be honest with yourself. Why do you want change?

· Am I truly burned out?

· Do I work too much?

· Do I just need a new job?

· Did I choose the wrong career?

· Can I still blame COVID?

· Did you get yourself into too much debt?

· Do these novel biologic medications genuinely me?

· Do I enjoy having scientific discussions with my peers?

· Will working in the pharmaceutical industry improve my career satisfaction?

To become an experienced clinician, you have dedicated many years of your life to science. Don’t let burnout, COVID or debt take you away from expanding your skill set and growing your career. Natural career progression changes our views on what is most important to us and how we want to spend our time. Do what makes you happy. AVOID COMPLACENCY! Find ways to spend your time that is not dreadful or stressful. At the end of the day, a job is a job. People often say, “Love your job and you will never work a day in your life”. While this has some truth, time away from you home and family is work. Your work can be enjoyable but still takes away from your personal time.

What Should You Do

Take some time to find out a little more about YOU. Does work make you stressed? Do you have a problem with spending? Are you able to make all your debt payments on time? What is most important to you?

· Work?

· Family?

· Money?

Make a list of short-term, intermediate-term and long-term goals. Don’t jump ship on a whim when things are tough. Do you plan to transition out of being a full-time clinician or just decrease the number of hours worked per week? OR do you truly enjoy practicing medicine and want to broaden/increase your career by working with pharma?

Does your lifestyle personal/family plans match up with your transition? With a major life event in the near future (i.e., birth of child, marriage, moving, ect.), consider holding off on any major career changes. The last thing you want to happen is to regret the change before you have a chance to enjoy it. For any of these pharma roles, there will be travel – local, region and/or national. It will require being away from your home in the evening and overnight hotel stays. As a speaker or advisory board member, you will have your travel, food and lodging paid for, a nice added bonus!

Many professionals believe in the 10,000 rule. This means you must work at something for 10,000 hours (40 hrs/week x 52 weeks x 5 years) until you can be viewed as an "expert". Think about that for a minute. How many years have you been in practice? Do you have the experience necessary to take on one of these roles?

Financial literacy is the ability to make smart financial decisions to achieve the life you want. Colleagues, social media, friends, and family have a way of influencing our decisions in life. But they don’t know everything about us or the details of our personal financial situation or even our individual goals. Before you begin working with the pharmaceutical industry, realize this could either be the best or worst decision of your career. Look deep at the personal, professional, and financial aspects of your life. Only you can decide what is best!

Your Unique, Personalize Journey

Check out The PAs Guide to Financial Planning or The NPs Guide to Financial Planning to use as a financial blueprint to navigate through your career! These comprehensive guides cater to your career and how to get ahead financially. Save 10s to 100s of hours doing research, phone calls and meetings. For only $20, this is the best return on investment on the market!

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Connect with Andrew Baker, PA-C, MBA in Boston at the Society of Dermatology PAs Summer Conference! In addition to being a full-time practicing PA in Dermatology, Andrew is the Owner/Operator of PA 4 Finance. He is a speaker for an international genetics and prognostics company, Castle Biosciences. He also participates on advisory boards of several pharmaceutical companies. In July 2023, he will begin serving as Director-at-Large for the Society of Dermatology PAs.