Written By Travis Hornsby, CFA®, CFP®
Updated on February 6, 2021
Nicole Hatcher is a physician assistant and the personal finance expert behind Frugal Chic Life. She’s also a personal friend of mine, having met her in an online mastermind group.
Hatcher knew she wanted a career in healthcare from a young age. She enrolled in college with the intent to become a medical doctor. Once Hatcher learned about the physician assistant (PA) profession, she was drawn to its flexibility.
Already, she’s had the opportunity to work in urgent care, emergency rooms, internal medicine, cardiology, inpatient and outpatient services, and psychiatry. And that’s flexibility she wouldn’t have as a medical doctor.
Here’s what Hatcher has to say about becoming a PA and the systemic racism she’s seen in medicine.
The cost of becoming a PA and earning potential
The PA profession started in the 1960s. Originally, it was a certificate program. “It came out of this idea of there being a physician shortage,” said Hatcher.
But now, most of the programs require a masters-level education and take two and a half to three years to complete.
The increase in education means most PA graduates accumulate six-figures of student loan debt. The average debt from our PA clients has $180,000 of student loan debt.
Pursuing a specialty as a PA is becoming more common, as well. “PAs are being lured into specialties where you can make more money,” said Hatcher.
“Because they have these big bills they have to pay now, as well as student loan debt and lifestyle creep,” many are opting for fast-paced positions at hospitals to qualify for student loan forgiveness even though they may have wanted to work in a private clinic in an underserved area.
The earning potential as a PA comes in around $90,000 and up. It can vary based on the area of practice, geographic area, and subspecialty.
“The higher salaries are usually for those surgical specialties or emergency medicine,” said Hatcher. “But some students come out with offers of $110,000 right out of school.”
Diversity in the PA profession
The PA field lacks diversity. According to the American Academy of PAs, 88% of PAs are white, while only 2.7% are African American.
A few theories exist as to what is holding the field back from representing what the American population looks like, including systemic racism and arbitrary degree-creep that increases educational requirements.
“Additionally, it’s a reflection of the medical community at large,” said Hatcher. “If you look at doctors, there’s a much smaller percentage of those that are minorities – and specifically African American.”
There are also very few HBCUs that still have PA programs. The one Hatcher graduated from has subsequently closed, and only a handful still exist today.
As a PA, she’s dealt with subtle racism and overt racist remarks. For instance, some white patients have refused to be treated by her and other Black doctors and nurses on duty.
She believes the profession is starting to make strides on a systemic level but it’s challenging at the patient level.
“At the patient level, it’s difficult interacting with people that you know think that you’re inferior because of the way you look,” said Hatcher. “They’re afraid you don’t know how to do your job because of what you look like.”
Diversity problems with paying for PA school
The gap between the “have” and the “have nots” is getting more pronounced as the educational requirements increase for physician assistants, nurse practitioners, physical therapists and other programs.
Becoming a PA used to require a certificate. Then it jumped to a bachelor’s degree. Now, in most cases, it requires a master’s degree.
If your family wasn’t set up in a way to help you pay for college, getting there is difficult. “I definitely think it makes it more difficult for folks to get in because you don’t have that head start where you have parents and grandparents who have said, ‘we covered your undergrad, all you got to do is cover your master’s degree,’” said Hatcher.
Instead, Black students have to figure out how to finance it themselves. “You start behind the eight ball, behind the starting lineup because you have all of these barriers just to get to undergrad,” said Hatcher.
Where to learn more about Nicole Hatcher
As a content creator, Hatcher continues to promote financial literacy and make people aware that everyone doesn’t start from the same place.
“I feel like I need to raise awareness of this thing that’s called white privileged, especially among my fellow content creators in personal finance,” said Hatcher, “because you do have minority people listening to your shows and reading your blogs.”
You can find Hatcher on her blog at Frugal Chic Life or subscribe to her YouTube channel.
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