As a PA, here’s what I actually believed for way too long:
- Get the certification → get paid more
- Get the masters or DMSc→ get more opportunities
- Stay loyal to the company → get rewarded eventually
None of it worked the way I thought it would. And I think in 2026, it’s going to work even less.
Because here’s what’s actually happening right now.
AI is coming for a lot of what we do clinically. Not all of it — but enough that betting your entire income on clinical skills alone is a real risk I don’t think most PAs are taking seriously. The game is changing. And the people who are going to win aren’t the ones with the most credentials. They’re the ones who understand how money actually moves.
What I wish someone told me earlier:
When I left clinical medicine and started learning business, I was shocked at how much I didn’t know. Like genuinely embarrassed. I didn’t know:
- how a practice actually makes money
- what patient retention meant for revenue
- how to look at a workflow and spot where money was being lost
Nobody taught me that shit. And I spent years in medicine thinking I was building toward something — when really, I was just getting better at a skill set with a ceiling on it.
The skills I wished I learned as PA that would make massive changes in my income:
- Customer journey — understanding how a patient goes from “never heard of you” to booked appointment to loyal patient. Practices pay well for people who get this.
- Email and retention — keeping patients engaged between visits. Simple stuff that most clinics completely ignore.
- Systems and SOPs — documenting how things run so the practice isn’t dependent on any one person. This is pure money saved.
These aren’t fancy. But they’re rare in our world. And rare = valuable.
The honest truth:
The version of you that understands medicine is a business and business runs on revenue — how it’s made, how it’s kept, how it’s grown — is worth a lot more than the version who just keeps stacking clinical hours. That’s the version I wish I built earlier. Unconventionally Yours, Sam