To PA or not to PA – that is the question

Earlier this week, I was taken off the waitlist at a PA program, and struggled with the decision of whether or not to attend. After deep considering (and SO much help from Instagram homies), I have officially decided to accept. And I couldn’t be more thrilled. Here are some of the arguments for both sides, which I hope will help guide others’ decision, as it so dramatically helped mine.

Before getting into the original post, an update:


I became a PA and I love it (lol)

I recently receive an email asking this very same question, and here is my response a few years out (writing this October, 2022).

Reasons I chose PA:
  1.  it’s super important to me that I’d be able to take patient’s insurance and people wouldn’t have to pay out of pocket to see me. Some NDs don’t take insurance so your clientele looks different. I work in community health, and it was always my goal to bring a more integrative approach to a western medicine setting, which is where I feel the most work needs to be done.
  2. I knew I wouldn’t have an issue finding a job and having patients. Sometimes with ND (unless you’re already in a very well established practice), you have to market yourself and try to find your own patients.
  3. shorter time in PA school meant more financial and time flexibility to continue to further my learning in the way I wanted it, ie I got my Master’s in nutrition and will probably continue to supplement my education through additional courses/curriculum. I loved the idea of choosing things that felt right to me to really individualize and tailor my personal practice.
  4. I wanted to learn western medicine prior to doing something more integrative. I firmly believe that in order to help make the system better, you kind of have to know how the system works.
Reasons I’m happy I chose PA: 
  1. flexibility of practice. If I wanted to choose a different specialty, I’d be able to with ease. I actually loved GI and emergency medicine and thought I may be happy doing those things.
  2. I’m 30 and can enjoy my life, rather than having to continue on in residency
  3. I’ve been able to really expand and practice how I want – I just started my group visits and I’m now doing procedures like IUDs, nexplanon insertions, joint injections (access to equitable birth control is supper important to me!)
Frustrating things about being a PA: 
  1. PA school sucks. You’re learning very strictly western medicine. You’d probably love the ND curriculum far more.
  2. Same thing as with practice – I work in a western medicine setting and a lot of providers you’ll come across are very medication-based with their interventions. But being a PA, I have the autonomy to practice how I want!


The original post:


Bryan Walsh, N.D. (one of my professors at University of Western States): “Hi, Katie. The short answer is, if I had to do it all again, I’d strongly consider going the PA route.  My wife and I have both talked about it and for many reasons, it is an attractive option.  Far less expensive, good scope of practice, job security, and leaves you with quite a few options. I hope that helps. Bryan”

“PA you are definitely going to be stuck in more of the western medicine world but you could also be the drive to help change that. You could change patients lives by igniting them with important information about nutrition and lifestyle.

“I think personally, the PA route. I worked with so many of them and I think your background and knowledge of nutrition will make you a well rounded medical professional. Instead of going to the prescription pad, you’d use your other knowledge to treat and prevent the ailments people come in with.”

“My recommendation would be taking the PA route. It’s such a solid career, and I think having your nutritional background would also open up huge opportunities for you and make you so marketable! I know you said you’re concerned about the current medical model of our healthcare system and education here in the US, but things are absolutely moving in the “preventative” direction and you could be a great catalyst for that! I definitely get the struggle trying to decide what the right path is for your future because I’ve been there! But PA has been ranked a top career the last 5+ years, has great pay, wicked high hire rates / job outlooks, and like you said, you can have flexibility!”

“I would really say PA school because you can open many more people’s minds who are not on the radar for functional medicine, nutrition, herbs, etc. . Also it’s more likely you can help people under their insurance coverage – whatever that means in the next 4 years.”

“I’m a doctor, and I did and exercise physiology masters (+ lots of nutrition background) before starting med school. My preventive minded philosophies have carried over through all of my training and I will continue to keep it as a major focus as I care for patients. You can do both! And we as practitioners need more people like you with a solid understanding of nutrition! You will thrive no matter what you choose. And you do not need to give up blogging!! I started during med school!”

“I just graduated from chiropractic school and am about to start the Functional Medicine Institute’s program – yay! I think if you have the financial mans and time to go through PA schoo, do it! Opening more doors for yourself and increasing your scope of practice is never a bad idea. there are tons of seminars / continuing education courses to keep learning about holistic treatment approaches, too!”

“As a woman and mother, I would love to have more PAs like you. Who seek the root cause first but are more mainstream easy to find.”

“My dads a PA and was for 30+ years. There is definitely pressure to see a lot of patients in a short time and I think that is why they want to treat with medications, which is quicker than taking time to actually find the root cause. He loved being a PA and it’s a great field with a lot of flexibility!”

“Hi!! I’ve been a PA over 6 years now. I love my career but I don’t always agree with the methods used especially since I follow a natural route. You have to do things you’re against doing at times. And PA school will take over your life for sure – no social life. But to me it’s worth it because job stability is on point! And options are endless!!”

“You should go to PA school. You have the knowledge already from a nutritional aspect, think about how many people you can reach as a PA that would never ever be able to go or even think about going to a naturopath. The world needs doctors with your mindset!”

“The benefits to being in the medical system from what I understand is that you can accept insurance and therefore support a wide range of people, whereas the other options don’t allow this usually (depending on your state).  Diana Rodgers (RD) speaks to this. She hated every part of her RD education because of the misinformation but she wanted to be in the system to help from within, and that was her drive to get through al the things she didn’t agree with. I know PA is different from RD, but that might give you some perspective.”

“Being in the medical world the past few years I realize how much more you can do if you’re an actual NP or PA or MD. i thin the medical world needs more health professionals that ARE intestesrd in the root causes and are not just trying to cover up symptoms. IAnd I feel that so many regular doctors are not educated/do not care about treating the root cause. So I vote that you pursue PA so that you can have the resources to order tests, etc. but still have the passion and knowledge to actually EDUCATE patients about how to change their life by treating the root cause through nutrition and a healthy lifestyle. I would be so happy to see more MDs and PAs that understood this and were using it in their practice!”

“Please seriously consider PA school. The world needs more medical professionals that have prescription and ordering powers with communication skills / personalities like yours.”

“Hi! I’m an RD in Atlanta and there ar days where I wish I had a medical credential also. I think nutrition and medicine can work together we just have to get doctors, nurses, pharmacists, etc on our side of preaching proper nutrition recommendation based on consuming whole real foods!”

“I am a medical student in CO. I appreciate and look forward to your daily wellness wisdom. I’m 23 and a second year medical student. I rushed into school but I don’t regret it. It’s the most rewarding path of all. What do you see yourself doing in 20 years. If it’s influencing patients on the most high level which is life and death then don’t way to pursue medicine. At a superior level you can incorporate your “food as medicine” influence. I plan on incorporating mor holistic practices. It’s a long road but even longer one if you wait.”

“Congrats! My sister is a PA and you can totally be a functional medicine PA. We need more people in the medical field you give a crap and know about nutrition!” – this helped me when I was deciding my path. Now at UT Knoxville working with antibiotic resistant bacteria, soon to project on a gut micobiome experiment. Feels better, to me, to work from the inside out. Naturopathic schools can be skeet. Though I love their intention, traditional schooling feels more legit in my life right now.”

“‘I’m actually currently in PA school but had the same struggle right before I got in after I completed my yoga teacher training. I had just come off of an intensive holistic care mind set and was not jumping into this western medicine program. In my opinion, PA school is a must. As a profession PA has already been bridging gaps in the medical field and I think you will find the most open minded individuals in the profession. As a collective PAs want to bring together health care and implement change for the better including alternative medicine. My hopes are that by becoming a provider I can give my patient all the options available to them and help them make the decision that is best for them. Like you I considered some more main stream was of being a holistic provider but because of insurances current restrictions of alternative care I felt I would be most impactful as a PA.”

“I think that becoming a PA and using your education and training in integrative / functional nutrition could be a killer combination. I think having diverse training and extremely in depth knowledge of both traditional medicine and integrative /functional medicine / nutrition is so important. You could apply both and integrate your skills into one very unique practice. This could also allow you to bring your nutrition expertise to populations who couldn’t normally have access to alternative nutrition and health information and support.”

“Honestly, I use a holistic medicine professional with a PA degree. The medical side is covered by my insurance and puts my parents at ease while the other stuff really works for me. Win win”

“I think that being a PA would be the perfect way for you to marry your love for nutrition and wellness with medicine through primary care, but I’m definitely biased  since I’m staring PA school this summer in Philly!”

“I”m leaning towards still pursuing the medical professional PA degree the later incorporate all we know as health/nutrition/prevention into our treatment for our patients.”

“I am currently in nurse practitioner school and really want to practice a holistic approach to medicine when I am done. I had a similar problem about a year and a half ago and eventually decided to choose nurse practitioner school over a health and wellness route. I figured in the on run it may take more time, but I will end up with a larger platform and more tools to help other people!”

“Most med/PA schools are focusing on population health + prevention now! And we need more clinicians dedicated to prevention, outreach, getting at the root cause of behaviors / outcomes and focused on the social determinants of health as opposed to reactive health care once patients are already sick!”

“Go to PA school. You’ll be able to put into practice what you care about and actually be reimbursed by insurance. Your input also will affect your education so you don’t have to be reactionary to what you’re taught when you already know the truth (/ it’s important the people like you go into traditional medicine to make changes to it). It’s so hard to reach the population most in need and be able to afford a career as an ND or RD. I’ve thought a lot about it myself and every ND I have spoke to advised me against it and highlighted the opportunity go my own direction within MD, i.e. Functional Medicine, integrative medicine, preventative medicine. Also your blog / insta is awesome but working in health care made me realize how the population who needs the most nutrition education and impact is one that doesn’t know how to navigate Instagram / internet. You’ll feel so fulfilled in a community health setting and definitely won’t lose sight of the online community created, obviously not as much time but also you’ll be learning so much more about the body and it’ll be 2000% worth it. Go to PA school!!! It’s also crazy easy to get caught up in the what if, you’ve gotten this far and worked hard to realize this goal. Nutrition is the future of medicine. So you gotta be in it!”

“I would go the PA route. Insurance providers don’t always cover naturopathy providers so I feel you would always have work and make a good salary.”


“I am going to PA school in may. My opinion is no to go to PA school because you will be under a physicians guidance and if you don’t find a more holistic doc you will not be able to practice how you want to. The reality of it is insurance doesn’t recognize holistic medicine and I think you will find yourselff at a stalemate. Those who are interested in alternative medicine aren’t going to look for a PA to give them that… they will seek alternative medicine.”

“I work for a chiropractor and in an office with an ND. She can pretty much do anything an MD does and is now recognized by some insurance companies in Oregon as a primary care.”

“Naturopathic medicine! Judging by your passion for healthy foods and herbs/supplements, I think you’d have a really hard time conforming to the conventional side. Knowing what you know concerning food as medicine and treating the root cause, go natural! There’s so much to offer in that realm the days. A lot of opportunities and ability to make decent money as well as actually helping people heal and get better and learn how to eat real food etc. That’s what we need here in America!!”

“I think you’d make an amazing naturopath. Mine is integrative so she does western and naturopathic medicine! It’s been so helpful to me and I think you’d make an amazing ND!”

“You probably don’t want to do this at all because of how crazy the whole med school process is, but getting a DO rather than an MD degree is an option too! My beliefs line up right with your s and this is my current plan for school. You have all the credentials of a doctor and, in my opnion, even more because you have the osteopathic background of looking at the body as aw hole and treating the root cause, keeping clear of medications when possible and even practice OMM (super cool stuff, similar to chiropractic / PT pracices). But once again it is a long process but in my opinion so worth it with all the knowledge you’ll gain and career opportunities down the line.”

“I’d go naturopath root if you can. It wold align better with your interested. I’m in medical school and we don’t focus on nutrition or anything like that. It’s all pharmaceutical and “sick care.” I wish I’d gone naturopath at this point!”

“chiropractic school for the win! My second choice would be naturopathic school but chiro school has been so amazing!”
“go to chiropractic school! you would thrive! Mad respect for naturopaths too! But the purpose of chiropractic care is not the treatment of conditions or disease but the restoration of normal function!”

“I applied and got into PA school as well. Didn’t end up gong for similar reasons. I had a masters in public health and worked in health education and prevention. Many of y PA and doctor friends said you don’t really get a chance to truly impact patients’ lives because you see them so sporadically and for a short period of time. And like you said, you are just diagnosing and treating symptoms and are expected to follow protocol. In terms of transforming lives, you are doing an awesome job (if not more effective than a PA!) through what you are doing right now. I honestly feel like I have gotten much more healthier though all of the social media accounts I follow than through my interactions with PAs/NPs/doctors. If you become a PA you will probably use it in creative / effective ways rather than just working at a hospital (not trying to put PAs/docs down at all! I definitely appreciate them immensely!). I ended up declining PA school, working in HIV prevention for many years (very fulfilling), and ended up starting my own non-profit and business which has been the most amazing ride. I’m also making a buttload more than a PA wit hate ability to be my own boss and make my own hours. Also, no school debt.”

“My sister went to PA school before getting involved in functional and integrative medicine. And it has been incredibly hard for her to find a job where she has the freedoms practice the way she wants to. Of course location has a lot to do with this, but she has found that practicing as a PA has hindered her ability to share her passion of healing through food and other methods to the point where she has forgone practicing altogheter to focus on starting a business where she can do what she really wants. I feel like you and her are very similar so I wanted to share that!”

“I’m an NP right now and hate it. I went to MGH IHP and they DO NOT focus on route cause. Looking back, I would love to go the natural route. I just got my NTP and I am looking into functional medicine degree too, it’s just $$$. But if I was starting form the beginning, I would go get a functional med degree right from the start.”

“I don’t think you can really go wrong, but I do know that naturopathic medicine is growing immensely. Personally, I have healed my autoimmune disease through my naturopathic doctor, although I have modern health insurance as well. I can’t even begin to compare the difference in care I’ve received and I feel it’s been worth every penny. From the outside looking in, it’s seems like naturopathic doctors get to spend much more one on one time with their patients and truly watch them heal. It seems like a very fulfilling job.”

“I can understand how there is a draw to be a PA when it comes to security! I’m not sure what it’s like in Boston but part of naturopathic medicine is covered by extended insurance plans in some parts of Canada. The scope is also different in BC as we have prescriptive rights. I didn’t always want to be an ND but when I looked more into what the program offered I decided to go with this route since I’m a strong believer in preventative and individualized medicine that treats the cause. There are some limitations since it can be costly and it’s not well known but it is a growing profession at the same time.”

“Have you thought about a Masters in Public Health? I went to undergrad for nutrition and love it but didn’t see myself in a clinical setting when I graduated (which is what my curriculum mostly focused on) so now I’m finishing up my MPH in nutrition – much more prevention-focused and community based. There’s a ton of different public health nutrition programs and also other concentrations, too! Food for thought!”

“Have you ever considered acupuncture school? I’m in it now (my second year) and it includes literally everything you’re saying you want. Could be worth researching more!”

“If you go the naturopathic route you should check out Bastyr University in Kenmore, WA.”

“Please please please pursue naturopathic medicine. The U.S. needs more naturopathic doctors who focus on the root cause and total body health.”

“Go the ND route! If your passion lies in nutrition, functional medicine, herbalist, and discovering the root cause, all of those concepts will be supported in an ND program. While a PA school would be supported more by popular culture, you would be going against what your heart is telling you! That is your best guide!”

“Definitely go the functional route. PA is mostly drug stuff.”

“Hey girl! I can kind of release to your current struggle a little bit. I switched my major a few times and struggled dot figure out what I wanted to study and do as a career. I switched from jammiest hat offered great pay and job security, to dietetics which his a great career path but may not be the easiest or smartest choice. But nutrition / dietetics is what I love and am passionate about, so I feel I made the right decision. I don’t know you personally, but from what I’ve learned about you on Instagram and your blog you seem to be very holistic. I feel like you care more about preventing the issue, than curing it later on. I could definitely see you going the nutrition / holistic medicine route more so than the PA route.”


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10 Responses

  1. Hey Kate,

    I’ve been following your instagram for some time now- feel like we have a lot in common regarding a desirable future in medicine yet wanting to be integrative and offer alternative treatments to pharmaceuticals. I have also applied for PA school, am currently enrolled in the University of Maryland’s clinical integrative nutrition program. I struggle with the fact that if I don’t go to PA school I may not be taken seriously in the medical world. I have worked for 8 years now as a medical sales representative (selling only products I truly believe in- currently promoting eye drops for patients having cataract surgery). I unfortunately have decided not to continue with PA school- I don’t have the funds after attending a private school for undergraduate and after paying out of pocket for my masters degree as well. I’m beginning to try and create a brand for myself as I will soon be finished with my graduate degree. I love your approach and your honesty with your followers. I’d love to collaborate on something if you’re open to it to maybe help me get my platform started as a nutritionist aiming to treat disease with dietary and lifestyle changes. I try and veer away from being ‘dietician’ based so as not to become someone creating meal plans for people but really looking to spread the bigger picture about the potentials of food and healing chronic disease. Any ideas or advice you could provide for me?

    -vitamin dee aka Dana 😉

    1. Hi Dana! I have a friend that goes to MUIH and loves their program! Your curriculum is so current and relevant that you’ll have so much insight to future patients. I’m not currently working on new collaborations right now (trying to get a grasp on my own studies / prepare for the start of PA school), but my advice is to find something that makes you stand out / makes you different and be consistent with that. Also engaging with your community is huge! Love the name vitamin dee and best of luck xoxo

  2. Great Website and Content!! Thanks so much for the honesty and help. How is PA school going? I am in the exact same spot you WERE in. I feel like im heading the ND route- I don’t want to waste two years going PA and deciding soon after that I should have gone ND. Thanks for the feedback. Blessings!

  3. I graduated with an Exercise Science degree and have been struggling to decide if I want to go to PA school or not because I don’t agree with prescribing medication first (i would prescribe exercise and nutrition first), and I like the idea of preventing disease rather than waiting until people already have them. At the same time, I feel like the average person won’t look for someone until they already have a health issue. Any advice? Looking back, are you happy with this decision you made? Thank you!

    1. This is such a great question! It’s really tough to make any sweeping generalizations, but in general I find everyone wants to feel better. And it’s been such an honor to help guide patients on that journey. I couldn’t be happier with my decision. It’s incredibly humbling and I’ve learned so much from patients in the past 7ish months of practice. I always try to meet where someone is at, rather than trying to push a lifestyle that I have for myself because everyone is so, so different and wants different things. I, like you, always offer lifestyle / nutrition first. And am so supported by my coworkers who hold similar values. The decision may not be the best fit for you but I truly don’t have a single regret.

      1. Hi Katie,

        In general, would you say that the patients who you’ve offered nutrition advice to are surprised that lifestyle/nutrition is the first thing you mention to them? And have you ever had a patient who was initially surprised/skeptical, but decided to go along with your advice (and who maybe didn’t need to be on medication after all?)


        – Hannah

  4. Hey there!

    I just stumbled on your blog while doing some research and consideration that seems very similar to what you were doing when considering your PA program. The responses you shared in your blog were super helpful and insightful. I too have a nutrition background and I’m still wondering if working in a Functional Medicine setting is realistic for a PA or is that just wishful thinking coming from someone with a holistic wellness background? I did love reading that the medical field needs more nutrition and root caus focused PAs! That’s encouraging and I hope my background would set me apart. Thanks!

    1. Hi Amanda,

      The skies the limit! I know of PAs that work in dedicated functional medicine settings as well as some that just incorporate integrative/functional principles into their practice in more traditional settings.


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