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You are here: Home / Physician Assistant Stories / Cookie Cutter Medicine: The Future of PAs and The Future of Medicine

Cookie Cutter Medicine: The Future of PAs and The Future of Medicine

October 22, 2012 By Stephen Pasquini PA-C 1 Comment

Cookie Cutter Medicine

One of the most popular books ever written on building a business is called The E-Myth Revisited (affiliate link), and here's what the author, Michael E. Gerber says about the perfect business model:

The model will be operated by people with the lowest possible level of skill

Because if your model depends on highly skilled people, it's going to be impossible to replicate. Such people are at a premium in the marketplace. They're also expensive, thus raising the price you will have to charge for a product.

The business model should be such that the employees needed possess the lowest possible level of skill necessary to fulfill the functions for which each is intended.

A medical firm should hire doctors, but you don't need the most brilliant doctors, what you need is to create the best system through which good doctors can be leveraged to produce excellent results.

You want to make a "cookie-cutter business" that you can scale fast, without regard to finding, nurturing, and retaining linchpin talent.

The Rule of Ordinary People

If you make your business possible to replicate, you're not going to be the one to replicate it, others will.

If you build a business filled with rules and procedures that are designed to allow you to hire cheap people, you will have to produce a product without humanity, personalization, or connection.

Which means that you'll have to lower your prices to compete. Which leads to a race to the bottom.

Or, in the case of healthcare, the level of individualized care and quality of medical providers is in a race to the bottom while the cost to the consumer goes up. It relies on the same business model.

Where do PAs fit into all of this?

PAs are in some sense part of this rule whether we like it or not:

The business model should be such that the employees needed possess the lowest possible level of skill necessary to fulfill the functions for which each is intended.

Our skill is built upon a shortened and compressed medical school training model that provides a skill level meant to create incredibly good diagnosticians with the ability to perform a wide range of medical procedures. Is this the minimum? I certainly don't think so, but I think we have found a sweet spot.

Our function is to diagnose and treat patients or work alongside doctors in various medical and surgical subspecialties to treat patients.

What we need moving forward: avoid "cookie-cutter medicine"

When I read the above passage in Seth Godin's book: Linchpin: Are You Indispensable? I thought of the term "cookie-cutter medicine" and "cookie-cutter PAs."

God knows I have felt this at times at my job, especially when it comes time for my annual review. Regardless of the institution a lot of what you do will come down to "numbers." How much you can produce relative to the cost to keep you producing.

Patient satisfaction can also use the same model. A hospital, clinic, or medical organization only needs to find a certain level of consumer satisfaction that will continue to feed the machine.

I don't blame the healthcare system as organizations themselves are being forced to turn employees into replaceable cogs in a vast machine. We are easier to replace and therefore, need to be paid less.

The embrace of a "follow these instructions and you don't have to think," or "do your job and you don't have to be responsible for decisions" has convinced us to leave our genius at home. And it is a shame because it is this very genius that holds the potential to revolutionize the way we do medicine.

The path forward

PAs hold the keys to developing a successful healthcare model both here in the United States and abroad. This is especially true in areas where the medical need is the greatest.

We have less time in school which translates into less student loan debt. We have a vast bed of working and growing knowledge; we have diverse backgrounds that allow us to see outside the box, and we can work for less.

Combined with government programs that help pay for PA school education it is going to be PA ran clinics and overseas organizations that may change the world.

Supervision will always be necessary; it is what defines us as a PA-C. If we change this, we lose the model. But I challenge you (if you haven't already) to start thinking about how you can help us avoid a cookie-cutter society, with cookie-cutter patients.

In the words of Seth Godin:

Our society is struggling because, during times of change, the very last people you need on your team are well-paid bureaucrats, note takers, literalists, manual readers, TGIF laborers, map followers and fearful employees. The compliant masses don't help much when you don't know what to do next.

What we want, what we need, what we must have are indispensable human beings. We need original thinkers, provocateurs, and people who care.

Some organizations haven't realized this yet, haven't articulated it yet, but we need artists.

Artists are people with a genius for finding a new answer, a new connection, or a new way of getting things done.

This could be you!

Stephen Pasquini PA-C

Resources:

Linchpin: Are You Indispensable? (affiliate link) image credit

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About Stephen Pasquini PA-C

Stephen has been a family practice PA since 2004 and is the creator of The PA Life and Smarty PANCE Board Review websites. A National Health Service Corps Scholar and a graduate of The University of Medicine and Dentistry of NJ (Rutgers) PA Program and the University of Washington in Seattle, WA. Stephen's goal is to provide one-of-a-kind online resources for those interested in or practicing in the PA profession, to promote better access to healthcare for all, and foster universal recognition/awareness of the PA profession. Read more about Stephen.

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Winnie, Pre-PA

Sarah did such a great job editing my personal statement! She was receptive to my concerns and had awesome ideas to make my essay stand out. I am very happy with how it turned out and I am excited to submit it. Thank you!!

Hannah, Pre-PA

Just wanted to drop you a quick line to let you know that I got accepted to UC Davis, and have accepted their offer. I can’t thank you enough for your help through this process. I owe much credit to you and your amazing editing skills in helping me get in. With endless appreciation!

Jolene Duthie

Carly was incredible! Her prompt edits were extremely helpful, and I will definitely provide updates on the status of my application later down the line!

Audrey, PRE-PA

I can’t begin to explain how thrilled I am to have stumbled on this service. Like many other PA applicants, I was unsure of whether I was on the right track with my personal narrative. Reading Stephen’s two different PA school application essays showed me how to come up with something unique and creative, but the private personal statement review really made my essay shine.

Duke was so kind and helpful in helping me understand what admissions committees look for in a strong essay. Our phone conversations were so thorough, as we read through and discussed every word in my essay. Sue’s guidance helped me cut out the fluff to reach the character limit.

Melissa T. Pre-PA

I am amazed by what Deanna was able to do in helping me get my supplemental essays in shape. I had hit a serious roadblock and she was able, and in an incredibly quick manner, help me remove those blocks. I am very grateful!

Lily, Pre-PA

Carly did more than help revise my grammatical errors and flow. She was able to show me the strengths and weaknesses of the concepts of my essay. She was able to tell me what it was missing as well as praise me for what I did correctly. It gave me confidence in my writing, and I truly believe it will make an impact on the way PA programs view me.

Sherry, Pre-PA

Duke went above and beyond to help me. I so appreciate his help and would recommend this service to anyone!

Jessica H. Pre-PA

I wanted to reach out and thank you for your help with my personal statement. I received compliments about my essay at every interview I had. I also wanted to let you know that I will be attending Duke’s PA Program – my top choice. Your help was amazing! Thank you so much again!

Kelli Tseng, PA-S

I was very pleased with this service. Writing has never been my strongest area. While I had the ideas that I wanted to convey I wasn’t able to articulate them as well as I’d hoped. Carly provided comments and suggestions without altering my central thesis. Any questions that I had were answered quickly and thoroughly. Any grammatical mistakes were also addressed which put my mind at ease. I would recommend The PA Life personal statement essay revision service to anyone applying.

Keith G, Pre-PA

I finally have amazing news. So first of all, in total, I was offered 13 interviews. I was just offered a seat at Nova Orlando! I am finally going to be a PA and a big part of that was from all of your help with my personal statement. So thank you very much for helping me succeed during this round.

Jennifer, PA-S

I have recently been accepted to a program that was one of my top choices, and I also was waitlisted with two other schools. I wanted to thank you again for all your help Duke.  Not only am I grateful for your knowledge of writing and grammar (which were invaluable), but most importantly your kind word and motivation, which I needed so much at the time.  You’re a great person!

Alex Taylor, PA-S

I just wanted to give you an update! So far I have had two interviews and been accepted to both! I have three more interviews scheduled as of right now, and still waiting to hear from a handful of schools. Thank you so much for all of your help with my essay!

Jennifer Bidwell, PA-S

Sarah Schultz was a great editor and was easy to communicate with. She answered my emails very promptly and made great suggestions while also helping me cut down and condense my essay to be in the character limit. She made me feel more confident in my work and helped me develop an essay that I am proud of. I would definitely use this service again!

Katie, Pre-PA

The edits I received were extremely helpful and insightful. I think they really brought my essay to the next level, and I am thrilled with the outcome. Thank you!!

Kelsey, Pre-PA

Deanna gave me excellent feedback on my personal statement, and I couldn’t be more grateful. She was very articulate and gave examples for me to work with on the rewrite. What I struggled with most was the organization of my writing, and Deanna helped me structure my paper so that it was easy to read. I would 100% recommend this service to a friend applying to PA school. Thank you so much!

Daniela, Pre-PA

I just wanted to send you a quick email, letting you know that I finally got accepted into PA school! I will be attending Sacred Heart University in Connecticut and will be starting this fall. I could not have made it this far without your help! This was my third time applying and during my first two cycles, I didn’t think that I needed outside help. But this time around, I decided that I needed to change my tactic and I am so freaking happy that I did. Your guidance and advice on my personal statement absolutely made a difference. I had 6 interviews and got accepted into 4! You have helped changed my life and I am forever grateful. I have several friends who will be applying this cycle so I will be referring them to you!

Christian, Pre-PA

Sue did an excellent job. Despite my sending a request just in time for a holiday, not only did she meet my deadline-she was early. She asked questions beyond the provided text, in an effort to gain deeper insight into me as a person. Her positive attitude and professional review help to ease my stressful anticipation. I am happy I sought her service! (Thanks, Sue)

Angela, Pre-PA

This was my third time applying to PA school and I wanted it to be my last so I figured getting help with the essay would make a difference in my application. Paying for the one on one service was the best idea I’ve had to date. Sarah was great in that she literally combined three different essays I had written into one phenomenal essay! I literally have no idea how she did it. Sarah helped me focus all of my thoughts and experience down into one concise, yet personal essay. I truly think this will help me get into PA school!

Anna M. PRE-PA

Sarah is an amazing writer. She helped clarify my thoughts and encouraged me on this journey. When/ if I get an interview, it will be because of her amazing writing skills.

Araceli, Pre-PA

I just wanted to let you know I was accepted to Mercy College’s PA Program last night! To say I’m ecstatic is an understatement! I wanted to thank you once again for all of your help with my essays and my interview. You helped me so much with everything and I couldn’t have done it without you! Thank you for everything.

Anna Mantikas, PA-S

I loved this service!!

Madeleine Zeichner, Pre-PA

About a year ago you helped edit my personal statement to get into PA school! I just wanted to let you know that I got interviews and was accepted to all the schools I applied to! I have decided to attend UAB in the fall! Thank you again for all your help!

Lauren Smith, PA-S

Sarah was absolutely incredible to work with! My initial draft conveyed all the ideas that I wanted it to, but I wasn’t sure that it flowed well or was memorable. Sarah did a great job with helping me make my introduction stand out and also helped me immensely with the overall structure of my essay. My personal statement had initially been a source of stress but I am so happy with my final draft and extremely grateful to Sarah for her thoughtful insights!

Tina, Pre-PA

I just wanted to let you know I got accepted to Yale!!!! I’m so pumped. I can’t wait to talk more in-depth with you about my experience. For now I just wanted to say thank you!!!! You really were SO helpful.

James Hennessy, PA-S

I had a great experience with The PA Life essay revision service. They were very professional and made revisions in a timely manner. My editor was very understanding about my schedule and when it would take me longer to reply to emails. I would recommend this service to any new grad PAs!

Sandy, Pre-PA

I really felt the person who edited my essay, Sue Edmondson, took the time to get to know me as a person because she wanted my essay to reflect exactly who I am. I couldn’t have been more impressed with the edits and revisions she has given me along with the reasoning behind each revision.

Nicala, Pre-PA

This was an AMAZING edit and I am highly satisfied with the level of service. 100% made it a worthwhile investment. I also used myPAresource and, although they were helpful, I found the PA Life to be a much higher quality evaluation of my personal statement. I will highly recommend it to my peers!

Jeremy, Pre-PA

This was a very quick service and the attention to detail and response time was amazing. I thank you for having a service like this and am so happy I decided to go with the PA Life!!

Rachel, Pre-PA

Sarah was fantastic to work with. She is excellent at her crafted skill and can help any thought or sentence come to life, fast!

Jessica D. PRE-PA

I really appreciated Duke and his way of cutting out the unnecessary fluff in my essay. He was extremely helpful and helped steer me in the right direction to better my writing and make me a more competitive applicant. I am currently still applying to programs and will notify you guys once I get an invitation!

Ani S. Pre-PA

I truly appreciate the ideas and comments Deanna provided for my personal statement. Without her expertise in having an understanding of what PA programs are looking for in a personal statement, I would have gone in a completely different and possibly wrong direction. I highly recommend this service!

Victoria, Pre-PA

I wanted you to know about my acceptance into Elizabethtown College’s PA program. I am incredibly excited – I loved the school, the program and thought the staff was incredible, especially the director. I know my personal statement was a key component of getting an interview with them, and I am so thankful for your help in getting my statement polished!

Steve, PA-S

Sue was extremely prompt and thoughtful in providing her comments, edits, and revisions. My essay had a good start but she helped me write it with admissions committees in mind. I will keep you updated on if I get interview invitations.

Kirsten, Pre-PA

I wanted to reach out and thank you for all of your help throughout my entire application process — your words, advice, and support made a world of a difference to me, and I’m sure everyone who has had the pleasure of working with you feels the exact same way. I thought I’d let you know that after my Stanford and Duke interviews over the past couple of weeks, I received acceptance to both programs! I’m still on cloud 9 and I don’t believe I’ll be coming down anytime soon. And as of early this week, I officially committed to Stanford University’s PA program and I begin in August!!! Thank you again for everything you’ve done to help!

Celine, PRE-PA

Susan did a fantastic job editing my essay! She guided me and gave me suggestions for strengthening certain sections and equally took out weak parts. After I followed her recommendations, I really felt like I had an essay where every sentence mattered and reflected who I was. Thank you so much Susan for your help. I feel that I have a stronger essay because of your honest feedback and your help!

Amanda Pre-PA

I am so thankful that this editing service exists. The personal statement is incredibly important which is why I was so nervous about it. It took me two weeks to even get started because I was so nervous about writing the wrong thing. After Carly helped me with my essay, I am now so much more confident in it. Her edits were very thorough and showed that she had a really good understanding of what is important for a PA personal statement. Her email detailing her overall impression of my essay also showed she understood every single point I was trying to make and what kind of feeling I was trying to give to people reading my essay. This has been the most reassuring thing.

Angela, Pre-PA

The edit that I received from Sue was exactly what I was hoping for. She was able to tighten up my draft beyond my personal skill level and made edits that I was would have never thought to make. She has definitely made my personal statement stronger. Thank you, Sue!

Ethan, Pre-PA

Just found your site today while trying to update my resume. Also, I have to recertify next year so your tests are great for a refresher course. I was in a specialty area of medicine so I now realize how much I forgot in the past 5 years. Thank you very much and I will pass on to other PAs.

Pattie Solomon PA-CNorTh Miami Florida

Wanted to let you know how this application season was going for me so far.

I’ve had two interviews, still have at least three more scheduled, and I received my first acceptance last week.

Thank you again for your help!

M.S, Pre-PA

Sarah was so helpful, accommodating my needs, and I would highly recommend her to a friend/peer. I love this company and the people that work here!

Erin Felter, Pre-PA

Sue is so incredibly kind! I needed so much help on cleaning up my personal statement and overall flow of the writing. She provided great insights and explanation.

Laila, Pre-PA

Sarah was a joy to work with! She was extremely helpful and patient with any questions I had for her! 10/10 recommend using this service!

Lori, Pre-PA

My editor did an amazing job of quickly getting my rough draft back to me. I paid for your service very late in the game, yet The PA Life worked with my timeline and was very thorough in the editing process. I am very impressed with how eloquent I sound in the personal statement. I can not recommend your service enough!!

Katie, Pre-PA

Sarah is absolutely amazing and really helped transform my essay into the best version it could have possibly been!

Shannon B. Pre-PA

Sarah was a pleasure to work with the entire time. I felt very overwhelmed when I was working on my personal statement on my own, but once I started working with Sarah, she made me feel at ease while getting my personal statement to look its best. Sarah is very knowledgeable, understanding, and professional. One of the things I loved the most about working with her is that no matter the time of the day she was always available and got back to you in a timely manner. The whole time we worked on my personal statement she made sure I felt comfortable with changes that had to be made and I appreciated this as well. Sarah is excellent at what she does and I would recommend her and this one on one service to anyone that needs it.

Odilia, Pre-PA

Holy cow! I wanted to let you know I have been accepted to PA school.  I will be attending the Franklin Pierce Physician Assistant Program, Class of 2019 in West Lebanon, NH. I cannot thank you enough for being part of my journey.

If you are reading this you might have been like me skeptical and trying to find a way to write a stellar essay for your PA application.  I want to share with you my exceptional experience using this service.  First, do yourself a favor and BUY the eBook, “How to Write Your Physician Assistant Personal Statement.”  I read it twice. Once before I started my essay draft and then again during.  I cannot stress how helpful the book was in clearly stating what the Admissions Directors are looking for in an application essay.  Next, the book reviews how to formulate a proper essay with clear instructions, easy reminders of the writing process, and excellent examples of good and bad writing choices.  After several drafts of my essay, I made an appointment to work with Duke Pasquini, one of the authors of the guide, through the internet and via phone to help with editing and my length issue.  Duke’s professional experience and kind and straight forward demeanor allowed me to create a winning essay that was an authentic representation of me.  Not only did I receive an interview from my top choice of PA school I was accepted a week later into their Physician Assistant Program, Class of 2019.  Thank you, “PA Life” for being a part of my journey.

Michele Williams, PA-S

I must say, I originally thought I had a fairly strong statement. But after reading Sue’s comments/revision. The quality, structure, and overall flow of my statement was in fact leaps and bounds better than my original.

George, Pre-PA

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Testimonials

Sarah did such an excellent job editing my personal statement that I wanted her expertise for my supplemental essays. I’ve had multiple interview invites so far. I’m so glad I used this service, and I’m so glad I had Sarah’s help! She really took my essays to a whole new level and had good suggestions. I’m recommending her to my peers.
Emily Crenshaw, Pre-PA
Sarah was incredible! She told me pointers that could really help bring my answers together and effectively summarize my points at the end of every question. I was so appreciative of her help!
Meghan Dunn, PA-S
I wanted to send you a quick life update and another BIG thank you! I received my acceptance at the University of Utah’s PA Program on Monday and couldn’t be happier. Thank you for all your help with my essay and interview prep. Both of these services that you provided were so helpful in my success. I will highly recommend you to any future PA student.
Lily, Pre-PA
Excellent service! The editor did a great job of working with me to write my personal statement as I wanted. They also provide some pointers and tips on how to write which is good for supplemental essays and writing prompts.
Ryan, Pre-PA
My editor with The PA Life was amazing! I will definitely suggest these services to anyone else applying to PA school. Thank you for everything!
Margarita, Pre-PA
I scheduled a mock interview before my third interview because I felt as I needed confidence and comfort going into this interview. After my mock interview with Sarah, I definitely wished I utilized this resource before my first interview. I feel very confident going into my interview. Sarah provided amazing feedback and pointers on how to enhance my answers from great to AMAZING!
Kylie, Pre-PA
I wanted to check-in and pass on some great news – I GOT INTO PA SCHOOL! I am going to be a Trojan PA! Thank you so much for helping me make this possible! Thank you for giving me the confidence to take on the interview process.. as none other than myself. I am very excited and wanted to pass along the great news. I’ll always be sure to refer any prospective students your way.
Anise, Pre-PA
I received an acceptance call from USC! I’m going to be a PA! ??‍⚕️ I’m so overfilled with joy and gratitude!! All of my experiences led to this, and I can’t help but feel immense gratitude for every single person that was part of this journey. You were a huge component of this journey, and I am so appreciative of all of your help. Thank you, thank you, thank you!!
Cintia Chávez, PA-S
Sue’s comments were very helpful. Her quick turnaround time is very impressive. She responded to my concerns and questions promptly. She clearly knows what to present to the PA school admissions team. I am very happy with her work.
Kitti, Pre-PA
I must say, I originally thought I had a fairly strong statement. But after reading Sue’s comments/revision. The quality, structure, and overall flow of my statement was in fact leaps and bounds better than my original.
George, Pre-PA

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101 PA School Admission Essays

Admissions Directors Know What They Want. Shouldn't You? You’re slaving away at your personal statement, but can’t help wondering if anyone will read past the first line. A troubling thought, isn’t…

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How to Write Your Physician Assistant Personal Statement

What Makes This Book Unique? We have worked with 1000’s of applicants through our Personal Statement and Essay Collaborative and have interviewed PA school faculty and Admissions Directors from 12…

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