www.wikipedia.org: Rather than a generic focus of education, Nurse Practitioners are able to specialize in an area of study they desire (e.g. Pediatrics, Family Practice, Adult, Geriatric, etc.), and provide care within the scope of their expertise. As well, Nurse practitioners in certain states can be “psychiatric clinicians” and perform similar practice (though at a different level) as a psychiatrist would.

Salary.com: Nurse Practitioner salary (25th-75th percentile) is $67,166 - $78,497. Generalist physician salary (25th-75th%) is $115,260 - $152,715.

Wikipedia: According to numerous salary reports throughout the years, CRNAs remain the highest compensated of all nursing specialties. Their average reported annual salary range in 2006, reported by the AMGA Medical Group Compensation and Financial Survey, was $140,396. The mean annual salary for an anesthesiologist in the United States in 2006 was $184,340. [1]

What’s my point? Fair question. First, NP’s have the same scope of practice as any physician. This is clear from my first statement about NP’s specializing. Whatever specialty you want as a physician, there’s an NP that can do the same thing. “But surely not for surgery?!” is the cry of retort. Well I promise you that within the next 10 years, some politician is going to realize that “Hey! PA’s and Surgical Tech’s can pop out gallbladders just as well as a surgeon can!”

Also note the salary differences. Now I can’t find information regarding the various NP specialties, but compare the lowest specialty to the most basic NP, the salaries are comparable, and the highest NP position to the highest (according to MSN.com) paid physician. When you do, you’ll note that physicians do, in fact, win. And NP’s must do 2 years of post bachelors work and one year of work experience (for a total of 3 years) compared to the 4 years post-undergrad for a physician. Big whoop. One year.

Well please note, the average med student graduates with around $200K in debt, while, according to Barry.edu (a school in FL that has both NP and PA programs) the PA program (the more expensive of the two) is $24,810.00 per year. This is roughly equivalent to medical school. However, you’re paying twice as much in med school because you go to school for twice as long. Also, one of the 3 requisite years for NP school is clinical experience. This is a paid job. RN’s make (again, 25th-75th%) $49,479 - $59,114. That means that if a med student and an NP were compared at the same time, 4 years post undergrad, the med student would be out $200,000 (roughly) and the NP would be out $521 (rounding to $25K/yr for both programs, and using the 25th percentile for RN’s). Add the interest on a med school loan, and that puts you at about $600,000 paid back (bc you pay back about 3x what you borrow, esp the financial geniuses that make up our MD population).

Now lets say that no matter what you do, you make $30,000/year more than your equivalent NP. You figure that after 30 years of practice (putting you at the nice comfortable retirement age of 66 for those of us that took the direct route) and you’re up $900K. Worth it, right? Well we haven’t incorporated malpractice insurance. Have you ever heard of anyone suing their NP? I sure as shit haven’t. Factor in 30 years of malpractice insurance bills, and I’ll promise you it brings you right back to even (not to mention that physicians’ salaries are trending down relative to inflation while all nursing salaries are trending up). Couple that with the hours worked by an NP relative to an M.D. and the paperwork/legal hassles handled by an MD that aren’t worried about by NP’s, and the conclusion is obvious.

Do the same thing for the same amount of money, and have a better quality of life. Become an NP.

Popularity: 14% [?]

Time is valuable, and there’s only so much of it in a day. The amount of reading you have to do during medical school won’t change, so in order to salvage more free time to enjoy life, you’ll need to create that time on your own.

One of the ways to create more time and still get the same amount of reading done is to increase your reading speed and comprehension. This is easier said than done, but it is possible. Here’s a tutorial on Overclocking Your Reading Speed. Now that summer is upon us and if you’re not on rotations or studying for Step I, this is the perfect time to get these methods under your belt and start reading more efficiently.

1. Realize that reading is not from beginning to end, but rather point to point.
2. Try using a pacing tool.
3. Get rid of all distractions and possible interruptions.
4. Try to read more than one word at a time.
5. Never move backwards.
6. Think visually.

Check it out.

Popularity: 5% [?]

Medical school blows. If one were to believe one actually likes medical school, one should please reread the first sentence carefully and completely.

Popularity: 6% [?]

Even though residency working conditions have nothing to do with me on a personal level, I am a huge, huge advocate for residency work hour reform.

There’s a really simple and free way for you to support work hour reform as well — simply place a link on your blog to HoursWatch.

Hours Watch is dedicated to ending excessive work hours for medical residents, and finding solutions that enhance patient care and residency education. Hours Watch is jointly sponsored by the Committee of Interns and Residents, and the American Medical Student Association, organizations that have led the fight to reduce unsafe and unhealthy overwork of medical trainees.

Although CIR and AMSA view the ACGME’s move to regulate work hours as a major step toward safer and more humane medical training, there is also reason for skepticism that an industry-dominated accreditation group can effectively enforce its own rules or provide adequate protection to residents who blow the whistle on violations within their training programs. Therefore, one goal of Hours Watch is to serve as an independent “watchdog,” monitoring and lobbying for enforcement mechanisms that offer better protections to residents.

Just a simple link back from your blog will increase exposure to the cause. Great examples of links are:

• HoursWatch
• I support work-hour reform
• End residency slave-labor
• Residents are indentured servants

Popularity: 4% [?]

It’s true, and is published in a recent NEJM article.

Residents in Europe work about 56 hours per week, and after August 2008, they will be allowed to work only 48 hours.

Sleep medicine experts state that current training restrictions with maximum 30-hour shifts and 80-hour workweeks are unsafe for both patients and physicians. A fine balance is being looked at as to where the optimal line of patient care vs. physician work hours can be drawn.

If you compare what US residents work to residents in Europe, the poor US guys and gals are working almost twice as much.

I think further work hour reform is on the horizon, especially if favorable data comes out of the decreased work hours for European residents. Only time will tell but I think it’s a push in the right direction. 80 hours per week is still too damn much.

Via: [NEJM]

Popularity: 5% [?]