Why be an MD when you can be an NP?
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.
Howdy, I’m a paramedic wrapping up my BS in mathematics. I’m at that great crossroads of choosing MD vs. NP school… and the more experience I have in healthcare, the less the MD seems worth it. Obviously MD’s have more training, but given the current healthcare environment, mediocrity (relative to an MD) as an NP is rewarded.
With the current state of healthcare I would advise th NP route. To much in the air with reimbursement for MDs and the new DNP level NPs are obviously going to be the new gatekeepers. MDs should maintain their training, integrity, pay, and exclusively be upper level specialty care providers.
Thankfully, to me, prestige is worth millions so the choice becomes easy.
Apparently, that’s why your name is Jaguar. Stunning.
“Thankfully, to me, prestige is worth millions so the choice becomes easy.”
This is very short-sighted. You think you own the suit and title, when the reality is, the title and the suit own you. Now because everyone knows of your degree, you will hate yourself if you don’t financially live up to expectations, sort to speak. So you drive in a mercedes to keep up the image, when deep down, you hate yourself every time you stare into the mirror.
hold Jaguar. By your comment, I gather that you feel the NP role is not a prestigious one?
and I second Bentley’s statement. Jaguar…you are certainly not giving the impression that you are in the profession for the money.
“Do the same thing for the same amount of money, and have a better quality of life. Become an NP.”
It’s good to see you back, Hoover! I had assumed that the medical schools had gotten together and paid you to stop writing!
Some senator or money appropriator on a federal level is going to start reading your work and re-evaluating how money is spent at these places and how doctors are trained. Have you ever thought about becoming a lobbyist? Back in the day I dated a couple– they are now in jail for racketeering but they were not as smart or subtley forked toungued and they didn’t they have a mission like you could. (They went to the highest bidder.) I’m not sure what your mission would be– but you would be great at it as soon as you defined it.
I am so glad that I started reading your blog before considering pursuing medical school seriously.
Thank you for the kind words Kellie. This piece was actually written by a guest blogger. I do, however, have some stuff that I’m working on.
=)
You have my email address. I want to buy the first autographed book that you sell. “To Kellie, for all the bad times we never shared.”
I think you are correct in your assement that we will see NP and PA’s popping out gallbladders– will it happen in our lifetime? (I’m in my mid-30’s– I presume I am not much older than you.) Will medical care go down or improve or just become more accessible?
dude you got it all wrong. Its not hte politicians that gave nurses the power to do everything as NPs, its the nurses THEMSELVES that did it.
YOu see, the nurses hide behind evertyhing as the “practice of nursing.”
Scripting a medication? “practice of nursing”
Trigger point injections? “practice of nursing”
Ordering imaging and lab tests? “practice of nursing”
Anesthesia? “practice of nursing”
Brain surgery? “practice of nursing”
You see, the state nursing boards can call building a rocket ship the “practice of nursing” and nobody can touch them. They are free to create a scope of practice for anything they want to do, regardless of how grandiose or stupid it is.
Joe Blow, who made the finite decision that MDs are the only ones who can practice medicine? What if another group educated students in a manner that would make them sufficiently capable of treating patients, but the education was simply based on a different premise?…holistic care, that takes into account multiple aspects of a patient’s milieu, rather than care that focuses solely on the treatment of symptoms.
why the hostility?
Why do we need nurses to “practice medicine.” Why don’t we have nurses to “practice nursing.” The holistic approach to patient care is B@llSh#t, they already have physcians who snuck onto the sceen with this description called DO’s.
Why is there a push for RN to become DNP. Is it possible that health care organizations have supported this? Do you think when this all falls into practice they will lower their insurance rates, or keep the excess in profit?
The problem with this is that there is already people who have trained to fill this position called MD’s. They have a role separate to RN that complement each other for “patient” care. Why confuse the matter. I understand that nurses want to push the envelope of their practice roles (perhaps for money and independence) but this will drive new medical graduates into more and more specialized training programs when we really need primary care physicians.
What’s next dentists that feel that they should be expanding their practice to full head and neck surgery, chiropractors who will operate on the spine, and optometrists who will be removing cataracts. Where will this all stop?
I don’t think you understand the problem. The problem is that there is a shortage of MD’s in most areas but especially in primary care. This shortage is only expected to grow with regards to the aging baby boomers. NP programs started as means to fill this gap. Like it or not the future of health care is nursing. We are filling the gap, doing just as good of a job, and are doing it for less cost. MD’s are becoming a thing of the past.
Can u do your job without them? Yea, Okay then. Soooo maybe u would get more done if you respected your collegues and didn’t like yourself so much…..
While you are correct about the unequal salary distribution between MD’s and NP’s, you are incorrect about malpractice. Just because you are unaware of someone suing a nurse doesn’t mean that it never happens. My state is currently listed as being hostile to both physicians and nurse practitioners.
This is kind of off topic but I thought I’d bring up this post from SDN because Hoover will definitely get a kick out of it. I didn’t know if I should find it hilarious, or feel bad for the kid.
I actually enjoy what I’m doing right now, but I still think this is pretty ridiculous…read and enjoy.
http://forums.studentdoctor.net/showthread.php?t=424817
For most patient care specialties, PAs and NPs will be given more and more leeway. Physicians will take on a more advisory role, just like pathologists.
But medical school is too damned expensive and painful to attend without knowing for a fact you gotta be a doctor. PA is a good deal, as well as a CRNA or NP.
Haha GB, great thread.
Indignant medical students are a riot. In my experience, though, the self-righteous are in the minority (though they are the most vocal.) The number of martyrs drops off drastically during junior year. Privately, everyone is all about landing that residency/fellowship that 1) is financially lucrative and 2) allows for a controllable lifestyle. Who wants to bust their ass for peanuts?
Nurse practitioners do…
Nurse practitioners do…
I’ve been an emergency medicine PA for 8 yrs and am going to Medical School in 2008…..
That said, If given a choice, go to PA over NP school.
I have been making between 85K (My first year) to 98-102K (the past 4 yrs).
Most good ER PA’s make at least mid 80’s.
You will be trained in the physician model, and have thousands of hours more training than an NP (Most NP programs require 500 hrs of clinical and most PA programs have more than 2000 hrs of training).
My masters in Emergency medicine had an additional 560 hrs of clinical training.
Additionally you will not be limited in your practice to only adult, women’s, pedi…etc, you can see all patients, and change your speciality if you desire without any specialized retraining.
From experience, PA’s can work circles around NP’s, and we make more money. Many of the emergency medicine groups I have worked for will not hire NP’s.
The choice to pursue medical school is a personal one. My desire is to improve my delivery of health care. I know from where I am clinically to where I want to be, this is the road I must take. I have spent 8 yrs in the trenches…I have no disillusions….
Don’t worry about the debt, there are many very creative ways to pay for medical school, and if the cost is a deterrent, question your passion.
Oh, by the way….I have never met an anesthesiologist who makes less than 350K, so check your $$$ on the salary calculations….. (My ER Docs all make between 290-350K where I currently work).
SF Doc–
It’s important to note that a Nurse Practitioner is a Registered Nurse before he/she becomes an NP. Therefore he/she undergoes much more patient care-relevant training than does a PA.
A PA can receive his bachelor’s (or associate’s) degree in almost any discipline while fulfilling a few basic science courses to gain admission to a PA program.
It’s important to note that many PA programs are just recently phasing out their associate’s and bachelor’s degree programs in favor of master’s programs. Nurse Practitioners at this time have post-bachelor training/master’s degrees. Soon they will be required to enter NP practice with the new nursing doctorate (DNP). An NP must have completed an RN program before entering an NP program (lots of clinical experience). In addition, many NP programs require nurses to have a certain amount or work experience in nursing to be accepted into their programs.
For you to say that NPs receive less clinical training than PAs is absolute B.S. I have never heard of an organization that prefers PAs over NPs–another load of B.S.
In my opinion it is better to be an NP than a PA because an NP has many more opportunities to advance in the field of nursing. Nursing and Medicine are integrally related, yet distinct fields. The only way a PA can advance is by becoming an MD (another 7 years of school/residency). An NP can advance into advanced clinical nursing roles, nurse education, nursing research, any countless other areas. Let’s not forget about Nurse Anesthetists, advanced practice nurses who provide the majority of anesthesia in a safe and cost-effective manner.
Don’t forget about the NP’s greater independence and autonomy. In a few [and increasingly growing number of] areas NPs are allowed to practice indepently. In all states, however, PAs must practice under a physician (hence, Physician’s Assistant).
As the above comment said, NPs are already RNs which has clinical practice incorporated. Plus 80% of NPs schools require 1 or more years of RN experience. In just a few years when the DNP starts, NPs will have 3 years of school and 1 year of residency/fellowship before being fully board certified(still on top of being an RN). So definitely NPs have way more experience before hitting their first job.
NP PROGRAMS DO NOT REQUIRE AS MANY HOURS OBVIOUSLY AS THEY ARE ALREADY NURSES THAT HAVE DONE CLINICALS IN THEIR UNDERGRADUATE, AND IN THEIR PROFESSIONAL CAREERS. HOW COULD YOU POSSIBLY FORGET THIS PREREQUISITE PRIOR TO NP SCHOOL? OH BECAUSE YOU HAD NO EXPERIENCE PRIOR AND ARE COMPLAINING ABOUT THE HANDS ON EXPERIENCE THAT NP’S ALREADY HAVE OBTAINED. THIS IS JUST ABSURD.
I had 7 years of bedside RN work experience in the acute care setting before graduating from NP school. As a new grad NP I started out at 92,000 a year and I work 40 hrs a week with no call and no holidays and no weekends. I work in the cardiology division of a big medical university. My colleague, who is a PA, had to jump through multiple hoops and demonstrate competencies before she could start practicing independently in this setting. I just wrote a practice protocol, had my supervising MD sign it, and I was off with no problem.The laws that govern PAs practice are way more stringent than they are for advanced practice nurses. We are given way more autonomy. She and I do the same job. She has also struggled with prioritization and timeliness and in keeping up with the fast paced environment. And she worked in an ER as a PA prior to this! I have not struggled at all, because I am used to having 5 billion things going on at the same time and getting it all done within a certain time frame, because I busted my ass as a bedside nurse for those 7 years. This job is a freaking piece of cake compared to being an RN. Meanwhile, the PA is struggling. You tell me who is better trained. I don’t give a shit how many “clinical hours” are required in PA school. It does not compare to doing it for real and for a living as a nurse first.
i agree….my bf is a PA and i just don”t get why we r bantering about who is better. i have worked w plenty of MDs, PAs and NPs who suck. How about putting our pts first instead of arguing about this petty BS. We all have different backgrounds and it still doesn’t change the fact that when u leave ur shift >>>how many lives did u save? It is not about who u are ..it’s about what we have done together.
@ Ashley and Smith…clearly, the most intelligent and level-headed people here.
Us NPs must stick together.
love all the input.
now that it is 2010 – anyone have some real thoughts on market and salary. I’m finishing up my RN…and I was intending to go straight through (while working) to the NP. I have an existing Bachelor’s in Music ( i know…., from my previous life as a concert violinist). Where I am, we can work and go through a RN-MSN/NP program. They offer the FNP, and I’m just weighing that against the PA. Or acute care NP.
I know myself, and I’m very analytical, I need a challenge, and although I find people interesting, I don’t have a high need for touchy feely people interaction. Areas that interest me are oncology (peds) , emergency, and I’m not sure what else yet.
Goal wise, I have to take into account quality of life as well. I am a very hard worker, but I want mobility, the ability to move out of the midwest, the ability to keep moving “up” (by that, I mean always setting and achieving new goals)
Are NP salaries still around the 80K mark? If not or if so, please elaborate. Areas that are better/worse? Both for salaries, and for hiring. Nothing is worth it if you aren’t making a living, so I have already considered the whole “do what you love, but not for the money” – that is simply disingenous. Anyway, thanks
I suggest you get work experience first. No NP school, just straight up working as an RN. If you don’t get at least a good 2 yrs of work experience first, you will struggle in NP school. Then you will struggle as a new nurse practitioner. Trust me. And it is totally worth it to go on to be an advanced practice nurse, but there is nothing like having good solid work experience first and foremost. I know this is a second career for you, and I don’t know how old you are. You may be in a hurry, and some programs give you the option of hurrying through some RN to MSN track and/or don’t require you to have much RN experience to even get in the program. That seems very appealing especially to people that are olsder and going back for a second career. Don’t let these programs tempt you. They just want your money, and don’t care how unprepared and how crappy of an NP you will be after you graduate. They mislead you into thinking you can just work full-time as an RN while earning your NP education, and that it is so easy. Well, you can try to work as an RN while completing an NP program, but once you start clinical rotations, that is like a full-time job in itself. You will not be able to work as an RN like you are thinking. You need to work as an RN solely at first and then explore applying to a quality NP program. I went to Duke, and it was worth every penny and all the hard work and time I put into it. I would recommend the FNP route as that is what I am. I work in adult cardiology, but I have the peace of mind knowing that I can go anywhere and to any setting to practice. The majority salary of entry level NPs in SC is mid 70s.
Oh, good luck, Futurenp!!!!
I just have to clear one thing up for those who don’t know, the only good thing about a PA is that they are taught with the medical model, other than that, they can not do anything without the physician present. NP’s can open their own practice and have prescriptive authority. The also make more than the PA because they function independently. They can also work in the ER and start at $90k a year.
SF Doc is FOS.
I will never get back the 5 minutes of my life I wasted on this.
I was surfing online to find out about med schools. When I read this thread, I just had to respond!
I am currently a Family NP and work in an ER. Like SF doc, I make about 85K a year working approx. 35 hours a week. The facility where I work prefers NP’s although we have some PA’s that work per diem. One of the NP’s attended an Emergency NP program.
Although it is true that NP’s do not have as many clinical hours of training in school. Most NP’s have many years of experience as an RN and work while attending school.
As a family nurse practioner there are no limits on the ages I can treat. As an NP I have also worked as a pediatric first responder to trauma alerts, assisted in surgeries, taught nursing students and worked as a clinical nurse specialist in an ER. Additionally, with my Masters degree I have taught at 2 local colleges in the nursing program which has been very finacially lucrative for me and is also helping develop upcoming health care professionals.
In the ER specialty, MD’s make about 3 times more than NP’s. For this reason, I would consider going back to school to become an MD. I am still undecided at this point.
I have been an RN since 1991 and have had many opportunities in the healthcare field. If you are considering NP versus PA, after school both are very comparable in salary. I do believe there are more varied opportunites with a NP degree and at this time many states offer more autonomy for NP’s than for a PA.
Just like “cjsaid,” I was also surfing the net but not for MD schools. I became a NP because I am a RN with a BSN and wanted to continue on. I am a Family NP and work in an ER setting that is a level 2 trauma center in a group that has only MD’s and NP’s and will not hire PA’s. In my state, NP’s work autonomously in both practice and prescriptive rights. I make about half (90K+)of what the ER MD’s (180K+) make and am getting ready to take another job making about 130K. When I was in the family Practice setting, I made 80K and the MD’s were making around 120-160 depending on the MD and their performance. We talk about the difference between our degrees and they are vast and yet still converging at one common ground which is patient care and treatment. I did not have to pay for either of my degrees (BSN & MSN-FNP) as I there is a vast amount of subsidies for these degrees. For my MSN, the federal government (NIH) paid my tuition because I was receiving a provider degree in primary care. I actually have been paid for every year that I have attended school and still took out student loans that have also been paid by my group and state. My MD counterparts have from over 100K in loans to over 200K in loans to date. As far as malpractice insurance, I pay about 1/10th of what the MD’s pay and this is because of the low rate of malpractice claims in my area for NP’s. Looking at the difference in schools, I had 2 undergraduate years of nursing with over 1300 clinical hours which includes my summer between junior and senior year externship. In my FNP program, I was required to obtain 780 hours but actually gained 820. Total hours over 2100 which is more than what a PA receives in their program. The PA’s have the same required prereq’s as what I had to get with the exception of us receiving Anatomy & Physiology and Microbiology, as a prereq where the PA’s receive this during their program. Most PA programs require that the applicant have a number of patient contact hours in either a CNA or EMT type setting where my undergrad program required that we be CNA’s with a number of contact hours. You cannot overlook the amount of hours that I received as a RN before and during my NP program.
I became a NP not because I could not go to medical school, which was never the case, but because I did not want to be a MD. I enjoy and continue to practice in a holistic manner and would not change that. I utilize non-pharmacological methods as much as I can and practice evidence based medicine daily (it has recently come out after a recent study that MD’s do not feel comfortable using EBM as they say that they were not properly trained. I can perform minor surgery (lump and bump removal, colposcopy, etc.) that I have been trained on and certified in. I am in my mid-30’s and will continue on to get my Doctor of Nursing Practice and I am glad that they have pushed for this as it helps to make us a stronger career field that in most states can only bill at 85% of what a MD bills. The hope is that with the DNP this would change.
I’ve worked in the Medical field as a Radiation Therapist (and a few other things) for 30 years. Almost every MD I know, and I know a lot of them since I’ve also worked in sales Nationwide, are making more money than god. A friend MD of mine walked into Siemens a few years ago (when I was working for them) and bought a $2,000,000 linear accelerator with his Visa card, then used the points to fly to Switzerland on the weekends to go skiing. Only the guys who work in hospitals and take a professional split or a salaryend up making $200K+. Everyone else is at least $400K/year, and a lot of them are making millions. So don’t give me that song about the money not being what it use to be. Get your MD and you’ll have plenty.
I’ve worked (locum tenens) in 40+ hospitals and private clinics. The difference between a nurse…even a nurse practitioner… and an MD in a hospital is like night and day. There is only one king of the hill in a hospital, and that is the MD. No one else. Not the Administrator… or anyone else. Everyone kisses the doctor’s rear end, whether he/she is right or wrong… and he/she is always right. They park where they want. They eat where they want, when they want. They call the shots. The only people doctors have to contend with is other doctors higher up on their food chain. But everyone else works for them. That too is part of what a few years in medical school buys you.
Yes, you have to work hard. Who the hell doesn’t? If you think that four years of medical school and a residency is harder to crank than, for instance, a PhD in medical physics where you have one mind-numbing math class and an original Disertation to construct and defend before you specialize in Medical Physics, you are mistaken. The very, very mistaken idea here is that if you don’t work hard in MedSchool, you won’t ever have to work hard. Think again. Everyone works hard…12 and 14 hours a day. Fact is that the lower level jobs like asphalt-slinging road worker probably work harder than you will ever come near. The difference between being a nurse and an MD is that you have lots of money, a big house and some fancy cars to console yourself.
You don’t have to bust your butt when you get your MD. Most MD’s do because they are type “A” over-acheivers that went o Harvard on daddy’s money. Fine for them. A doc friend of mine I know made it a habit for years to work 6 or 7 months, then take a year off to bum around Europe. When he ran out of money, he worked again for 6 or 7 months, and took another year. He could make enough in that 6 or 7 months to live quite well for a year… and then some.
Another friend decided he didn’t like surgery, so he opened a holistic center. You can do that, you know. You can hang just about any kind of shingle out that you want because you are an MD. Just like in my profession, there is a law against anyone running my machine without a lincese to run it… unless you are a doctor. Then you do whatever the hell you like. Or there is the case of the C.G. Jung institute in San Francisco. To get in, you have to already have a lincese in psychotherapy or psychology … unless you are a doctor. Then you just waltz on in.
Come on, guys. Suck it up and get through your few years of hard concentration. Then you’re set up for life. You can sit in your office and read medical journals, talk on the phone with refering docs (and your broker), scribble a few lines on an x-ray, and churn out a nice article to make yourself famous. And when the day is done, you can jump in your BMW and drive back to your million dollar house on pill-hill while I try to figure out how I’m going to pay next months rent.
“Almost every MD I know, and I know a lot of them since I’ve also worked in sales Nationwide, are making more money than god.”
Mike,
How much do you think God makes?
Another huge difference between MDs and NPs: MDs are greedy and do this for the money only. I actually like making people feel better. I may sound like a cliche, but I like helping people. Granted, I think I deserve to get paid well above minimum wage for what I do, especially considering the fact that I have an NP education from Duke. (Yes i wil toot my own horn on that forever and I don’t care if it’s bragging.) But I don’t need to make 2 million a year and have a BMW and bum around Europe like some loaner weirdo. I do expect to be paid enough to be comfortable and happy, but I also simply enjoy helping my patients.
Ashley,
“Granted, I think I deserve to get paid well above minimum wage for what I do, especially considering the fact that I have an NP education from Duke. (Yes i wil toot my own horn on that forever and I don’t care if it’s bragging.)”
If what you say is really true and you really like helping people, prestige and money would not matter to you. Apparently, it sounds like it does.
I must comment on this subject as a practicing NP. Now I truly understand the problem with health care the lack of unity and understanding each persons role in health care. MDs and NPs are destinctly different and both provide an a service that should benefit our society. As a NP, I understand my role and function well within the scope of my practice, I do not and will not pretend or function in the role of a MD, MDs not only have a broader scope but also have several years of preparation to functions as physician. NPs are and should be nurses who have at least 5 yrs of nursing experience to be an adjunct in this time of shortages of nursing and physicians. It saddens me to think that we don’t have enough physicians because our youth of today, don’t want to commit to the longevity, nor do they have the intestinal fortitude to stick to something longer than a day. And for those of you who read this and think, I am some nurse who wanted to be a doctor, “no” to that, I am a nurse who has always wanted to be a nurse, but one with integrity and one who contributes, not one who wants to get “paid”, and one who does not understand that MDs/NPs make sacrifices and it takes sacrifices not what you expect to make and the long hours and not feeling compensated for what you do, if you want to enter the health care field for money, then no matter what you chose you will never be happy, no one could ever pay you for what is given to humanity. When you take care of another human being with compassion and your knowledge is so great that it allows you to figure out things that maybe no one else thought of or was to busy to see, then that is payment, striving to improve the human condition, I am glad to be a nurse practitioner and I am equally impressed by those who are physicians, and truly hope that we are choosing our career paths based on more than just salaries.
NP/PA vs MD
Gosh, as a patient I’m really scared to listen all these comments by so-called professionals and wanna-be MDs, NPs or PAs. I just hope you care for me as a patient as much as you care for the prestige your title brings or the money your job pays. In the end, it doesn’t matter what your personal hang-up is as to why you don’t want to be an MD/PA/NP or why you do because my health and my life is all that matters to me. You are nothing but one spoke in a wheel to help me maintain my health or heal me. Don’t let that get to your head if you’re shooting for MD (”prestige” reasons). If you’re want to treat patients, you better be good at it and get that “God-like” image out of your head. That’s not who you are and maybe you should be put on Haldol for a while…..
Sounds like you missed your dose.
You nurse Practitioners do not understand the concerns and pain MDs are suffering due to your very existence. We have 200+ K loans, sacrifice beyond anything you can imagine, actually learn much, much more in depth than you are required to learn, represent the top 2% of college science majors and have to take incredibly difficult boards to keep our credentials and jump through increasing loops. Then the NP comes along and takes all of our cush and good jobs, are extremely insecure and arrogant, constantly trying to justify why you are allowed to do the exact same things as MDs, why you can replace MDs and do it with little comparative sacrifice and training. You have no idea how many misdiagnosis by NPs I have to treat after patients get worse and seek out an MD. Being mostly women (I am one too) and being nurses (evil), your entire mindsets, not changed by so-called advanced training, is of a total different nature. You practice EBM becasue you were created to do so. You are a government, not medical profession creation. When we become physicians we are continuing centuries of a professional foundation that provides a depth you cannot understand, one that makes us doctors. While you and your books with knowledge and marginal training come from medicine. It is disorder and chaos and you are the pawns, though well compensated. What the powers that be have done is slapped us in the proverbial face and told us we are obsolete and someone with less training thinks, and I say, thinks that they do as good a job? Who has the ego. I cannot begrudge you for being an NP. The system closed half of the medical schools and created the so-called crisis. I just worked with a bunch of NPs and it was the biggest nightmarish hell I’ve experienced in 22 years of being an internist. They even wanted me to use my first name so they’d be comfortable. Any discussion I had with them regarding patients required my cowtowing to their weak esteem and I was forced to leave. Your profession has made a sham of medicine and if health care (the government) hadn’t highjacked medicine (physician training), you’d be non-existent. It’s like slavery and what it does to the working man and the ethics of working. Workers suffer. If you don’t go to medical school you cannot know what doctors know and as far as doing just as good a job, the touchy feely thing is irrelevant. I worked with NPs and they are not all that, but great politicians. It’s a sham. DNP equivalent to MD. Holy crap. Is a HS diploma equivalent to a BS or that to an MS or that to a Ph.D. If you were equivalent to MDs – you’d be MDs. In today’s world, 2 + 2 =5. You are pawns to help in population control.
Wow-you may want to relax. I have heard that much built up aggression is not good for you.
demetrius–
You are definitely not a physician. NPs and PAs are vital to our healthcare system. The great majority work under physicians and actually allow physicians to see more patients, therefore increasing their salaries–a win-win situation. These mid-levels can take care of less-serious medical concerns, therefore allowing the physicians to take care of more serious medical concerns.
haha you gotta chill out demetrius, the way it sounds like is that your to good for this world. It is true, a NP or PA will never ever have the same scope of practice or ever be a physician, but the fact of the matter is that they are a vital part of the team and were created to fill a necessary gap. Simply put, you gotta accept the facts and get that stick out of your ass and relax. It is doctors like you who ruin the team.
Hey douchebag>>>> i challenge u any day to live or die medicine>>>bad thing is…u r so green u have no idea how to appreciate your help..u silly little person. Im sure you’re that person who people have to deal with because you’re alive…sorry about your bad luck and your poor patients!
AEP>>>who needs letters behind their name when you have this guy who makes anyone look better than them…..
Wow, I’ve been reading through these posts and I had to comment on this one. You sound like a complete psycho. I think there is something to be said about good bedside manner and positive patient interaction, because when it comes to me treating my longstanding chronic pain condition, I have not seen a single doctor with an ounce of compassion that I have experienced with the one nurse practitioner I saw. You guys think that the misery and hell you have to go through to get where you are entitles you to treat your patients like crap and show no empathy for a hell you will never realize, and that’s horrible illness, something that patients come to you every day for and you show nothing but science and facts and no compassion for the hell this “ordinary” people live every day. You make it all about you, the preparation, the time and sleep you lost to get where you are, and you completely forget WHY you are there, it isn’t for YOU – it’s about the PATIENT, and by the time you get to where you were building up to the empathy and idealistic attitudes you may or may have not had prior to entering medical school have been completely beaten out of you. I don’t feel this same issue with nurses or nurse practitioners, and pretty much all other health professionals that have contributed POSITIVELY to me healing (physical therapists, psychologists, naturopathic doctors and the like) why they may not have the same “training” or “knowledge” that you have acquired, they listen, and because they listen, they learn. They learn things that all the chemistry, biology anatomy blah blah crap has not afforded you to do.
yeah, but when you are dying from some obscure disease that the NP hasnt seen before, I bet you will want that “asshole doctor” to come with his biochemistry and blah blah blah to save your pretentious ass. You can have your Positive Healing, I’ll take my science. When you are really sick you will understand. I am very idealistic, my friend and I founded a medical clinic for the homeless this year, but tire of the same old stereotypical bullshit.
Yes! thank you it was time someone said it exactly like you did. Nurse practioners are nothing but mindless robots walking around with their little medication handbook.
ps. demetrius you are my idol
pss. the biggest ignorance is to not know how ignorant you really are, in other words nurse practioners do not know what they do not know that is why they think they are doctors.
You sound like a psychopath. The fact is that most bsn prepared nurses have to help and push most resident physicans through their residency. They do not think or want to be doctors, but have experience and would like the best outcome for their patients. This compare and contrast of practitioners is ridiculous. This should not be about confidence, but the well-being of our patients.
Hey douchebag>>>> i challenge u any day to live or die medicine>>>bad thing is…u r so green u have no idea how to appreciate your help..u silly little person. Im sure you’re that person who people have to deal with because you’re alive…sorry about your bad luck and your poor patients!
AEP>>>who needs letters behinf their name when you have this guy who makes anyone look better than them…..
Take a benzo fool.
Very well said. Applaudable.
“……MDs are suffering…. We have 200+ K loans…. sacrifice beyond anything you can imagine…..have to take incredibly difficult boards…. and jump through increasing loops….. Then the NP comes along and takes all of our cush and good jobs…….”
Bummer D.
Sounds like capitalism, supply and demand, and all that. It’s my understanding that, in most of Europe, med school is free, but you make half of what you make in The States. However, you don’t have malpractice insurance.
Either way, I guess if you were motivated by a cush job, big bucks, and an easy lifestyle, you picked the wrong field. You should consider becoming a stockbroker or business banker. I hear they make tons of bucks just spending other people’s money
When you doctors treat patients like crap and don’t apply your training, you provide for that motherly appeal of NPs to override dumbed down patient’s expectations. I have had to intervene too many times in family member’s care by NPs and PAs practicing beyond their scopes due to the nice factor. Doctors need personalities because most of them are social misfits. Only ER docs have real personalities and many FPs but Internists are A-holes for the most part. Sorry. Patients equate niceness with competence and so do NPs. They are different breed. More lay than professional but you’d never be able to tell them anything. The nurse lobby is BIG. That is how I see this big mess and getting an MD is a big waste of time. Insurers and the government care about the bottom line and not your training, knowledge or application of either.
haha np’s rule!
WOW. I am an NP with over 15 years of exp….and never knew that I was hated by MD’s. Never knew how we have impacted your life. I guess I always thought we were a good team, NP’s & MD’s.I have never put my pt’s life at risk and used kindness as a medical dx. Only used kindness as compassion. Very disappointing to read how we are viewed by some. Our healthcare industry is at a cross road, and coming together as a unity will be far more benificial to the system then under minding our peers. My job as an NP is to see low risk pt’s and minor medical problems so my MD’s can focuse and have more time with complicated pt’s.
sorry for the response to an old post……………………..my NP dovetails perfectly with my MD; they are 2 women who work their butts off to keep me (and many others) healthy……….my NP recently convinced me (gently) that my heme-positive) rectal exam warranted a colonoscopy……..and it just saved my life!.. nurses (especially women) have a special empathy……I talked my MD out of a colonosopy, but my NP looked me straight in the eye and told me: “you need to do this” I’m here to help you through it and let’s do whatever it takes to get it done. I almostfainted, she was so kind. may have saved my life.
Mike Staples is a idiot…… really…….
Honestly I think there are good and bad doctors and good and bad NPs. Some Nps are better than MDs and vice versa. It is always good to promote enhanced training in all professions the world needs health care whether it is from MD, NP, or PA.
Quite frankly, you all got it wrong. Its all about going for the MT. We are talking about raking in $32k to 50k a year, folks! That and you get the distinct pleasure of getting to play in stranger’s shit, blood and piss for 40 hours a week!
*fades backs, aims… nothing but net!*
Argument closed.
Demetrius~I’m sorry that you have such a difficult life.
i’m 19 and am terrified by what i just read. i was just recently accepted into the local RN program at my community college. i hope to work and continue with school to become a NP. personally, i think it’s sad that this is the way my “teachers” act toward each other. the way i see it is that NP’s hours are on the job, PA’s hours are in the classroom, pick whatever way you choose, because the (apparently evil) government views both as suitable to treat patients. as far as MD’s, i had better grades and test scores than all of my classmates that are pre-med. as “angela” stated i simply just want to be a nurse, not because it is faster and cheaper but because that is the role that suits me. so thank you so much EVERYONE for making me feel like shit about a job that i’ve been dreaming all my life to do just because i won’t make as much as you or have as many clinical training hours. this is why our health care system is in the toilet because no one RESPECTS one another. Really MD’s do you ever think that an RN is smarter than you? do you think that maybe they like their job and that is why they do not want to become doctors….not because they can’t. that is why american’s thinking patterns BLOW!!!! you put your own morals onto other people because you seem to that what is important to you must be to everybody else. well guess what your WRONG! because i guarantee that the girl sitting next to you when you were in high school that breezed through physics, chemistry, and calculus was me and guess what I’M GOING TO BE AN RN IN TWO YEARS AND I LOVE IT!!!!!! bahahhaha
lol Im a paramedic and I’m 19 not to brag. lol. But What matters is your care for the patients, I dont care if your a 75 yr old persuing nursing. What we need is people that care for patients. Who gives a f**k about prestiege yes its nice its very nice, but who do you think is gonna make the patients feel comforted a doctor or NP who does the PE without telling them and using medical jargon. Or the guy who brings the patient food and actually takes time out to speak to the patient and ask him how he is feeling, and what he would like? Actually giving the patient some attention. THank you. BTW I got a 38 on my MCAT and will be applying to medical school as soon as I finish my prereqs.
wow! way to take a tiny piece of information from what i said and blow it out of proportion. i just wanted to include my age to show that i am not at all experienced in the medical field……..(”experienced” meaning i have not yet witnessed these actions taken by “professionals”, such as them speaking to one another like that ^). my whole point is that everybody is so far up their own asses i wanted to exploit them by making a mockery of them and doing the same thing.
i do agree with you though. patients should be the number one priority….not how many letters come after your name or numbers on your paycheck. the only reason why i said anything at all was because i found this conversation as embarrassing to the health care industry and everyone that considers themselves a part of it.
congratulations on an impressive MCAT score.
(and by the way “its” is possessive and i do not think you intended it to own nice. so i believe the word you were looking for was it’s. see potential nurse smarter than the potential doctor…..happens everyday. no offense.)
okay still embarrassing to the field. i’m sorry.
To “NURSINGstudent”
This argument has been going on for a Looong time, but honestly, I don’t believe it is shared by all health care professionals. It seems to me that you have a good head on your shoulders, so remember that what people say, speaks about them.
Some are bitter, and maybe they ought to be if they have had bad experiences…but it doesn’t mean that their experience applies as a universal truth!
I’m a nurse, finishing her NP master. I have worked for 9 years as a RN and caring for people has always been very rewarding to me. I wanted to lean more, know more, and have a voice, but that is the only reason I decided to pursue a master NP degree.
I think that it might be important to mention that my husband is a physician, and that many of my clinical preceptors are physicians. I respect them for their knowledge, and the generosity they displayed by sharing this knowledge with me. I have a new found appreciation for the stress and responsibilities of their position and daily job since I started working with them.
I think that we are all important pieces in the care of our patients, with individual qualities that complement each other’s. Don’t let disgruntled individuals spoil your excitement and pride to be becoming an RN, however they are, whatever their training or titles are.
Good luck with your career path!
PS for all: NPs were never meant to “replace” MDs! Stop feeling threatened or comparing…we are supposed to be working TOGETHER, complementing each other’s strong and weak point for the patient’s sake.
Peace !
oh and I plan on studying Herbal Medicine/ with the ultimate goal of being a Natropathic Doctor, hopefully both a MD/ND. God Willing.
go you.
“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.”
Actually when you count residency docs do at least 8 years of training so a difference of 5 years, BIG Whoop.
SO RIGHT!
The biggest issue is that the minimum family practice residency for an MD includes 10,000 hours of supervised clinic work. DNPs have between1,000 and 1,800 hours of supervised clinical work upon graduation with no post graduation training. Below is a link to a great article that includes the differences in the focus of the training and in the amount of clinical exposure.
It comes to a minimum difference of 15,000 hours of training. Certainly worth reading.
http://www.studentdoctor.net/2011/04/sdn-reports-the-dnp-degree/
I’m only a weekend hospital clinical pharmacist and a full-time airline pilot; so I have the unique experience of being a patient and a clinician (sort of). I’m a reluctant patient, because my airline job demands “perfect” health whatever that means; but I’m blessed with a doc who employs a NP and they both keep me in great health. Both are women and both can instantly cut thru my objections to preventative care (you need a colonoscopy, the MD or the NP are going to check your enlarged prostateEVERY visit.. BITCHES! they are so nice that I might live forever! I never heard my NP or my MD complain aout their salaries; I make what they make or more, and they always end each encounter with “how can I help you today”? Sometimes the NP is better at it and sometimes my MD is better at it….when they double-team me; I do whatever they say…..I have been seeing my NP/MD team for 3 years…my blood sugar, CHO, liver enzymes, chemistry is normal. When I came to them, I was 5′8″ and 262, now down to 160……gee, I have been shot doen and served in 2 wars, and these 2 women are intent on saving me……………….physicians vs NP or CRNA (one took care of me after a nearly fatal crash)………I hope that everone gets practitioner like I have.. NP.CRNA, MD, DO……my titles are BS, PharmD, and CFII…………if any of my practitoners say that I need an orchioctomy. I’ll get them snipped…and I make more than any of them…they are just THAT GOOD
I jut saw a NP for my annual physical and she did a super job. I hate going to the doctor (just because), but the NP may change that. I can afford to see anyone that I want to; I could care less who makes more, a NP or an MD. Gee, I hope that being a physician means something. Anyway, when my NP found that I had rectal bleeding (hidden); she called my primary care doc and the 2 of them had me in for a colonoscopy before I could say “let me think about it”. And it may have saved my life. My daughter is a med student and I hope that she becomes as good a practitioner as my NP.
Reading this has really opened my eyes to the opinions and beliefs of some “doctors”. I have seen doctors that have absolutely horrible bedside manners more than once. Whether that is due to the “god” complex that some seem to have on this website or whether they were just tired and overbooked, I truly do not know. I have seen doctors overlook obvious reoccuring problems just as frequently as PA’s. They are all over worked, no one knows your name at the end of the day, you were just a time slot filled. I have chosen to go the NP route not due to the inablity to make the grade but due to the fact that the field (Naturopathic Doctor) that I would most like to pursue is not offered in my fine state and I am unwilling to relocate. I wouldn’t be a Medical Doctor if I was paid to go. I wouldn’t because there is nothing at all they will say or do to help the whole person, most write the rx for the 1:30 appt and go on to their next client. Notice I say client and not patient because at the end of the day all that matters is the money. Not all doctors are this way, but I’ve seen my fair share. Why go NP instead of PA? Why should I have to work with those(docs) I have described above? As a NP I won’t have to. I can treat those people with respect and know that I don’t have to ask Doc for the approval for the anitbiotics that someone needs. When I do have a patient that requires the advice of a specialist I hope that I will have had the luck to meet and coorespond with some decent humas beings that also happen to specialize in said field. Don’t get me wrong. I’m not bashing all Docs just the ones on here and those out in the field with the ‘god’ complex. There really should be a “Vanity test” that doctors have to pass to practice. Prestige my butt… If it looks like a jerk and talks like a jerk it must be a Doctor.
why don’t you get your “doctor” in homeopathy instead. Then you can really help some people! Im glad your “choosing’ not to go into medicine. If you understood what went on behind the scenes a physicians office, you would not be so judgmental.
I will be graduating as an FNP in May and I am extremely proud to become one of the group of NPs who have responded here on this blog. I don’t pretend to know as much as a physician, but I’m pretty bright, work hard, study hard, and have a lot of compassion. It won’t make me a whole lot of money, but maybe one day I can make a difference in someone’s life like you do every day. NPs rock!
Congrats to you! Where did you graduate?
I bookmarked this guestbook., http://telemarketingleads.tumblr.com/ telemarketing leads for you, >:-(,
This article is very short sited
The training b/t physicians is very different than NPs
and Np’s must be supervised to practice
The salary gap is huge
Of the group, NP’s recieve the least amount of training
NP program (DNP = approx 80 credits) MS program = average of 60 credits…over the course of 2 years part time. Accelerated nursing programs are 1 year in length and about 30 credits. Neither program requires much in the way of pre-requisites. Some require statistics.. They complete an average of 600 hours of clinical training. they are regulated by the nursing boards versus the medical boards of each state. They have a limited scope of practice limited to their trainning. They often have very limited hospital privalages if any at all. They DO NOT complete residency training. They care for the simple patients while MD’s and PA’s manage the more complex patients. NP’s never recieve generalist education, rather they just train in a specific specialty. Basically a house on posts…..no foundation.
PA’s education averages 120 credits of course work with over 2000 hours of clinical training. they must complete rigorious hard science coursework similar to medical school (biology, chemistry, organic chemistry, ect…) They recieve a generalist education just like physicians and then specialize. They are regulated by the medical boards of each state (which is much more critical). PA’s have a scope of practice withint their training/education and experience and parallels that of their supervising physician. PA’s embrace the PA: MD team approach to care. They have a very strong foundation in science and the medical arts. Residency training for PA’s is optional. There currently a bridge program from PA to MD. This option does not exist for NP’s due to their lack of science eduation.
Evaluate programs for yourself if you question the validity of the information above
You are idiot
To “pgu says”
ABSOLUTELY everything you wrote is wrong (inaccurate if you will,except so far from the truth that inaccurate doesn’t begin to describe it).
Check your “facts” please.
How about you start by looking up the requirements and program curriculum for ACNP and CRNAs (just to give you something specific to look up). Then report back on your findings, will you?
Another NOTE
NP’s do not practice independently. They must have a collaborating physician for hosptial privalages and script rights
If they wish to practice truly independently, they cannot have either of these privalages
but how would you practice without them????????
Don’t believe me – look it up yourself. It’s a misleading technical feature NP’s like to perpetuate to the ill-informed.
NP’s and PA’s are both supervised. PA”s have much more autonomy because of their training – Period
pgu,
Please check your information before you spout….dependent on the state the NP works in, NP’s DO work independently, and autonomously. An NP can rent an office/building and hang their own shingle without ANY supervision from anyone other than the state and certifying/licensing entities. NP’s have their own DEA # without restrictions in my state. If you don’t believe me….look it up!!!
Wow, I never would have imagined this to go on to the extent it did.
I have been searching for something to make me feel more confident in spending the extra time to become an MD vs a NP. I have a friend that is in med school who told me”don’t do it, become a NP, this is too hard” I know I can do, I just don’t know if I want to wait 8 years till I’m making money. I have a family, a 2-yr-old and a husband. I am a compassionate person and would like to bring this to an MD role as well as the holistic approach. I want to take away this sterotype of a NP showing more compassion than a MD. However my fear is that after all the MD schooling I’ll wish I would have just became an NP and could already be working with people and establish myself.
My main goal, of course, is to help people, to educate them about their health and help them become healthier. Of course money is a factor for paying off loans, putting my kid(s) and family in college, donating to local charities and such (i don’t care about having a bmw or millon $ home)… I want to help my community.
Advice please,
-pre-med student, elizabeth
Elizabeth,
Just because you are an MD, doesn’t mean you cannot educate and care for your patients. I am very tired of hearing how NPs are the only people who care about or talk to patients. I am in med school right now and see physicians every day that are compassionate and caring. These doctors really make a difference in patients lives. As a family practice doc you can very well educate on health, if that is a priority for you. The difference in an NP and a MD is the way they think. MDs are trained in the many “what ifs”of medicine, NPs are trained in the “probablies”. If you truly want to help the community and you are capable, you should attain the highest level of education possible in order to provide the best practice for your patients. Good luck with your decision.
Dear Elizabeth,
Keep trying. If you want to be a dr, do it. There are roles for PA’s, NP’s, and DNP’s. Hopefully, the person practicing one profession is well trained and happy in it. I believe being satisfied with who you are makes you a better provider, no matter what type of provider. Being jealous and comparing abilities is really counter-productive. The job is hard enough to avoid wasting time arguing about who is better.
Spending your life helping others is indeed worth it, whether you are a teacher, therapist, policeman, nurse or doctor. Even one good deed “can” live on after you. The practice of medicine is definitely demanding, but also very rewarding. No doubt, sincerely wanting to help the patient and genuinely caring about their emotional and physical well-being should be the priority for any provider; whether you are the nurse’s aid, the licensed practical nurse, the xray tech, the RN, the NP or the MD. No doubt, caring and listening are therapeutic in and of themselves. There IS a therapeutics that simply resides in the bond of the patient-provider relationship. “I felt better when you walked in the room.” This “therapeutic relationship” is built on a history of good outcomes over time and multiple visits. However, no one should want to be loved, BUT incompetent. Patients tend to trust us and we need to live up to that trust.
There are a lot of sick people out there; sick people who need help. Hopefully, there will be appropriate providers, with adequate skill and training, there to see them. The problem is where are the lines between what this level of training will allow and what it will not. Not all NP’s are the same. Not all dr’s are the same. One is forced to hope no one provider will be put in a position outside his/her scope and not realize it. (Hmmm.. I wonder if attorneys would allow paralegals to simply start doing the simple things like writing wills, doing no fault divorces and house closings … probably not…) Godspeed to us all.
Why go to Healthcare in general ? You want ot help? Become a social worker and don’t get in troubles of 15 years of studies, decreasing salaries and respect, always getting considered like a bitch by Insurers, not being able to like a stable relationship, watching your friend’s pictures in a bar having fun in a friday night in FaceBook at 3 am because you have to work over time and tell yourself “Why did i fall for the hype ? Why the fuck did i thought of Dr.House and Grey’s Anatomy while i was a pathetic clueless premed?”…etc.
I know most of you retards are in it for the money, but you know where money REALLY is ?
B.B.A. + M.B.A. —-> Get your CFA and boom, you have access to tons of 35-50 hours/week jobs paying over 150,000$/year + FULL BENEFITS PACKAGE.
But that’s your choice, while you may be hating your job serving others, someone else will be serving himself and will be enjoying the big salaries.
What’s sad is I didn’t realize that earlier in my undergraduate career, and wasted time, energy, and money studying for classes and the MCAT. I’m happy I didn’t get in med school, but I regret the time I spent leading up to it. I wish I stayed in B-school or at least double majored with a business degree.
Good luck making 150K working 35 hours a week. I think your the deluded retard. Why are you even on a med school forum? Could you not make it in school and are trying to justify your failures? Take your hate mongering somewhere else.
3 friends in med school, and they’re all already over 50k in debt, and not even finished their first year.
Every single doctor shadowed says the money isn’t there, and most is eaten up by loans, office expenses, and malpractice, and reimbursement is expected to go lower in relation to inflation because of gov’t regulation. It doesn’t take a financial adivser to know that it doesn’t pay.
In case you aren’t aware, this forum isn’t exactly the positive light for the field of medicine. While my friends are studying for relentless exams and for the Step, I’m planning my cruise vacation after making a nice killing on the stock market. I am quite the failure in life, as you say. Since you’re a medical student, shouldn’t you be studying instead of going to site like this?
just to intro myself, my wife’s a case management nurse and I am in the healthcare profession myself but not a MD nor a nurse. i do however, make equal to or more than a typical MD.
**“Thankfully, to me, prestige is worth millions so the choice becomes easy.”
This statement above might be an ego boost for some. but really, all this shows is that you think you are a hotshot for getting a MD.
**Do the same thing for the same amount of money, and have a better quality of life. Become an NP.
This statement above just shows that NP is the easy way out to become a “MD” by practice/salary/lifestyle without getting the 4 years of education + 2 years of residency. (no, Medical school is not 1 more year vs. nursing, it’s 3). is this really how our healthcare system is going to be in the future? if NP who are just advanced RNs get paid more or equal to that of a MD, why would anyone want to bust their balls to get into a medical school, get an advanced medical education and work as a DOCTOR of medicine. our healthcare system will be filled with less competent practitioners. would u want someone like that to care for you especially in case where a specialist referral is needed and there’s no MD specialist to turn to?
I think all professions have the right to climb the ladder but i also don’t believe that the easy way out is always the answer. For the efforts that MDs have to do to get to where they are now, I think they deserve their salary.
MDs do not maintain a concern lifestyle or image to keep up with their title. in fact, i know a bunch of MDs, DDS, NP, PT,pharmD whatever you can think of that don’t have a self centric ego about who they are based on their professional status. However, i find more MDs who honestly went into the profession because they truly have a passion for service others through healthcare than do most going into nursing (since it is the easier way out).
now with that said, would you rather go to a primary care provider that has a mentality of milking you for all you have got in tests and exams (nursing mentality) or one that sees your true concern and will do whatever is most comfortable for you to resolve it (MD’s humanistic approach to patient care).
at health care conferences, there’s always big issues among different professions. here’s what’s most concerning each:
medicine: rural and third world access to medical care. providing free medical services to third world countries.
pharmacy: increasing pharmD’s roles in hospitals to work with inpatient care. compounding and higher levels of overseeing drug Rx among all health professions and ways to minimize errors.
PT: alternative approach to pain with less medication to help those on multiple meds to minimize drug interactions.
DDS: reaching out to rural and limited dental care areas around the US and the world. arranging missions trips to third world countries to provide free dental services. increasing health and oral education to kids and do dental screenings to minimize caries prevalence in a community starting at a young age.
Nursing: increasing roles and authority in the healthcare system. to demand an increase of salary and independence from medical professionals. (dental hygienist kinda do the same with trying to tap into doing fillings instead of just cleaning teeth).
you see how every other profession isn’t about the money. but nursing and hygiene are always try to better themselves financially through all means possible saying how there’s not enough distribution of care and what not so you need to expand their roles. in today’s age, there’s less applicants to med school than nursing! so if you want to expand that role and get paid more, why don’t you go to medical school, bust some ass and do it the RIGHT way.
Can we please stop pretending like working as an RN counts as working as an NP? If the hours gained working as an RN are just as good as those working as an NP… why become an NP? There are many nurses who choose the PA route, but they don’t count the RN hours as part of their education. It is important to note the difference in the role that an RN and an NP/PA are filling. Once you begin your graduate training, only the hours from then on out can be counted because those are the hours you have gained working and learning as that specific provider. Therefore, a PA has ~1000 hours didactic and \~2000 clinical hours and an NP has ~500 didactic hours and ~700 clinical hours. Plus, go to any school that offers both programs and look at their respective curriculums. The PA curriculum consists of all hardcore science and relevant clinical classes. The NP curriculum has so much nursing theory and research methods fluff I don’t know how they can go through the program and not demand a change!
Just for the record I have my BS in Molecular Biology, then I got an accelerated BSN (1.5 years of nursing theory and other fluff courses – really a lot of unecessary courses). I worked for 1.5 years as an RN and now I am in the middle of applying to PA school (1 interview invite so far!!). My Molec Bio degree was a hundred times harder than the BSN.
PAs definitely have better training. That is why I am choosing that over going the NP route. And NPs DO NOT have a larger scope of practice than a PA. An NP that works with a doctor might have the SAME scope as a PA, but if an NP opens up his or her own practice (WHICH A PA CAN ALSO DO – google it) then they are extremely limited in what they can perform. As a midlevel you are limited, period. But working with a physician allows you to do more because they are able to supervise you on more difficult things. And a PA can prescribe medications in all 50 states including the Virgin Islands and Guam. Jeeze people. A PA can do anything they physician they work with can do. Which means, in theory, they can have the same scope of practice as a physician. Now, this doesn’t mean that they should… another argument.
And don’t even get me started on the DNP. Doctors think it’s ridiculous as does everyone outside of the nursing community. In fact, most nurses think the DNP is as asinine as anything can be. That’s all I will even say on the subject.
Also, there is in fact a Physciain Assistant to Physician bridge program. LECOM started it this year (2010). It is only available to PAs for precisely the reason stated above – NPs do not have a similar curriculum to physicians. An NP would need to go through all 4 years of medical school.
Now, I’m not hating on nursing or nurses too much. I am a nurse after all. But I have to say the nursing culture is really repulsive. Many are not nice people, they are very pious and they want too much for too little. Nurses have their place and they are very important in that place. But they should either revamp their education or stop trying to over reach.
Just the thoughts of a BSN to hopeful PA! And let’s not even pretend the PA/NP vs MD/DO debate is worthwhile. Because it just so is not.
OH, and I meant to make a reference to my name MSIII. My sister is an MSIII at PITT’s medical school. So I know all too well that a NP education does not even compare to an MD education. The PA curriculum comes close as it was modeled after an MD curriculum. Which would explain how the PA to physician bridge is possible.
omg u pompous ass…im sure ur degradation of ur collegues will get u far. what a piece of shit and embarrassment u r…
I am an undergraduate student who has been searching for countless hours on the internet to find out the true differences between a PA and an NP. I am currently a pre-nursing student who has been struggling with the decision of what my major should be. For months I have been trying to get down to the dirt about these two particular professions. Although some of these replies may be disturbing, I think I have finally made a decision as to how I should register for courses next semester. I’m hoping that many of you who say who are speaking from experience truly are because my future is now dependent upon you! haha just kidding. But I am truly glad that I finally got the dirt on these professions instead of constantly hearing the same thing from advisors and reading on the internet that “one is better than the other”. BUT WHY? well there is not one “better” than the other. I would say that it is whatever you feel suits you best. At the moment I feel confident it my decision to pursue the PA route. This will open up the oppurtunities I plan to seek in the future and allow me to learn from those above me as well. THANKS!
I’d like to first begin by saying– I have heard all kinds of views tonight on this obscure blog I accidentally ran into –about who has better training, who is more competent, who has a larger scope of practice, who makes more money, who has a better “quality of life”……
#1. There is nothing “easy” about pursuing education, regardless of what type it is–medicine, nursing, social work, counseling, dieticians, pharmacists, and yes, even the administrative assistant!. To the person that commented on certain types of “education being the easy way out”… Its expensive, and all should be commended for completing their training. It’s a compliment to those who have raised you, and you are an example to those that you have influence on that follow. It matters not what degree you pursued…..but are you using it to its fullest potential and is it benefitting you, your family, and others?
#2. I know lots of miserable people (and now be honest, so do you)–doctors, nurses, NP’s, PA’s, social workers…..they are everywhere. I know lots of very productive, happy people–also doctors, nurses, NP’s, PA’s, and so on. If you are miserable, you are to blame. Not the professions or what they “can’t offer you”. Find something that suits you–and take responsibility for your happiness. They all make money and pay the bills just fine. What do you like doing each day when your feet hit the floor? You only get one trip around the sun you know……there are not many “do overs”.
#3. Healthcare, in case you haven’t noticed….is collaborative. Docs–you can’t do it by yourselves, NP’s and PA’s, neither can you. I’ve never done it by myself, and I’m not more important, nor is anyone more important than me–we all put our pants on the same way each day don’t we? There are plenty of people to take care of–and there is plenty of money to be made. Jobs (yes, being a doctor is simply that, a JOB….you can’t take the title with you when you die, and same to all other professions) pay bills, feed families, and allow you to live life the way you can do so willfully.
#4. It doesn’t matter who you are in healthcare–your job is to take care of patients competently, and somehow, bring home the bacon to pay your bills. And at various points along the way, sometimes you really like your job, and other times, you don’t. That is life. Thankfully, you don’t have to take your job with you when you go. Respect everyone for what they contribute.
Don’t forget the “life experience” education. Try paying the electric bill, caring for your sick children, trying to avoid bankruptcy from paying for chronic health expenses and holding the hand of the homeless woman while she passes so she won’t leave the world alone. Look across at the parents that just lost a child and ask them to consider donating the child’s heart to the child several states away so that those parents do not have to suffer the same grief. Or what about that sweet little lady that was diabetic, that couldn’t read, that you taught how to take her blood sugars so she could take her medication better and stay out of the hospital from all those blood sugar problems! Or… Hold tightly the man that looks into your eyes, breathing his last breath, knowing that it was you that made his last days as comfortable as possible, that worked until his hands bled so that you–you could go to college, and have a better life than he did. These are things you don’t go to school to learn–you are called by a higher power, and placed into those situations….to bring about change…and do something meaningful…..really and truly meaningful….and your education….regardless of the type…..enables you to have the skills to handle tough situations like those mentioned above….I know mine sure did. And many times, I was not ever truly aware of how I was being prepared or molded into a better person, until situations unfolded.
Just some thoughts to ponder while you are deciding which profession YOU are going to “get more satisfaction from”. It’d be nice…..if you think about…..letting others benefit from who you are, and not necessarily, just what you are.
Sincerely
An NP who has known lots of wonderful doctors, PA’s, nurses, NP’s, dieticians, social workers, respiratory therapists, CNA’s, and administrative assistants
I agree. Both my parents were physicians. i remember my father taking me to the medical school at the academic med ctr where he was chief resident to show me a framed lighted sheepskin of the hippocratic oath. It made a huge impression on me. In that oath physicians promise to raise the children of their fellow physicians if one dies leaving orphans and I know a physician who raised the children of a colleague when the colleague and his wife died in a plane crash.
. I visited the my dad’s room at the hospital. The room he lived in when he was working because back then the residents actually resided at the hospital. He told me that being a physician was like being called to the priesthood or the veil. I believed him and for years believed that I just wasn’t bright enough or wasn’t called to be a physician. For me becoming a physician was fraught with meaning and I was interested in literature and art. Did I feel a priestly call? Nope. I did not until many years later when at age 37 I realized that becoming an NP was a lot like becoming a 1940’s era physician. When antibiotics were new. When a doctor’s clinical armamentarium was thin.What interested me about medicine was the human component. Becoming a nurse practitioner was perfect for me. I didn’t want to be a physician. I’ve been an np for over 15 years and it’s been perfect for me. Mostly I’ve worked in oncology. There are always those folks who need more time than the MD has. Pts who need teaching about their treatment or who need a supportive ear as they discuss their alternative treatment. Early on my supervising physician told me that what he valued most about me was my honesty. I worked along the continuum of my practice, but if I didn’t know something I asked. I know well the limits of my training and I try to practice there. I have done hundreds, maybe thousands of bone marrow biopsies and pts often tell me that when I do the procedure they experience less pain than when they have had this procedure before. For over 10 yrs I trained a lot of physicians in that procedure.( the visiting japanese rn’s were baffled) The docs who didn’t think I had anything to teach them usually ended up doing the procedure in the wrong anatomical location, occasionally injuring the pt. Even when I was training those physicians I was always aware that this was the only procedure I was experienced enough to teach. Frequently the MDs I work with call me “doctor” as a compliment but I always bring them back to the truth. I am a nurse practitioner and I am proud of that.
I often explain to pts that the doctor will “cure” their cancer but that I am there to make sure that they are not in pain,nauseated or constipated.. Physicians are highly trained. Much of what interests me about pts is way down on their list of priorities. Together we can give the pt better care than if we practiced independently. I can and have practiced independently but I feel like I have made my greatest contributions to pt welfare as an NP in collaboration with an experienced physician.
Finally an intelligent post!
Thank you “Holistic”, it was discouraging to read all those hating posts and realize that those people are our colleagues and may be our care takers the day we, or our loved ones, become sick.
J.
Hi. I’m an MD and on this site due to questions from a few people, younger than I, about NP and PA programs. I thought about being a NP but then decided it would take 3 years to get my NP and 4 to get my MD, so it seemed better to get the MD. However, the BIG difference is residency which, in the specialties like FP, IM, surgery is really stressful even now with the “easy” 80 hour limitation on work hours. Residency and fellowships often take 3 to 12 years, meanwhile one earns about $42 to $50K for 80+ hours of work. One big deciding issue for me is that I really hated doctors and didn’t want to work under stupid and mean doctors, such as those who had cared for my mother. However, now that I am on the other end, I have more sympathy for the stress, though some MDs are still very insensitive, but typically I see real caring and have great respect for most of the medical practitioners I work with, from RNs to NPs and PAs to other docs.
I personally do see a huge knowledge difference between MDs and advanced providers. It’s not a matter of who is the smartest or did the best in school. One would have to be mentally disabled to learn less in 8 years of training (or more) in med school and residency than someone learns in 2 years. Experienced NPs and PAs recognize the difference and it doesn’t seem to be much of an issue. It is a lot of work to take care of sick people and typically we all work together in a very collaborative way. I cannot remember a significant conflict that I have experienced or witnessed between MDs and PA/NP.
But, if you want to potentially be at the top, run things, and innovate in medicine, one needs more education (which could be a Ph.D in Nursing or other subject). However, the likelihood of a normal life is better for NPs and PAs usually. $80K at 35hr/week or $150K with 70 to 80 hr a week, it doesn’t matter.
Here is a copy of an email I sent:
PAs and NPs perform essentially the same roles. Legally, there are some differences although this is in a state of flux but may be relevant. In some states, PAs have more authority and can even see pts without an MD present, in other states, NPs can write prescriptions but PAs can’t while in some states PAs can write Rx but NPs cannot. You can bet that the professional organizations are working furiously to support their own agendas.
I would google the professional licensing boards for whichever states interest you to try to sort this out. Try, e.g. “Board of Nursing” or “Board of Medicine” or licensing boards and Kentucky or Tennessee or whereever. Also search for professional associations of NPs, PAs and look for information on those websites in the political sections. Read the relevant info as you definitely want to have as much independence as possible. For instance, it is helpful to be able to see patients if the MD is not in the office, as long as he/she is “immediately” available. Also, you want to be able to prescribe all drugs, including narcotics. I do not recommend that PAs/NPs work totally on their own as they do not have enough training to do this.
I have noticed some differences between NPs and PAs. NPs first have to train as nurses and tend to be more oriented towards the care of the patients vs. PAs and MDs who are more oriented towards diagnosis and developing a treatment plan. That doesn’t mean that the MDs and PAs don’t care as much, it is just a different orientation. One advantage of being an NP is that you can always pick up some extra hours working as an RN, however, it will probably take at least 1-2 years more to get your NP, so I’m not sure that is worth it. You could always get an RN and a PA anyway.
I personally tend to prefer to work with PAs as it seems that they have been trained more similarly to an MD and therefore do better in assuming the MD role and can help me more. I would pick a PA over an NP for this reason, though I’m not sure this is universally shared. Nursing trains you to be more subservient to the MD, which comes across in attitudes vs. PAs, even women, seem to be more assertive.
Nursing PAs usually get Master’s degrees and there are also Ph.Ds in Nursing for those who wish to teach or do research in clinical care, usually. There is a shortage of Nursing faculty mainly because clinical RNs can earn such a good income that no one wants to do it and take a pay cut. NP probably earn a bit more but a critical care RN, working shifts and weekends with some overtime can do very well. I do not believe that the academic track for PAs is as well developed and, in order to teach, one might need a MS or Ph.D in a relevant field but not sure. This may not matter to you if you are not interested, even potentially, in academics.
I don’t recommend an MD unless you are really committed as it is not just med school, it is residency and then longer hours typically also c/w a PA. That said, there are some fields in medicine, such as Pathology, Radiology, Administrative Medicine (e.g. hospital administration, insurance, etc.), Dermatology, Public Health, Emergency Medicine that have regular hours.
Healthcare is a wonderful field: you are helping people, the work is interesting, the problems challenging and always different. You can live almost anywhere. The job market for physician extenders is likely to grow so you won’t lack for a job, though the first one can be hard to get. One advantage of being a NP or PA is that you can change fields much more easily than can an MD. People often find that they like something different than what they expected. I work with two RNs who thought they wanted to do pediatrics but now love oncology. Meanwhile, one nurse who wanted to do Oncology has found her true love working as a school nurse. I thought I wanted to do family practice but ended up in a high tech specialty, which I never would have predicted. So, while you may like family medicine, the bottom line is that you don’t really know until you do it what you will like. Also, life is long and, if you work for 30 or 40 years, it is likely that you will want to do different things at different times in your life as you mature, learn, and have personal life circumstances that have a way of going in their own direction.
Doing a PA/NP is very cost effective. For about the same cost as an expensive SUV, you get into a profession that will pay reasonably well, is respected, is interesting and even fun. How can you lose?
I’m so glad to educate myself on this subject as a layperson. My personal experience is that I feel more comfortable dealing with MDs. I guess I’ve been very fortunate.
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