Dr. Nurse?

BU Medical Sciences
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scarletgirl777 said:
I have seen nurses work, and I know that they are hardworking. It is not that they are lazy. It is that becoming a doctor redefines the word hardworking. I have a met a lot of nurses who are unhappy about their jobs, who hated being on-call, doing overnight shifts, etc. Nearly every shift I'd volunteer at my hospital, they'd make these complaints and they just generally never smiled EVER. I never heard doctors make these complaints. Do you know why? Because they never had the time, they were too busy running around. :)

The bar to become a nurse practitioner is lower than the bar to become a doctor. You need to contribute a higher combination of money, work ethic, intellect to become a doctor. Once you become a doctor, you can't unionize to make what you consider fair pay or fair work hours, and you don't get paid overtime. This means that overall, there is more work required in becoming a doctor and staying a doctor. And that is not a knock on nurses, that is just the reality of the situation.
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You know you are lying.
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wisconsindoctor said:
How dare you say that. What PandaBear was getting at is that the majority of nurses don't have the same knowledge base as medical students, residents, and attendings (not that nurses are dumb people). What the majority of pre-meds don't get is that when nurses graduate from college they know more about medicine then they do. This doesn't change until the pre-med is a medical student and goes into residency.

I think someone should sentence you to a month of community service (shadowing) with a busy nursing department to see how hard working nurses can be and how dedicated they are to provide good patient care. Nurses have a lot more to deal with during their undergraduate studies (B.S. level..not AS level) then pre-meds students do. Nurses have to show more dedication to their training during the undergraduate days then pre-meds do. The advanced nursing training is not up to par with medical student and residency. That is where the change takes place. NOT BEFORE.
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when you stop hyperventilating and actually READ what I wrote, nowhere did I say that nurses are dumb people, and I wasn't talking about pre-meds (who I don't have a whole lot of respect for). What I said was that IN COMPARISON to med students/doctors, most (NOT ALL) are not as intelligent as doctors, m'okay?

OH, and by the way, I got a nursing education in another country, and I have worked in hospitals in that country as well as volunteered in the ER here for 5 YEARS, so trust me, I know what I am talking about, m'kay?
 
Doublecortin said:
when you stop hyperventilating and actually READ what I wrote, nowhere did I say that nurses are dumb people, and I wasn't talking about pre-meds (who I don't have a whole lot of respect for). What I said was that IN COMPARISON to med students/doctors, most (NOT ALL) are not as intelligent as doctors, m'okay?

OH, and by the way, I got a nursing education in another country, and I have worked in hospitals in that country as well as volunteered in the ER here for 5 YEARS, so trust me, I know what I am talking about, m'kay?
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It's best not to respond to that guy. It only encourages him.
 
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wisconsindoctor said:
You know you are lying.
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I know that I am not lying. I volunteered in the same hospital for many years and that is my experience. And given that you are a troll who is constantly changing his story (are you in college? or residency? or are you done with a training) I'm only posting this to remind everyone that your sole job on these boards is to dissuade us from medicine and that your comments are bull****.
 
I agree with most of what has already been said. I'm a nurse now and premed and I don't think we need a nurse doctor mid level. If they just made it more lucrative to be a primary care physician or less lucrative to specialize then we'd have more primary care physicians. It would be funny that the "doctor nurse" ends up being so specialized and none of them want primary care.
 
Panda Bear said:
Man. This is the biggest misconception on SDN. When you read salary surveys, they are, with few exceptions reporting pre-tax income. Malpractice insurance is not deducted from this number and is assumed to be either paid by the doctor's employer before salary or the self-employed doctor deducts it himself before he reports his "salary."

In other words, the actual "take-home-before-taxes" pay of your average Family Physician is $140,000 out of which he pays FICA and the usual income taxes which afflict most working people. His income is not $140,000 minus thirty-thousand for malpractice. I just signed a contract for a very high hourly wage and it is clearly stipulated in the contract that my employer will pay both malpractice (including "tail coverage") as well as my contribution to the state's Patient's Compensation Fund.
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Panda, I did not know that. Thank you for the info.
 
Panda Bear said:
Whoa. Try 130-160 a month which is more the going rate anywhere but Bos-Wash and San-San.
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I think you meant to bold the part about hours not pay?

This is all based on one doctor in one ER so obviously I am not an export just repeating what I was told. they work 120 hours / month through their group. Also I know that when they appear in court and have to take the day off work the charge is $1,000 for a days work. From there I did the math. But again, I am not an expert or even well researched in the topic, just dropping my 2 cents and relatively uninformed opinion.
 
Panda Bear said:
In other words, the actual "take-home-before-taxes" pay of your average Family Physician is $140,000 out of which he pays FICA and the usual income taxes which afflict most working people. His income is not $140,000 minus thirty-thousand for malpractice. I just signed a contract for a very high hourly wage and it is clearly stipulated in the contract that my employer will pay both malpractice (including "tail coverage") as well as my contribution to the state's Patient's Compensation Fund.
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When comparing salary/income figures, it's important to take into account that self-employed physicians are paying both the employee and employer portion of the FICA/Medicare tax. The after-tax income of a salaried, W-2 physician with a $140,000 income is approximately $7,500 more than a self-employed physician who reports a $140,000 income.
 
wisconsindoctor said:
How dare you say that. What PandaBear was getting at is that the majority of nurses don't have the same knowledge base as medical students, residents, and attendings (not that nurses are dumb people). What the majority of pre-meds don't get is that when nurses graduate from college they know more about medicine then they do. This doesn't change until the pre-med is a medical student and goes into residency.

I think someone should sentence you to a month of community service (shadowing) with a busy nursing department to see how hard working nurses can be and how dedicated they are to provide good patient care. Nurses have a lot more to deal with during their undergraduate studies (B.S. level..not AS level) then pre-meds students do. Nurses have to show more dedication to their training during the undergraduate days then pre-meds do. The advanced nursing training is not up to par with medical student and residency. That is where the change takes place. NOT BEFORE.
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No one is seriously questioning whether nurses are hardworking or dedicated but they are not on par with physicians. If you want to argue this point try to find a group of nurses that will work 80 hours a week. Oh yeah, no overtime.
 
The elephant is bigger than the mouse.
A plane is faster than an automobile.
The MCAT is more difficult than the NET.

These are truths.
 
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Yea, sorry...

I've seen practice questions for the NET exam. They're quite easy, and the format is also different, and simpler. It looks like the bar is set lower for getting into nursing school. Does that mean that nurses aren't as capable as doctors? You guys work that out.
All I'm saying is that I know someone who got around in 50th percentile on the MCAT and then scored above the 90th percentile on the NET without studying.
If the exam is easier, maybe less is expected of nurses in some aspect.
Nurses are awesome at what they do. However, we should leave the doctors to do the doctor work...I guess?
These topics make me nervous; I just thought I'd stick in some insight about the exams.
 
Yet...I hear that some of the higher nurse "specialties" are hard to get into and necessitate that the applicant be a more capable one.
 
wisconsindoctor said:
Nurses have to show more dedication to their training during the undergraduate days then pre-meds do. The advanced nursing training is not up to par with medical student and residency. That is where the change takes place. NOT BEFORE.
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Please. You don't know what you're talking about. I studied a lot more in undergrad than almost every nursing student, and before you say that I must not know any nurses, I had several friends in the nursing program, my mom is a nurse, and I married a nurse that I dated through undergrad. I studied more than she did. Throw in my all-but-required extracurriculars, and it definitely took more effort for me than it did for her. A nurse can have a 3.0 and no one will bat an eye during the job interview, but try going to a med school interview with a 3.0 (without an upward trend or post-bacc work).
 
handwriting said:
Yet...I hear that some of the higher nurse "specialties" are hard to get into and necessitate that the applicant be a more capable one.
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It's definitely more work to become a nurse anesthetist than a regular floor nurse. A nurse needs ICU experience before applying to a CRNA program.
 
All they have to do is make a reality TV show about primary care and exaggerate it's excitement to the FULLEST extent.
 
People who become doctors are filtered, distilled, and concentrated as the top science performers in the country. They undergo much more training and are expected to have the highest work ethic.

You can dance around the issue of intrinsic intelligence issue all you want, but anyone who has gotten through all these hoops has just about proven it.

And even if Einstein was a nurse, he couldn't just pull all the training out of his ass.
 
gplex86 said:
People who become doctors are filtered, distilled, and concentrated as the top science performers in the country. They undergo much more training and are expected to have the highest work ethic.

You can dance around the issue of intrinsic intelligence issue all you want, but anyone who has gotten through all these hoops has just about proven it.

And even if Einstein was a nurse, he couldn't just pull all the training out of his ass.
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:thumbup:
 
gplex86 said:
People who become doctors are filtered, distilled, and concentrated as the top science performers in the country. They undergo much more training and are expected to have the highest work ethic.

You can dance around the issue of intrinsic intelligence issue all you want, but anyone who has gotten through all these hoops has just about proven it.

And even if Einstein was a nurse, he couldn't just pull all the training out of his ass.
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I have to agree with this. There is some basic science to nursing, but it is far less intensive than the scientific curriculum required for a premed or med student. In fact, I would say that nursing is more humanities-oriented than science-based, although humanities constitutes a significant portion of medicine as well. My point is that a DNP could not do the same job as effectively as a physician simply because their curriculum doesn't train them the same way. Medicine and nursing, although allied with each other, are two different fields. So I really don't see how a DNP could practice without any oversight from a physician.
 
scarletgirl777 said:
People who come up with these stupid ideas forget that there is a nursing shortage. The solution is not to take a subsection of nurses, give them a lot of initials, and train them to do things that doctors traditionally do. The solution is to get more people interested in primary care, and to open more spots in medical school that are specifically geared towards primary care. Expanding programs like the National Health Service Corps would be a start.

I feel like this is more about nurses trying to expand their prestige and the marketability of the profession. Nurses with master's degrees already practice autonomously in many states and requiring a PhD would serve no purpose.
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1) It's a lot cheaper for the US to produce mid levels than doctors. In an era of high health care spending, it's a way to cut out some of the spending. For a PCP the government has to pay for 3 yrs of residency (vs. zero years for a mid level). [Although one could argue that they make a lot of that money back on federal loans.]

2) Opening more spots in medical school would simply push more people with a lot of debt into specialties that pay less and ones they don't necessarily want to be in.

3) Expanding NHSC would be a great, but not everyone wants to have to live in rural areas for a couple of years.
 
Tony1029 said:
140,000? What is that, the average salary of a family practitioner? key word there is average, hermoine girl. how much money do you need anyway? if i end up making $140,000 a year doing anything, medical related or not, i'd call my income a pretty good success.
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That would be 140,000 minus:

30% tax: -42,000
malpractice: -10-30k
Equals: $97,990-77,990

A handsome sum, but if you have loans to repay ($100-200k average):

To repay in 10 years: -10-20K
Repay in 5 yrs: -20-40K
(not counting interest)

So your netting about $30-80K depending on your loan situation your first 5-10 years in practice. On the low end it would be difficult to raise a family, have a house, or new car...on the high end doable. Most people don't want to be living like a student for the 12-17 yrs it'll take them to train as a PCP and pay off their debt when they could be making triple that sum with a tad more effort.
 
GreenShirt said:
That would be 140,000 minus:

30% tax: -42,000
malpractice: -10-30k
Equals: $97,990-77,990

A handsome sum, but if you have loans to repay ($100-200k average):

To repay in 10 years: -10-20K
Repay in 5 yrs: -20-40K
(not counting interest)

So your netting about $30-80K depending on your loan situation your first 5-10 years in practice. On the low end it would be difficult to raise a family, have a house, or new car...on the high end doable. Most people don't want to be living like a student for the 12-17 yrs it'll take them to train as a PCP and pay off their debt when they could be making triple that sum with a tad more effort.
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Aeeiii! Look, salary surveys from whence the "$140,000" come account for malpractice insurance and the "$140,000" is your actual gross (pre-tax) income. While it is true that the money your employer (who pays your salary) pays for malpractice could go to you, and while it is also true that there are many Family Practitioners in private, solo practice who are struggling, salary is salary and FPs can expect to make "$140,000" per year.

Now paying back loans, that's a different story. If you go to a cheap medical school and are very frugal you can probably escape with less than $60,000 in loans which is not bad and you can consolidate it for some ridiculously low rate that turns your loan into practically free money and is not that bad as far as monthly payments. The point is that if you want to do primary care go to the cheapest school you possibly can.
 
Out of curiosity, whose liscence would a Dr. Nurse act under? Would they have their own liscencing procedures, or will there still be a doctor on the line for their actions?
 
The purpose of a doctor nurse is to serve as someone capable enough to practice medicine without any supervision. I believe the proposed licensing procedure would be three mini-steps similar to the USMLE Steps. In this case, would it mean that the NBME oversees doctor nurse licensing? I thought there was another topic that discussed these issues in greater detail. I think it was in the allo forum.
 
Today PCP's are seen more as health administrators who can defer to specialists and hospitalists when things get complicated. In this context it does make sense to train people interested in primary care in subjects like epidemiology, statistics, and longitudinal care, and also have a shorter/easier training period. They're called family medicine residents.
 
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