Why do you NOT want to be a Physician Assistant or Nurse Practicioner?

[Dr Trek 1]

Nowadays, NPs and PAs can do many things that phyisicians can do (open their own practicies, write scripts, have authority, etc.) They also get great pay, much better hours, and less schooling. They have more time and opportunity to care about patients rather than deal with all the red tape that doctors have to deal with. When some people tell me that they want to be doctors, I sometimes ask them why they do not want to be a PA or NP and they usually have no idea, some don't even know what they are.

I personally know why I do not want to pursue these fields but was curious why everyone else doesn't want to?

I think it would make a great medical school interview question.

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[momof2]

Tell us your reasons.

 

[luckyzero]

lots of reasons, off the top of my head, I want to be "Dr. so and so" not "Mr. so and so.

 

[lisa13579]

1)I almost applied to PA school, but the 3 PA's I shadowed all wished they went to medical school.
2) I really enjoy school and learning about science and won't mind the extra years of training.
3) I know I will make it thru medical school successfully and love it (most of the time) , so why not end up a "doctor" in the end instead of a Ms. - as luckyzero put it!

 

[size_tens]

NP's and PA's are more limited in the scope of what they are allowed to do compared to MD's. For example you probably won't have much luck becoming a surgeon as a NP. However for someone interested in primary care I think the PA route is a good idea.

 

[thewzdoc]

The depth and breadth of the education for these are no where near what you get with an MD. It is true that PA?s can write scripts and open practices but they still have to be subordinate to an MD.

 

[Dr Trek 1]

I really don't think that reasons such as "I want to be called Dr. and not Mr." are in the best interest of the patient. In many cases, a NP or PA can directly help a patient more so than a busy MD, and many NPs and PAs are thankful for their job for that reason.

What my question really meant was, what are your reasons for not being a NP or PA other than the fact that you want to be called a "Dr."

In other words, I don't think a med school interviewer would appreciate it if your answer was, "Becuase I want to be called Dr., not Mr., becuase titles mean a lot to me." Even if that is not your only reason, it's still a pretty quack reason.

 

[Anka]

Yeah, and then if you go to some part of the world where surgeons are still "Mr."...

I want to be a surgeon, but then the question is, why not be a PA when in, say, cardiothoracic surgery, the PA can often do more than the junior residents (from what I understand, just about everything but the anastomoses)? My answer is that I like the care of the whole patient, pre-op, post-op, and intra-op. The continuity of care is important to me. Second, as one nurse I respect put it, "caring seeks competence." I want to have as much competence as I can get my hands on, and for me that means getting the extra training. Finally, the "ownership" of the case is important to me, i.e. I want to be the one who takes responsibility when things go right or wrong.

Best,
Anka,
p.s. I actually considered the PA/CRNFA (=certified registered nurse first assist, which is a nurse who can fill the first assist position during an operation).

 

[thewzdoc]

Originally posted by Dr Trek 1
I really don't think that reasons such as "I want to be called Dr. and not Mr." are in the best interest of the patient. In many cases, a NP or PA can directly help a patient more so than a busy MD, and many NPs and PAs are thankful for their job for that reason.

What my question really meant was, what are your reasons for not being a NP or PA other than the fact that you want to be called a "Dr."

In other words, I don't think a med school interviewer would appreciate it if your answer was, "Becuase I want to be called Dr., not Mr., becuase titles mean a lot to me." Even if that is not your only reason, it's still a pretty quack reason.

So tell us, Oh enlightened one, what is your answer.

P.S. I agree with your last point completely.

 

[bigdan]

I'd like to be an MD vs. a PA or NP for the depth and breadth of training and education that is required to be a medical doctor. I hope that my education in medical school (science years and rotations both) will provide me with a base from which my resdiency can be used to learn and apply my knowledge to the betterment of others.
I do believe that this additional knowledge and training affords physicians some "perks" like authority, autonomy, and high income, and justly so.
But I'm extremely interested in the science of medicine, too. I don't mind extra hours in the lab, reviewing journals, etc. As a lifestyle issue, PAs and NPs are in an enivable position...

dc

 

[GoodMonkey]

the OP is right, though, about the "good interview question" potential ..... i was asked almost this exact same question three times and three separate interviews. it's a good idea to know your motivations and be able back them up coherently.

 

[....]

As lil kim says...

Money Power and Respect.

Im not going to be a PA who does everything (which is BS anyway) a CT surgeon does just to make a TENTH the money.

Im the boss, I worked at mcdonalds I didnt like it. I insted sold golf balls that i dove for in lakes. I was the boss and made a heck of alot more than i would have with a boss. Yeah Yeah the customer is always the boss, or more the president the voters are boss. BS. There is not comparing being a PA to a doc in this regard.

And respect. The DOs do EXACTLY was MDs do...but they still have to explain that their not a real MD. And belive me, NO ONE likes doing that. And I sure as heck dont want Assistant anything being attaced to my name.

Shallow? No...thats why all you people are applying to MD schools not DO. THe eduactiod is the same, your job is the same..everything is identical...except the the letters. But its enough to make DOs the backup for MDS in 99% of premeds book.

 

[MeowMix]

because it's even harder to get into PA school

because it would take me 2 years to fulfill the prereqs for NP

because if I'm going to spend all that time and money, I want to have the autonomy and knowledge of an MD or DO

because I shadowed a doctor whose whole practice is MDs, no NPs or PAs because they decided it took too much work to have to supervise the lower-level practitioners, and their patients preferred to see a doctor anyway

because my friend who has been a nurse for 20 years told me I would last about 5 minutes as a nurse

 

[Dr Trek 1]

Originally posted by MeowMix
because it's even harder to get into PA school

Anyone have any facts to back this up?

Jonathan

 

[agent]

because patients know what MD means and not what PA or NP means..

and of course respect.. you want your hard worked years to mean something

call me prideful

 

[Chronotropic]

This smells an awful lot like the threads where people ask things like "why do you want to be a doc" so they can use other peoples' answers on their interview.

 

[agent]

Originally posted by danwsu
This smells an awful lot like the threads where people ask things like "why do you want to be a doc" so they can use other peoples' answers on their interview.

Yeah it does, especially since he's not giving us his answer

 

[beatla19]

Actually, I think this question is extremely helpful for those, such as myself, trying to figure out which health profession to pursue.

 

[agent]

Originally posted by beatla19
Actually, I think this question is extremely helpful for those, such as myself, trying to figure out which health profession to pursue.

im having the same quandry

 

[cdreed]

Most PA programs require that applicants (qualified ones) have approx 2000 hours of direct patient care. Because PAs get a crash course in medicine, although somewhat abbreviated, schools expect that PA students have a decent amount of hands-on already. Exceptions do occur though.

My reasons for not pursuing that route crystallized after spending three years in the Air Force medical corps on a surgical unit. I realized that professionals in these positions lack a lot of the autonomy that a physician possesses. I also echo Anka's earlier post in that I want to "own" the patient care process. If I make a mistake, I want to be the one who takes responsibility for it. Likewise, if I assist a patient to better health, I know that I will have made a positive impact on that patient's life.

On a critical and analytical level, I want to be the one running the Code. I want to rely on my education and intuition to see a patient in cardiac/respiratory arrest return to a stable condition. These are just a few of my reasons for choosing to acquire a medical degree. Oh, and to hightrump, I chose to pursue a DO degree. I view the OMM as an extra modality of treatment that I can offer my patients. I want to know as much as I can so that I will be able to care for my patients to the best of my ability. I am not ashamed of the initials that will follow my name.

Cyndi

 

[Anka]

Hey,

I don't know about you guys, but I always go to see an NP if I have a choice. Look, your average NP is of a much higher quality than your average general practicioner. Here's why -- your NP has, at each point in his or her career chosen to get more training, after starting out on the nursing path (which many do because medical school, heck college, isn't an option for them for financial or social reasons; others do it because they actually want to be involved in patient care, rather than just a glorified technician or referal specialist, like many docs are these days). Your GP, after medical school (which he or she probably chose because they wanted to be called Dr. not Mr., or wanted the money, or because their parents expected it, or because someone with their background couldn't take the societal step down and actually do some work) consistently decided to take the easiest route, i.e. short residency, no call, etc. Granted, these things don't hold always -- there are some really sucky NPs and some really good GPs, but give me the choice of a randomly selected NP or a randomly selected GP, and I'll take the NP every time.

Second, NPs actually give a Sh-- about you, your health, and so on, and you generally get a longer visit. They're more aware of social issues, i.e. if you can't afford anticonvulsants for your father, they can help you work something out, whereas most doctors will up and judge you, or tell you "Well, see the wonderful thing about being a doctor is I get paid for this visit whether or not you do what I tell you to." [yes, I actually had a doctor tell me this once].

Finally, about the CT surgery NP thing -- dude, take a look over at the surgery part of this forum. You'll see the surg people complaining about how much the NPs get to do. And the residents I'm around all the time also complain about it.


Anyway, especially in these days, if you want to do family practice type work, you might actually be serving your patients better by being an NP.
--Anka

 

[agent]

good post anka

 

[....]

Finally, about the CT surgery NP thing -- dude, take a look over at the surgery part of this forum. You'll see the surg people complaining about how much the NPs get to do. And the residents I'm around all the time also complain about it.

They do alot. Not denying that. So why bother getting trained is your not going to make the dough?

Also, do you think residency is BS then? CT surgs dont learn anything. THey could have learned it in 2-4 years of PA school? I dont think so.

 

[Anka]

Hightrump -- I already answered the NP question in a previous post on this thread.

To summarize the previous post, the things that the surgeon has that the NP or CRNFA or PA doesn't are (in brief) (1) ownership of the case -- if something goes wrong, it's the surgeon's fault. If something goes right, we know who gets the credit; (2) continuity of patient care -- I don't just want to be an operating room technical genious; the best surgeons aren't always the best sewers, rather, the best surgeon is the one who can decide when to operate, get their patient in a good state to handle the operation, operate well, continue post-op care and follow-up. (3) you do have more training, so you can deal with the random stuff that comes up, not just the routine stuff that occurs over and over and over and over and...

Finally, as a totally personal thing, I want to have the option to do research if I run into something good.

Anka.

 

[MeowMix]

Originally posted by MeowMix
because it's even harder to get into PA school

I have only anecdotal info for this, and what the local premed advisor says.

But I now have another reason: it would take me 2 years to fulfill the prereqs for PA school.

 

[docuw]

I have a PA student in my M3 rotation right now who just came out of undergrad and is getting a PA masters degree with no prior patient contact. So, I dont think that 2000 hour rule is valid across the board.

I also have a personal problem with PAs and NP running their own clinics. I think Ankas remarks are very stereotypical to the few and not the majority of MDs who go into General Prac. Most do love what they do, do spend the time with their patients (and wind up running late and staying at the office until 8:30), most do take the societal and social factors into account when caring for a patient (most commonly through Med Samples, Free Counseling referals to charity based services, etc.). On top of that, the MD is not simply going through an algorithm that they learned in a 20 minute lecture as to what antibiotic to give for an earache, etc. They actually do the workup, include drug interactions and side effect profiles, electrolytes and other labs, etc. and assemble of this into an integrative treatment plan. I feel that a Physician's Assistant should be just that, and Assistant. See the patients before I come see them in the room to get a few of the minor things done, and move on. Managing a patient's medical condition should be left up to people who have been trained to consider every aspect of a patients complaint and trained to handle any adverse occurances.

The private practicing PA/NP is a fad that I whole heartedly disagree with. I hope that as we move towards a better "payer" system and get more MDs into underserved areas, we phase out this dangerous unsupervised (which, even with the 20% rule, is just a signature) practice.

 

[docuw]

I realize that many may not agree with my above opinion. Many arguments stem from the fact that an NP or PA has more time for the patients, are cheaper to see, and they can open up clinics in areas that couldnt sustain and MD due to the price.

I do agree that they can do routine exams (eg., a Pap Smear). I still think, though, that they need to run any treatment plans by an MD after providing an adequate history and before the patient leaves (much like a resident does with an attending).

I think that the "cheaper" and "more time" arguments simply offer more fuel to the healthcare reform fire. I don't, however, feel that a patient should have to settle for healthcare offered by an individual who chose not to receive an education that was complete and exhausitive in all aspects of the human body and its care. To do so is to settle for less than the best. And, using the above arguments, it is settling for less when we could make some changes in the health care system to prevent it.

 

[MeowMix]

docuw, the more you write, the more I disagree with you.

I work at a clinic that serves primarily the uninsured, Medicaid, etc.. If we did not have PAs and NPs, we would be in trouble. For all that I want an MD or DO for my own degree, I have great respect for our PAs and think they do an excellent job.

If we demanded that the PAs and NPs be supervised to the extent that you suggest, it would be a complete waste of everyone's time. It would be a waste of our PAs' skills to have the doctor come in and give the blessing after they have done the preliminary work - and absolutely unnecessary. They are not medical assistants - they are perfectly skilled enough for the work, and they know the limits of their knowledge, which many inexperienced doctors do not. They ask for help when they need it, and they know their limitations and their scope of practice.

Maybe their decision to choose a 2-year instead of a 4-year postgraduate degree was based upon financial and practical considerations, not settling for a less demanding intellectual path.

 

[Dr. Xavier]

Because I wanna do boob jobs and tummy tucks for porn stars.

 

[gschl1234]

Have any of you actually looked into the qualifications you have to meet just in order to apply to PA programs? Many require a minimum of 1000-2000 hours of clinical (not volunteer) work. That means that you have to already be in the medical field. How many college students actually have these credentials? You'd have to plan on going to PA school from your freshman year and already have a plan set for what in which field you want to get liscenced. I know a girl who became a surgery tech her freshman year and is still working (now 1 year after graduation) to get the 1000s of hours. Being a PA is great in one respect but if you haven't planned early enough, you might not meet the prerequisites.

 

[docuw]

see my aove post re: the 2000 hour rule.

Meow Mix, I do agree that it would be a waste of time. But, I dont feel that a 2 year degree with no postgrad training (a residency) should even be an option that is more practical or costs less money if they want to be in private practice. The only reason that it is (or was) a good option is because the poor structure US Healthcare system neccessitated the cheaper care. If these very intelligent and capable (which 99% of them are) individuals wanted to go into healthcare and practice autonomously, they should get the full education.

The best analogy I can make is the in the field of law. Without having a law degree and state bar accredation, and individual is not allowed to practice law. They (legal aid, etc) can assist with paperwork, but can not provide advice or represent in court.

 

[....]

lets not confuse the issue of 2000 hours of clinical work with making PA school more competitve. Its just more tedious to get into.

And to the guy talking about how smart PAs are...if they were so smart they would have been a doctor. I know it sounds mean, but oh well. No one even LEARNS about the existance of PA's untill they go to their advisor with a bad GPA or MCAT and say "What do i do?" I think the larga majority fit this description. Not all. Maybe some have special reasons.

 

[manna]

Originally posted by hightrump
And to the guy talking about how smart PAs are...if they were so smart they would have been a doctor. I know it sounds mean, but oh well. No one even LEARNS about the existance of PA's untill they go to their advisor with a bad GPA or MCAT and say "What do i do?" I think the larga majority fit this description. Not all. Maybe some have special reasons.

I can't believe you just said that. You sound as if you know little-nothing about PA school at all.

PA school is competitive, and all its students are not MD/DO rejects. Are you even aware of the amount of clinical hours that you must have completed to be considered for many PA schools?

Most of the PAs I've met pursued that path becuase they already had some form of healthcare exp (RN, RT, MLT, etc) but wished to further their education, without having to make the huge investment of time and money required to go MD/DO.

Get your facts straight.

 

[DAL]

I'm not sure where you all are from, but in North Carolina getting into PA school is not a joke. I won't say it's as difficult as getting into med school, but a friend went to med school after failing to get into PA school for two years. I realize that's anecdotal, but what's surprising is that perception that some users have of PA's and NP's. I think it's pretty ridiculous.

People seem to totally toss out the logic that there are many, many reasons people choose their path in life. Just because someone chooses the PA or NP route doesn't necessarily make them less intelligent (less motivated maybe). People have monetary issues to consider, family issues to consider, and timing issues to consider. Getting your MD is great (I'm going for it myself) but to have the outlook that it's MD or bust is pretty sad. If you maintain that outlook once you get your MD, and treat PA's, NP's, and everyone else as less intelligent, worthless pee-ons then I feel sorry you and reception you get.

 

[jscarbrough]

Originally posted by hightrump

And to the guy talking about how smart PAs are...if they were so smart they would have been a doctor. I know it sounds mean, but oh well. No one even LEARNS about the existance of PA's untill they go to their advisor with a bad GPA or MCAT and say "What do i do?" I think the larga majority fit this description. Not all. Maybe some have special reasons.

This is one of the most uneducated things I have ever read on this board.

 

[....]

People, take some logic classes.

"Just because someone chooses the PA or NP route doesn't necessarily make them less intelligent"

Statments like that do no work in fight my statment of.....

"I think the larga majority fit this description. Not all. Maybe some have special reasons."

They are compatible stances.

As is this...

"PA school is competitive, and all its students are not MD/DO rejects"

Again, I never said all.

I thinnk PA can be a great way to go. The money to time in school ratio is very good.

But Im not going to pretend that experience=difficulty.

Being head janitor probably requiers 2000 hours of janitorial experience. Does that make it COMPETITIVE or DIFFICULT? no. As a senior does that mean i would get into med school before i could get hiered as a head janitor? probably. But that of course...means jack.

And 2-3 anectodes about a friend of a friend are not going to convince anyone that PA school is tougher to get into than med school.

 

[XT777]

some individuals who might be intellegent, persistent and driven enought to get into medical school normally might consider P.A. school if they felt that they were too old to get into a medical school.

I am 27 but would be 29-30 by application time.

that is one example of how it might be possible that an individual would be capable (in most regards) of med school but is pursuing a P.A. degree instead.

Your derisive remarks about P.A. make me question even that path though.

XT777

 

[DAL]

Originally posted by XT777
some individuals who might be intellegent, persistent and driven enought to get into medical school normally might consider P.A. school if they felt that they were too old to get into a medical school.

I am 27 but would be 29-30 by application time.

that is one example of how it might be possible that an individual would be capable (in most regards) of med school but is pursuing a P.A. degree instead.

Your derisive remarks about P.A. make me question even that path though.

XT777

You need to read this board passively. You can get some great advice from SDN, but ultimately you need to do what's best for you unique situation. PA is a great option, you'll get all the patient interaction you could ever dream of, work a normal 40 hour week in most instances, and life a comfortable life. That's no denying that. Age, money, and family issues are several reasons among many that people choose the PA route. It's a great option. For myself, if I knew I wanted to do family practice and didn't have research goals I'd like to achieve, I seriously would consider becoming a PA.

hightrump, I understand what you're saying, but you don't say it well at all. Seriously, you just used an analogy comparing experience required for a PA candidate to that of a head janitor. You imply that people who choose the PA or NP route only do so because they can't get into med school or they can't cut it as an MD. That's terribly wrong. There are many many PA's and other healthcare professionals that would be excellent physicians.

 

[Dr Trek 1]

I'm very happy that this thread has become so active... I think this entire issue is very important, and often overlooked.

I want to agree with everyone about the underestimation of PAs and NPs.

It comes down to this: most people who pursue the PA or NP degree have already been in the medical field for quite some time and would like to have the ability to help patients in a different way without worrying about too much strain on their family and personal life that now means so much to them.

Most people who pursue a MD/DO are younger and have not yet had a career in the medical field but would like to become a physician and build their entire life around it (holding off on having kids, getting married, etc).

I know PAs and PA students who would make outstanding physicians, and they certainly have the ability to do it, but chose not to for a plethora of different reasons.

Those on this board who have said that PAs and NPs are med school rejects: you obviously have no idea what you are talking about. Sure, I suppose that this is true for some cases, but, as one poster put it, we simply never know the circumstances in someone's life. Perhaps someone wants to be an MD so they can sit in a lab all day and conduct research, perhaps so that they can really directly make a difference in someone's life, or perhaps because mommy and daddy said that successful boys and girls grow up to be doctors and they swallowed that value whole. Everyone has different reasons for entering the medical professions and we can only guess what they are.

And for the person who said that many NPs and PAs were not "smart" enough to get into medical school: two of the most important characteristics to get into medical school are the ability and desire to work hard and perseverance. And I bet if all NPs and PAs studeid for and took the MCAT, they'd do just as well, if not better, than most physicians-- if that's what you mean by "smart."

 

[beastmaster]

Originally posted by Dr Trek 1
I really don't think that reasons such as "I want to be called Dr. and not Mr." are in the best interest of the patient. In many cases, a NP or PA can directly help a patient more so than a busy MD, and many NPs and PAs are thankful for their job for that reason.

I see you're confusion now. Your goal is to become the slave of a patient, to live your life in the best interest of someone else.

The rest of us here rational creatures choose to live our lives with our best interests in mind, as rightly we should. A job is a money-making tool, simple as that. Not a crusade to save the world.

We've weighed the positives against the negatives and decided that med school will bring US more positives. Some will later regret the decision, others will not.

 

[Dr Trek 1]

Originally posted by beastmaster
I see you're confusion now. Your goal is to become the slave of a patient, to live your life in the best interest of someone else.

The rest of us here rational creatures choose to live our lives with our best interests in mind, as rightly we should. A job is a money-making tool, simple as that. Not a crusade to save the world.

We've weighed the positives against the negatives and decided that med school will bring US more positives. Some will later regret the decision, others will not.

Isn't this what physicianhood is all about? Making decision based on the patient, not yourself. As a physician, your primary concern is the patient, you are no longer your primary concern. And even though this will probably never be the case for you, it certainly should be. Medicine is a very selfless profession, or at least it should be. Unfortuantely there are plenty of physicians like you will be who also really want to make a lot of money and be respected. There's not much that I can do about that.

Personally, I'm not going to try to save the world. But I am trying to devote my life to medicine, specifically mental health, so that the system may be improved in the best interest of the patient. Do you think that I care that psychiatry is one of the lowest paid MD positions? Do you think that I care that a lot of people don't even know that a psychiatrist is a medical doctor? No, I care about the patient, I could care less about me. The personal rewards I will get for helping patients far outweighs any material or ego benefit.

 

[DAL]

Originally posted by beastmaster
I see you're confusion now. Your goal is to become the slave of a patient, to live your life in the best interest of someone else.

If anything the MD has more vested interest in the patients. They work more hours and assume total responsibility for the care of that patient. How many PA's and NP's do you see getting sued over mistakes?

Becoming a PA or NP doesn't equate to becoming a "slave of a patient" or living their life in the best interest of someone else. If anything it offers a more flexible and easygoing lifestyle.

 

[....]

"hightrump, I understand what you're saying, but you don't say it well at all. Seriously, you just used an analogy comparing experience required for a PA candidate to that of a head janitor. You imply that people who choose the PA or NP route only do so because they can't get into med school or they can't cut it as an MD. That's terribly wrong. There are many many PA's and other healthcare professionals that would be excellent physicians."

Look, im not posting in this thread any more.

How many times does someone have to say "most" "Not all" "usually", before they cant be attacked by goober who think that they mean "EVERYONE, ALL PAs and NURSES are med school rejects" Be rational and reasonable and read my words for what they are, not for what you would like to assume the mean for the sake of getting your post count up with angry replys.

I know MANY MANY MANY people who chose PA or nursing because they knew they were uncompetitve at MD programs. A RATIONAL person would say that this is evidence for believing a good # of PAs and nurses are med school rejects. It is NOT evidence supporting a postion stating that ALL of them are.


"And I bet if all NPs and PAs studeid for and took the MCAT, they'd do just as well, if not better, than most physicians-- if that's what you mean by "smart.""

PLEASE! Im not saying that there are CERTIAN PAs that would beat the socks off of CERTIAN MDs. But the blanket "if not better"
is LAUGHABLE. Wake up and face reality.

 

[beastmaster]

Isn't this what physicianhood is all about? Making decision based on the patient, not yourself. As a physician, your primary concern is the patient, you are no longer your primary concern.

If we follow your reasoning to it's logical destination, we end up with preposterous conclusions. Your job is to provide excellent service, that of which you are being compensated for. Nothing beyond that and any compassion you choose to offer.

Medicine is a very selfless profession, or at least it should be.

Incorrect. The medical profession imposes not only killing hours, but continuous tension and pressure. The only thing that enables doctors to survive this life is selfishness, not self-sacrifice. The doctor is constantly working and thinking. And to his credit, he expects to be rewarded materially for his skill -- to make a good living, which is the least they can be offered for their achievements. Pure capitalism. It is kind of sad, though, the doctors are freightened to assert such a stance. I'm sick of this "I want to help and serve" stuff. It is the last refuge of a logical vacuum.

Becoming a PA or NP doesn't equate to becoming a "slave of a patient" or living their life in the best interest of someone else. If anything it offers a more flexible and easygoing lifestyle.

Like I said, you weigh the positives against the negatives. There is more to a profession than lifestyle. Much more. You weight all, not just one. And I never equated becoming a slave with PA or NP professions, only with the reasoning that one wants to dedicate their life for the sake of someone other then themselves.

 

[MeowMix]

I agree with Beastmaster that under great pressure, the only thing that enables one to survive is the willingness to put yourself first. Sure, you can write it off as the immature view of an Ayn Rand fan, but over time I believe he/she is right.

I've already reached the age of 40, when reality sets in. I went through my selfless helpful stage working in public education. By the time I quit doing that, I had realized that no matter how much time, energy, and effort I dumped into that black hole, there would still always be huge unsolvable problems. My being selfless was not going to fix public education, and it will not fix my patients. I'm going to do my best to help others, and do what I need to keep myself happy and healthy.

But ultimately, my choice to go into medicine is selfish - it is what I want to do because it meets my needs on a variety of levels.

 

[Jasminegab]

This is not the best way to ask this question IMO. One cannot compare being a doctor vs being a nurse vs being a PA. Being a nurse is one duty while being a PA is another. Being a doctor is yet another field in itself. None is better than the other. Nurses are needed. So are PA's. So are doctors. Each work to benefit the patient. They each fill a role in the Healthcare delievery system.

Think about it for a moment. The question is not why you don't want to be a nurse or PA instead of a doctor. The question should be, why is becoming a doctor so important to you?
The same would apply to any profession one ends up entering.

 

[jenni4476]

Originally posted by MeowMix
I agree with Beastmaster that under great pressure, the only thing that enables one to survive is the willingness to put yourself first. Sure, you can write it off as the immature view of an Ayn Rand fan, but over time I believe he/she is right.

I've already reached the age of 40, when reality sets in. I went through my selfless helpful stage working in public education. By the time I quit doing that, I had realized that no matter how much time, energy, and effort I dumped into that black hole, there would still always be huge unsolvable problems. My being selfless was not going to fix public education, and it will not fix my patients. I'm going to do my best to help others, and do what I need to keep myself happy and healthy.

But ultimately, my choice to go into medicine is selfish - it is what I want to do because it meets my needs on a variety of levels.

Several thoughts-

Yes, one person being selfless does not fix "huge unsolvable problems". I agree with you there. But by helping one person at a time you CAN make a difference. Notice I said make a difference, not change the world. I sure hope there aren't too many people out there naive enough to think they can change the world by themselves. Personally, I will be more than happy if I can change even a few people's lives for the better-I don't have such high unrealistic aspirations.

Also, there's a big difference between being "selfless" and empathetic, and also selfish at the other extreme. I got into it on another website with some posters who seemed to think that being a doctor automatically put them in a position to dictate everything in the patient's life (religious beliefs, to be specific-not that this in particular applies here but the general principle does). I firmly believe that patients need to be treated in THEIR world, not the "doctor's". Physicians need to be capable of viewing it in terms of: OK, what's best for THEM. Which embodies a degree of selflessness. But you also can't totally forget yourself, then you're no good to anyone, and this is what the idealistic altruists seem to overlook. Keep everything in moderation, selflessness and selfishness alike, is my motto.....

As far as my reasons for not pursuing PA/NP, they are very similar to those listed by several posters. One, I want to be as competent and knowledgeable as I can be. Two, I like the autonomy and responsibility and being in a position to overview the whole case. Three, I would also like the opportunity to move into research someday if I decide that's what I want to do eventually.

Personally, I don't look down on PA/NP's at all. Different strokes for different folks-I don't have the right to judge anyone else's decision or put them down b/c of it...

 

[Thewonderer]

2000 hours of clinical exposure is not much. As a 3rd year med student, breathing and living in the hospital for 80+ hours a week, you can rack in 2000 quality hours in less than 7 months. Therefore, if you really want to argue, I would say that a med student graduating from med school already has as high clinical competency (if not more) as an PA or NP graduating from their grad schooling. True, an average PA or NP student would have had more clinical exposure than an average med student PRIOR to staring their respective education programs, but rest be assured, med students catch up really fast during their two clinical years AND they go on for years and years of post-grad training. Thus, you cannot really compare the competancy of an average PA/NP with an MD attending. That's ridiculous.

Furthermore, those 2,000 hours vary in quality. Some phlebotomists or nursing aids can probably count their work hours to those 2000-hour requirements but not a single minute of those 2000 hours are helpful to them in becoming a quality "clinician." Moreover, if you really have worked with nurses, then you would have known that the nursing model is vastly different from the medical model. Nurses might know about benadryl being used for sleep but have little ideas about its mechanisms or even much about benzodiazepines. Trust me, you do not want nurses to "diagnose nor prescribe" anything. Diagnosis and coming up with treatment plans are not part of what they teach in nursing schools (they do that in NP school). Therefore, again, I do not feel that those hours NP get before entering their master's work really help with their "diagnostic and treament" abilities.

 

[NYCGurl]

Originally posted by Thewonderer

Nurses might know about benadryl being used for sleep but have little ideas about its mechanisms or even much about benzodiazepines. Trust me, you do not want nurses to "diagnose nor prescribe" anything. Diagnosis and coming up with treatment plans are not part of what they teach in nursing schools (they do that in NP school). Therefore, again, I do not feel that those hours NP get before entering their master's work really help with their "diagnostic and treament" abilities.

Well it's obvious you've never been in nursing school Wonderer because gee golly, they DO teach us about things like benzodiazepines and mechanism of action of drugs! Maybe your knowledge of nursing education is limited which is fine but please don't make broad statements like that.

And since I "trust you" that I would not want nurses to diagnose nor prescribe anything, next time I see a resident asking a nurse how many mgs of a drug seems right for a certain patient, I'll be sure to remind him that surely nurses can't know anything they didn't learn in medical school

I agree with you 100% that medical diagnosis and treatment plans are not a part of nursing school and I would never purport to have the ability to make a formal diagnosis, but that doesn't mean I am oblivious to what my patient's signs and symptoms may point to. That's one of the reasons some NP schools want their applicants to have work experience instead of just a degree, that knowledge you get from working with actual patients.

 

[Thewonderer]

Originally posted by NYCGurl
Well it's obvious you've never been in nursing school Wonderer because gee golly, they DO teach us about things like benzodiazepines and mechanism of action of drugs! Maybe your knowledge of nursing education is limited which is fine but please don't make broad statements like that.

And since I "trust you" that I would not want nurses to diagnose nor prescribe anything, next time I see a resident asking a nurse how many mgs of a drug seems right for a certain patient, I'll be sure to remind him that surely nurses can't know anything they didn't learn in medical school

I agree with you 100% that medical diagnosis and treatment plans are not a part of nursing school and I would never purport to have the ability to make a formal diagnosis, but that doesn't mean I am oblivious to what my patient's signs and symptoms may point to. That's one of the reasons some NP schools want their applicants to have work experience instead of just a degree, that knowledge you get from working with actual patients.

There are many nursing schools out there with varied education. You might have gone to a good school, but there are plenty of schools that offer associate degrees and do not focus on mechanisms.

Working with nurses on the floor, my impression is that many nurses in fact learn on their jobs but never go the extra mile to understand the pathophysiology nor the mechanisms behind things in the books. The nursing model is more focused on interacting with the patients and making them feel comfortable. It also focuses on other areas of needs that doctors are not aware of (i.e. activity of daily livings, when to call PT/OT, etc.). But seriously, a lot of times, nurses just make simple suggestion such as the pt was complaining of indigestion after lunch, can he get some maalox for it? Then it is up to the doctors to look up the creatinine and BUN level from the last chem 7 to make sure the pt does not have renal failure or other contraindication for it. That's fine. People have different roles. But even nurses who have learned some forms of drug mechanisms, by working in the nursing field for a year or two, they would have forgotten about these mechanisms already.