Doing it all over again?

[Green34RN]

Hi-

I'm an RN looking to further my education, and I'm really not sure what path I'm going to take yet. For all the NPs and PAs, would you had gone to medical school if you had it to do all over again? Ten years down the line, I don't want to look back and have any regrets. Do you enjoy your jobs and feel you are respected within the medical community? Thanks for your replies

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[julie walker]

Hi-

I'm an RN looking to further my education, and I'm really not sure what path I'm going to take yet. For all the NPs and PAs, would you had gone to medical school if you had it to do all over again? Ten years down the line, I don't want to look back and have any regrets. Do you enjoy your jobs and feel you are respected within the medical community? Thanks for your replies

I have had many of my friends who became RN's first then went on to be Pa's and they seem to be satisfied with the job. However, there is not much scope for a PA to move upwards so it would be best for you to go to med school. A nurse practitioner can work is many areas also. I would do whatever suits me.

 

[Febrifuge]

Actually, the scope of practice for any PA is identical to the scope of their supervising physician. So if a PA decides they are no longer happy with their scope of practice, or the way the practice assigns tasks, that PA has the opportunity to move on to another job.

I'm in school now, so I'm afraid I can't speak to the original question. I am very happy with my decision to go the PA route, as opposed to four-year med school.

 

[primadonna22274]

Yes, and probably will be doing just that.
Feel free to search my previous threads for plenty of explanation. In reality, PA is a good gig for the right person but I've never been a content PA.
I have had a very good patient following for most of my career (eighth year as a PA). I have had high autonomy and a lot of respect from many physician colleagues. I have certainly fought the midlevel suspicion from many other physicians and other allied health in that time as well. I have had good jobs and not-so-good jobs and have been mostly happy in my practice but never really comfortable.
If you think you might have regrets if you choose PA or NP, in my opinion you probably will. I have found there are plenty of PAs/NPs who have been entirely happy and content in their roles. Unfortunately I've never been one of them. Most of those who seem happy and content have told me they never considered becoming a physician and don't feel the need. That's the secret of contentment: not having more but wanting less. But for those of us who want to do it all and not be restricted by our education, license, title, whatever, the answer is still: go to medical school.
Good luck to you. It's your decision.
Lisa

Hi-

I'm an RN looking to further my education, and I'm really not sure what path I'm going to take yet. For all the NPs and PAs, would you had gone to medical school if you had it to do all over again? Ten years down the line, I don't want to look back and have any regrets. Do you enjoy your jobs and feel you are respected within the medical community? Thanks for your replies

 

[primadonna22274]

Not really Feb. The scope of practice is defined by the supervising physician and in general, you cannot do anything your SP cannot do, but there are plenty of things my SP can do that I cannot do: admit patients to hospital, certain procedures like endoscopy/colonoscopy (not that I want to), etc.
There IS still lateral mobility within the PA profession. I fear that will be slowly eroded as the move to credential PA residencies becomes a requirement. If we go on with the ridiculous notion of doctoral degrees for PAs, there will soon be no reason to become a PA. Might as well go to medical school.
L.

Actually, the scope of practice for any PA is identical to the scope of their supervising physician. So if a PA decides they are no longer happy with their scope of practice, or the way the practice assigns tasks, that PA has the opportunity to move on to another job.

I'm in school now, so I'm afraid I can't speak to the original question. I am very happy with my decision to go the PA route, as opposed to four-year med school.

 

[orthopa]

Hey Greenie-

Like you are currently doing, seek out others who are where you are considering going, be it PA, NP, MD, or DO. Listen to there opinions, as you will learn benefits and problems with each.

Do your research, listen to others, but only you can decide which path to take. Each educational path will take a different amount of time and dedication to complete. Each profession has its own distinct pluses and minuses in practice.

I was an RN for ten years and enjoyed every one of them, but understood its limitations. I have been a PA for seven years and have enjoyed every one of them, but understand its limitations.

Just my .02. Good luck with your decision.

Jim

Beware of the sockpuppet, they are not you friend.... Julius Caesar

 

[schutzhund]

I was an RN. I wanted more. I convinced myself that if I was an NP I could "be just like a doctor" and been finished much faster. It was a big mistake! I went back to medical school and now I'm a resident. I don't regret it. The only thing I regret was wasting more time getting here.

If your doubting the NP or PA route, I would would just bite the bullet and go to medical school. I have LOTS of friends that were in the same position as me and are unhappy because life happened and they couldn't go back to medical school. Keep in mind, many opinions you get here probably represent some cognitive dissonance so beware. NPs and PAs have a good job but it isn't and never will be the same as a physician.

 

[Febrifuge]

Quite right -- to be more precise the upper limit of a PA's scope of practice is the scope of their supervising physician.

Whether it goes to that point or not seems to be a question of location, hospital policy, experience, and that indefinable something that makes some MDs give some PAs all kinds of autonomy, while others... not so much.

I guess the point I was trying to make is, there is no other clearly-defined "ceiling" on PA practice except for what I stated... in practice, things work out however is best for the practice, and usually that does mean limitations on the PA... but that can change over time, in a PA's career, and depending on several different factors.

People who want to be able to be the boss and "do everything" should point themselves toward med school. But then again, they should be sure they'll be happy practicing in one area over another. Either way, you give something up.

Not really Feb. The scope of practice is defined by the supervising physician and in general, you cannot do anything your SP cannot do, but there are plenty of things my SP can do that I cannot do: admit patients to hospital, certain procedures like endoscopy/colonoscopy (not that I want to), etc.

 

[primadonna22274]

Agreed on all points.
For me, FP is the only thing I can really focus on because I like the diversity and flexibility of the field. It's got its downside for sure, most notably low reimbursement and lack of respect from peers, but it's what I like best.
We probably both know PAs who have earned through many years of learning and hard work (and dedicated mentorship) a very broad scope of practice. To echo another thread, I'm not sure that I know any PAs who do solo appys and lap choles but I do know several who do most of a CABG etc while the attending is right there. There are also plenty of invasive procedures that PAs have been trained to do and are credentialed to do in interventional rads, etc that most SDNers would be up in arms about because they don't know how to do them and unlikely will ever train to do them.
L.

Quite right -- to be more precise the upper limit of a PA's scope of practice is the scope of their supervising physician.

Whether it goes to that point or not seems to be a question of location, hospital policy, experience, and that indefinable something that makes some MDs give some PAs all kinds of autonomy, while others... not so much.

I guess the point I was trying to make is, there is no other clearly-defined "ceiling" on PA practice except for what I stated... in practice, things work out however is best for the practice, and usually that does mean limitations on the PA... but that can change over time, in a PA's career, and depending on several different factors.

People who want to be able to be the boss and "do everything" should point themselves toward med school. But then again, they should be sure they'll be happy practicing in one area over another. Either way, you give something up.

 

[primadonna22274]

Fair enough. That PA lost credibility right then and there--I wouldn't have allowed him to work on me either. We're required by law to wear ID that states who and what we are, "Lisa ___, Physician Assistant" in easily recognizable lettering. It's important that the patient knows who is treating him or her. I agree that the patient should have choice but in nearly 8 years of practice I can count maybe five people who have flat out refused to see me because I'm "just a PA". Most have been happy and pleased I think. Plenty I've turfed and have told them flat out, "you have a complex problem that I need a physician's help with, so I want you to see them". It's worked out fine. Some I've had to cajole into seeing the doc because "can't I take care of it?"

Few people on SDN object to PAs, or the procedures that they perform/assist on. The "up in arms" comes in when non-physicians attempt to take sole responsibility for the workup, diagnosis, counseling, and treatment of diseases.

I once refused to let a PA operate on me, but only because he did not identify himself as a PA, and the nurse introduced him as "Dr. so-and-so". Had he told me up front who he was, I likely would have had no problem with it.

 

[julie walker]

Fair enough. That PA lost credibility right then and there--I wouldn't have allowed him to work on me either. We're required by law to wear ID that states who and what we are, "Lisa ___, Physician Assistant" in easily recognizable lettering. It's important that the patient knows who is treating him or her. I agree that the patient should have choice but in nearly 8 years of practice I can count maybe five people who have flat out refused to see me because I'm "just a PA". Most have been happy and pleased I think. Plenty I've turfed and have told them flat out, "you have a complex problem that I need a physician's help with, so I want you to see them". It's worked out fine. Some I've had to cajole into seeing the doc because "can't I take care of it?"

Amen!