DPM or nursing?

[dudestheman90]

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[NYCGuy86]

lol, an NP practices under his or her specialty. Some NP's specialize under psychiatry, oncology/hematology, peds, ect..... If i was a Psychiatric NP for example, than I perform a role similar to that of a psychiatrist but i wouldn't go and perform a heart surgery or something like that. My scope of practice has to fall under my specialty of training however this goes the same with medicine. A neurosurgeon is not going to do a heart surgery b/c that's a different specialty. That's another reason that steered me away from becoming a PA, pa's can switch specialties w/o any schooling. Doesn't make much sense to me since a neurosurgeon spends 7-8 years to train for it after medical school, how in the hell are you going to hire a PA with only 2-3 years of graduate training which is geared towards primary care. Isn't that like a huge liability hiring someone that isnt fully trained to deal with aspects of neurosurgery besides learning the basics in PA school. An NP needs to go through additional schooling/education for every specialty and cannot switch specialties w/o additional training and certifications. However a PA doesn't have to train for anything and can switch specialties whenever. That's a huge liability risk in my opinion.

I don't think you've thought about or researched how this functions in the real world.

PAs are trained as generalists (as physicians are). PA school is similar to medical school in that you receive a general medical education. You are not just trained in primary care, but also have didactics and clinical rotations in the major medical specialties, such as surgery, internal medicine, ob/gyn, emergency medicine, psychiatry, pediatrics, etc. After graduation and licensure, some PAs attend post-graduate training programs (i.e. residency) in various specialties, such as cardiothoracic surgery, critical care, orthopedic surgery, neurosurgery, dermatology, cardiology, ob/gyn, etc.

Yes, a PA is able to practice in any specialty (which is what draws many to the profession). However do you really think that a family medicine PA can just quit and go immediately start practicing as a neurosurgical PA the next day? In the real world, that PA would either attend a PA residency program for focused clinical training, or participate in extensive on the job supervised training with the physicians and experienced PAs until they are competent to practice autonomously. I hope you don't believe this is any different than a new NP on their first job, or when an NP changes specialties (for example, an ACNP changing fields from cardiology to surgical critical care).

Luckily in the real world, "a PA doesn't have to train for anything and can switch specialties whenever." is false, and I'm not sure where you got that idea.

 

[NYCGuy86]

My state differentiates bwtn calloboration and direct supervision. Under my state laws, NP's are fully and independently licensed to practice w/o direct supervision of a physician. NP's fall under the same category as pharmacists, physicians, clinical psychologists, ect...NP's are responsible for their own actions and are held accountable for what they do and not the physician. PA's are under-direct supervision at all times, and the physician is ultimately responsible for the PA's actions. However an NP is responsible, not the physician. NP's only require a joint protocol to prescribe meds only but treats and diagnosis w/o physician involvement. Every state is different, where i live we have greater autonomy. A PA operates under an MD/DO, his license is useless w/o a supervising physician, an NP operates under his/her own license/doesn't need physician oversight.

Again, what is "direct supervision"? Please define it. What does it mean that they are under "direct" supervision at all times? Please give an example. I hope you understand the differences between various levels of supervision.

So in your state you need a 'joint protocol" to prescribe? What does the protocol have to state? You don't think the physician bears some responsibility for what you're prescribing? This is not fully independent practice.

"You do realize that in hospitals, PAs and NPs will have some form of physician oversight (whether or not this is in an "independent practice" state), right?". Many hospitals have PAs and NPs "running" various services. For example, a hospital I was just at has PAs running the neuro ICU. However, no hospital, whether or not they are in an independent NP practice state, would have a patient without an attending physician on record that is ultimately responsible for the care delivered.

Also, which state are you in?

 

[DrShoegal]

Thank you all for the advice! I chose podiatry. I shadowed DPMs for a few years and just shadowed an RN this week. I can definitely see myself in podiatry-better fit for me. Thanks again for all of the opinions!

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[Farcus]

Psychologists, pharmacists, dentists, PTs, optometrists, podiatrists, etc, etc. are all people who earn doctoral degrees and work around physicians. I do not care if people call themselves doctor or not (assuming they have a doctorate degree in the field of their practice) AS LONG AS the person is crystal clear about their role. Like, "I'm Dr. X, your psychologist", "I'm Dr. Y, the clinical pharmacist", etc.

No one complains about these other fields using their titles. I don't understand why the world explodes and suddenly we're all very concerned that patients may get "confused" when a nurse earns a doctoral degree, but apparently it's a huge problem.

This is coming from someone with no plans for a doctoral degree in nursing and will most likely go by my first name.

Personally I think its superflous and superficial for a pharmacist to introduce themselves as Doctor blah blah blah other than in academic setting. I went to school to be a pharmacist not a physcian. You can be 3rd year trained pharmacy resident at academic teaching hospital or a community pharmacist, its the same thing.