How logical is it, really?

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Endolphins

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I have recently been accepted into a DO program and I didn't have any doubts until..well...after being accepted. I am trying to figure out if the time and debt and endless sacrifice will be worth it for me. I am having trouble seeing the benefits of being a DO rather than an NP, for one. Reality is, as a DO I will likely go into a primary care specialty. This is with about $300K in loans by the end of med school, which will accrue about $15K every year during residency. I will have to wait about 12 years from now before buying a house or pay loans slowly and end up paying much more for my education. Then, there will be malpractice and such cutting into a primary care income.

I am also realizing that it is extremely hard to fit in time with patients for things like counseling, education, or chit chat....things that I looked forward to. NP's do have this time and can more easily work part-time at some point for things like children. I understand that NP's will have much less training and less knowledge, but it doesn't seem to hold them back as far as treating patients goes. So, how is it logical to do primary care as a physician vs NP? Please correct me if any of my perceptions are skewed about these two paths.
 
Endolphins said:
I have recently been accepted into a DO program and I didn't have any doubts until..well...after being accepted. I am trying to figure out if the time and debt and endless sacrifice will be worth it for me. I am having trouble seeing the benefits of being a DO rather than an NP, for one. Reality is, as a DO I will likely go into a primary care specialty. This is with about $300K in loans by the end of med school, which will accrue about $15K every year during residency. I will have to wait about 12 years from now before buying a house or pay loans slowly and end up paying much more for my education. Then, there will be malpractice and such cutting into a primary care income.

I am also realizing that it is extremely hard to fit in time with patients for things like counseling, education, or chit chat....things that I looked forward to. NP's do have this time and can more easily work part-time at some point for things like children. I understand that NP's will have much less training and less knowledge, but it doesn't seem to hold them back as far as treating patients goes. So, how is it logical to do primary care as a physician vs NP? Please correct me if any of my perceptions are skewed about these two paths.
Click to expand...

This. Doesn't that matter to you?
 
Do you WANT to go into primary care? You can specialize as a DO, nothing is holding you back from doing so. If you want to do primary care, there are great loan repayment/loan forgiveness programs for working in underrepresented or rural areas. Don't let money hold you back.
 
I'm a nurse who was just accepted as well. I plan on doing primary care too. I'm closing in on 30 and am feeling the internal pressure to start a family/buy a home. I'm a guy so i can delay this for a while more. For me, it's about the knowledge deficit, respect, and being the leader of a healthcare team. The ability to handle complex cases without anyone's assistance was important in my decision too. In 10 years I don't want to look at my life and know that I took the easy way out.

As far as time spent with patients, that's directly up to you. The whole NP's spend more time with patients is bogus. It is completely independent of what degree you hold.

Salary is quite far down on my list of priorities so I'll let someone else delve into that, but I doubt too many physicians are stealing bread and living in double wides.
 
You can go into any specialty you like. Search the match lists for some DO schools and you'll see many programs send more then just a few students to surgery, anesthesia, EM, etc. In fact, many schools send graduates to neuro surg, ortho, and oto.

No matter if you're in a DO or MD program, if you want to specialize you have to do exceedingly well on your boards, rotations, etc. Most MD programs place the vast majority of their graduates in IM, peds, OB/GYN, and fam med compared to the specialties as well.

It may be an uphill battle as a DO, but it is very realistic with some dedication.
 
My mothers an NP in family medicine and she is under the same time crunch as her physicians to see patients. That doesnt change because your an NP or PA. Also, your board scores and your willingness to work in a said field determine where you practice. It's not predetermined because you're choosing DO. It seems you have done very little research into your questions / concerns. I suggest shadowing to get the answers you re looking for.
 
Endolphins said:
I have recently been accepted into a DO program and I didn't have any doubts until..well...after being accepted. I am trying to figure out if the time and debt and endless sacrifice will be worth it for me. I am having trouble seeing the benefits of being a DO rather than an NP, for one. Reality is, as a DO I will likely go into a primary care specialty. This is with about $300K in loans by the end of med school, which will accrue about $15K every year during residency. I will have to wait about 12 years from now before buying a house or pay loans slowly and end up paying much more for my education. Then, there will be malpractice and such cutting into a primary care income.

I am also realizing that it is extremely hard to fit in time with patients for things like counseling, education, or chit chat....things that I looked forward to. NP's do have this time and can more easily work part-time at some point for things like children. I understand that NP's will have much less training and less knowledge, but it doesn't seem to hold them back as far as treating patients goes. So, how is it logical to do primary care as a physician vs NP? Please correct me if any of my perceptions are skewed about these two paths.
Click to expand...
Don't let that opportunity pass by. Don't go for np. This coming from a nurse who is trying to go to med school to become a primary care physician.
 
Less knowledge and less clinical skill = reason to do DO and not NP.

Sent from my SGH-T999 using SDN Mobile
 
Medicine (capitol M there) is more than a vocation, it's a calling, like being a priest or a policeman.

While it's normal to have some anxieties about any new endeavor, I stongly urge you to talk to five NPs and five DOs and see what they say.

Finally, listen to your heart, instead of a bunch of peopkle on an anonymous message board.



Endolphins said:
I have recently been accepted into a DO program and I didn't have any doubts until..well...after being accepted. I am trying to figure out if the time and debt and endless sacrifice will be worth it for me. I am having trouble seeing the benefits of being a DO rather than an NP, for one. Reality is, as a DO I will likely go into a primary care specialty. This is with about $300K in loans by the end of med school, which will accrue about $15K every year during residency. I will have to wait about 12 years from now before buying a house or pay loans slowly and end up paying much more for my education. Then, there will be malpractice and such cutting into a primary care income.

I am also realizing that it is extremely hard to fit in time with patients for things like counseling, education, or chit chat....things that I looked forward to. NP's do have this time and can more easily work part-time at some point for things like children. I understand that NP's will have much less training and less knowledge, but it doesn't seem to hold them back as far as treating patients goes. So, how is it logical to do primary care as a physician vs NP? Please correct me if any of my perceptions are skewed about these two paths.
Click to expand...
 
I really appreciate everyone sharing their experiences. The reason that I kind of assume I will be in something like FM is because I know I want to be near a particular location and that will narrow my residency options.
As far as spending time with patients, I have seen and heard many different opinions. I work on inpatient units and I see that doctors spend most of their time on computers. I saw NP's almost exclusively until I was about 20 and I was impressed by how thorough they were with me, but I will admit that I have shadowed at least one doctor who spent time talking with people even though it meant patients waited longer in the waiting room.
I work around RN's and many have told me that nursing is the way to go if I ever hope to have a family or even go on vacation....that scared me. There are people out there that say that NP's are almost dangerous because of their lack of knowledge and experience, but they ARE out there doing a great job and their learning does not have to stop after graduation. It is hard to know how much of this doubt about NP's is biased.
It is great to hear from people who are in similar situations or have experience, it helps a lot!
 
Endolphins said:
I really appreciate everyone sharing their experiences. The reason that I kind of assume I will be in something like FM is because I know I want to be near a particular location and that will narrow my residency options.
As far as spending time with patients, I have seen and heard many different opinions. I work on inpatient units and I see that doctors spend most of their time on computers. I saw NP's almost exclusively until I was about 20 and I was impressed by how thorough they were with me, but I will admit that I have shadowed at least one doctor who spent time talking with people even though it meant patients waited longer in the waiting room.
I work around RN's and many have told me that nursing is the way to go if I ever hope to have a family or even go on vacation....that scared me. There are people out there that say that NP's are almost dangerous because of their lack of knowledge and experience, but they ARE out there doing a great job and their learning does not have to stop after graduation. It is hard to know how much of this doubt about NP's is biased.
It is great to hear from people who are in similar situations or have experience, it helps a lot!
Click to expand...


Common sense tells you that NPs are excellent at handling your typical FM/IM type stuff, but once something atypical happens, you'd rather be with a MD/DO than NP/PA.

Tons of docs have kids, and FM is definitely conducive to having a family.
 
Regarding $$,

You'll spend more to be a physician, but the ceiling is orders of magnitude higher. With that said, money is #53 on the things to consider before becoming a doctor.
 
My sister is an OB nurse and is working to become an NP. She told me that she is lucky because the requirements are going to change soon(after she is done). What is now a masters program will be a phD program for NP, so the time commitment will not be all that significantly different aside from residency.
 
Family Medicine is awesome. Some people in medical community ( but mainly just people on medical forums) look down at FM as what you do when your not smart enough to specialize. They are out of touch. In the real world, all the specialists suck up to the PCP because they are the referring doctor. While NP is a noble profession that is increasingly getting larger practice rights, they are still not the doctor, and its nice to be the boss. So don't fret, go DO!

Also proportionally more DO's match orthopedic surgery (you know the supposed holy grail of specialities) than MD's. Half of all DO's specialize, so don't worry about that either. (Interestingly more and more NPs are "specializing" nowadays too)
 
Endolphins said:
I have recently been accepted into a DO program and I didn't have any doubts until..well...after being accepted. I am trying to figure out if the time and debt and endless sacrifice will be worth it for me. I am having trouble seeing the benefits of being a DO rather than an NP, for one. Reality is, as a DO I will likely go into a primary care specialty. This is with about $300K in loans by the end of med school, which will accrue about $15K every year during residency. I will have to wait about 12 years from now before buying a house or pay loans slowly and end up paying much more for my education. Then, there will be malpractice and such cutting into a primary care income.

I am also realizing that it is extremely hard to fit in time with patients for things like counseling, education, or chit chat....things that I looked forward to. NP's do have this time and can more easily work part-time at some point for things like children. I understand that NP's will have much less training and less knowledge, but it doesn't seem to hold them back as far as treating patients goes. So, how is it logical to do primary care as a physician vs NP? Please correct me if any of my perceptions are skewed about these two paths.
Click to expand...

NP will never equal MD/DO, simple as that. 4 years of medical school + residency training can't be substituted for a 2 - 5 year program. Sure as an NP you can handle typical cases, but atypical cases will arise and all you can do is refer them to somewhere else.

Also I suggest researching more. While I agree you should follow your heart, the job market for (new) NPs is pretty bad. Here's an SDN like message board for nurses on this subject: (http://allnurses.com/nurse-practitioners-np/new-np-job-490416.html)

I suggest going DO. Even as an FM you will have zero problem paying the debt and the prospect of getting a job is very high almost anywhere. And what is so bad about FM? Stop listen to SDN.
 
HooliganSnail said:
Family Medicine is awesome. Some people in medical community ( but mainly just people on medical forums) look down at FM as what you do when your not smart enough to specialize. They are out of touch. In the real world, all the specialists suck up to the PCP because they are the referring doctor. While NP is a noble profession that is increasingly getting larger practice rights, they are still not the doctor, and its nice to be the boss. So don't fret, go DO!

Also proportionally more DO's match orthopedic surgery (you know the supposed holy grail of specialities) than MD's. Half of all DO's specialize, so don't worry about that either. (Interestingly more and more NPs are "specializing" nowadays too)
Click to expand...

Who says ortho is the holy grail? Holy grail = ROAD

Sent from my SGH-T999 using SDN Mobile
 
HooliganSnail said:
Family Medicine is awesome. Some people in medical community ( but mainly just people on medical forums) look down at FM as what you do when your not smart enough to specialize. They are out of touch. In the real world, all the specialists suck up to the PCP because they are the referring doctor. While NP is a noble profession that is increasingly getting larger practice rights, they are still not the doctor, and its nice to be the boss. So don't fret, go DO!

Also proportionally more DO's match orthopedic surgery (you know the supposed holy grail of specialities) than MD's. Half of all DO's specialize, so don't worry about that either. (Interestingly more and more NPs are "specializing" nowadays too)
Click to expand...

In 2012, 641 out of 16,527 graduating us md's matched Acgme orthopedics. 3.8%
In 2012, 93 out of 4623 graduating DOs matched AOA orthopedics and 2 others matched Acgme orthopedics. 95/4623 is 2%.
 
medicine...simple as that...think of all of th possibilities you have 3rd year of med shool..you are open to find the specialty that you love. if you become a NP th only thing you can do is family practice. ( well some nurses are scoping now but thats beside the point. think of how rewarding it will be to get that DO
 
My mom is an NP( has been for 20 years) and she actually works in an ER. She makes about as much as a FP doctor( probably more in some cases). Granted she works a lot of hours (60-80 hrs/ week depending on the week).

She actually made over 200k last year.
 
Buckeye1992 said:
My mom is an NP( has been for 20 years) and she actually works in an ER. She makes about as much as a FP doctor( probably more in some cases). Granted she works a lot of hours (60-80 hrs/ week depending on the week).

She actually made over 200k last year.
Click to expand...

She isn't salaried by the hospital?
 
? Are you asking if she gets paid flat? If so no. She makes 65/hour. The ER she works at requires her to at least work enough hours to make 110k and.then she also works at an urgent care where she is essentially a partner with the doctors. And this is in NW Ohio, so I am guessing NPs work for more other places. The hospital she used to.work at was bought out by a new company that would have paid her 80/hr (without benefits). But she turned them down because the company has a bad rep for treating their employees bad.
 
IMO there's a reason why a fair number of nurses go on to become physicians. I haven't met any, but I've even heard about NP's and PA's who choose to become physicians after becoming mid-levels. My opinion is this -- there is a reason why you initially selected medicine as your career choice instead of nursing. Examine those reasons, and determine if it is possible that you'd ever be unsatisfied as a nurse/midlevel with the very real ceiling that does exist for them.

Also, family practice is a specialty where it is probably easier to control your hours if you are interested in spending more time with your family. I don't have any hard evidence of this, but I would also suspect that it would be easier to control your hours as a DO than an NP, as NP's are usually employed while physicians are in more of a partnership structure. This would give you more control over your life.
 
"With only 2,553 available positions and 2,212 participants in the match, it is not possible to analyze and report on every factor. (Only 2,208 participants in the match for whom data are available are included in this analysis.)"

^taken from match data link in the second post of this thread.

can someone explain to me why DO is a risk if there are more residency spot than applicants?
 
pre med 2014 said:
"With only 2,553 available positions and 2,212 participants in the match, it is not possible to analyze and report on every factor. (Only 2,208 participants in the match for whom data are available are included in this analysis.)"

^taken from match data link in the second post of this thread.

can someone explain to me why DO is a risk if there are more residency spot than applicants?
Click to expand...

With the new schools opening up for MD schools and DO schools as well as an increase in class size (for instance, FIU MD has increased its class to double its opening class), residencies will start feeling a crunch. For the 2015 match it is projected that residencies will be almost at parity with US medical school graduates. 2017+ match class, there may be an equal amount of USMD graduates and residencies available.

Opening of medical schools is tightly controlled and hardly any new ones opened while residencies expanded back then. IMGs and FMGs could take the extra available spots and everything was ok. The AAMC decided recently to expand the number of US medical schools and thus theres an explosion of new schools all over.
 
MedPR said:
Who says ortho is the holy grail? Holy grail = ROAD

Sent from my SGH-T999 using SDN Mobile
Click to expand...

Ortho has always been debatable. I know a girls father who is ortho. Mansion, Ferrari, Maserati, convertible BMW, lake house with boats and jet skis, vacation every single break..you name it. He has time to live it up per se.
 
torshi said:
Ortho has always been debatable. I know a girls father who is ortho. Mansion, Ferrari, Maserati, convertible BMW, lake house with boats and jet skis, vacation every single break..you name it. He has time to live it up per se.
Click to expand...

I've shadowed 5 different orthopods over the years. Your friends father is in the severe minority. All of whom I worked with made great money. Certainly not Ferrari and mansion money, but they also worked their lives away to earn the money.

In fact, 3/5 of the surgeons I was with were in the middle of a divorce. Something I was told wasn't uncommon for the field.
 
MGMA says the average ortho makes 524k/year. From my experience, they seem to work 65 hrs per week.
 
Mehd School said:
I've shadowed 5 different orthopods over the years. Your friends father is in the severe minority. All of whom I worked with made great money. Certainly not Ferrari and mansion money, but they also worked their lives away to earn the money.

In fact, 3/5 of the surgeons I was with were in the middle of a divorce. Something I was told wasn't uncommon for the field.
Click to expand...

This.
Many of the ortho surgeons I know are either in the middle of a divorce or have already been divorced and are in their 2nd marriage.
 
cliquesh said:
MGMA says the average ortho makes 524k/year. From my experience, they seem to work 65 hrs per week.
Click to expand...

I think we traditional pre-meds on SDN underestimate what 60+ hours per week really is. That's five 13-hour days. That leaves you with about 10 hours of "me" time during the week, with probably 75% of that being sleep. That's literally doing nothing but working 72% of the week.

I used to think "80 hours per week? Pff. Doctors do it all the time, and It won't bother me either." Then over the summer I worked 3 consecutive 45 hour work weeks with mcat prep thrown on top of it. Totally changed my tune.

TL;DR -- A workweek of 65+ hours per week will consume your life.
 
Mehd School said:
I think we traditional pre-meds on SDN underestimate what 60+ hours per week really is. That's five 13-hour days. That leaves you with about 10 hours of "me" time during the week, with probably 75% of that being sleep. That's literally doing nothing but working 72% of the week.

I used to think "80 hours per week? Pff. Doctors do it all the time, and It won't bother me either." Then over the summer I worked 3 consecutive 45 hour work weeks with mcat prep thrown on top of it. Totally changed my tune.

TL;DR -- A workweek of 65+ hours per week will consume your life.
Click to expand...

To be fair, those 60+ hours likely include being on call, which as an Attending I believe you can take from home or somewhere outside (but near) your hospital. So yeah, you might have to go into surgery or clinic or whatever, but if you're on call outside the hospital you can still do some stuff until you actually need to go in.

Otherwise, I agree. 60+ hours per week is a lot, and it's even worse when you consider the possibility of not having a routine schedule like most jobs (9-5 jobs) have.
 
torshi said:
Ortho has always been debatable. I know a girls father who is ortho. Mansion, Ferrari, Maserati, convertible BMW, lake house with boats and jet skis, vacation every single break..you name it. He has time to live it up per se.
Click to expand...

Cool story.. I know an IM who paid 3 million dollars to open up his own clinic. How people spend their money isn't always indicative of their salary.
 
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