I don't understand the whining?

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health123

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I was doing some research on job opportunities throughout the nation specifically for anesthesia jobs and came across many lucrative offers in great urban locations (I'm not talking about farm country in the middle of nowhere). Recently, I constantly read and hear medical students/residents complain about future "bad" pay and the debts they have accumulated throughout the years of schooling, etc. However, there seems to be a plenty of great jobs opportunities out there where they offer huge (five to six figure) bonuses, school debt repayment (up to 50k a year!), plus the usual start salary of about 300k for anesthesiologist. Am I missing something here?
 
health123 said:
I was doing some research on job opportunities throughout the nation specifically for anesthesia jobs and came across many lucrative offers in great urban locations (I'm not talking about farm country in the middle of nowhere). Recently, I constantly read and hear medical students/residents complain about future "bad" pay and the debts they have accumulated throughout the years of schooling, etc. However, there seems to be a plenty of great jobs opportunities out there where they offer huge (five to six figure) bonuses, school debt repayment (up to 50k a year!), plus the usual start salary of about 300k for anesthesiologist. Am I missing something here?
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A few for now:

-you are not really the boss (so no or little respect), and often you're considered expendable by the higher-ups.
-you have little control over your schedule in that some days you can be done by 3pm while other days you might not be done till 3am because a case took longer than expected. this can get old for some people, sort of like how it's fun to travel on business but when you have a family it's not so fun anymore. if a surgeon wants to add on a case near the end of the day, you can't just easily reschedule for another time, like you could if you're in a patient-facing specialty and a patient arrives late to see you. no, you just have to do the case. also the surgeon can often schedule cases on days or times convenient to him or her, which may or may not be convenient to you.
-you cannot directly control payer mix, which in turn influences how much you can or cannot make, unlike say a PP ophthalmologist or dermatologist who simply refuses to accept mostly Medicare patients.
-it can be physically demanding (e.g. OR toil), which is harder to recover from with age.
-all other things equal, career longevity is probably more likely in a specialty like pathology, radiology, heme/oncology, etc. than anesthesiology. not as much wear and tear in general, more thinking than doing. of course this is by no means a hard and fast rule, there are many exceptions. like someone could die of boredom in a specialty they hate even if it's "easier" on the body or lifestyle or whatever, but work forever in one they love even though it's got a harder lifestyle etc. however, if you're on the fence about two specialties then career longevity might be worth taking into consideration.
-since it's quite procedural and lacks patients, if you get injured like breaking an arm then it's harder to do your job, unlike other physicians like cards or GI or even some surgeons who can at least still see some patients or prescribe drugs or schedule future surgeries or dictate some orders or otherwise rely on non procedural means to keep the income somewhat flowing until they recover and can operate again.
-you may still need to take the most onerous form of call for most your entire career - e.g. coming into the hospital to do cases in the middle of the night.
-acute care is fun when you're a med student or resident, but when you're the attending with the brunt of the legal liability it could be quite a different story.
-big mistakes in the OR can happen in seconds or minutes. some thrive on this, others not so much. know thyself.
-the ACT is here to stay so most likely you should expect to do less of your own cases and more managing CRNAs.
-is the PSH the future?
-most CRNAs are chill but the militant ones are anything but, and as a result spoil so much including patient care and safety without necessarily realizing it.
-anesthesiologists seem to be significantly losing their current share of the market to AMCs and CRNAs, though an optimist can hope the trend stalls or even reverses. how likely this is is up for debate.
-no patients is both a blessing and a curse, but the curse is hospitals and others don't give you the time of day and you may have limited decision-making abilities with them since you're not actively bringing in patients and thus money to the hospital. but this can be ameliorated in some ways like if you do a fellowship in pain and work partly in pain or serve on a hospital committee and are politically savvy enough to garner influence and support, etc.
-note I didnt mention anything about salary, not that it shouldn't be a consideration, but because it shouldn't be the sole or even primary consideration. for many people you couldn't pay them enough to do a job they hate or don't feel like they're contributing to or making a difference in or are proud of or the like. or at least many people would be willing to trade money for other things like time or respect etc. know yourself, your goals and priorities in life, investigate the good and bad of specialties you're interested in, not just the medical science but also other concerns including the bread and butter cases, the patient population, the available practice environment options, the personality or culture of the physicians of each specialty. just my two cents'.

(There are positives too, of course, but since you asked what you might be "missing"...)
 
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Many good points above, but hardly physically demanding. You do have to be able to get up fairly early. That is probably my biggest issue with anesthesia. I'm not a morning person, and when retirement comes, barring extreme circumstances, I'll never be up before 8 again. I liked my .mil job at the small hospital as we started at 8. Late start, 5 min commute, and a sweet physician parking lot were a luxury. 🙂
 
bashwell said:
-acute care is fun when you're a med student or resident, but when you're the attending with the brunt of the legal liability it could be quite a different story.
-big mistakes in the OR can happen in seconds or minutes. some thrive on this, others not so much. know thyself.
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This is critical to a happy and long career in anesthesia. Some people have ice water in their veins and can approach a critical situation in a very emotionless and calculating way, others are prone to dramatics and hand waving.
The former are happier than the latter. Many people are entirely unsuited to anesthesia.
 
health123 said:
Am I missing something here?
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Entitlement, and wounded pride. There are people who will straight argue with you that the package you describe is inadequate. Someone out there is getting a better deal than that, either in this specialty, or another. And since they both had to go through the same basic grist mill and be damaged more or less equally by it, the idea that someone else might be getting the better end of it is maddening to some folks.

$300k plus student loan repayment benefits? You can argue that some aspects of that job may not be ideal to everyone's liking, that it may have some downsides. (As if there are any jobs that don't have some downsides.) But you are right that it isn't a terrible package. That just isn't going to be a popular thing to say when there are people who figure they deserve even more.
 
health123 said:
I was doing some research on job opportunities throughout the nation specifically for anesthesia jobs and came across many lucrative offers in great urban locations (I'm not talking about farm country in the middle of nowhere). Recently, I constantly read and hear medical students/residents complain about future "bad" pay and the debts they have accumulated throughout the years of schooling, etc. However, there seems to be a plenty of great jobs opportunities out there where they offer huge (five to six figure) bonuses, school debt repayment (up to 50k a year!), plus the usual start salary of about 300k for anesthesiologist. Am I missing something here?
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In the past your salary was dictated by your collections. In the present and future your salary is/will be dictated by how much it would cost to replace you by private equity owners who don't know you, don't know your job, and contribute nothing to your practice in exchange for the money they take off the top.
Is it a good job now? Hell yeah!
Will it stay good for 20 more years? Idk
 
health123 said:
I was doing some research on job opportunities throughout the nation specifically for anesthesia jobs and came across many lucrative offers in great urban locations (I'm not talking about farm country in the middle of nowhere). Recently, I constantly read and hear medical students/residents complain about future "bad" pay and the debts they have accumulated throughout the years of schooling, etc. However, there seems to be a plenty of great jobs opportunities out there where they offer huge (five to six figure) bonuses, school debt repayment (up to 50k a year!), plus the usual start salary of about 300k for anesthesiologist. Am I missing something here?
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"Lucrative"??? Is that what defines a good job or profession for you?

Is a $300k job which puts you at risk for millions of dollars in malpractice payout lucrative?
Is a job where you spend more time on call than with your family lucrative?
Is a job where you take most of the risks while others get most of the profits lucrative?
Is a job where you are so stressed out that you wonder if you'll make 50 lucrative?
Etc.

Don't waste your time on this forum, people. It's not lucrative.
 
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"Am I missing something here?[/QUOTE]"

Do you know what it costs just to "keep" medical licenses in the few states in which I hold them? You know how much it costs to be an ASA, and SPA, an ASRA member? How much to subscribe to some specialty journals, and be a member of some subspecialty societies? What does it cost to go to a few conferences? What's MOCA cost? What's malpractice run? Taxes? Insurance? Insurance? And more insurance? Phones, computers, internet? Gotta have that for work. You must have a "get-you-there-on-time-every-time" car in this business. What's that cost? You change the oil yourself on your day off? Do you have a kid or two? You married, help support anyone? Hey bud, you're working all hours for that 3-hun, you got child-care covered? Insurance for taking care of loved ones if the goomba in your head gets too big to focus? You want to take off a week and do some volunteer work overseas--what's that cost? Got any student loans? You renting an efficiency or do you have a mortgage on a house? Did you take a job somewhere your kids aren't "getting it" in the public schools? Ouch, private school tuition baby. You got taxes/insurance/bills/food--basic stuff without the fancies? You're not even having a beer yet! How about catching up with some retirement savings since you were in school/training for a decade longer than a lot of people? You ever get sick? You better friggin hope not. You like air conditioning, warm tubbies? Costs money baby. And don't forget the revenuers, because they are getting their half--up front, and you can work that sh#@ out with what's left. What about financial aid for little Susie? "…Next."
 
imfrankie said:
"Am I missing something here?
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"

Do you know what it costs just to "keep" medical licenses in the few states in which I hold them? You know how much it costs to be an ASA, and SPA, an ASRA member? How much to subscribe to some specialty journals, and be a member of some subspecialty societies? What does it cost to go to a few conferences? What's MOCA cost? What's malpractice run? Taxes? Insurance? Insurance? And more insurance? Phones, computers, internet? Gotta have that for work. You must have a "get-you-there-on-time-every-time" car in this business. What's that cost? You change the oil yourself on your day off? Do you have a kid or two? You married, help support anyone? Hey bud, you're working all hours for that 3-hun, you got child-care covered? Insurance for taking care of loved ones if the goomba in your head gets too big to focus? You want to take off a week and do some volunteer work overseas--what's that cost? Got any student loans? You renting an efficiency or do you have a mortgage on a house? Did you take a job somewhere your kids aren't "getting it" in the public schools? Ouch, private school tuition baby. You got taxes/insurance/bills/food--basic stuff without the fancies? You're not even having a beer yet! How about catching up with some retirement savings since you were in school/training for a decade longer than a lot of people? You ever get sick? You better friggin hope not. You like air conditioning, warm tubbies? Costs money baby. And don't forget the revenuers, because they are getting their half--up front, and you can work that sh#@ out with what's left. What about financial aid for little Susie? "…Next."[/QUOTE]

Remember guys, the emotional people that want to vent are more likely to post than the ones who are content with their practice and specialty. You'll see a disproportionate amount of histrionics.
 
Medicine is full of whiners. Nobody is forced to become a doctor. I hear my partners whining...about call, working late, surgeons, nurses, taxes, blah blah blah. Then they turn on Fox News in the lounge to watch other people whine. Most of it is not justified. We all signed up for this. If you don't like it, please move on. Nobody is forcing you to stay.

It's a great job.
 
I mostly agree with nimbus. Everything is relative and, at the end of the day, there are more people envying us than the opposite (for now). But, as I said, everything is relative, and life is not only about money, or work. Even at work, what makes a job enjoyable is rarely money. So stop focusing on the money, people.

It's easy to judge those who are unhappy with their jobs, most of them in bad markets. It's so convenient and easy to just ascribe it to incompetence. It's such a proof of lazy thinking, usually from some lucky bastard in a good partnership. He might think the difference between him and the "whiners" is mainly competence, but I would bet it's mostly just the year of graduation. And sheer stupid dumb luck.

Plus it's not that simple to just uproot one's family, especially if one's spouse is happy with his/her job. You've heard the saying "happy wife, happy life"; it applies to both sexes. So one does what one can do: vents and warns others not to commit the same mistake, while running a few more laps in the rat race.

Such a waste of time, warning people... Those who know, know, and those who don't won't believe you anyway, until they get burnt themselves. In the meanwhile, they call you a whiner. 🙄

I am discovering that watching another interesting EM/CCM/anesthesia-related video or reading another chapter in a good book makes me much happier than being called names here. I strongly recommend that path. If you need a few good starters, just let me know.
 
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FFP said:
Is a $300k job which puts you at risk for millions of dollars in malpractice payout lucrative?
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How much of your personal assets are at risk from a malpractice payout? In my state it is essentially unheard of for a jury to make an award beyond the limit of the malpractice insurance of the physician.
 
For me, anesthesia has been nothing short of awesome. Now that I have arrived at my dream gig in my dream location... everyday is a blessing.

I am generally a happy person and I love the job... from pedi cases to big brain tumors to complicated arch repairs to a day of needle jockeying in the ortho room.. The variety is a lot of fun for me and fits my personality. I wouldn't have it any other way.


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Mman said:
How much of your personal assets are at risk from a malpractice payout? In my state it is essentially unheard of for a jury to make an award beyond the limit of the malpractice insurance of the physician.
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Not in my state.

All of my personal assets are at risk (the homestead exemption is a joke, and we don't have tenancy by entirety), until I get to a number at which it's worth investing in asset protection planning.

Let me put it this way: if most payouts were truly limited, nobody would argue against malpractice caps. 😉
 
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[QUOTE="FFP, post: 16275008, member: 171991"🙄 discovering that watching another interesting EM/CCM/anesthesia-related video or reading another chapter in a good book makes me much happier than being called names here. I strongly recommend that path. If you need a few good starters, just let me know.[/QUOTE]
Yes please say more about what you mean by this path FFP?
 
imfrankie said:
"Am I missing something here?
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"

Do you know what it costs just to "keep" medical licenses in the few states in which I hold them? You know how much it costs to be an ASA, and SPA, an ASRA member? How much to subscribe to some specialty journals, and be a member of some subspecialty societies? What does it cost to go to a few conferences? What's MOCA cost? What's malpractice run? Taxes? Insurance? Insurance? And more insurance? Phones, computers, internet? Gotta have that for work. You must have a "get-you-there-on-time-every-time" car in this business. What's that cost? You change the oil yourself on your day off? Do you have a kid or two? You married, help support anyone? Hey bud, you're working all hours for that 3-hun, you got child-care covered? Insurance for taking care of loved ones if the goomba in your head gets too big to focus? You want to take off a week and do some volunteer work overseas--what's that cost? Got any student loans? You renting an efficiency or do you have a mortgage on a house? Did you take a job somewhere your kids aren't "getting it" in the public schools? Ouch, private school tuition baby. You got taxes/insurance/bills/food--basic stuff without the fancies? You're not even having a beer yet! How about catching up with some retirement savings since you were in school/training for a decade longer than a lot of people? You ever get sick? You better friggin hope not. You like air conditioning, warm tubbies? Costs money baby. And don't forget the revenuers, because they are getting their half--up front, and you can work that sh#@ out with what's left. What about financial aid for little Susie? "…Next."[/QUOTE]

Awesome post, imfrankie. Hard for the silver spoons and 20 somethings of the world to relate to this but it is the damn truth!!! Suddenly, that 350K job doesn't look so great. And don't forget the new Obama Medicare tax that I got to pay this year (Yeah!!!)
 
Mman said:
How much of your personal assets are at risk from a malpractice payout? In my state it is essentially unheard of for a jury to make an award beyond the limit of the malpractice insurance of the physician.
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How would one find out which states are good to practice in (litigation wise)?
 
Tuohy said:
"

Do you know what it costs just to "keep" medical licenses in the few states in which I hold them? You know how much it costs to be an ASA, and SPA, an ASRA member? How much to subscribe to some specialty journals, and be a member of some subspecialty societies? What does it cost to go to a few conferences? What's MOCA cost? What's malpractice run? Taxes? Insurance? Insurance? And more insurance? Phones, computers, internet? Gotta have that for work. You must have a "get-you-there-on-time-every-time" car in this business. What's that cost? You change the oil yourself on your day off? Do you have a kid or two? You married, help support anyone? Hey bud, you're working all hours for that 3-hun, you got child-care covered? Insurance for taking care of loved ones if the goomba in your head gets too big to focus? You want to take off a week and do some volunteer work overseas--what's that cost? Got any student loans? You renting an efficiency or do you have a mortgage on a house? Did you take a job somewhere your kids aren't "getting it" in the public schools? Ouch, private school tuition baby. You got taxes/insurance/bills/food--basic stuff without the fancies? You're not even having a beer yet! How about catching up with some retirement savings since you were in school/training for a decade longer than a lot of people? You ever get sick? You better friggin hope not. You like air conditioning, warm tubbies? Costs money baby. And don't forget the revenuers, because they are getting their half--up front, and you can work that sh#@ out with what's left. What about financial aid for little Susie? "…Next."
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lol I don't know, what does a Camry or an Accord cost? I didn't know reliable cars were so expensive.
 
Baller MD said:
How would one find out which states are good to practice in (litigation wise)?
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I have no earthly idea. I'm sure a malpractice insurer could probably give you ballpark rates by state since your insurance costs are higher in states that are worse for malpractice.
 
 
 
Promethean said:
Entitlement, and wounded pride. There are people who will straight argue with you that the package you describe is inadequate. Someone out there is getting a better deal than that, either in this specialty, or another. And since they both had to go through the same basic grist mill and be damaged more or less equally by it, the idea that someone else might be getting the better end of it is maddening to some folks.

$300k plus student loan repayment benefits? You can argue that some aspects of that job may not be ideal to everyone's liking, that it may have some downsides. (As if there are any jobs that don't have some downsides.) But you are right that it isn't a terrible package. That just isn't going to be a popular thing to say when there are people who figure they deserve even more.
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What's this? Another premed, declaring that the paycheck he hasn't earned yet is too much money? 🙂
 
It's not just us:
Unfortunately, in recent years, much of the public has begun to take health care for granted, and often regard those who provide their care as little more than a common utility. This general decline in public esteem for our profession has robbed many dedicated practitioners of the joy of their life’s work. It has led to growing frustration, anger, and burnout. Many talented physicians and surgeons have chosen early retirement or alternative employment opportunities, rather than endure the abuse of a system that treats them simply as replaceable parts in a giant factory.
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http://www.kevinmd.com/blog/2015/03/surgeon-will-always-two-spouses.html
 
pgg said:
What's this? Another premed, declaring that the paycheck he hasn't earned yet is too much money? 🙂
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I'm not a 22 year old. I've earned a living, bought a nice home, and supported a family on far less. So, hearing people whine that they can't possibly survive on 5-6 times my yearly income? My heart just doesn't bleed for them.

But tell me, how much would finally be enough? What figure would finally stop the whining? And how long would it take before lifestyles rose to and exceeded beyond that point, too?
 
Promethean said:
I'm not a 22 year old. I've earned a living, bought a nice home, and supported a family on far less. So, hearing people whine that they can't possibly survive on 5-6 times my yearly income? My heart just doesn't bleed for them.

But tell me, how much would finally be enough? What figure would finally stop the whining? And how long would it take before lifestyles rose to and exceeded beyond that point, too?
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While the gross salary might be 5-6 times your yearly income, the net salary is not raised by the same amount. If you earn 50K a year, you take home about 50K per year. If you earn 300K per year, you take home about 200K per year. And to earn that 300K, you had to go into 6 figure debt that you probably pay about 7% interest on. And to earn that 300K per year, you work a lot more than 40 hours a week. And a lot of those hours are at night and on weekends so it's a lot more stressful than your average 9-5. And on and on and on.
 
Promethean said:
I'm not a 22 year old. I've earned a living, bought a nice home, and supported a family on far less. So, hearing people whine that they can't possibly survive on 5-6 times my yearly income? My heart just doesn't bleed for them.

But tell me, how much would finally be enough? What figure would finally stop the whining? And how long would it take before lifestyles rose to and exceeded beyond that point, too?
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Boo-f*cking-hoo. Nobody gives a ****. Life isn't fair. At least you don't hear me calling out doctors for "whining."
 
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Come on. Promethean has a point.

What s/he doesn't understand is that there is a lot of years of sacrifices and hard work, even as an attending, behind a physician's income. When one takes into account the about 8-10 years of graduate and post-graduate medical slaving, I mean education, and the continuous investments required by various medical organizations, the numbers are not that rosy anymore. Still nothing to complain about, relative to the average American, but, as I said above, it's not just about the money.

The truth is:
Planktonmd said:
Ladies and gentlemen... it is time for all of us to accept that medicine is no longer a sacred profession, and that the art of healing is no longer highly regarded by society as it used to be.
We are now simply vendors of a service that can be provided by others, we now have competitors!
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Promethean said:
I'm not a 22 year old. I've earned a living, bought a nice home, and supported a family on far less. So, hearing people whine that they can't possibly survive on 5-6 times my yearly income? My heart just doesn't bleed for them.
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First of all, no one here said anything about "survival" so you can quit ****ing that chicken. The goalposts are over here, away from the strawmen.

What you, like all premeds, don't know (can't know) is the price you're going to pay in medical school and residency. You think you know what you're getting yourself into, but you don't. You know, on some intellectual philosophical level that medical school is "hard" and residency is "difficult" and that the hours are "long" but your understanding of that meaning is limited to knowing the definitions of those words. Similarly, your understanding of the "risk" and "liability" we accept is also limited or non-existent ... if you think of those words at all.


It's a running joke on SDN. Over and over and over, the people who post things like "I'd be totally cool making $150K as a doctor" are premeds. Occasionally a med student. Never a resident, never an attending.

Perspective is good. It's true that we'll probably never be unemployed, or hungry, or unclothed, or forced to live in dangerous crime-ridden neighborhoods. We are, as a group, aware of that and grateful that our work is being rewarded. Perhaps, 10 years from now, when you've bought and paid for your ticket, you'll have a different perspective. Until then ... just be wary of selling yourself and your future profession short (if you make it).
 
I've been a nurse for about a decade now. The last 6 years were spent in the OR at a level one pediatric trauma center. I understand that attending physicians are ultimately held responsible for their patients, but running the OR desk every weekend for two years meant that I was the one responsible for coordinating surgical resources for multiple traumas, ECMO cannulations of premies, etc. When we were understaffed, I would sometimes have to do the job of two or three people, running between rooms to make everything go right. I generally did that for 50-60 hours per week, while taking classes and running a business.

I do get it that residency is much harder, that the hours are longer, that the responsibility is greater. I watched groups of interns that I had met on the med/surg unit where I used to work go through their residencies and fellowships to become attendings. I saw much, though not all, of what they went through. I didn't live it personally, but I really do have some sense of what I am getting myself into.

Since I've been certified in two nursing specialties, I regularly get offers to go work travel assignments that pay more than double my current rate. If I hustled a bit, with my work ethic, there is no reason that I couldn't be pulling down 120k/year... without taking on any more student loan debt or going back to school at all.

Instead, I have decided that I need to become a physician, Family Med. Given the resources of the population that I ultimately want to serve, I will be lucky to see $120k, and that is probably about what my loans are going to be. Again, if I hustle and do some locums for a couple years out of residency and keep my lifestyle where it is, I can be debt free again within a couple of years. Without debt, $120k, even after taxes, would mean an extremely comfortable lifestyle. Anything above that is gravy. Maybe it is that I grew up so very poor, and that I have made so much out of so little, that I am so content. I deeply appreciate how incredibly fortunate I am to have gotten this far.

But there is no question that I will make it. A fellow student died of leukemia when we were in nursing school. I was close to her and think of her often, how she was struck down while pursuing her dream. Nothing short of dying will stop me from becoming a physician. I've wanted this too long, and now that the way is open to me at last, nothing, nothing will stop me. Inshallah.

I will be here in 10 years, barring calamity, and if any of the rest of you are, I will be glad to revisit this topic. I may be able to earn more, if some of my schemes work out, or I may just be scraping by... but so long as I can fulfill my purpose in life, I expect that I will be satisfied. You can think that I'm just the latest edition of a running joke, or that I'm just another pompous premed. But I'm telling you that, while I am not the special snowflake that is going to be different, I have paid my dues and can speak with some earned confidence.
 
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Promethean said:
I've been a nurse for about a decade now. The last 6 years were spent in the OR at a level one pediatric trauma center. I understand that attending physicians are ultimately held responsible for their patients, but running the OR desk every weekend for two years meant that I was the one responsible for coordinating surgical resources for multiple traumas, ECMO cannulations of premies, etc. When we were understaffed, I would sometimes have to do the job of two or three people, running between rooms to make everything go right. I generally did that for 50-60 hours per week, while taking classes and running a business.

I do get it that residency is much harder, that the hours are longer, that the responsibility is greater. I watched groups of interns that I had met on the med/surg unit where I used to work go through their residencies and fellowships to become attendings. I saw much, though not all, of what they went through. I didn't live it personally, but I really do have some sense of what I am getting myself into.

Since I've been certified in two nursing specialties, I regularly get offers to go work travel assignments that pay more than double my current rate. If I hustled a bit, with my work ethic, there is no reason that I couldn't be pulling down 120k/year... without taking on any more student loan debt or going back to school at all.

Instead, I have decided that I need to become a physician, Family Med. Given the resources of the population that I ultimately want to serve, I will be lucky to see $120k, and that is probably about what my loans are going to be. Again, if I hustle and do some locums for a couple years out of residency and keep my lifestyle where it is, I can be debt free again within a couple of years. Without debt, $120k, even after taxes, would mean an extremely comfortable lifestyle. Anything above that is gravy. Maybe it is that I grew up so very poor, and that I have made so much out of so little, that I am so content. I deeply appreciate how incredibly fortunate I am to have gotten this far.

But there is no question that I will make it. A fellow student died of leukemia when we were in nursing school. I was close to her and think of her often, how she was struck down while pursuing her dream. Nothing short of dying will stop me from becoming a physician. I've wanted this too long, and now that the way is open to me at last, nothing, nothing will stop me. Inshallah.

I will be here in 10 years, barring calamity, and if any of the rest of you are, I will be glad to revisit this topic. I may be able to earn more, if some of my schemes work out, or I may just be scraping by... but so long as I can fulfill my purpose in life, I expect that I will be satisfied. You can think that I'm just the latest edition of a running joke, or that I'm just another pompous premed. But I'm telling you that, while I am not the special snowflake that is going to be different, I have paid my dues and can speak with some earned confidence.
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Thanks for sharing this. I genuinely hope you fulfill your dream of becoming a physician.

That said, I think the essential point is: there's a difference between what you are okay with for yourself vs. what you think others should be okay with.
 
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OP:

Someone can find joy or aggravation in whatever they do. A job others hate might be one you love. :shrug:

To each their own.
 
pgg said:
. The goalposts are over here, away from the strawmen.
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Wow. I love that line and will be using it in the future. What an excellent way to remind someone of a fundamental fallacy in debating.
 
Promethean, I admire your story. I have been an Adult primary NP for many years and past few years Adult Critical Care NP and understand your desire for medical school. I have been around many NPs and many MDs/DOs. In our large hospital the lines are blurred between NP and MD and ultimately our goal is to treat and stabilize patients, whether it's done by the NP or the MD. I love what I do, and it's a long history how got here. But, as a side note, I am extremely frustrated with the nursing profession in general and understand your desire to continue onto MD. I am mostly upset at the "militant" (a term I've learned on this forum) academic NPs who keep pushing the idea that NPs are equal in knowledge etc. to MDs. I have to be honest, we are not. Especially when you're newly graduated. It takes a lot of years to get the knowledge down. And what bothers me is that NP school isn't revamping their education to meet those standards. They keep pushing the fact that we're practicing in the "nursing model" but it's furthest from the truth. Once you're an NP, you're practicing in the medical model. We learn from books published by MDs, we are lectured by MDs (most systems). So, how is that nursing anymore? We didn't become NPs to take the short cut. We want the education. I want to go through 4 years of NP school, take all the courses MDs take, go through 3 years of residency, then become a DNP if that's what we want to call ourselves. Why isn't that in place? Why can't we take the USMLEs after a revamped program. I can't stress this enough to all academia nurses. WE DON'T PRACTICE NURSING WHEN WE'RE NPs! We are given privileges to prescribe, to diagnose, to treat, etc. This is not nursing; nursing is implementation. In fact, the best physicians I have met were the ones who were nurses before. It's not a bad idea to be a nurse first, then MD/DO or DNP model as long as the education is there. I can gather a list of many NPs who feel this way. We need to change our education system to earn respect by fellow physicians and most importantly by ourselves (knowing we truly have the knowledge to care for patients independently). Sorry if I sound all over the place; I'm frustrated!
 
health123 said:
Promethean, I admire your story. I have been an Adult primary NP for many years and past few years Adult Critical Care NP and understand your desire for medical school. I have been around many NPs and many MDs/DOs. In our large hospital the lines are blurred between NP and MD and ultimately our goal is to treat and stabilize patients, whether it's done by the NP or the MD. I love what I do, and it's a long history how got here. But, as a side note, I am extremely frustrated with the nursing profession in general and understand your desire to continue onto MD. I am mostly upset at the "militant" (a term I've learned on this forum) academic NPs who keep pushing the idea that NPs are equal in knowledge etc. to MDs. I have to be honest, we are not. Especially when you're newly graduated. It takes a lot of years to get the knowledge down. And what bothers me is that NP school isn't revamping their education to meet those standards. They keep pushing the fact that we're practicing in the "nursing model" but it's furthest from the truth. Once you're an NP, you're practicing in the medical model. We learn from books published by MDs, we are lectured by MDs (most systems). So, how is that nursing anymore? We didn't become NPs to take the short cut. We want the education. I want to go through 4 years of NP school, take all the courses MDs take, go through 3 years of residency, then become a DNP if that's what we want to call ourselves. Why isn't that in place? Why can't we take the USMLEs after a revamped program. I can't stress this enough to all academia nurses. WE DON'T PRACTICE NURSING WHEN WE'RE NPs! We are given privileges to prescribe, to diagnose, to treat, etc. This is not nursing; nursing is implementation. In fact, the best physicians I have met were the ones who were nurses before. It's not a bad idea to be a nurse first, then MD/DO or DNP model as long as the education is there. I can gather a list of many NPs who feel this way. We need to change our education system to earn respect by fellow physicians and most importantly by ourselves (knowing we truly have the knowledge to care for patients independently). Sorry if I sound all over the place; I'm frustrated!
Click to expand...

That's not in place because if nurses actually wanted to put in all that work, they would just go to medical school. Very few actually do
 
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health123 said:
Promethean, I admire your story. I have been an Adult primary NP for many years and past few years Adult Critical Care NP and understand your desire for medical school. I have been around many NPs and many MDs/DOs. In our large hospital the lines are blurred between NP and MD and ultimately our goal is to treat and stabilize patients, whether it's done by the NP or the MD. I love what I do, and it's a long history how got here. But, as a side note, I am extremely frustrated with the nursing profession in general and understand your desire to continue onto MD. I am mostly upset at the "militant" (a term I've learned on this forum) academic NPs who keep pushing the idea that NPs are equal in knowledge etc. to MDs. I have to be honest, we are not. Especially when you're newly graduated. It takes a lot of years to get the knowledge down. And what bothers me is that NP school isn't revamping their education to meet those standards. They keep pushing the fact that we're practicing in the "nursing model" but it's furthest from the truth. Once you're an NP, you're practicing in the medical model. We learn from books published by MDs, we are lectured by MDs (most systems). So, how is that nursing anymore? We didn't become NPs to take the short cut. We want the education. I want to go through 4 years of NP school, take all the courses MDs take, go through 3 years of residency, then become a DNP if that's what we want to call ourselves. Why isn't that in place? Why can't we take the USMLEs after a revamped program. I can't stress this enough to all academia nurses. WE DON'T PRACTICE NURSING WHEN WE'RE NPs! We are given privileges to prescribe, to diagnose, to treat, etc. This is not nursing; nursing is implementation. In fact, the best physicians I have met were the ones who were nurses before. It's not a bad idea to be a nurse first, then MD/DO or DNP model as long as the education is there. I can gather a list of many NPs who feel this way. We need to change our education system to earn respect by fellow physicians and most importantly by ourselves (knowing we truly have the knowledge to care for patients independently). Sorry if I sound all over the place; I'm frustrated!
Click to expand...

The only people who practice medicine are physicians. You're definitEly not practicing medicine with a nurse practioner title.

You're title says it all "NURSE practioner". You may have better/longer training than a typical RN, but you're still practicing as a nurse. To try to justify it any other way is a blatant lie.
 
health123 said:
Promethean, I admire your story. I have been an Adult primary NP for many years and past few years Adult Critical Care NP and understand your desire for medical school. I have been around many NPs and many MDs/DOs. In our large hospital the lines are blurred between NP and MD and ultimately our goal is to treat and stabilize patients, whether it's done by the NP or the MD. I love what I do, and it's a long history how got here. But, as a side note, I am extremely frustrated with the nursing profession in general and understand your desire to continue onto MD. I am mostly upset at the "militant" (a term I've learned on this forum) academic NPs who keep pushing the idea that NPs are equal in knowledge etc. to MDs. I have to be honest, we are not. Especially when you're newly graduated. It takes a lot of years to get the knowledge down. And what bothers me is that NP school isn't revamping their education to meet those standards. They keep pushing the fact that we're practicing in the "nursing model" but it's furthest from the truth. Once you're an NP, you're practicing in the medical model. We learn from books published by MDs, we are lectured by MDs (most systems). So, how is that nursing anymore? We didn't become NPs to take the short cut. We want the education. I want to go through 4 years of NP school, take all the courses MDs take, go through 3 years of residency, then become a DNP if that's what we want to call ourselves. Why isn't that in place? Why can't we take the USMLEs after a revamped program. I can't stress this enough to all academia nurses. WE DON'T PRACTICE NURSING WHEN WE'RE NPs! We are given privileges to prescribe, to diagnose, to treat, etc. This is not nursing; nursing is implementation. In fact, the best physicians I have met were the ones who were nurses before. It's not a bad idea to be a nurse first, then MD/DO or DNP model as long as the education is there. I can gather a list of many NPs who feel this way. We need to change our education system to earn respect by fellow physicians and most importantly by ourselves (knowing we truly have the knowledge to care for patients independently). Sorry if I sound all over the place; I'm frustrated!
Click to expand...

Your post screams "I want to be a physician." If that's the case, why the fuukk didn't you go to medical school? I'll tell you why NP school pushes the "nursing model" rather than the "medical model"... Because it is an advanced nursing program, and that's what you signed up for. If you want to practice the "medical model" go to medical school. Last I checked, there are plenty of RNs with bachelors degrees going to medical school every year. DNP is a fukking shortcut to a limited practice of medicine. Plain and simple. It's a fine career, but accept it for what it is.

I wish folks who want to be doctors would just MAN THE FUUKK UP AND GO TO MED SCHOOL or quit bitchin. It's (almost) never too late.
 
anes said:
The only people who practice medicine are physicians. You're definitEly not practicing medicine with a nurse practioner title.

You're title says it all "NURSE practioner". You may have better/longer training than a typical RN, but you're still practicing as a nurse. To try to justify it any other way is a blatant lie.
Click to expand...
I think you are wrong, and health123 is right, and that's the reason we have the chaos in healthcare licensing in this country. The key word here is "independent" (practice).

Any independent unsupervised practitioner who is involved in prescribing treatments or performing certain advanced procedures should be regulated, at least for those activities, by the medical board. There should be no backdoor for it, as it is today, with independent APRNs regulated only by the nursing boards, despite clearly practicing medicine. What independent APRNs do is not nursing, period; even when supervised it's very debatable. And all the states which have laws about equal reimbursements for APRNs and doctors, when they bill for the same activities, agree with me.

It's like saying that a driver who did not learn driving in driving school does not need a driver's license.

I can't understand why American medical professional organizations don't fight the current licensing structure. It's absolutely preposterous for a nursing board to decide who and how gets to practice a form of medicine, just because the person went initially to nursing school.

I am not saying independent APRNs = MDs. Or that they should get a medical license. I am just saying they should be regulated (also) by the medical boards. For the general public, independent APRNs are as much their treating physicians as the MD around the corner. So why don't we regulate them, the same way we regulate resident physicians? Or PAs. Or AAs.
 
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FFP I completely agree. This is the point I am trying to make. I think physicians on this forum respond emotionally rather than looking around and recognizing what's happening in reality. If the medical board can't/won't regulate APRNs, then there should at least be a curriculum and testing (USMLE) set like medical school for ANY individual wanting to diagnose, treat a patient. period. whether pa, np, etc.
 
FFP said:
I think you are wrong, and health123 is right, and that's the reason we have the chaos in healthcare licensing in this country. The key word here is "independent" (practice).

Any independent unsupervised practitioner who is involved in prescribing treatments or performing certain advanced procedures should be regulated, at least for those activities, by the medical board. There should be no backdoor for it, as it is today, with independent APRNs regulated only by the nursing boards, despite clearly practicing medicine. What independent APRNs do is not nursing, period; even when supervised it's very debatable. And all the states which have laws about equal reimbursements for APRNs and doctors, when they bill for the same activities, agree with me.

It's like saying that a driver who did not learn driving in driving school does not need a driver's license.

I can't understand why American medical professional organizations don't fight the current licensing structure. It's absolutely preposterous for a nursing board to decide who and how gets to practice a form of medicine, just because the person went initially to nursing school.

I am not saying independent APRNs = MDs. Or that they should get a medical license. I am just saying they should be regulated (also) by the medical boards. For the general public, independent APRNs are as much their treating physicians as the MD around the corner. So why don't we regulate them, the same way we regulate resident physicians? Or PAs. Or AAs.
Click to expand...

Let's agree to disagree. You cannot convince me that a nurse who went to nursing school, takes nursing exams, and has the title nurse in their title, Isnt practicing nursing. Is an "independent" crna practicing medicine (even if they do the exact same case the exact same way as an md)? I think most people will agree that they're not practicing medicine. They're nurses who trained as nurses, went to nursing school, took nursing exams, went to NURSE anesthesia school, and took NURSE anesthesia exams.

You can set whatever curriculum you like. Go to nurse practioner school, even take USMLE steps 1 through 3. Unless you actually go to medical school and complete a physician residency, you are not a doctor.
 
anes said:
Let's agree to disagree. You cannot convince me that a nurse who went to nursing school, takes nursing exams, and has the title nurse in their title, Isnt practicing nursing. Is an "independent" crna practicing medicine (even if they do the exact same case the exact same way as an md)? I think most people will agree that they're not practicing medicine. They're nurses who trained as nurses, went to nursing school, took nursing exams, went to NURSE anesthesia school, and took NURSE anesthesia exams.

You can set whatever curriculum you like. Go to nurse practioner school, even take USMLE steps 1 through 3. Unless you actually go to medical school and complete a physician residency, you are not a doctor.
Click to expand...

I think that this is what is frustrating to so many NPs and the reason I have no interest in that route.

Being an NP has got to be confusing. You aren't really nursing anymore, but you aren't really being a physician. You are constrained by your training and background to pay lipservice to nursing, but what you are doing has nothing to do with what you learned in nursing school. Nursing is implementation, and implementation is important, but not valued. So there is a desire for a broadened scope in order to finally gain access to the withheld respect that was due all along.

The NP gets stuck in the middle.

Nursing wants to keep you, as a pin in its cap, because it isn't happy with what it is. Medicine wants no part of you and shuns you for not having gone through the proper channels. Everyone conspires to pretend that the work that NPs and other advanced practice nurses are doing has anything to do with nursing. It suits all the vested interests to deny that NPs are practicing medicine, but without the depth of theory and practical training to do it with the full competence of a physician. What a mess!

EDIT: Before anyone blasts me for describing what NPs do as medicine, recall that practicing medicine without a license is a thing. NPs are doing that, except that they do have a license. The degree of competence they bring has a lot to do with the individual and the training they did pursue, but in no case does it hold a candle to that of a fully trained physician. It is refreshing to hear an NP who is aware of this and intellectually honest enough to admit it aloud. For those docs who are concerned about the APRN lobbies that want to claim privileges they haven't earned, maybe make a few allies of those of them who didn't drink that koolaid.
 
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