Is PA worth it?

[emergentmd]

EM doctor here and worked with many PA/NP in the ER. I have a high achieving college student wanting my thoughts on PA school and I have always advised that this is a fantastic option but looking at the landscape, I don't feel this way anymore.

We started to use only PAs in the ER about 10 yrs ago and it was difficulty to find PAs who wanted to work in the ER for $60/hr with benefits which is about 125K/yr with benefits. This is a big city and everyone wants to live here so highly competitive.

Over the past 10 yrs, There seems to be a glutton of NPs graduating and has flooded the market with midlevels. So ERs where I work at have more NPs than PAs with a corresponding decrease in pay. Even in nondesireable places there are no shortage of APCs wanting to work in the ER.

It seems like every young ER nurse is working while doing online NP degrees which essentially are degree mill.

Now our ERs have a dominance of NPs just b/c the group has a working relationship with these nurses and they already know the system. Its a no brainer hiring within.


This trend will continue to Push PAs out of the ER and I suspect most other settings as both fields are interchangeable in the mind of physicians.

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[pamac]

It seems like every young ER nurse is working while doing online NP degrees which essentially are degree mill.

Now our ERs have a dominance of NPs just b/c the group has a working relationship with these nurses and they already know the system. Its a no brainer hiring within.

This trend will continue to Push PAs out of the ER and I suspect most other settings as both fields are interchangeable in the mind of physicians.

My first response is “so what?”.

You don’t mention if quality is an issue with the NPs. It’s probably not, so who cares? Apparently you guys even balked at offering $125k back in the day. There’s nothing keeping you folks from STILL offering that much and STILL insisting on PAs, but I guess that would eat in to your bottom line, which is likely 2-3x that much. You could stick to your PA “only” standards and keep finding PA new grads with no healthcare experience to come in, instead of RNs who are now NPs, and have more familiarity with the ED processes, flow, and atmosphere. But apparently you absolutely MUST save money along with the rest of the world, and lower your pay because the market is flush with cheap meat. Well, take a vacation with the money you guys save, and drown your tears in Hawaii.

You don’t even know whether those new nurses are going to degree mills, or not, or even what that would mean? Do you mean something like Ross, or foreign med schools? Why should nurses stay home and not have a way to advance their careers, make some more money for their families, and make it so physicians have to hunt farther and farther from their own homes to pick up contract work where they fly across the country all the time? It seems like plenty of places are now also deciding they can do with less physicians as well. So what? I want to make some more money in my life than what a floor nurse makes. You lament this. You feel like I should worry about your cares, which seem superfluous compared to what I’m doing as an NP. Come put food in my kids mouth, and pay for some of our Disney vacations that we want to take before you lament us wanting to have a bit of the good life too.

 

[emergentmd]

Whooooaaa... I didn't intend to touch a nerve. Corporate CMGs own the staffing, and they pick the rate. We give recs on who we want and it tends to be the nurses we work with.

I have no clue why you are so bitter, but someone needs to some time off the computer.

 

[pamac]

Naw, someone is part of the insufferable crowd who doesn’t want anyone else to challenge your paradigm. You wanted to stir it up, which is why you took your keyboard over here to criticize NPs. If you did touch any nerve, it would be a nerve you set out to touch, so why are you defensive now that I step up to respond? You just came over to speak low of NPs for a constructive dialogue? Who needs more time away from the computer... me, or the guy who came to troll? “Didn’t intend to touch a nerve”! LOL! Ok bra....

So here’s what your friend can do if the market for PAs is tanking.... he can become an NP, or maybe he can go to medical school to be an EM doc, and maybe by that time admin will get around to cutting back on physicians too, so then he can hop contract flights to Nebraska and leave his family to work for a week at a time for another penny pinching admin who is doing things on the cheap as well.

What is your question, point, or solution that you came here to put in front of us... just to not touch nerves and impart your important thoughts that “NPs are bad”?

Thank you, doctor. Your opinion is so important here. What else do we need to know from you?

 

[Makati2008]

Let’s stay on topic guys. I don’t see anything malignant in emergentmd post and as someone who worked for a CMG in the past he is just stating how it is now. Physicians have little control in this situation.

 

[762513]

EM doctor here and worked with many PA/NP in the ER. I have a high achieving college student wanting my thoughts on PA school and I have always advised that this is a fantastic option but looking at the landscape, I don't feel this way anymore.

We started to use only PAs in the ER about 10 yrs ago and it was difficulty to find PAs who wanted to work in the ER for $60/hr with benefits which is about 125K/yr with benefits. This is a big city and everyone wants to live here so highly competitive.

Over the past 10 yrs, There seems to be a glutton of NPs graduating and has flooded the market with midlevels. So ERs where I work at have more NPs than PAs with a corresponding decrease in pay. Even in nondesireable places there are no shortage of APCs wanting to work in the ER.

It seems like every young ER nurse is working while doing online NP degrees which essentially are degree mill.

Now our ERs have a dominance of NPs just b/c the group has a working relationship with these nurses and they already know the system. Its a no brainer hiring within.


This trend will continue to Push PAs out of the ER and I suspect most other settings as both fields are interchangeable in the mind of physicians.

Why don’t you suggest the nursing route for your college student? There’s a lot to be said for the versatility the RN offers. Your question looks a whole lot like a statement, however, if you are asking one I’ll reply.

A high achieving student can go to a top ranked NP program, maybe specialize in mental health or work for an ortho group or even become a CRNA and make a very respectable income.

I think the point you ran afoul of PAMAC was by implying that most NP’s went to a online degree mill. There’s been a lot of trolling of NP’s in this forum lately, and we may be a little easily triggered. This is something we hear often here; every NP went to an awful school. It’s not true, and it’s frustrating to hear all the time.

 

[KeikoTanaka]

Why don’t you suggest the nursing route for your college student? There’s a lot to be said for the versatility the RN offers. Your question looks a whole lot like a statement, however, if you are asking one I’ll reply.

A high achieving student can go to a top ranked NP program, maybe specialize in mental health or work for an ortho group or even become a CRNA and make a very respectable income.

I think the point you ran afoul of PAMAC was by implying that most NP’s went to a online degree mill. There’s been a lot of trolling of NP’s in this forum lately, and we may be a little easily triggered. This is something we hear often here; every NP went to an awful school. It’s not true, and it’s frustrating to hear all the time.

Do NPs have as much freedom in changing specialty, and jobs, if they so desire? I know NPs can do fellowships and what not, is there a point in which your skills would be less transferable? I take his question to be along the lines of like should he be recommending NP vs PA? And maybe he's trying to challenge his own bias and get his opinions from others. I know a FNP who has been one for quite some time, so would it be much harder for her to jump ship and go work for an ED, or Urologist? I know a PA who has done that, but I'm not sure if NP is more "specialized" in certain fields than PAs

 

[762513]

Do NPs have as much freedom in changing specialty, and jobs, if they so desire? I know NPs can do fellowships and what not, is there a point in which your skills would be less transferable? I take his question to be along the lines of like should he be recommending NP vs PA? And maybe he's trying to challenge his own bias and get his opinions from others. I know a FNP who has been one for quite some time, so would it be much harder for her to jump ship and go work for an ED, or Urologist? I know a PA who has done that, but I'm not sure if NP is more "specialized" in certain fields than PAs

FNP is the most versatile; in fact most ED’s prefer FNP’s over Acute Care NP’s because of the ability to treat children. You can specialize as an NP, or you can pick a broad NP cert, and have tons of options to change specializations.

 

[Cheeni17]

My first response is “so what?”.

You don’t mention if quality is an issue with the NPs. It’s probably not, so who cares? Apparently you guys even balked at offering $125k back in the day. There’s nothing keeping you folks from STILL offering that much and STILL insisting on PAs, but I guess that would eat in to your bottom line, which is likely 2-3x that much. You could stick to your PA “only” standards and keep finding PA new grads with no healthcare experience to come in, instead of RNs who are now NPs, and have more familiarity with the ED processes, flow, and atmosphere. But apparently you absolutely MUST save money along with the rest of the world, and lower your pay because the market is flush with cheap meat. Well, take a vacation with the money you guys save, and drown your tears in Hawaii.

You don’t even know whether those new nurses are going to degree mills, or not, or even what that would mean? Do you mean something like Ross, or foreign med schools? Why should nurses stay home and not have a way to advance their careers, make some more money for their families, and make it so physicians have to hunt farther and farther from their own homes to pick up contract work where they fly across the country all the time? It seems like plenty of places are now also deciding they can do with less physicians as well. So what? I want to make some more money in my life than what a floor nurse makes. You lament this. You feel like I should worry about your cares, which seem superfluous compared to what I’m doing as an NP. Come put food in my kids mouth, and pay for some of our Disney vacations that we want to take before you lament us wanting to have a bit of the good life too.

Naw, someone is part of the insufferable crowd who doesn’t want anyone else to challenge your paradigm. You wanted to stir it up, which is why you took your keyboard over here to criticize NPs. If you did touch any nerve, it would be a nerve you set out to touch, so why are you defensive now that I step up to respond? You just came over to speak low of NPs for a constructive dialogue? Who needs more time away from the computer... me, or the guy who came to troll? “Didn’t intend to touch a nerve”! LOL! Ok bra....

So here’s what your friend can do if the market for PAs is tanking.... he can become an NP, or maybe he can go to medical school to be an EM doc, and maybe by that time admin will get around to cutting back on physicians too, so then he can hop contract flights to Nebraska and leave his family to work for a week at a time for another penny pinching admin who is doing things on the cheap as well.

What is your question, point, or solution that you came here to put in front of us... just to not touch nerves and impart your important thoughts that “NPs are bad”?

Thank you, doctor. Your opinion is so important here. What else do we need to know from you?

He asked a question and you got triggered not much more to it. Sorry if you feel your education was inferior

 

[Cheeni17]

Why don’t you suggest the nursing route for your college student? There’s a lot to be said for the versatility the RN offers. Your question looks a whole lot like a statement, however, if you are asking one I’ll reply.

A high achieving student can go to a top ranked NP program, maybe specialize in mental health or work for an ortho group or even become a CRNA and make a very respectable income.

I think the point you ran afoul of PAMAC was by implying that most NP’s went to a online degree mill. There’s been a lot of trolling of NP’s in this forum lately, and we may be a little easily triggered. This is something we hear often here; every NP went to an awful school. It’s not true, and it’s frustrating to hear all the time.

The ones at his institution might have gone to degree mills hence why they are working in ER full time still. It’s not really a hard to get degree if you can work full time and still get enough “clinical hours”

 

[Cheeni17]

Naw, someone is part of the insufferable crowd who doesn’t want anyone else to challenge your paradigm. You wanted to stir it up, which is why you took your keyboard over here to criticize NPs. If you did touch any nerve, it would be a nerve you set out to touch, so why are you defensive now that I step up to respond? You just came over to speak low of NPs for a constructive dialogue? Who needs more time away from the computer... me, or the guy who came to troll? “Didn’t intend to touch a nerve”! LOL! Ok bra....

So here’s what your friend can do if the market for PAs is tanking.... he can become an NP, or maybe he can go to medical school to be an EM doc, and maybe by that time admin will get around to cutting back on physicians too, so then he can hop contract flights to Nebraska and leave his family to work for a week at a time for another penny pinching admin who is doing things on the cheap as well.

What is your question, point, or solution that you came here to put in front of us... just to not touch nerves and impart your important thoughts that “NPs are bad”?

Thank you, doctor. Your opinion is so important here. What else do we need to know from you?

I’d they are a high achieving college student they can do better than going to the prack assembly line

 

[Cheeni17]

Why don’t you suggest the nursing route for your college student? There’s a lot to be said for the versatility the RN offers. Your question looks a whole lot like a statement, however, if you are asking one I’ll reply.

A high achieving student can go to a top ranked NP program, maybe specialize in mental health or work for an ortho group or even become a CRNA and make a very respectable income.

I think the point you ran afoul of PAMAC was by implying that most NP’s went to a online degree mill. There’s been a lot of trolling of NP’s in this forum lately, and we may be a little easily triggered. This is something we hear often here; every NP went to an awful school. It’s not true, and it’s frustrating to hear all the time.

Don’t doubt there’s some good ones out there but you know there’s a lot of bad prax out there from like Walden and stuff

 

[Cryc_to_the_point]

Man, these inferiority complexes are getting feisty.

 

[Cheeni17]

Man, these inferiority complexes are getting feisty.

Yeah the hospital I’m in residency at only hires from good prac schools and most of them are bad enough

 

[Cryc_to_the_point]

I'd just say play it safe, go with PAs. Known clinical and basic science education vs. NPs which are vastly more variable.

 

[Cheeni17]

I guess for the original poster they should go to computer science stuff. It’s what I would do if I could go back. Yeah grass ain’t greener and pay is less but computers are cool and I like to mess with them anyway. Of course everything gets less fun once it’s a JERB

 

[762513]

I’d they are a high achieving college student they can do better than going to the prack assembly line

What’s a prack? Did you just invent that?

 

[Cheeni17]

What’s a prack? Did you just invent that?

No I’m not that creative. Slang for practitioner

 

[762513]

No I’m not that creative. Slang for practitioner

Hmmm never heard of that, and I am a “prack.” Interesting.

 

[Cheeni17]

Well I mean doc for doctor and prack for practitioner it’s not really a bad thing amirite?

we can call doctors fiz

 

[762513]

Well I mean doc for doctor and prack for practitioner it’s not really a bad thing amirite?

we can call doctors fiz

It’s not offensive or anything just sounds kinda made up.

 

[Cheeni17]

It’s not offensive or anything just sounds kinda made up.

organically curated sir

 

[Boatswain2PA]

EM doctor here and worked with many PA/NP in the ER. I have a high achieving college student wanting my thoughts on PA school and I have always advised that this is a fantastic option but looking at the landscape, I don't feel this way anymore.

We started to use only PAs in the ER about 10 yrs ago and it was difficulty to find PAs who wanted to work in the ER for $60/hr with benefits which is about 125K/yr with benefits. This is a big city and everyone wants to live here so highly competitive.

Over the past 10 yrs, There seems to be a glutton of NPs graduating and has flooded the market with midlevels. So ERs where I work at have more NPs than PAs with a corresponding decrease in pay. Even in nondesireable places there are no shortage of APCs wanting to work in the ER.

It seems like every young ER nurse is working while doing online NP degrees which essentially are degree mill.

Now our ERs have a dominance of NPs just b/c the group has a working relationship with these nurses and they already know the system. Its a no brainer hiring within.


This trend will continue to Push PAs out of the ER and I suspect most other settings as both fields are interchangeable in the mind of physicians.

I would not recommend a young brilliant person to become a PA unless they are unable to get into medical school for all the reasons you stare, and many many more.

Not only are there too many NP diploma mills, there is a rapid growth in PA programs as well.

 

[KeikoTanaka]

I would not recommend a young brilliant person to become a PA unless they are unable to get into medical school for all the reasons you stare, and many many more.

Not only are there too many NP diploma mills, there is a rapid growth in PA programs as well.

Just out of curiosity, how has all this affected the nursing shortage? Are midlevels becoming saturated?

 

[Stagg737]

Do NPs have as much freedom in changing specialty, and jobs, if they so desire? I know NPs can do fellowships and what not, is there a point in which your skills would be less transferable? I take his question to be along the lines of like should he be recommending NP vs PA? And maybe he's trying to challenge his own bias and get his opinions from others. I know a FNP who has been one for quite some time, so would it be much harder for her to jump ship and go work for an ED, or Urologist? I know a PA who has done that, but I'm not sure if NP is more "specialized" in certain fields than PAs

Generally NPs can switch fields at any time with minimal to no extra training. I've worked with several who have done it and I previously worked with an FNP who worked in a FM clinic for 6 months, switched to EM because FM lifestyle was "too hard" (lol), switched to peds from EM because she was tired of physicians changing her treatment plan (wonder why), and then was fired from that peds office. Looked her up a few weeks after she was fired and apparently she was working in a derm office.

 

[pamac]

FNPs have the easiest time making those kinds of moves. I’ve noticed it tightening up in certain cases, like having inpatient NPs being recruited from adult gerontology acute care grads instead of FNPs, but that’s not a given.

 

[Boatswain2PA]

Just out of curiosity, how has all this affected the nursing shortage? Are midlevels becoming saturated?

I think in some places, and some specialties, we are. This leads to very wide pay differences. I know some MLPs who make less than $80k/yr doing FP or hospitalist, while others make $200k/yr at busy single coverage EDs.

 

[pamac]

I think in some places, and some specialties, we are. This leads to very wide pay differences. I know some MLPs who make less than $80k/yr doing FP or hospitalist, while others make $200k/yr at busy single coverage EDs.

That’s becoming more consistent for sure. And you very rarely seeing something along the lines of $200k for FP, and $80k for ER coverage. Things are becoming more consistently set.

 

[Ho0v-man]

I would not recommend a young brilliant person to become a PA unless they are unable to get into medical school for all the reasons you stare, and many many more.

Not only are there too many NP diploma mills, there is a rapid growth in PA programs as well.

This post pretty much sums it up.

I almost went PA, but with the insane NP expansion, I’m so glad I didn’t. Admins/some docs don’t care about quality so it doesn’t matter that PAs are significantly better than NPs. Just whoever will do the job the cheapest.

Just a personal hunch, but with “prack” advocacy groups like AANA being outright anti-physician, future physicians currently in training may not want to bother with “pracks” as a whole. Which sucks for the really great ones out there.

 

[pamac]

This post pretty much sums it up.

I almost went PA, but with the insane NP expansion, I’m so glad I didn’t. Admins/some docs don’t care about quality so it doesn’t matter that PAs are significantly better than NPs. Just whoever will do the job the cheapest.

Just a personal hunch, but with “prack” advocacy groups like AANA being outright anti-physician, future physicians currently in training may not want to bother with “pracks” as a whole. Which sucks for the really great ones out there.

Physicians are currently being turned from being partners to being employees due to industry consolidation of practices. Add that to the success of NP (and potentially PA) independence relieving them of the duty and burdens of supervision, and they won’t have to worry about the being “bothered” part. Are you going to go hang out your own shingle upon graduation, or are you going to go join a practice?

 

[Ho0v-man]

Physicians are currently being turned from being partners to being employees due to industry consolidation of practices. Add that to the success of NP (and potentially PA) independence relieving them of the duty and burdens of supervision, and they won’t have to worry about the being “bothered” part. Are you going to go hang out your own shingle upon graduation, or are you going to go join a practice?

Oh gosh I’m still a student and thus still have several years more training. Too far out to consider either. One of the few things I know about that is that I won’t accept the modest pay increase to be a liability sponge for PAs/NPs. I’m happy you’re so confident that it won’t be an issue for me.

You’re certainly welcome to practice independently if you want. I wish you and your patients the best.

 

[pamac]

Oh gosh I’m still a student and thus still have several years more training. Too far out to consider either. One of the few things I know about that is that I won’t accept the modest pay increase to be a liability sponge for PAs/NPs. I’m happy you’re so confident that it won’t be an issue for me.

You’re certainly welcome to practice independently if you want. I wish you and your patients the best.

It may not be a matter of you having the choice not to supervise. Your potential employer might want the added revenue non physician providers bring in, and could potentially need you to supervise if you want to work there.

Or, you may decide to start your own practice, and see the value of having NPs or PAs to extend your reach to more patients and more revenue. But if you do, it’s my hope that in all 50 states, you have to deal with an independent provider, and negotiate on a level as you would with another provider... not necessarily with parity of salary, but with the knowledge that the Pa or Np doesn’t depend entirely on you for their livelihood.

Independence isn’t about going out and opening your own practice. Incidentally, around 5% of PAs open their own practice, which matches the rate of NPs doing that as well, and PAs aren’t independent anywhere. What that means is that being independent doesn’t mean people rush out to work for themselves. They typically go out to find a place to work for. Even the folks that do open their own practices tend to be providers that are experienced enough to feel up to the significant challenge.

You are a student, and when you chime in about your concerns regarding NPs, you really are giving in to the hype that you know nothing about. It may feel good to try to add to the vernacular regarding “pracs” or whatever, but you can’t even get that right.... nobody calls us that. Maybe ignoramuses do, but whatever.

For me, being independent is less about running my own business as much as it is about NPs and PAs having control over their profession, and the flow of dollars. When reimbursement rates are 85% of what physician rates are, but we aren’t paid 85% of what physicians make, that begs the question of where that money is going and why. Being independent brings all sorts of voice to the conversation. As the physician employment paradigm changes to them being employees, the antiquated structure of “midlevels” being attached to them like squires to knights seems outdated as well. With the reigns off, we can act as independent employees as well, and be judged on the merits of our work. If a practice wants to employ a bunch of NPs, they should be able to without a bunch of red tape. If the NPs in the area are green, a practice should be able to choose to hire a doc to supervise. They can mandate that it be done that way. The hospital I was an RN at had that kind of requirement where the NPs had a lot of oversight even though they were independent. That’s probably good because most of them were very new, and frankly, it showed. (I’m certainly not a fan of many of the NPs I’ve worked with... many have sucked). But overall, it’s just the matter of everyone not having to exist under the umbrella of being caught up in the conflict of interest of having your ability to practice be predicated upon physicians standing over you by statute. It keeps people from being taken advantage of.

I’m not a fanboy of NPs like many of you may assume. I’ve been treated poorly by zero doctors in my professional life. That may seem like a stretch, but I presented myself well in my work as a nurse. I didn’t waste their time, I was professional and direct, and I exuded an appropriate level of confidence, and they knew I cared about patients. And I also have to assume these folks are overall very decent. On the opposite end of the spectrum, I’ve had most the NPs I actually dealt with professionally as an RN were condescending, petty, overconfident based on their abilities, defensive, entitled, and lacked appropriate self awareness. I’ve seen them make significant mistakes, and even had one try to blame me for something that was that NPs fault. Several of them were terrible RNs, but thought the NP gave them powers that they didn’t possess as RNs, and then they proceeded to try to make judgements upon my RN work. But fortunately, most of my NP colleagues are on the opposite end of the spectrum. So I get it. There are plenty of oddballs in the Np realm. We see it too. That still doesn’t turn me off to the notion that NPs and PAs need to be their own career, not a helper class for the physicians.

 

[Ho0v-man]

It may not be a matter of you having the choice not to supervise. Your potential employer might want the added revenue non physician providers bring in, and could potentially need you to supervise if you want to work there.

Or, you may decide to start your own practice, and see the value of having NPs or PAs to extend your reach to more patients and more revenue. But if you do, it’s my hope that in all 50 states, you have to deal with an independent provider, and negotiate on a level as you would with another provider... not necessarily with parity of salary, but with the knowledge that the Pa or Np doesn’t depend entirely on you for their livelihood.

Independence isn’t about going out and opening your own practice. Incidentally, around 5% of PAs open their own practice, which matches the rate of NPs doing that as well, and PAs aren’t independent anywhere. What that means is that being independent doesn’t mean people rush out to work for themselves. They typically go out to find a place to work for. Even the folks that do open their own practices tend to be providers that are experienced enough to feel up to the significant challenge.

You are a student, and when you chime in about your concerns regarding NPs, you really are giving in to the hype that you know nothing about. It may feel good to try to add to the vernacular regarding “pracs” or whatever, but you can’t even get that right.... nobody calls us that. Maybe ignoramuses do, but whatever.

For me, being independent is less about running my own business as much as it is about NPs and PAs having control over their profession, and the flow of dollars. When reimbursement rates are 85% of what physician rates are, but we aren’t paid 85% of what physicians make, that begs the question of where that money is going and why. Being independent brings all sorts of voice to the conversation. As the physician employment paradigm changes to them being employees, the antiquated structure of “midlevels” being attached to them like squires to knights seems outdated as well. With the reigns off, we can act as independent employees as well, and be judged on the merits of our work. If a practice wants to employ a bunch of NPs, they should be able to without a bunch of red tape. If the NPs in the area are green, a practice should be able to choose to hire a doc to supervise. They can mandate that it be done that way. The hospital I was an RN at had that kind of requirement where the NPs had a lot of oversight even though they were independent. That’s probably good because most of them were very new, and frankly, it showed. (I’m certainly not a fan of many of the NPs I’ve worked with... many have sucked). But overall, it’s just the matter of everyone not having to exist under the umbrella of being caught up in the conflict of interest of having your ability to practice be predicated upon physicians standing over you by statute. It keeps people from being taken advantage of.

I’m not a fanboy of NPs like many of you may assume. I’ve been treated poorly by zero doctors in my professional life. That may seem like a stretch, but I presented myself well in my work as a nurse. I didn’t waste their time, I was professional and direct, and I exuded an appropriate level of confidence, and they knew I cared about patients. And I also have to assume these folks are overall very decent. On the opposite end of the spectrum, I’ve had most the NPs I actually dealt with professionally as an RN were condescending, petty, overconfident based on their abilities, defensive, entitled, and lacked appropriate self awareness. I’ve seen them make significant mistakes, and even had one try to blame me for something that was that NPs fault. Several of them were terrible RNs, but thought the NP gave them powers that they didn’t possess as RNs, and then they proceeded to try to make judgements upon my RN work. But fortunately, most of my NP colleagues are on the opposite end of the spectrum. So I get it. There are plenty of oddballs in the Np realm. We see it too. That still doesn’t turn me off to the notion that NPs and PAs need to be their own career, not a helper class for the physicians.

I’ve had extensive interactions with “pracks” ( I only discovered this term in this thread and thought it was funny). I’ve had some RN friends who transitioned to NP as well. I’ve even taken a few NP tests for one of them. The coursework is very easy and I’m not sure how any of it makes an RN qualified to expand their scope. I’m not really jumping on a bandwagon with my stances on them. My personal experiences with their clinical performance and lackluster education has colored my opinions. Honestly, regular RN coursework seemed much harder than anything I’ve seen from an NP school.

I hope your predictions about supervision work out. I don’t care to be on the hook for anyone’s mistakes, and I’m sure you don’t either. I also don’t care to be bothered by questions by “providers” who did not go to medical school. If you’re good enough to be independent then you shouldn’t need my help (assuming we’re in the same specialty). I hope for the sake of your future patients that you are. Feel free to have control over your profession. I just want left out of it.

I guess no one knows the future. But regarding my future choices in types of practice, I remain confident I’ll have options. There are still plenty of jobs for physician only practice in anesthesia, the field most inundated by mid levels, as long as ones geographically flexible. It’s only better in other fields. So I’m not too worried.

We’ve really gone off topic here. If you’d like to discuss this further in private message, I’d be fine with it. But I’d rather not derail the thread any further. If you choose to continue in this thread on the matter, I will not respond. Good luck in you future endeavors.

 

[pamac]

So you say you helped an NP student cheat on a test? Classy! Lol!

And why would I want to discuss anything with you over PM? It’s not even worth conversing with you across a thread.

 

[pamac]

I’ve had some RN friends who transitioned to NP as well. I’ve even taken a few NP tests for one of them. The coursework is very easy and I’m not sure how any of it makes an RN qualified to expand their scope. I’m not really jumping on a bandwagon with my stances on them. My personal experiences with their clinical performance and lackluster education has colored my opinions. Honestly, regular RN coursework seemed much harder than anything I’ve seen from an NP school.

Here’s a suggestion for you... if you are concerned about the quality of NP education, DON’T TAKE NURSES TESTS FOR THEM! LOL! For the sake of everyone’s patients, I hope you quit doing this. It certainly isn’t good for business!

Any more thinly condescension aimed my way? What else are you concerned with regarding my patients? I can tell you I’m highly concerned about you enabling cheating! How often do you help NPs cheat on tests?!

 

[Splenda88]

So you say you helped an NP student cheat on a test? Classy! Lol!

And why would I want to discuss anything with you over PM? It’s not even worth conversing with you across a thread.

If you spend time in the hospital as med student or a physician, chances are that you have helped one the RN-NP student that you work with these online exams. I also tutor them from time to time.

 

[pamac]

Suuuurrrre............I've been in health care for over a decade. I've never seen that, nor done that myself. Most of the time folks are too busy to hammer out online tests at work, with the risk of something disrupting you in the middle of it (like a code, or like your manager coming in and telling you to come back to the floor for something). I honestly didn't have any tests that were expendable enough for me to risk doing that with. Besides, the correct course of action isn't for a physician or student to take someone's test for them, especially if you guys are so concerned about the state of NP education. For real, its just not very convenient for an NP student to do a test that way. I know maybe it fits in well with the narrative being pushed for you to say that you guys take tests for NP's and they are so easy, but most folks like to take their tests in the comfort of their own home. Besides, Hoov-man is just a med student. The med students I knew of at work were busy with their own work as well, not chilling out with the nurses, taking their tests.

At this point its fun to see people making things up as they go.

 

[Ho0v-man]

So you say you helped an NP student cheat on a test? Classy! Lol!

And why would I want to discuss anything with you over PM? It’s not even worth conversing with you across a thread.

Well I suppose I have to go against what I said about not replying as I realize I’m in a spot where I could be construed as academic dishonesty which is not something I would ever condone. The tests I took, several years ago for a friend, were all open-note, open-book, open-internet search, untimed and unproctored. There was nothing in syllabus that even discouraged collaboration with others. Even her midterms and finals were like that (didn’t take those bc they were lengthy).

For clarity’s sake, I took them as a premed. No medical knowledge was required to excel on these tests.

I’m not sure why you’ve latched on to me like this. My initial post was merely agreeing with something a PA said to a physician about potential job prospects of future PAs.

Not too sure what’s got you upset as you’re initial post was about how my job prospects as a physician and I guess trying to tell me you’re all here to stay or something. Your motive was never really made clear. You then proceeded to insult my familiarity with the subject. When I showed more knowledge on the subject you laser focused on one part of it.

Edit: so do you have a point or are you just trying (emphasis on this word) to one up some random med student on the internet on any topic hopefully, eventually? I apologize if my condescension came off veiled in previous posts. I’ll attempt to make it less subtle for you in the future.

 

[pamac]

Well I suppose I have to go against what I said about not replying as I realize I’m in a spot where I could be construed as academic dishonesty which is not something I would ever condone. The tests I took, several years ago for a friend, were all open-note, open-book, open-internet search, untimed and unproctored. There was nothing in syllabus that even discouraged collaboration with others. Even her midterms and finals were like that (didn’t take those bc they were lengthy).

For clarity’s sake, I took them as a premed. No medical knowledge was required to excel on these tests.

So where are you misconstruing that you were acting in an academically honest way when you stated that you "took" the tests for someone else. I didn't read that in your description of the methods of reference that were allowed by the professor.

There's so much that doesn't add up anymore. Is this what you want to keep doing?

I guess if I have a point at this phase of the conversation, its simply to highlight how full of it you are, what with the stories changing, and the clarification, etc. You're a stranger across the internet, and yet this conversation is a big thing for you. You came here to drop what you thought were truth bombs with your own version of "truth" that actually seems plausible, but you couldn't even present it in a way that reflects it to be your own lived experience.

But if nothing else, if what you said was authentic, it would suggest that back when you were an undergrad, you took what you said were tests for an NP student (which probably could have been what sounds like assignments) that seemed easy to you (which could have just been on an easy topic module), and from that supposed event, you've then extrapolated that all NP tests are like those. Wow. The ultimate n=1.

Carry on. Are there more clarification bombs to drop?

 

[Boatswain2PA]

The tests I took, several years ago for a friend, were all open-note, open-book, open-internet search, untimed and unproctored. There was nothing in syllabus that even discouraged collaboration with others. Even her midterms and finals were like that (didn’t take those bc they were lengthy).

For clarity’s sake, I took them as a premed. No medical knowledge was required to excel on these tests.

From what I have seen, this is not uncommon in many NP programs.

NP education is generally poor. Good NPs become good by overcoming this.

 

[Ho0v-man]

So where are you misconstruing that you were acting in an academically honest way when you stated that you "took" the tests for someone else. I didn't read that in your description of the methods of reference that were allowed by the professor.

There's so much that doesn't add up anymore. Is this what you want to keep doing?

I guess if I have a point at this phase of the conversation, its simply to highlight how full of it you are, what with the stories changing, and the clarification, etc. You're a stranger across the internet, and yet this conversation is a big thing for you. You came here to drop what you thought were truth bombs with your own version of "truth" that actually seems plausible, but you couldn't even present it in a way that reflects it to be your own lived experience.

But if nothing else, if what you said was authentic, it would suggest that back when you were an undergrad, you took what you said were tests for an NP student (which probably could have been what sounds like assignments) that seemed easy to you (which could have just been on an easy topic module), and from that supposed event, you've then extrapolated that all NP tests are like those. Wow. The ultimate n=1.

Carry on. Are there more clarification bombs to drop?

No. These were true tests. And anyone with an internet connection could pass them. It was not against any rules. Perhaps your school was more rigorous. I only have experience with 2 of them.

I posted in this thread to agree with another poster that the NP degree has vastly over saturated the midlevel market. You’re the one who’s tried to drop knowledge on me ever since.

 

[pamac]

No. These were true tests. And anyone with an internet connection could pass them. It was not against any rules. Perhaps your school was more rigorous. I only have experience with 2 of them.

So the professor was like "yeah, and you can also have someone else take your test too".... LOL

 

[Ho0v-man]

So the professor was like "yeah, and you can also have someone else take your test too".... LOL

You got offended at my initial post and told me that since I’m a student, that I must be spouting an uninformed opinion.

I clarified that I have extensive experience working with NPs and have had first hand experience with the rigor (or lack thereof) with NP education.

You’ve since questioned my ethics, and I further clarified the situation.

Your argument since has been to call me a liar.

So this conversation has really devolved. You’ve really just been bouncing around to whatever topic you can think of to try to put me, an anonymous med student on the internet, down because I guess I insulted your fragile ego. You haven’t really added anything, you’ve just been trying to “win” the argument despite not really ever having a focus of your argument to begin with. Your only real goal here is to try to claim superiority to me bc what I commented to another poster hurt your feelings. This was not my intent. I apologize for that.

Thank you for reminding me why I’ll be happily be taking a pay cut to never supervise/collaborate with NPs. Feel free to quote this and take the last word if it makes you feel better. Have a great day.

 

[pamac]

You are projecting quite a bit regarding egos, feeling insulted, who is taking offense at things, who is trying to prove what, superiority, experience, competence, winning, losing, etc. Then you try to take the high ground.... then you try to be the victim.....then you try to claim being misunderstood....then you apologize facetiously.....then take it back....then you walk away....then you come back to argue....then you walk away again... then back claiming superiority.... then claiming expertise... then concern trolling.... then claim you cheated for someone.....then not really cheated, but helped them because the professor would have been ok with that... then claim an attack on your honor...

I also appreciate the projection you demonstrate by granting permission for me to do things I haven’t asked permission for.

This could be exhausting if it wasn’t such a useful exposition of lack of self awareness. It’s just the internet, but you clearly care a lot. That’s why this keeps going. That’s why you clarify so... many.... times.....

Also, why would one interaction with a stranger on a message board be the catalyst for you to resolve to never.... supervise....or collaborate.... with NPs..... (dun dun dun!). That’s either a childish attempt to score a point by smacking at me (as if I ruined it for any awesome potential Hoov-man/NP collaboration by my attitude), or it represents you being too short sighted to take a situation on a case by case basis. Either way, it looks silly. Here I am, one NP, and supposedly I ruined NPs for you? Now you are resolute in your decision. Nope... it’s just another way for you to condescend. Here’s some condescension back, maybe you’ll recognize it: I think I’ll be wary of partnering with physicians like yourself when you try to employ me and use my effort to make you money that you haven’t earned.

 

[Boatswain2PA]

That's what you read. I read that he understands the severe limits of NP education, and despite this the push for independence that comes from the NPs.

 

[pamac]

That's what you read. I read that he understands the severe limits of NP education, and despite this the push for independence that comes from the NPs.

That’s because you love reading something that fits into your worldview. What you said demonstrates you’ll look past a lot of absurdity if it does that one thing for you. You aren’t that complex on the subject.

 

[Boatswain2PA]

You are welcome to your opinion, right or wrong. Meanwhile, despite your deflections here, many (most?) In healthcare understand that 2 years of part-time online classes followed by 500 hours of poorly organized clinical rotations is insufficient medical training.

Yes, some programs are better than this, but this is the minimum standard....as described by Hoov.

 

[pamac]

Back to your broken record approach and insisting that only “some” programs are better, and now 500 hours is the new standard instead of 600 hours. Every time you come in hard by broadly casting the minimums as the typical, and you haven’t done it yet today, but where are you with your every/most-NP-is-a-brand-new-RN assertion? Time to pull that one out again.

It’s disingenuous every time you suggest (or yell) that the minimum is the standard for most. So keep yelling it. You are fine with the idea of always being a dependent provider, which is why your peers in the PA world aren’t onboard when you insist they shouldn’t be independent either. Probably suits you well.

Again, you’ll cozy up to the hot mess approach that Hoov-man took just because it matched your world view.

I guess just take it up with the powers that be. NPs are moving ahead despite the detractors. PAs seem energized to do it as well.

 

[MidwestPAC]

Back to your broken record approach and insisting that only “some” programs are better, and now 500 hours is the new standard instead of 600 hours. Every time you come in hard by broadly casting the minimums as the typical, and you haven’t done it yet today, but where are you with your every/most-NP-is-a-brand-new-RN assertion? Time to pull that one out again.

It’s disingenuous every time you suggest (or yell) that the minimum is the standard for most. So keep yelling it. You are fine with the idea of always being a dependent provider, which is why your peers in the PA world aren’t onboard when you insist they shouldn’t be independent either. Probably suits you well.

Again, you’ll cozy up to the hot mess approach that Hoov-man took just because it matched your world view.

I guess just take it up with the powers that be. NPs are moving ahead despite the detractors. PAs seem energized to do it as well.

The standard for a profession is always set on the lowest common denominator. For NPs that is the standard that A LOT of the school require < 700- 800 clinical hours. Same for the MD/DO, they have to go to school for at least 130 weeks. For PAs we have to go to school for 100 or more weeks and do at least 2,500 clinical hours. Do you NOT see the trend here. The standard is always set for the MOST COMMON.

P.S. are you seriously arguing over a 100 clinical hours (500 vs 600 hrs). If you are trying to get that number up by any means that will still not help your situation that NPs are in. Please show evidence of MOST schools requiring > 1,000 clinical hours.

 

[762513]

You are welcome to your opinion, right or wrong. Meanwhile, despite your deflections here, many (most?) In healthcare understand that 2 years of part-time online classes followed by 500 hours of poorly organized clinical rotations is insufficient medical training.

Yes, some programs are better than this, but this is the minimum standard....as described by Hoov.

Now NP is 2 years part time?