N.P vs MD/DO ?

[fab4fan]

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Take Music Theory if you have played an instrument, and it should be easy. I made the mistake of taking Music Appreciation....and completely tanked it. I'll never forget because we had to memorize dates of when things were written, etc. I could play all of the pieces (i was classically trained), and I could describe the various music theory behind the music, but damn if I could remember when a piece was written or who belonged to which era. It was one of the only Cs I've ever gotten. 🙁

See, that would be a cakewalk for me; I did that with a jazz appreciation course. Who wrote what when; which type of jazz is this? I did get sick of Miles Freaking Davis, though. He lived a long time for a guy who abused his body with so much drugs and booze.

 

[IMDoc607]

Hi guys, I am not sure exactly where this convo is going but be happy you are a NP or PA....being a doctor is one of the worse things you can do to your life. It's funny my friend was telling me that at PA student asked why doctors/med students are so unhappy. It is because doctors are being replaced by you guys and our salaries are going down with an increase in inflation and malpractice insurance. Guys be happy with your decision and do not even think about going to medical school after you finish PA school!

 

[deleted87716]

being a doctor is one of the worse things you can do to your life.

How would you know? You're a DO student.

 

[fab4fan]

Originally Posted by IMDoc607
being a doctor is one of the worse things you can do to your life.

How would you know? You're a DO student.

I'll bet being an unappreciated English teacher is worser.

 

[IMDoc607]

How would you know? You're a DO student.

Alright, alright.....true

But being a medical student blows. I was looking at it from a POV where I am $180,000 in debt and if the profession gets any worse with Obamacare that I would have a hard time paying back my loans. Hence, that is why I feel it is better to be a PA or NP. It is quicker, finanically stable, and still rewarding.

 

[Therapist4Chnge]

there are a few direct entry combination fnp/nd(naturopathic) programs out there. 6 yrs straight from high school and you are an independently practicing doctorate level medical professional with full rx rights.....

That is down right scary.

 

[deleted87716]

I feel it is better to be a PA or NP. It is quicker, finanically stable, and still rewarding.

Not sure where you're getting the "financially stable" part. You don't think mid-levels are going to be affected by healthcare reform? Think again.

 

[IMDoc607]

Not sure where you're getting the "financially stable" part. You don't think mid-levels are going to be affected by healthcare reform? Think again.

What are your feelings on the healthcare reform?

 

[deleted87716]

What are your feelings on the healthcare reform?

 

[J1515]

Alright, alright.....true

But being a medical student blows. I was looking at it from a POV where I am $180,000 in debt and if the profession gets any worse with Obamacare that I would have a hard time paying back my loans. Hence, that is why I feel it is better to be a PA or NP. It is quicker, finanically stable, and still rewarding.

And they don't go into nearly as much depth of the pathophysiology and treatment of disease. Medical school was the best 4 years of my life and I would repeat it in a heart beat (and I have over $200,000 debt). Perhaps people should stop entering fields strictly because of salary or lifestyle.

 

[fab4fan]

And they don't go into nearly as much depth of the pathophysiology and treatment of disease. Medical school was the best 4 years of my life and I would repeat it in a heart beat (and I have over $200,000 debt). Perhaps people should stop entering fields strictly because of salary or lifestyle.

It scares me when I hear people say that one of their primary reasons for going NP/PA was it was a quick way to a good lifestyle. Yeah, I really want someone who decided to take the quick and easy route to take care of me if I get sick.

Sorry, after much observation my stand hasn't changed. If I get sick, I want a doctor. No disrespect, that's a "must" for me. I'm getting older--something is bound to break one of these days.

 

[zenman]

Kind of a way of explaining how music works.

Ok. I don't play an instrument...other than shaking a rattle and beating a drum occasionally, but I understand how music works. You start a fire, then shake your rattle or drum and your body wants to move...that's how music works.

 

[IMDoc607]

And they don't go into nearly as much depth of the pathophysiology and treatment of disease. Medical school was the best 4 years of my life and I would repeat it in a heart beat (and I have over $200,000 debt). Perhaps people should stop entering fields strictly because of salary or lifestyle.

I give you credit....this is something I do not hear very much from physicians and my fellow classmates.

 

[IMDoc607]

Enough said

 

[Dwindlin]

I give you credit....this is something I do not hear very much from physicians and my fellow classmates.

Then they chose the wrong career. Medical school should not be miserable.

 

[ncguy2005]

Music theory...explain that to me. I only had a music appreciation class.

Yea... it sort of explains how western music works... you start out in theory I looking at things like how to read different clefs, basic chord structure, and transposition...

You get to theory four and you're writing four part chord progressions while following the rules set forth by western music tradition... Also you start learning how to analyze more complicated works of music (for example, we took short Beethoven pieces and analyzed the chords and why he used them in certain places...) Just like in cell biology, music theory follows the rule of "Form indicates function"... at least in respect to how chords are used.

 

[devilpup]

No disrespect, that's a "must" for me. I'm getting older--something is bound to break one of these days.

i love your candor, hahaha

 

[RGMSU]

Then they chose the wrong career. Medical school should not be miserable.

It shouldn't be?

 

[jbeau06]

It scares me when I hear people say that one of their primary reasons for going NP/PA was it was a quick way to a good lifestyle. Yeah, I really want someone who decided to take the quick and easy route to take care of me if I get sick.

Sorry, after much observation my stand hasn't changed. If I get sick, I want a doctor. No disrespect, that's a "must" for me. I'm getting older--something is bound to break one of these days.

I don't get this line of thinking, especially from a nurse. If you were hospitalized, RNs would be taking care of you, and chances are some hospitalist NPs too. You wouldn't be ok with this? Those RNs and NPs will stop the interns from killing you! 🙂

 

[Therapist4Chnge]

More likely that the residents/attendings would have to save you from the NP who thinks they are a physician after a pseudo-education and no post-graduate experience comparable to a residency.

I think it is important to differentiate RNs from NPs, as they function quite differently. As for who is more likely to kill a person (RN, NP, MD/DO), that is a rather impossible scenario to predict. I personally would feel more comfortable with a physician, but in most cases an NP or PA would probably suffice.

In regard to this original discussion, I think the issue of oversight is the sticking point for many. Collaboration > Independance is my preference.

 

[RGMSU]

I don't get this line of thinking, especially from a nurse. If you were hospitalized, RNs would be taking care of you, and chances are some hospitalist NPs too. You wouldn't be ok with this? Those RNs and NPs will stop the interns from killing you! 🙂

There are lots of factors which go into competence. Generalized statements about who is more likely to kill who neglect this. The issue to me is a system that has order rather than chaos. When you have four captains of the ship instead of one it complicates things greatly. I think your colleague was referring to an attending anyway, not an intern, which is why interns are supervised by attendings.

 

[Dwindlin]

It shouldn't be?

I don't think so. I'm enjoying it. This is of course my opinion and I am sure there are many docs who are great who were miserable through medical school. But I would think if you truly want to be a doc then med school should be interesting and fun. Does that mean it isn't hard? Of course not.

And because someone is likely to bring up the fact that I'm only an M1 I look at it like this. Everyone told me M1 would be miserable and I would hate it. I don't. As I said its the opposite. Now people tell me the same about M2, but after talking with friends who have been through (especially the ones who came from very similar back ground as me) they actually enjoyed M2 more, and then enjoyed M3-4 even more. So even though I haven't experienced it, I suspect (given the fact that I actually enjoy working 100+ hours a week) that I too will enjoy M2, M3 and M4 just as much or more than I am digging M1 right now.

 

[IMDoc607]

Then they chose the wrong career. Medical school should not be miserable.

🙄

I don't think you should judge someone on whether or not they chose the right career. I know plenty of students that are not having fun in medical school. Personally, I enjoy it a lot. However, there are times I hate it too.

Please spare us the righteous attitude, but continue to have fun. M3 & M4 are awesome especially M4.

Enjoy

 

[fab4fan]

I don't get this line of thinking, especially from a nurse. If you were hospitalized, RNs would be taking care of you, and chances are some hospitalist NPs too. You wouldn't be ok with this? Those RNs and NPs will stop the interns from killing you! 🙂

I have no problem with a smart nurse caring for me. I have a big problem with a nurse playing doctor caring for me. In any case, we don't have a lot of hospitalist NPs in our area, and none of the docs I go to use them, so the point is moot. It would be my right to say, "I don't want to be treated by an NP." I'd trust an RN over some of these direct entry nurses any day of the week.

Sorry, you are barking up the wrong tree with your agenda. My health care $$ get spent how I see fit. I want a doctor if I'm sick; and in an MD/DO.

 

[Dwindlin]

🙄

I don't think you should judge someone on whether or not they chose the right career. I know plenty of students that are not having fun in medical school. Personally, I enjoy it a lot. However, there are times I hate it too.

Please spare us the righteous attitude, but continue to have fun. M3 & M4 are awesome especially M4.

Enjoy

Read my post directly above yours. As I said, it is simply my opinion, no judgment on anyone. I hear all too often that "med school wasn't worth it" and "no way I would ever do it again". To me those don't sound like people who are happy with the path they choose. There was no "righteous attitude" meant, and if that's how it was taken my apologies.

 

[jbeau06]

I was making a joke with my comment; that being said, the interns/residents I've seen have ALWAYS gone to the NP with questions.

I get that the whole "independent practice" thing scares many, but I just want to make sure that we are all on the same page with what it means. To me, it means an NP can be a primary care provider but that if something came up outside their scope of practice (cancer, heart disease, etc.) they would refer to a specialist. I would hope a primary care physician would do the same. This is the same framework we're working under, correct? With this, I see no problem.

The same with an endocrine attending thinking they can diagnose and work with pulmonary problems. I'd hope they'd get a pulmonary attending to do a consult, yet I still view these as independent practitioners.

I agree with fab that I would not want to see a new grad NP with NO RN experience. But an NP that was an RN for even 2 years I wouldn't mind being my PCP as long as they are thorough. My favorite PCP was a PA who had only been a PA for 3 years with no HCE beforehand.

I also am against direct entry programs that allow someone to become an NP without ever being an RN. I've been an RN since August and I've seen so much in the past 4 months that I would never have seen if I did a direct entry program and I'll have been an RN for 3 years by the time I graduate with my MSN. There really is no substitute for seeing lab values and interpreting them and then seeing the manifestations in a patient. I would be scared to see an NP that just graduated and never worked as an RN.

 

[fab4fan]

An RN with 2 years exp. barely knows her own profession, let alone how to be an independent practitioner. Have an NP with 2y exp as a nurse as my primary caregiver? I don't think so, Tim.

 

[Paseo Del Norte]

An RN with 2 years exp. barely knows her own profession, let alone how to be an independent practitioner. Have an NP with 2y exp as a nurse as my primary caregiver? I don't think so, Tim.

Agree, and the older and more broken I become, the harder it is to keep things running. Therefore, I prefer to have a provider well versed in keeping me up and running.

 

[fab4fan]

Agree, and the older and more broken I become, the harder it is to keep things running. Therefore, I prefer to have a provider well versed in keeping me up and running.

It's funny, I was thinking of you when I was thinking of the kind of nurse who I would be willing to consider seeing as an NP. But then, you and I have both had the conversation that the longer we've been doing this, the less enchanted we are with the idea of being an NP because we realize how much there is that we don't know.

When you are young in the profession, you really don't know what you don't know. When you're older in the profession, you realize how much you don't know, and your older self gets scared witless for your foolish younger self.

 

[deleted87716]

When you are young in the profession, you really don't know what you don't know. When you're older in the profession, you realize how much you don't know, and your older self gets scared witless for your foolish younger self.

The more you learn about medicine, the more you realize how little you really know.

 

[fab4fan]

The more you learn about medicine, the more you realize how little you really know.

At the rate I'm going, I should be a half-wit in no time!

 

[zenman]

The more you learn about medicine, the more you realize how little you really know.

Which is an argument for studying about patients vs studying about medicine.

I'm currently reading a psychopharm book with a focus on the experience of the side effects of these drugs and how they interfere with individual functioning. It's actually very interesting and will certainly impact how I prescribe.

 

[deleted87716]

The study of medicine is the study of patients. Unless you aren't paying attention. 😉

"To study medicine without reading textbooks is like going to sea without charts, but to study medicine without dealing with patients is not going to sea at all." - Sir William Osler

 

[DNPDoctor]

It's funny, I was thinking of you when I was thinking of the kind of nurse who I would be willing to consider seeing as an NP. But then, you and I have both had the conversation that the longer we've been doing this, the less enchanted we are with the idea of being an NP because we realize how much there is that we don't know.

When you are young in the profession, you really don't know what you don't know. When you're older in the profession, you realize how much you don't know, and your older self gets scared witless for your foolish younger self.

How long have you been a RN?

Do you know that the nursing students nowadays take microbiology, biochem, chemistry, physiology, patho-physiology, anatomy, nutrition, and pharmacology?

RNs now are educated differently than the older RNs.

 

[deleted87716]

How long have you been a RN?

Do you know that the nursing students nowadays take microbiology, biochem, chemistry, physiology, patho-physiology, anatomy, nutrition, and pharmacology?

RNs now are educated differently than the older RNs.

 

[DNPDoctor]

 

[Paseo Del Norte]

How long have you been a RN?

Do you know that the nursing students nowadays take microbiology, biochem, chemistry, physiology, patho-physiology, anatomy, nutrition, and pharmacology?

RNs now are educated differently than the older RNs.

A semester or so of principles of chemistry or some such class is a far cry from a year of general chemistry, a year of organic chemistry, and I do not know how many semesters of bio chem. That is assuming a nursing program requires chemistry. In addition, the two semester A&P requirement is only a very basic introduction to the said subject. A semester of pathophysiology is not going to be a comprehensive study of the said subject. Likewise, a semester of microbiology is really only a basic introduction.

With that, I find nursing programs are plagued with problems. Lack of qualified instructors and quality clinical experience is lacking in all the programs I have dealt with in recent years. I know of a program that only has one day of clinical experience a week. This amounts to roughly 500 clinical hours for the entire program. I am in respiratory therapy school with several prior nursing students who dropped out after the first year of nursing school because their entire first year of clinical experience consisted of CNA work in a nursing home. While CNA skills are essential, an entire year of this experience?

As I stated earlier, nursing needs to focus fundamental areas such as education before pushing other agendas IMHO.

 

[DNPDoctor]

A semester or so of principles of chemistry or some such class is a far cry from a year of general chemistry, a year of organic chemistry, and I do not know how many semesters of bio chem. That is assuming a nursing program requires chemistry. In addition, the two semester A&P requirement is only a very basic introduction to the said subject. A semester of pathophysiology is not going to be a comprehensive study of the said subject. Likewise, a semester of microbiology is really only a basic introduction.

With that, I find nursing programs are plagued with problems. Lack of qualified instructors and quality clinical experience is lacking in all the programs I have dealt with in recent years. I know of a program that only has one day of clinical experience a week. This amounts to roughly 500 clinical hours for the entire program. I am in respiratory therapy school with several prior nursing students who dropped out after the first year of nursing school because their entire first year of clinical experience consisted of CNA work in a nursing home. While CNA skills are essential, an entire year of this experience?

As I stated earlier, nursing needs to focus fundamental areas such as education before pushing other agendas IMHO.

First year is usually at the nursing homes doing the CNA works.
From the second year, the students go into acute setting (Hospital).

I had a degree in science before going into nursing.

It's more like a full year of the subjects like physiology and patho-physiology.

I was able to transfer many of the courses because they were going to take the same ones that I took during my science degree.

For patho-physiology, although we didn't actually do the differential diagnosis at the hospital, when I was taking the course, the nurse practitioner who was teaching it gave us many assignments where we needed to make differential diagnosis and figure out which medications were the best to use for such and such situations using pharmacology knowledge.

I don't think that the training and education that the older RN has received in the past are the same as the ones the new RNs are receiving.

 

[Therapist4Chnge]

Lack of qualified instructors and quality clinical experience is lacking in all the programs I have dealt with in recent years.

Unfortunately the money is not in academics for nursing. I know a few nurses who teach, and they do it because they enjoy the experience, and not for the money. Schools will have to spend more money if they want more quality professionals teaching.

 

[J1515]

How long have you been a RN?

Do you know that the nursing students nowadays take microbiology, biochem, chemistry, physiology, patho-physiology, anatomy, nutrition, and pharmacology?
.

They take them at the undergrad level, and they are extremely watered down. For example, at my undergrad, there was nursing chemistry, and then there was chemistry for science majors. I was a TA for the nursing chemistry classes as well as their microbiology classes. It barely even scratched the surface of what we learned in med school and the majority still found it very difficult.

 

[fab4fan]

How long have you been a RN?

Do you know that the nursing students nowadays take microbiology, biochem, chemistry, physiology, patho-physiology, anatomy, nutrition, and pharmacology?

RNs now are educated differently than the older RNs.

With the exception of biochem, I had all of those courses in my curriculum.

Any other ageist assumptions you'd like to take a swing at?

 

[fab4fan]

First year is usually at the nursing homes doing the CNA works.
From the second year, the students go into acute setting (Hospital).

I had a degree in science before going into nursing.

It's more like a full year of the subjects like physiology and patho-physiology.

I was able to transfer many of the courses because they were going to take the same ones that I took during my science degree.

For patho-physiology, although we didn't actually do the differential diagnosis at the hospital, when I was taking the course, the nurse practitioner who was teaching it gave us many assignments where we needed to make differential diagnosis and figure out which medications were the best to use for such and such situations using pharmacology knowledge.

I don't think that the training and education that the older RN has received in the past are the same as the ones the new RNs are receiving.

IOW, this is your opinion. You do realize that you have just marginalized a group of nurses based on age. That's a form of discrimination. I could say the same regarding the work ethic of younger nurses, even cite specific examples. But that would be wrong.

I think what you're really doing is a bass-ackward attempt to get back at people who have posted anti-DNP posts. People like me. Nice passive-aggressive gesture on your part, but pretty transparent.

I really couldn't care less what kind of assignments you did/didn't get during your DNP education. When I got sick earlier this week, I went to a physician. I realize I need to be clear now since I can't say doctor anymore, now that that term has been muddied.

 

[fab4fan]

This says all I need to know about you.

 

[zenman]

I don't think that the training and education that the older RN has received in the past are the same as the ones the new RNs are receiving.

That's true; it was better back then...and it continues to go downhill.

 

[zenman]

They take them at the undergrad level, and they are extremely watered down. For example, at my undergrad, there was nursing chemistry, and then there was chemistry for science majors. I was a TA for the nursing chemistry classes as well as their microbiology classes. It barely even scratched the surface of what we learned in med school and the majority still found it very difficult.

Might be true at your place but none of my undergrad courses were pre-nursing oriented.

 

[zenman]

The study of medicine is the study of patients. Unless you aren't paying attention. 😉

"To study medicine without reading textbooks is like going to sea without charts, but to study medicine without dealing with patients is not going to sea at all." - Sir William Osler

Close Kojak, but no lollypop for you yet. You said "the study of patients."

 

[deleted87716]

Close Kojak, but no lollypop for you yet. You said "the study of patients."

I didn't expect you to understand. Really, I didn't.

 

[J1515]

Might be true at your place but none of my undergrad courses were pre-nursing oriented.

With all due respect, many (I hesitate to say most because I don't know for a fact) colleges have different chemistry classes for nurses vs. pre-meds. It's similar to science vs non-science major courses.

 

[zenman]

I didn't expect you to understand. Really, I didn't.

Let me put it another way. Instead of studying patients, or about patients, or patient's response(s) to what you do, are you studying the patient's experience?

 

[Paseo Del Norte]

With all due respect, many (I hesitate to say most because I don't know for a fact) colleges have different chemistry classes for nurses vs. pre-meds. It's similar to science vs non-science major courses.

Many of the health majors ( nursing and allied health ) will take these same courses. For example, a prospective RCP, RN, and RT student may be required to take a chemistry course for health majors or some such course. While chemistry is never a bad thing, these types of chemistry courses should not be confused with the general chem, O-chem, and Bio chem courses that biology and chemistry majors are required to take.

While my chem course was quite good, subjectively speaking of course, I would not consider my knowledge of chemistry to be on par with a pre-med, let alone a med student or physician. I'm no idiot and can balance equations, identify D & L stereoisomers and chiral carbons, and identify conjugate acids and bases among a few other concepts that may impress high school chemistry teachers, I would not consider myself to be on par with people who have taken dedicated chemistry courses.