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I am looking for some honest and unbiased advice from the perspective of someone who is in (or has gone through) medical school. Is it worth it? I am currently a nurse. Originally, I thought I would go back to school to become a NP, but after lots of consideration I realized that I think I want to pursue a medical degree instead. I love nursing for what it is... and this is in fact the first time I have ever even thought about med school. I am absolutely aware that these are two very different professions. Comparing doctors and nurses are like comparing apples and oranges. But these are my main thoughts:
1. Work-life balance. Nursing school is hard and demanding - very very true - but the time I spent studying was just a sliver of the amount of time my pre-med friends would spend in the library. I don't want to wait 7-10 years to start a family. I would be essentially starting out as a pre-med student. I would have to take some physic and organic chem classes, try to find some shadowing experience, and study for the MCAT. I am looking at 3 yrs vs. 7-10 yrs.
2. Financial burdens. I know every medical student is up to their ears in loans. NP school is shorter, generally less expensive, and most people are able to work on the side (this is also a con, because I would love to be 100% focused on my classes).
3. Nurses and doctors have very different approaches, as I am sure we all know. Nurses are more holistic, and doctors have an education rooted in science. I am not saying that nurses practitioners do not understand pathophysiology, but not in the same way a doctor does. I think I would find it scary to be able to diagnose and prescribe with just a nursing background. But if I had a guarantee that a NP education would prepare me for safe and competent patient care, that might be enough for me. I just don't know if it can...

Sure, it's not just about finances and years, but I would silly not to consider an "alternative" when I am seemingly much closer to it. So, from the perspective of someone who is going through or has gone through this demanding process, what would you recommend to someone like me? Do the benefits outweigh the cost? And are NPs really as awful as some physicians make it seem?
 
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culturekweenXx

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What exactly appeals to you about being a physician other than a better understanding of pathophysiology? Not sure that most users here would agree with your assessment of the differences between the professions, either
 
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Matthew9Thirtyfive

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3. Nurses and doctors have very different approaches, as I am sure we all know. Nurses are more holistic, and doctors have an education rooted in science. I am not saying that nurses practitioners do not understand pathophysiology, but not in the same way a doctor does. I think I would find it scary to be able to diagnose and prescribe with just a nursing background. But if I had a guarantee that a NP education would prepare me for safe and competent patient care, that might be enough for me. I just don't know if it can...

This is completely the opposite of what I have experienced in reality. Nurses (specifically NPs) are not more holistic. That is propaganda pushed by the nursing lobby. In reality, the vast majority of the time they just look at individual symptoms and throw medications at them and shotgun tests because they don’t understand how to formulate a ddx or recognize a constellation of symptoms. It is almost comical how easy it is to spot a patient being “managed” by an NP. I say almost because it’s a real person being harmed.

This isn’t an insult to nurses as people. The education for NPs is just woefully inadequate and in no way prepares them. Your education as an NP will not prepare you to diagnose and treat patients on your own.

And it is insulting to imply that doctors are somehow not holistic or somehow only care about the science. To even get into med school we have to spend hundreds of hours volunteering to take care of people in multiple settings, and then in med school it is hammered into us constantly to be addressing the entire patient when caring for someone. That isn’t anything special. That’s good medicine.

Also, think about it. When you say you think it’s good that you can work part time while in NP school, what does that actually mean? The school is already shorter than medical school (I’m not even including residency). The volume in medical school is so much that it’s almost impossible to work even a few hours a week. Some people manage to do it during preclinical years, but it’s highly, highly discouraged because of the volume of material. And during clinical years, you can’t.

So that means the volume and rigor of NP school must be significantly less if it’s possible to easily work a part time job while doing it (and it is since so many people do it). And yet you’re still finishing in fewer years.

How can they possibly cover the same material? We get like 4,000 hours of clinical hands on work and 1.5-2 years of full time didactics before we graduate med school, and we are completely unprepared to practice on our own. But you think someone with a couple years of watered down courses and 500 hours of shadowing is going to be ready?

If you want to independently take care of patients, then you want to be a physician. Go to medical school and do a residency and do it right.

Edit: also, I don’t know how old you are, but I started premed at 33 with a wife and kids. I started med school at 35. I’ll be 39 when I graduate. Plenty of my classmates are getting married and/or having kids in school (and yes, I mean the women too). You do not have to wait until you’re done to start a family.
 
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ChymeofPassion

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hOLiStiC. Go to medical or PA school, please dont contribute to the NP abomination.
 
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Ho0v-man

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If you can’t imagine studying as much as a premed then you definitely shouldn’t go to med school bc premed was a drop in the bucket.
 
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7331poas

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My honest advice would be to go to PA school.
 
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fldoctorgirl

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This is completely the opposite of what I have experienced in reality. Nurses (specifically NPs) are not more holistic. That is propaganda pushed by the nursing lobby. In reality, the vast majority of the time they just look at individual symptoms and throw medications at them and shotgun tests because they don’t understand how to formulate a ddx or recognize a constellation of symptoms. It is almost comical how easy it is to spot a patient being “managed” by an NP. I say almost because it’s a real person being harmed.

This isn’t an insult to nurses as people. The education for NPs is just woefully inadequate and in no way prepares them. Your education as an NP will not prepare you to diagnose and treat patients on your own.

And it is insulting to imply that doctors are somehow not holistic or somehow only care about the science. To even get into med school we have to spend hundreds of hours volunteering to take care of people in multiple settings, and then in med school it is hammered into us constantly to be addressing the entire patient when caring for someone. That isn’t anything special. That’s good medicine.

Also, think about it. When you say you think it’s good that you can work part time while in NP school, what does that actually mean? The school is already shorter than medical school (I’m not even including residency). The volume in medical school is so much that it’s almost impossible to work even a few hours a week. Some people manage to do it during preclinical years, but it’s highly, highly discouraged because of the volume of material. And during clinical years, you can’t.

So that means the volume and rigor of NP school must be significantly less if it’s possible to easily work a part time job while doing it (and it is since so many people do it). And yet you’re still finishing in fewer years.

How can they possibly cover the same material? We get like 4,000 hours of clinical hands on work and 1.5-2 years of full time didactics before we graduate med school, and we are completely unprepared to practice on our own. But you think someone with a couple years of watered down courses and 500 hours of shadowing is going to be ready?

If you want to independently take care of patients, then you want to be a physician. Go to medical school and do a residency and do it right.

Edit: also, I don’t know how old you are, but I started premed at 33 with a wife and kids. I started med school at 35. I’ll be 39 when I graduate. Plenty of my classmates are getting married and/or having kids in school (and yes, I mean the women too). You do not have to wait until you’re done to start a family.
/thread.

Seriously this needs to be published somewhere lol. So well-worded.
 
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This is completely the opposite of what I have experienced in reality. Nurses (specifically NPs) are not more holistic. That is propaganda pushed by the nursing lobby. In reality, the vast majority of the time they just look at individual symptoms and throw medications at them and shotgun tests because they don’t understand how to formulate a ddx or recognize a constellation of symptoms. It is almost comical how easy it is to spot a patient being “managed” by an NP. I say almost because it’s a real person being harmed.

This isn’t an insult to nurses as people. The education for NPs is just woefully inadequate and in no way prepares them. Your education as an NP will not prepare you to diagnose and treat patients on your own.

And it is insulting to imply that doctors are somehow not holistic or somehow only care about the science. To even get into med school we have to spend hundreds of hours volunteering to take care of people in multiple settings, and then in med school it is hammered into us constantly to be addressing the entire patient when caring for someone. That isn’t anything special. That’s good medicine.

Also, think about it. When you say you think it’s good that you can work part time while in NP school, what does that actually mean? The school is already shorter than medical school (I’m not even including residency). The volume in medical school is so much that it’s almost impossible to work even a few hours a week. Some people manage to do it during preclinical years, but it’s highly, highly discouraged because of the volume of material. And during clinical years, you can’t.

So that means the volume and rigor of NP school must be significantly less if it’s possible to easily work a part time job while doing it (and it is since so many people do it). And yet you’re still finishing in fewer years.

How can they possibly cover the same material? We get like 4,000 hours of clinical hands on work and 1.5-2 years of full time didactics before we graduate med school, and we are completely unprepared to practice on our own. But you think someone with a couple years of watered down courses and 500 hours of shadowing is going to be ready?

If you want to independently take care of patients, then you want to be a physician. Go to medical school and do a residency and do it right.

Edit: also, I don’t know how old you are, but I started premed at 33 with a wife and kids. I started med school at 35. I’ll be 39 when I graduate. Plenty of my classmates are getting married and/or having kids in school (and yes, I mean the women too). You do not have to wait until you’re done to start a family.

I'm sorry, I did not mean to imply that doctors are not "holistic" and nurses are. That is not what I mean at all. Nursing training is very, very focused on caring for the whole person - physically, mentally, emotionally... When I am taking care of a patient, only a fraction of what I do is medical interventions. Good nursing is more than just doing detailed nursing assessments, administering medications, medical procedures - and I do not doubt that is the same for doctors. However, I do think the nurse-patient relationship is more intimate than the physician-patient relationship (my background is med-surge nursing, and this might be different in other fields). I think this is simply because nurses care for a handful of patients, and doctors typically see very many. I have never seen a doctor spend an hour listening to a patient talk about their grandchildren, or brush a patient's hair and give them a bath because they haven been laying in a hospital bed for three days. I don't expect them to do this either - but I bet a lot of them would if they could. Doctors, on the other hand, are legitimate scientists. The education is centered around science, right?

This is one of the reasons that I was never sure about becoming an NP... because it doesn't seem at all like nursing to me. It seems like a weird in-between. I completely understand how it would be easy for a NP to just treat individual symptoms. In my limited experience though, most NPs assist the doctors and fill in the gaps. I have also seen many NPs as a patient myself, and I have always been completely comfortable with my care... maybe I am just ignorant though.

I completely agree with the schooling thing. NP school is just very convenient - I never said better. In all honesty, I think I am just a little scared to devote years of my life to med school, and then wake up one day and realize I hate being a doctor... that must happen all the time, right? Also, I don't think that NPs should necessarily be able to independently care for their patients. And I don't think they should replace physicians, but supplement them. I want to advance my career one way or the other, increase my autonomy, and eventually move away from the bedside... and these are just two potential (very different) paths.
 
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Alright, let me provide my perspective as an NP and now MS1. I have been a nurse since 2009, got my NP degree in 2015, started medical school this year at the age of 34. I went back to medical school when I was making 130k-150k a year, even though I was working 50-60 hours per week. From a financial perspective, going back to medical school sounds like a crazy idea; but there is always one thing I always had in my mind, and that is medical knowledge. Clinical experience comes with time, and any medical professionals will gain it with time. What NPs will never have is a solid medical knowledge background. And when I say solid, it does not simply mean prescribing Amoxicillin for Strep Throat. What do you know about Streptococcus bacteria? Do you know if it is gram-negative or gram-positive? What is unique about GAS that we should aggressively treat it? Do you know the mechanism of Amoxicillin? Why should we give Amoxicillin and not, let say, Ciprofloxacin?
Nurse practitioner training that I received did not go deep enough into pathophysiology, microbiology, mechanisms of different types of antibiotics that are applicable to the above scenario. Sure, any NPs can treat Strep Throat, but how many can say that they can handle Acute Post-streptococcus Glomerulonephritis or Acute Rheumatic Fever?
If you want work-life balance, becoming an NP is great, as I do believe NPs have an important role in our healthcare system. Can NPs provide competent patient care? Absolutely, if you learn to recognize when it is time to refer your patients with complicated medical conditions to physicians.
BUT, if you want to travel deep into medicine, to explore your true potential, then by all means go to medical school. You are not the first nor will be the last nurse to walk this difficult journey. There are many folks here who were NPs and PAs, who can chime in and share their experience with you. Good luck!
 
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Matthew9Thirtyfive

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any NPs can treat Strep Throat

Except they don’t usually manage it appropriately, nor are they trained to recognize when it’s not just a strep throat. There’s a reason 2/3 of pharyngitis cases are treated with antibiotics, but only ~18% of them are GAS.
 
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Alright, let me provide my perspective as an NP and now MS1. I have been a nurse since 2009, got my NP degree in 2015, started medical school this year at the age of 34. I went back to medical school when I was making 130k-150k a year, even though I was working 50-60 hours per week. From a financial perspective, going back to medical school sounds like a crazy idea; but there is always one thing I always had in my mind, and that is medical knowledge. Clinical experience comes with time, and any medical professionals will gain it with time. What NPs will never have is a solid medical knoledge background. And when I say solid, it does not simply mean prescribing Amoxicillin for Strep Throat. What do you know about Streptococcus bacteria? Do you know if it is gram-negative or gram-positive? What is unique about GAS that we should aggressively treat it? Do you know the mechanism of Amoxicillin? Why should we give Amoxicillin and not, let say, Ciprofloxacin?
Nurse practitioner training that I received did not go deep enough into pathophysiology, microbiology, mechanisms of different types of antibiotics that are applicable to the above scenario. Sure, any NPs can treat Strep Throat, but how many can say that they can handle Acute Post-streptococcus Glomerulonephritis or Acute Rheumatic Fever?
If you want work-life balance, becoming an NP is great, as I do believe NPs have an important role in our healthcare system. Can NPs provide competent patient care? Absolutely, if you learn to recognize when it is time to refer your patients with complicated medical conditions to physicians.
Thank you for this. I feel like you said what I couldn't put into words. That is what draws me to going to med school... I want to go beyond treating strep throat.
 
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7331poas

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Thank you for this. I feel like you said what I couldn't put into words. That is what draws me to going to med school... I want to go beyond treating strep throat.

That may be true, but thats not a good enough reason to go to medical school. Do you really want to throw away 5+ years of extra training for the MD letters and more knowledge.

PA school is the best bet in my opinion as you get better training than an NP but you also get to leave training earlier.
 
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I'm sorry, I did not mean to imply that doctors are not "holistic" and nurses are. That is not what I mean at all. Nursing training is very, very focused on caring for the whole person - physically, mentally, emotionally... When I am taking care of a patient, only a fraction of what I do is medical interventions. Good nursing is more than just doing detailed nursing assessments, administering medications, medical procedures - and I do not doubt that is the same for doctors. However, I do think the nurse-patient relationship is more intimate than the physician-patient relationship (my background is med-surge nursing, and this might be different in other fields). I think this is simply because nurses care for a handful of patients, and doctors typically see very many. I have never seen a doctor spend an hour listening to a patient talk about their grandchildren, or brush a patient's hair and give them a bath because they haven been laying in a hospital bed for three days. I don't expect them to do this either - but I bet a lot of them would if they could. Doctors, on the other hand, are legitimate scientists. The education is centered around science, right?
It's true that nurses usually spend more time with their patients in most specialties, and yes it's because they have fewer of them. Also there is a lot of extra work physicians have to do. But there are specialties where physicians will spend an hour with their patients (e.g., psych). And nothing is really more intimate than being literally inside of someone like a surgeon. But I do know what you're saying. Being an NP isn't like being a nurse with doctor knowledge though. That whole "heart of a nurse, brain of a doctor" crap is a load of garbage, and it insults both professions.
This is one of the reasons that I was never sure about becoming an NP... because it doesn't seem at all like nursing to me. It seems like a weird in-between. I completely understand how it would be easy for a NP to just treat individual symptoms. In my limited experience though, most NPs assist the doctors and fill in the gaps. I have also seen many NPs as a patient myself, and I have always been completely comfortable with my care... maybe I am just ignorant though.
NPs can fill in the gaps and be suuuuper useful in certain areas. The ideal scenario for an NP would be a nurse who spent a significant amount of time as a bedside nurse in a specific field (e.g., oncology) and then went to NP school, did their clinical hours in that field, and then went to work as an NP in that field supervised appropriately by a physician. They do exist, and they are awesome. Oncology, the NICU, the ICU. They are amazing.

If you would like to have a narrow focus for your career and practice as a physician extender, then NP or PA school is a fantastic option and you will be a huge help. But if you want to do anything more broad like primary care or psych or EM, you need to go to medical school.

I don't mean this as an insult, but you just don't know whether you're getting appropriate care. I worked in healthcare for a decade before medical school, and I had no idea just how incompetent the majority of midlevels are in the primary care setting. When you're young and healthy, you don't really see it for a couple reasons. 1) most things young and healthy patients come in for a fairly self-limiting (bronchitis, pharyngitis, rhinosinusitis, VGE) and will get better regardless. So when they prescribe you amox or a z-pack (Lord help me) for your "sinus infection" and it gets better, it seems like they did the right thing even though they didn't. 2) harm in primary care can take a long time to manifest. I just read about a case where an NP mismanaged a patient with CHF for over a month before they finally went to the ED because they felt like they were drowning. And they were in heart failure. 3) finally, you just don't know what appropriate care really looks like. One thing I've learned in med school is that there is just so much to primary care.

Most patients who like their midlevels like them because they feel like they listen to them. That's good, but sitting there listening to you doesn't mean they are providing you good care or practicing good medicine.

I completely agree with the schooling thing. NP school is just very convenient - I never said better. In all honesty, I think I am just a little scared to devote years of my life to med school, and then wake up one day and realize I hate being a doctor... that must happen all the time, right? Also, I don't think that NPs should necessarily be able to independently care for their patients. And I don't think they should replace physicians, but supplement them. I want to advance my career one way or the other, increase my autonomy, and eventually move away from the bedside... and these are just two potential (very different) paths.
You have to look at what you want. If you want to do anything independent, you need to go to medical school. But you CAN have a career as an NP where you're actually helping patients and helping the healthcare team in a great way. PA school as well. It's just hard because in those schools they will try to brainwash you into thinking you are just as good as a physician at independently practicing, and unless you can keep the perspective that your schooling is just no where close (literally, it's like 3%), the temptation to go out and do that could be strong.

But I've worked with NPs in the more supervised, limited scope settings, and they have all been amazing. If that's an appealing career to you, then I'd say go for that since you already have the nursing experience.
 
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Wordead

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I'm sorry, I did not mean to imply that doctors are not "holistic" and nurses are. That is not what I mean at all. Nursing training is very, very focused on caring for the whole person - physically, mentally, emotionally... When I am taking care of a patient, only a fraction of what I do is medical interventions. Good nursing is more than just doing detailed nursing assessments, administering medications, medical procedures - and I do not doubt that is the same for doctors. However, I do think the nurse-patient relationship is more intimate than the physician-patient relationship (my background is med-surge nursing, and this might be different in other fields). I think this is simply because nurses care for a handful of patients, and doctors typically see very many. I have never seen a doctor spend an hour listening to a patient talk about their grandchildren, or brush a patient's hair and give them a bath because they haven been laying in a hospital bed for three days. I don't expect them to do this either - but I bet a lot of them would if they could. Doctors, on the other hand, are legitimate scientists. The education is centered around science, right?

This is one of the reasons that I was never sure about becoming an NP... because it doesn't seem at all like nursing to me. It seems like a weird in-between. I completely understand how it would be easy for a NP to just treat individual symptoms. In my limited experience though, most NPs assist the doctors and fill in the gaps. I have also seen many NPs as a patient myself, and I have always been completely comfortable with my care... maybe I am just ignorant though.

I completely agree with the schooling thing. NP school is just very convenient - I never said better. In all honesty, I think I am just a little scared to devote years of my life to med school, and then wake up one day and realize I hate being a doctor... that must happen all the time, right? Also, I don't think that NPs should necessarily be able to independently care for their patients. And I don't think they should replace physicians, but supplement them. I want to advance my career one way or the other, increase my autonomy, and eventually move away from the bedside... and these are just two potential (very different) paths.

Most of my nurses just know the patients as room 25-1 and give me a blank look when I tell them names.
 
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Matthew9Thirtyfive

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Just to head this off, this thread won’t devolve into a nurse bashing session. Totally fine to talk about the differences between the education and skill sets and even to discuss how that plays out in practice. But posts that basically are just like “nUrSeS sUxOrS” or “DoCtErS oNlY cArE aBoUt MoNeY” will not be allowed.
 
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zero0

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My honest advice would be to go to PA school.
Absolutely do not do this. The growing NP cancer overrunning this country has taken an even bigger toll on PAs than physicians.

PAs are dying out because they can't keep up with the lobbying efforts of NPs. A lot of hospitals seem to prefer hiring NPs over PAs because NPs are better at tacking on tons of useless credentials after their names that clueless administrators are impressed by. PAs are slowly being pushed out of the job market as a result. Sad but true since their training is actually superior.
 
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Zen Arcade

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Absolutely do not do this. The growing NP cancer overrunning this country has taken an even bigger toll on PAs than physicians.

PAs are dying out because they can't keep up with the lobbying efforts of NPs. A lot of hospitals seem to prefer hiring NPs over PAs because NPs are better at tacking on tons of useless credentials after their names that clueless administrators are impressed by. PAs are slowly being pushed out of the job market as a result. Sad but true since their training is actually superior.
One of the many, many reasons why people practicing actual medicine should be the ones making administrative decisions.
 
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Ho0v-man

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Absolutely do not do this. The growing NP cancer overrunning this country has taken an even bigger toll on PAs than physicians.

PAs are dying out because they can't keep up with the lobbying efforts of NPs. A lot of hospitals seem to prefer hiring NPs over PAs because NPs are better at tacking on tons of useless credentials after their names that clueless administrators are impressed by. PAs are slowly being pushed out of the job market as a result. Sad but true since their training is actually superior.
It’s really bc PAs actually have stricter supervision guidelines whereas NPs can just be set loose.
 
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calivianya

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If you’re hungry enough to put the time in, ignore everyone telling you to go PA and just go for the physician degree. I did.

I didn’t want to have yet another job where, once again, I wasn’t the most qualified person in the room. If I was okay with *not* being the most qualified person in the room, I would have just continued to be a regular RN. You can make NP/PA money easily with what you have right now. Start traveling and you can triple your current income... or just pick up a decent paying PRN gig or go to the float pool. It’s not hard to pull ~$100k+ as a RN if you’re flexible on your location, willing to travel, willing to put in the overtime, and/or willing to pick up a second gig, and I’m saying that as someone whose base pay was ~$50k at my last job and I nearly doubled it several years, without picking up every available overtime shift.

Anyway, why go back to school for the same amount of money you could already make (just in fewer hours and with less hassle as a NP), and still have less knowledge than someone else in the room? I wasn’t going to go to school again for anything other than the terminal degree in medicine. I wouldn’t have been satisfied with less.

If it’s just getting out of direct patient care that’s the goal, and that’s the most important thing to you, sure, you’ll be happy as a NP/PA. That’s why a lot of my friends went NP - they couldn’t take direct patient care anymore and it had nothing to do with wanted a deeper education. They just wanted the heck out of bedside nursing no matter what. If, however, the reason you’re unhappy with nursing is the depth of the science/medical training, you’re going to be unhappy with being a NP or PA. Just my two cents.
 
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I have a slightly different way of approaching this question. What do you ultimately what to do in practice? What will your day to day actually look like?

If you want to practice primary care, then you’d probably be better off going the NP route. You’d finish faster and you’d essentially be doing the same job for comparable pay. Sure, your training wouldn’t be as good but your day to day would be the same. You could select a practice environment where you had some supervision to help with more challenging cases. It would be like being a lifelong resident, but for 2-3x the pay and working half the hours.

If your goals in medicine are fields outside primary care or anesthesia or anything where there isn’t a well defined advanced practice nursing paradigm, then medical school is the way to go. Want to be a surgeon? You’re stuck going to medical school.

Essentially I would make sure medical school is truly necessary to get you where you want to go. I think all the debate about training and knowledge is less important. There are plenty of docs working alongside NPs doing the same basic job and all that extra knowledge probably doesn’t matter 90% of the time.

It’s a noble goal to invest the time to get that addition knowledge that will make you better, but as a working nurse your calculus is different. You could be a practicing NP in just a couple of years. Your path to medicine is probably 8 years minimum assuming you’ve already been studying for the mcat and already have all the pre reqs and don’t have any GPA repair to do. If you haven’t done those things then we’re getting toward 9-10 years depending on how fast you can get things done.

If you weren’t even a nurse yet, then the numbers are similar - you’d still be looking at getting your BSN, doing a couple years in practice, then applying to some APP program, 2-3 years in that, etc. At that point the numbers get closer. From where you are now they aren’t even close, so I would only pick the longer journey if it gets you somewhere you can’t go otherwise.
 
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QuizzicalApe

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I am looking for some honest and unbiased advice from the perspective of someone who is in (or has gone through) medical school. Is it worth it? I am currently a nurse. Originally, I thought I would go back to school to become a NP, but after lots of consideration I realized that I think I want to pursue a medical degree instead. I love nursing for what it is... and this is in fact the first time I have ever even thought about med school. I am absolutely aware that these are two very different professions. Comparing doctors and nurses are like comparing apples and oranges. But these are my main thoughts:
1. Work-life balance. Nursing school is hard and demanding - very very true - but the time I spent studying was just a sliver of the amount of time my pre-med friends would spend in the library. I don't want to wait 7-10 years to start a family. I would be essentially starting out as a pre-med student. I would have to take some physic and organic chem classes, try to find some shadowing experience, and study for the MCAT. I am looking at 3 yrs vs. 7-10 yrs.
2. Financial burdens. I know every medical student is up to their ears in loans. NP school is shorter, generally less expensive, and most people are able to work on the side (this is also a con, because I would love to be 100% focused on my classes).
3. Nurses and doctors have very different approaches, as I am sure we all know. Nurses are more holistic, and doctors have an education rooted in science. I am not saying that nurses practitioners do not understand pathophysiology, but not in the same way a doctor does. I think I would find it scary to be able to diagnose and prescribe with just a nursing background. But if I had a guarantee that a NP education would prepare me for safe and competent patient care, that might be enough for me. I just don't know if it can...

Sure, it's not just about finances and years, but I would silly not to consider an "alternative" when I am seemingly much closer to it. So, from the perspective of someone who is going through or has gone through this demanding process, what would you recommend to someone like me? Do the benefits outweigh the cost? And are NPs really as awful as some physicians make it seem?
Hello,

To address your thoughts

1. Work life balance: Any professional training program will be demanding; the training is definitely longer with the physician path way, especially for some specialties. In either pathway NP vs Physician your ultimate work life balance will depend on your specialty and the kind of job you sign on for. This is a personal question that you'll have to answer for yourself. There are both NPs and Physicians that have families during training. There are NPs and physicians who don't because they can't handle starting a family. Finally, there are both NPs and Physicians who think they can handle it but their personal life collapses when they find out they can't.

2. You are correct that the financial burden of becoming a physician is higher, though the potential financial benefit is much greater; again, specialty dependent.

3. This final thought is propaganda nonsense; not an insult to you, it is just commonly parroted. People biased toward the "nursing model" or NP education like to say it, but realistically every healthcare profession adopts a "holistic approach" in the modern era, taking into account cultural, spiritual, and socioeconomic factors that together impact a patient's health. Non-physician training programs like to say it because they think it is one thing that gives their training the edge, but it is unfortunately not a real thing.

You are right to be concerned about the quality of the NP education; I do not mean to imply that NP training programs are categorically bad, because they are not, but it is a lot easier to set up a bad NP program and start enrolling students than it should be. Attending a US med school gives you some baseline assurance of competent training that you can't just take for granted with NP training, but you can certainly find a good NP program if you go looking for one.

At the end of the day, you have to decide what you want out of your career. If you want to be in academia, or serve as a leader of a healthcare team, or serve in certain specialties (surgery, oncology, etc) that you just don't get full scope of practice as an NP, then being a physician is a no-brainer. If your goal is to get a good job that pays decently without incurring too much debt, then NP will work just fine for you.

The bias against NPs exists mostly because of the national NP advocates pushing irresponsibly for independence often through flawed cherry-picked studies, false equivocation with physician training, and nonsense like that holistic bit; individual NPs are often great.

Hope that is helpful
 
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BacktotheBasics

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I am looking for some honest and unbiased advice from the perspective of someone who is in (or has gone through) medical school. Is it worth it? I am currently a nurse. Originally, I thought I would go back to school to become a NP, but after lots of consideration I realized that I think I want to pursue a medical degree instead. I love nursing for what it is... and this is in fact the first time I have ever even thought about med school. I am absolutely aware that these are two very different professions. Comparing doctors and nurses are like comparing apples and oranges. But these are my main thoughts:
1. Work-life balance. Nursing school is hard and demanding - very very true - but the time I spent studying was just a sliver of the amount of time my pre-med friends would spend in the library. I don't want to wait 7-10 years to start a family. I would be essentially starting out as a pre-med student. I would have to take some physic and organic chem classes, try to find some shadowing experience, and study for the MCAT. I am looking at 3 yrs vs. 7-10 yrs.
2. Financial burdens. I know every medical student is up to their ears in loans. NP school is shorter, generally less expensive, and most people are able to work on the side (this is also a con, because I would love to be 100% focused on my classes).
3. Nurses and doctors have very different approaches, as I am sure we all know. Nurses are more holistic, and doctors have an education rooted in science. I am not saying that nurses practitioners do not understand pathophysiology, but not in the same way a doctor does. I think I would find it scary to be able to diagnose and prescribe with just a nursing background. But if I had a guarantee that a NP education would prepare me for safe and competent patient care, that might be enough for me. I just don't know if it can...

Sure, it's not just about finances and years, but I would silly not to consider an "alternative" when I am seemingly much closer to it. So, from the perspective of someone who is going through or has gone through this demanding process, what would you recommend to someone like me? Do the benefits outweigh the cost? And are NPs really as awful as some physicians make it seem?

1. What the moderator above says is not physician propaganda but a reflection that is more worthy to be read than a NYT/WSJ opinion article. The reason NP/PA independent practice is gaining momentum is that American capitalism hasn't learnt how to proactively filter out bad ideas (Independent NP practice) until they are implemented and lead to issues.

2. Everything you've typed shows a proclivity towards nursing which is fantastic. If you want to go for the NP, do it. The main upside is an increased salary but you're essentially going to be implementing algorithms and using your nursing training to identify potential issues with patients that were designed by physicians. Figure out if you want to drive patient care or help with it. Then weigh that against everything else ($$, time, lifestyle, etc.) and make your decision based off that. I'm not saying NPs can't be innovative. They could perhaps design implementation strategies in healthcare but the actual pathophysiology -> bedside is a physician domain.
 
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Splenda88

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Take it from someone who was a nurse and is close to being an attending (Internal Medicine): I would do it all over again. Medical school is hard but the things you learn especially in residency are "gold".

The 'holistic' thing you talk about is just nursing propaganda...
 
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Splenda88

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These are sample questions of the NP exam that RN take to become NP and be able to open their clinic and practice medicine on day 1 in ~30 states... while physicians can not even get a full license in ~ 20 states after passing Step1/2(CS/CK)/3 and completing PGY1. Seriously!

Our system is a joke...


1. Which drug is associated with increased lipoprotein levels?

Furosemide (Lasix).
Hydrochlorothiazide (HCTZ).
Spironolactone (Aldactone).
Triamterene (Dyrenium).

2. What is the main reason for administering a progestational medication to perimenopausal women who use estrogen?

Preventing hot flashes.
Preventing osteoporosis.
Promoting growth of the uterine lining.
Decrease the risk of endometrial hyperplasia.

3. The family nurse practitioner asks a patient to perform rapid, alternating movements of the hands to evaluate:

cerebellar functioning.
cognitive functioning.
reflex arc functioning.
stereognostic functioning.

4. A 38-year-old patient who is Vietnamese tells the family nurse practitioner that his or her parent died in his or her 40s from liver cancer. The nurse practitioner assesses that the patient is at risk for:

hepatitis B.
malaria.
tularemia.
tyrosinemia.

5. A 55-year-old male patient who is Chinese has a follow-up appointment after cardiac bypass surgery. The patient brings his father with him into the examination room. The family nurse practitioner provides culturally sensitive care by:

asking the patient's father if he has any questions regarding his son's care.
asking the patient's father to leave the room due to confidentiality issues.
performing the examination without commenting to the patient's father.
performing the examination, then telling the patient's father the examination findings.

6. A difficult aspect of determining occupational exposure to disease is the:

confidentiality of the information within company records.
inaccuracy of occupational disease reporting.
long latency period between exposure and disease development.
reliance on workers' memories.

7. The family nurse practitioner exhibits professional leadership by:

adding clinical protocols to the nurse practitioner scope of practice.
comparing the workplace roles of the registered nurse and the nurse practitioner.
creating a task force to address scope-of-practice concerns.
lobbying to eliminate continuing education requirements.

8. To comply with regulations for third-party payor reimbursement and documentation, a family nurse practitioner correlates:

evaluation and management code with history, examination and medical decision making.
health outcomes with physical examination findings and plan of care.
medication orders and treatment plan with electronic billing.
patient privacy with informed consent.

9. The family nurse practitioner examines a patient who has sustained a non-work-related injury that interferes with the patient's ability to perform his or her job. The patient does not qualify for medical disability and has a reasonable chance of engaging in a suitable occupation with proper therapy. The nurse practitioner recommends that the patient apply for:

Family and Medical Leave Act benefits.
home health services.
Social Security benefits.
vocational rehabilitation services.

10. A 45-year-old patient who is an opera singer reports progressive hoarseness for the last four weeks. The hoarseness began after a three-hour opera performance. The patient does not smoke and reports no weight loss, upper respiratory infection, dysphagia, or shortness of breath. The family nurse practitioner manages this patient by:

ordering a computed tomography scan of the head.
ordering an immediate lateral neck x-ray.
prescribing systemic antibiotics and cool mist inhalations.
requesting a referral for evaluation of the larynx.

11. Routine immunization guidelines recommend administering the hepatitis B vaccine at birth and repeating doses at:

one month and six months.
one month and two months.
four months and two years.
six months and 12 months.
 
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Splenda88

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That may be true, but thats not a good enough reason to go to medical school. Do you really want to throw away 5+ years of extra training for the MD letters and more knowledge.

PA school is the best bet in my opinion as you get better training than an NP but you also get to leave training earlier.
PA training is better than NP but I would not advise it over med school based on my experience with PA students where I am. We have both PA students and 4th-year med students with us and the 4th year med students are way better in term of medical management. These students are from the med/PA schools that my residency is affiliated with.
 
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Matthew9Thirtyfive

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These are sample questions of the NP exam that RN take to become NP and be able to open their clinic and practice medicine on day 1 in ~30 states... while physicians can not even get a full license in ~ 20 states after passing Step1/2(CS/CK)/3 and completing PGY1. Seriously!

Our system is a joke...


1. Which drug is associated with increased lipoprotein levels?

Furosemide (Lasix).
Hydrochlorothiazide (HCTZ).
Spironolactone (Aldactone).
Triamterene (Dyrenium).

2. What is the main reason for administering a progestational medication to perimenopausal women who use estrogen?

Preventing hot flashes.
Preventing osteoporosis.
Promoting growth of the uterine lining.
Decrease the risk of endometrial hyperplasia.

3. The family nurse practitioner asks a patient to perform rapid, alternating movements of the hands to evaluate:

cerebellar functioning.
cognitive functioning.
reflex arc functioning.
stereognostic functioning.

4. A 38-year-old patient who is Vietnamese tells the family nurse practitioner that his or her parent died in his or her 40s from liver cancer. The nurse practitioner assesses that the patient is at risk for:

hepatitis B.
malaria.
tularemia.
tyrosinemia.

5. A 55-year-old male patient who is Chinese has a follow-up appointment after cardiac bypass surgery. The patient brings his father with him into the examination room. The family nurse practitioner provides culturally sensitive care by:

asking the patient's father if he has any questions regarding his son's care.
asking the patient's father to leave the room due to confidentiality issues.
performing the examination without commenting to the patient's father.
performing the examination, then telling the patient's father the examination findings.

6. A difficult aspect of determining occupational exposure to disease is the:

confidentiality of the information within company records.
inaccuracy of occupational disease reporting.
long latency period between exposure and disease development.
reliance on workers' memories.

7. The family nurse practitioner exhibits professional leadership by:

adding clinical protocols to the nurse practitioner scope of practice.
comparing the workplace roles of the registered nurse and the nurse practitioner.
creating a task force to address scope-of-practice concerns.
lobbying to eliminate continuing education requirements.

8. To comply with regulations for third-party payor reimbursement and documentation, a family nurse practitioner correlates:

evaluation and management code with history, examination and medical decision making.
health outcomes with physical examination findings and plan of care.
medication orders and treatment plan with electronic billing.
patient privacy with informed consent.

9. The family nurse practitioner examines a patient who has sustained a non-work-related injury that interferes with the patient's ability to perform his or her job. The patient does not qualify for medical disability and has a reasonable chance of engaging in a suitable occupation with proper therapy. The nurse practitioner recommends that the patient apply for:

Family and Medical Leave Act benefits.
home health services.
Social Security benefits.
vocational rehabilitation services.

10. A 45-year-old patient who is an opera singer reports progressive hoarseness for the last four weeks. The hoarseness began after a three-hour opera performance. The patient does not smoke and reports no weight loss, upper respiratory infection, dysphagia, or shortness of breath. The family nurse practitioner manages this patient by:

ordering a computed tomography scan of the head.
ordering an immediate lateral neck x-ray.
prescribing systemic antibiotics and cool mist inhalations.
requesting a referral for evaluation of the larynx.

11. Routine immunization guidelines recommend administering the hepatitis B vaccine at birth and repeating doses at:

one month and six months.
one month and two months.
four months and two years.
six months and 12 months.

There’s already a problem with the first question. I’m sure they’re looking for furosemide, but HCTZ and spironolactone can both raise LDL. I’m guessing that’s too nuanced for them.
 
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BacktotheBasics

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I don't think those questions are a joke unless they are being marketed to certify someone for independent practice. They're meant to test elementary medical knowledge that is accessible to a layperson. The NP/PA role is to know all those things to recognize things to bring to the attention of their team. If you want to be able to make safe medical decisions given all the information, you need to know more than that.
 

Splenda88

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I don't think those questions are a joke unless they are being marketed to certify someone for independent practice. They're meant to test elementary medical knowledge that is accessible to a layperson. The NP/PA role is to know all those things to recognize things to bring to the attention of their team. If you want to be able to make safe medical decisions given all the information, you need to know more than that.
Well, they can practice independently in 28 states...
 
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7331poas

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PA training is better than NP but I would not advise it over med school based on my experience with PA students where I am. We have both PA students and 4th-year med students with us and the 4th year med students are way better in term of medical management. These students are from the med/PA schools that my residency is affiliated with.

Who cares? Like I said, why would you want to waste 5 years of your life just so you can claim to have better medical management?
 
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Who cares? Like I said, why would you want to waste 5 years of your life just so you can claim to have better medical management?
It is the passion for medical knowledge, a testament to my patients that I have gone through extensive medical training that hopefully will prepare me to make the right decision at the critical moment, a promise to future generations of physicians that there is no shortcut to medicine. Years from now, when I look back to the date that I decided to quit my nurse practitioner job to pursue something dear to my heart, I can tell my sons that I have made so many sacrifices not because of the title behind my name, but because of something that I am in love with.
 
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ChymeofPassion

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It is the passion for medical knowledge, a testament to my patients that I have gone through extensive medical training that hopefully will prepare me to make the right decision at the critical moment, a promise to future generations of physicians that there is no shortcut to medicine. Years from now, when I look back to the date that I decided to quit my nurse practitioner job to pursue something dear to my heart, I can tell my sons that I have made so many sacrifices not because of the title behind my name, but because of something that I am in love with.

/clap
 
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7331poas

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It is the passion for medical knowledge, a testament to my patients that I have gone through extensive medical training that hopefully will prepare me to make the right decision at the critical moment, a promise to future generations of physicians that there is no shortcut to medicine. Years from now, when I look back to the date that I decided to quit my nurse practitioner job to pursue something dear to my heart, I can tell my sons that I have made so many sacrifices not because of the title behind my name, but because of something that I am in love with.

The admissions committee isn't here, you don't have to show off
 
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The admissions committee isn't here, you don't have to show off
It’s not about showing off. I made a similar decision for the same reason.

When you already have a successful career in healthcare, the things that poster said are the only reason you switch. It’s an ideological/emotional reason, not a practical one. I’d go as far as to say that most of the people who go into medicine go into it for reasons like these. It’s so much longer and so much more expensive to go into medicine than any other field in health care that it’s almost never a practical decision. There’s nothing practical about going for another four year degree after you already have a bachelor’s, that’s going to be followed with a few years more of residency, that’s additionally going to require taking out six figures in debt. The only way going to medical school could even remotely be considered practical is if you get a full ride or do the military option so it’s free.

If you just want to ”help people” or “make money” you can do pretty much anything else with your life instead of going to medical school.
 

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My advice based on your original question: Go to NP school. It seems like it will be quicker and easier than trying to apply to PA schools. Nursing/NP lobbying is some of the best too.

Longer explanation: I'm not saying any of this is good or that I agree with the politics/policies behind all of this (as others have more eloquently pointed out), but if someone is asking for career advice, that's the best advice imo. I understand a lot of what people are talking about in the thread, but if you're asking what is solely the best financial/career decision for you it seems to be pretty clear to me. Or maybe work as a nurse for a couple more years and see if the answer becomes more clear.

Like others said, if the process of getting into med school seems like it might not be worth it (which there is 100% nothing wrong with) then don't go to med school. At the end of the day, you're talking about jobs. Doctors, NP, PA, they are all just different jobs, someone who went to PA or NP school didn't "not go all the way" or some other odd thing someone might want to say by not becoming a doctor. They are completely different jobs and training paths.
 

dienekes88

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I am looking for some honest and unbiased advice from the perspective of someone who is in (or has gone through) medical school. Is it worth it? I am currently a nurse. Originally, I thought I would go back to school to become a NP, but after lots of consideration I realized that I think I want to pursue a medical degree instead. I love nursing for what it is... and this is in fact the first time I have ever even thought about med school. I am absolutely aware that these are two very different professions. Comparing doctors and nurses are like comparing apples and oranges. But these are my main thoughts:
1. Work-life balance. Nursing school is hard and demanding - very very true - but the time I spent studying was just a sliver of the amount of time my pre-med friends would spend in the library. I don't want to wait 7-10 years to start a family. I would be essentially starting out as a pre-med student. I would have to take some physic and organic chem classes, try to find some shadowing experience, and study for the MCAT. I am looking at 3 yrs vs. 7-10 yrs.
2. Financial burdens. I know every medical student is up to their ears in loans. NP school is shorter, generally less expensive, and most people are able to work on the side (this is also a con, because I would love to be 100% focused on my classes).
3. Nurses and doctors have very different approaches, as I am sure we all know. Nurses are more holistic, and doctors have an education rooted in science. I am not saying that nurses practitioners do not understand pathophysiology, but not in the same way a doctor does. I think I would find it scary to be able to diagnose and prescribe with just a nursing background. But if I had a guarantee that a NP education would prepare me for safe and competent patient care, that might be enough for me. I just don't know if it can...

Sure, it's not just about finances and years, but I would silly not to consider an "alternative" when I am seemingly much closer to it. So, from the perspective of someone who is going through or has gone through this demanding process, what would you recommend to someone like me? Do the benefits outweigh the cost? And are NPs really as awful as some physicians make it seem?
NPs are not as awful as some on SDN make them seem. They also aren't more holistic than the nurses would have you believe.

I may go against the grain when I say most routine things could be managed by an NP with moderate experience and a good set of guidelines and algorithms to follow. As has been mentioned, the NP education lacks the depth to go off the deep end in complex management. However, most patients are not in that category, so most of the time they are fine.

I think that with costs rising, the demand for NPs is going to continue to rise. Good paying job, limited liability, portability, decent hours... what's not to like?

I think focusing on the sliver of complex patients where we as physicians shine is not the way we are going to make ourselves relevant again. People (especially payors) don't value high quality complex care, in which MDs have the greatest advantage. People and payors value moderate quality simple care with good patient selection, i.e. send the complex patients to the university hospital or don't offer them care. The example with strep pharyngitis, what would be the added cost of optimizing care in all those patients with the understanding that plenty of physicians also write abx for viral pharyngitis? What is the cost/QALY? What is the NNT for an additional life saved? There needs to be a frameshift in physician-led care delivery and it probably starts with medical records and billing.

I could go on, but I'm just taking a break from studying for the boards.
 

Matthew9Thirtyfive

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NPs are not as awful as some on SDN make them seem. They also aren't more holistic than the nurses would have you believe.

I may go against the grain when I say most routine things could be managed by an NP with moderate experience and a good set of guidelines and algorithms to follow. As has been mentioned, the NP education lacks the depth to go off the deep end in complex management. However, most patients are not in that category, so most of the time they are fine.

I think that with costs rising, the demand for NPs is going to continue to rise. Good paying job, limited liability, portability, decent hours... what's not to like?

I think focusing on the sliver of complex patients where we as physicians shine is not the way we are going to make ourselves relevant again. People (especially payors) don't value high quality complex care, in which MDs have the greatest advantage. People and payors value moderate quality simple care with good patient selection, i.e. send the complex patients to the university hospital or don't offer them care. The example with strep pharyngitis, what would be the added cost of optimizing care in all those patients with the understanding that plenty of physicians also write abx for viral pharyngitis? What is the cost/QALY? What is the NNT for an additional life saved? There needs to be a frameshift in physician-led care delivery and it probably starts with medical records and billing.

I could go on, but I'm just taking a break from studying for the boards.

You might want to check out r/noctor or the repository of malpractice cases against midlevels. It is not a sliver of patients.
 
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dienekes88

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You might want to check out r/noctor or the repository of malpractice cases against midlevels. It is not a sliver of patients.
But despite this. Payors and healthcare organizations are willing to expand the scope and number of APPs. Its easier and probably cheaper to pay the malpractice suits and provide ok care than it is to actually improve the quality of care.
 

Matthew9Thirtyfive

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But despite this. Payors and healthcare organizations are willing to expand the scope and number of APPs. Its easier and probably cheaper to pay the malpractice suits and provide ok care than it is to actually improve the quality of care.

Unfortunately, yes.
 

7331poas

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You might want to check out r/noctor or the repository of malpractice cases against midlevels. It is not a sliver of patients.

I am sure any person on this forum could throw out some stories about docs doing crazy things as well.

The truth of the matter is that NPs are poorly undereducated, but docs are also poorly policed.
 

Matthew9Thirtyfive

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I am sure any person on this forum could throw out some stories about docs doing crazy things as well.

The truth of the matter is that NPs are poorly undereducated, but docs are also poorly policed.

The plural of anecdote isn't data. There is actual data that midlevels provide inferior care.

But I do agree that physicians do an inadequate job of policing their own.
 
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You guys should joint Physicians for Patient Protection to get a realistic picture of the losing battle physicians are facing. I am an NP and I know my limits, that is why I go back to medical school, and actively pushing against NPs gaining independent practice. I scored 99% on my AANP exam, and it really opens my eyes of the huge difference between MD/DO training and NP training. The only reason I have not had a lawsuit is because I know when to involve my supervising physician.
When a nurse or an NP asks for advices to go back to medical school, it is because we are dissatisfied with our training, we believe we can do better, we want to travel deeper into medicine, we want to realize our true potential. We want to receive encouragement that it is a right thing to go back to medical school. Heck, I can just get my DNP degree with another 150 clinical hours and claim and I am doctor and I am no different than a physician. We have been working as nurses and NPs for many years in different settings, we know what it feels like to fail our patients. There are 1001 reasons not to go back to medical school, but all we need is just 1 reason to do so. I am thankful that my supervising physician supported my decision to go back to medical school and did not just advise me to keep working as an NP, otherwise I would not be in medical school right now. I hope that one day when you become an attending physician, and when a nurse or NP asks you for advices, you will be realistic, but at the same time, motivate them as well.
 
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kb1900

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Oct 4, 2015
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You guys should joint Physicians for Patient Protection to get a realistic picture of the losing battle physicians are facing. I am an NP and I know my limits, that is why I go back to medical school, and actively pushing against NPs gaining independent practice. I scored 99% on my AANP exam, and it really opens my eyes of the huge difference between MD/DO training and NP training. The only reason I have not had a lawsuit is because I know when to involve my supervising physician.
When a nurse or an NP asks for advices to go back to medical school, it is because we are dissatisfied with our training, we believe we can do better, we want to travel deeper into medicine, we want to realize our true potential. We want to receive encouragement that it is a right thing to go back to medical school. Heck, I can just get my DNP degree with another 150 clinical hours and claim and I am doctor and I am no different than a physician. We have been working as nurses and NPs for many years in different settings, we know what it feels like to fail our patients. There are 1001 reasons not to go back to medical school, but all we need is just 1 reason to do so. I am thankful that my supervising physician supported my decision to go back to medical school and did not just advise me to keep working as an NP, otherwise I would not be in medical school right now. I hope that one day when you become an attending physician, and when a nurse or NP asks you for advices, you will be realistic, but at the same time, motivate them as well.
It’s not really a losing battle. The lawsuits and claims against NPs are snowballing in certain areas. We’re simply moving to a two tiered system in America.

legislation, lawsuits, expansion of residency slots are the biggest factors in how this plays out over the next few decades.
 

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