Nurse Practitioner take-over = PA profession death?

[PSYCHNP]

I cut and paste this from the PA TO MD thread:
atkinsje, to clarify, my beefs were with statements such as these:
Quote:
PA ~> MD bridge = 4 years of medical school. Period.

Why don't you midlevels get it?

EDIT: PA school is nowhere as indepth or intense as medical school. Still another PA delusion. Why are some of you guys modeling your fight after NPs? PAs are our allies, but if more of them become like you, they'll be the enemy as well.
Quote:
Remember when the s%$# hits the fan, the buck stops with the doc.

As far as medicine shortening the bridge even further than a 3 year bridge program, that is ludicrous.
These statements, to me, showed a terrible lack of insight regarding PA education, as well as not understanding the scope of practice that many PAs are responsible for. It bothers me when people speak so loudly on a topic, that they're not fully educated on. How can anyone say what is "nowhere" or "ludicrous", when they most likely can't even explain what PA education consists of, or what Physician organizations are involved in PA program accreditation?

If I came on too strong, it's probably because of these two FMGs I've been working with who literally think I'm a Medical Assistant; one of them handed me a urine sample to dip, and another asked if I was ready to do a history and physical on a patient. I was like, are you frigging kidding me? I'm going to run it by my precepting Doc, I think this will be a prime time to explain to them what a PA is and does.

Anyhow, interesting stuff, eh? And thanks for the well-wish, 2 more weeks to go.

Students, after reading posts like this I would never want to be a PA. Even if I was offered the opportunity to go to a PA school for free I wouldn't go. At this point in my professional career it wouldn't be worth my time. I can tell you one thing the PA schools (taught by these docs) could not get one red cent from me. The only thing they can get from me is a hard time. I have too much self respect and dignity. I was telling a friend of mine that may be an option for him but I am beginning to reconsider this. Before I went to PA school I would go to nurse anesthetist school, or Pharmacy school.

I could never be under the thumb of these docs. I need a solid profession. These docs tried to do the same thing to RNs as I see them doing to the PAs. Back in the days they wanted RNs to restrict their practice to a single hospital.

I don't know what the PA student above expected. I told you students PA was not world renown. I am surprised the foreign doc didn't hand her a urinal.

There is nothing worse than a burned out, frustrated, underappreciated, undercompensated healthcare professional with no real retirement benefits after working for these docs. It's a sad sight.

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[deleted6669]

There is nothing worse than a burned out, frustrated, undercompensated healthcare professional with no real retirement benefits after working for these docs.

don't know where this came from. there are folks burned out on every profession.
almost every pa I know makes a good salary, most over 90k and many up to 150k( as an aside most of these folks work em, derm, surgery, or ortho, not primary care- a derm pa I know well made 187k last yr working 4.5 days/wk....lots of minor biopsies/ procedures=$$$) his sp makes 500k/yr working 2 days/week.... nationally the avg pa out of school at least 1 yr and working at least 32 hrs/week made 93k last yr.not a bad avg salary....
most pa's get good retirement benefits. the pa's in my group get the same retirement deal as the docs; 25% of yearly income into a mutual fund account we control at the end of each yr so a pa making 100k/yr for example gets 25k/yr in retirement without having to set aside a single cent themselves. this is actually a fairly common arrangement among pa's working for independent er groups( I know 3 local groups in the area that do the same thing). at my last job we got 5%/yr into a 401k + a pension after 5 yrs. I was there 7 yrs and at 65 they will owe me around 1200/mo for the rest of my life. union gig. sweet benefits and pay but scope of practice sucked so I left.

 

[PSYCHNP]

almost every pa I know makes a good salary


sweet benefits and pay but scope of practice sucked so I left.

A good salary as compared to who? You said it yourself in a previous post the PAs you work with drive Hondas, while the MDs make three times the salary and drive exotic cars.

I can see paying you a high salary. As I mentioned earlier you seem to be quite an expert, you have been working for over 23 years. Yet, issues like scope of practice must still be addressed. That is what gives us satisfaction as professionals besides monetary gains. Now I can see why barriers like the name "physician assistant", and how much credit for previous education a PA could get in a DO bridge program are highly debated by MDs and PAs on SDN.

From an outsider's point of view it seems like the PAs want to "have one foot out and one foot in". Let me explain, it seems like you want to have scope of practice, viable bridge programs, more independence ect. and still be in the good graces of the MDs. Almost like you want to have your cake and eat it too.


Finally, I suggest reading a simple book, for starters, if you truly believe the compensation for a PA working for an MD is adequate. The name of it is Rich Dad Poor Dad and it was written by Robert Kiyosaki. I have read the posts by PAs stating that they feel shorted when they work for MDs.

By the way, what state do you practice in? That way our students can have an idea of the PA salaries in that region of the US.

 

[deleted6669]

I have read the posts by PAs stating that they feel shorted when they work for MDs.

you can only be shorted if you let someone do it to you. I know what I am worth and except in a few situations will not work for less.
dream job with every imaginable benefit(including sabbatical-don't laugh , I have gotten it before) and I design my own schedule( seven 24 hr shifts/mo)? I might work for less/hr then...
regarding cars...it's not that pa's can't drive nice cars. many I know drive bmw, mercedes, audi, etc. it's just that one needs to prioritize that vs say great vacations or other fancy toys. many pa's prefer other high yield things over a nice car so they drive a honda instead. one senior pa I work with owns 3 homes, 2 in vacation destinations. he drives a 10 yr old toyota to make it work. I recently did a major house remodel paid almost entirely with cash. another of my pa colleagues owns 3 lg sailboats and drives a beater old ford truck. it's about priorities. yes, I drive a honda, but I paid cash for it so I don't have a monthly payment. it's 12 yrs old, runs well , and I will drive it as long as I can. a car is just transportation to me.
being a doc and making 200k+ allows you more playthings.....that was my point in the earlier post( you changed my quote by the way). a doc who manages his money well can have the porsche AND the 2nd home.
FYI- avg pa salaries by state 2009:
http://nurse-practitioners-and-phys...Breakdown/PA-Salaries-by-State-2009-2010.aspx
and by specialty(2008-2009 date so a little low):
http://nurse-practitioners-and-phys...cle/PA-Salaries-by-Specialty-2008-2009-2.aspx
I bitch a lot about being a pa. I probably would find stuff to bitch about as a doc as well. grass is always greener. there really are a lot of great jobs out there. I might actually do this one when the kids go off to college:

Physician Assistant / Nurse Practitioner (2010-2011)
Requisition ID 3047BR
External Job Details Physician Assistant / Nurse Practitioner (2010-2011)
Raytheon Polar Services – Experience Antarctica

Seeking a unique adventure as well as employment? How would you like to be one of the few people on the planet to have the opportunity to live and work in Antarctica ? Raytheon Polar Services is the primary contractor for the National Science Foundation's (NSF) U.S. Antarctic Program. We are currently looking for a Physician Assistant/ Nurse Practitioner to deploy to the McMurdo and South Pole Antarctic research stations and Deep Field Camps on a contract basis starting approximately October 2010.
We are looking for Primary and Alternate employees to fill all contract positions. The Primary is first in line for the position. The Alternate is next in line to deploy should the Primary be unable to meet deployment requirements.
Responsibilities:
The Physician Assistant/ Nurse Practitioner is responsible for patient care at McMurdo Clinic, South Pole, or deep field camps. Also Performs other clinical and facility duties within the clinic.

another cool job. even has a housing allowance and 5 weeks off/yr( 4 weeks vacation and 1 week cme):
Physician Assistant- Annette Island Service Unit
Terms & Conditions for this employment are:
Salary at a rate of $85,000. DOE
$9,000. Retention bonus
Annual Leave – Four Weeks
Sick Leave – 3.69 hours each payroll (every 2 weeks)
11 paid holidays
Paid professional membership fees
Licensing renewal
ACLS, PALS
1 week CME
Transportation to Annette Island Service Unit. Metlakatla, Alaska ($10,000)
Transportation to next employment location ($10,000.)
Housing allowance $500.00 per month
Health Insurance – Blue Cross Medical, Dental & Vision for employee & family
Access to Annette Island Service Unit medical facilities

 

[PSYCHNP]

you can only be shorted if you let someone do it to you. I know what I am worth and except in a few situations will not work for less.
dream job with every imaginable benefit(including sabbatical-don't laugh , I have gotten it before) and I design my own schedule( seven 24 hr shifts/mo)? I might work for less/hr then...
regarding cars...it's not that pa's can't drive nice cars. many I know drive bmw, mercedes, audi, etc. it's just that one needs to prioritize that vs say great vacations or other fancy toys. many pa's prefer other high yield things over a nice car so they drive a honda instead. one senior pa I work with owns 3 homes, 2 in vacation destinations. he drives a 10 yr old toyota to make it work. I recently did a major house remodel paid almost entirely with cash. another of my pa colleagues owns 3 lg sailboats and drives a beater old ford truck. it's about priorities. yes, I drive a honda, but I paid cash for it so I don't have a monthly payment. it's 12 yrs old, runs well , and I will drive it as long as I can. a car is just transportation to me.
being a doc and making 200k+ allows you more playthings.....that was my point in the earlier post( you changed my quote by the way). a doc who manages his money well can have the porsche AND the 2nd home.
FYI- avg pa salaries by state 2009:
http://nurse-practitioners-and-phys...Breakdown/PA-Salaries-by-State-2009-2010.aspx
and by specialty(2008-2009 date so a little low):
http://nurse-practitioners-and-phys...cle/PA-Salaries-by-Specialty-2008-2009-2.aspx
I bitch a lot about being a pa. I probably would find stuff to bitch about as a doc as well. grass is always greener. there really are a lot of great jobs out there. I might actually do this one when the kids go off to college:

Physician Assistant / Nurse Practitioner (2010-2011)
Requisition ID 3047BR
External Job Details Physician Assistant / Nurse Practitioner (2010-2011)
Raytheon Polar Services – Experience Antarctica

Seeking a unique adventure as well as employment? How would you like to be one of the few people on the planet to have the opportunity to live and work in Antarctica ? Raytheon Polar Services is the primary contractor for the National Science Foundation's (NSF) U.S. Antarctic Program. We are currently looking for a Physician Assistant/ Nurse Practitioner to deploy to the McMurdo and South Pole Antarctic research stations and Deep Field Camps on a contract basis starting approximately October 2010.
We are looking for Primary and Alternate employees to fill all contract positions. The Primary is first in line for the position. The Alternate is next in line to deploy should the Primary be unable to meet deployment requirements.
Responsibilities:
The Physician Assistant/ Nurse Practitioner is responsible for patient care at McMurdo Clinic, South Pole, or deep field camps. Also Performs other clinical and facility duties within the clinic.

another cool job. even has a housing allowance and 5 weeks off/yr( 4 weeks vacation and 1 week cme):
Physician Assistant- Annette Island Service Unit
Terms & Conditions for this employment are:
Salary at a rate of $85,000. DOE
$9,000. Retention bonus
Annual Leave – Four Weeks
Sick Leave – 3.69 hours each payroll (every 2 weeks)
11 paid holidays
Paid professional membership fees
Licensing renewal
ACLS, PALS
1 week CME
Transportation to Annette Island Service Unit. Metlakatla, Alaska ($10,000)
Transportation to next employment location ($10,000.)
Housing allowance $500.00 per month
Health Insurance – Blue Cross Medical, Dental & Vision for employee & family
Access to Annette Island Service Unit medical facilities

Thanks for all the great info. you are definitely an asset to SDN. Sorry for changing your quote I didn't intend to do so. I was trying to comment on it, but what I typed was highlighted.

Anyhow, I can see the job opportunities are plentiful and the pay is great for PAs. I just want to remind our students out there that working in acute care settings like the ER pays well, but can be stressful. Especially as a new grad. Believe me, these folks earn every penny of their salaries. We are truly blessed to have professionals like Emedpa to take care of our friends and families.

Anyhow Emed, keep up the great work. By the way, don't forget to have some sort of concrete retirement plan. I have met folks from law enforcement and the fire department who will be sitting on an island sipping margaritas when they retire. Why can't we as healthcare professionals enjoy some of these same benefits?

It's always a pleasure to exchange information and engage in intellectual conversation with a true professional.

 

[Footpain]

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[Footpain]

I don't know where you are getting your facts from, but pharmacists practice the science of pharmacy. That is their body of knowledge. Go around and ask which profession is more respected and people will tell you pharmacy. They make more money, their profession is world renown, their professional program is a 4-5 year clinical doctorate (which is why they are more highly educated), and they are regarded more highly in professional circles. The field of Pharmacy has its own body of knowledge and the tradition (I believe PAs use the medical model not their own body of knowledge based on their own research). Ask mothers out there who they would prefer their daughter to marry a PA or Pharmacist. You can use that test as a barometer.

Optometrists are another group of healthcare professionals that garner more respect than PAs. Their program is rigorous and science based. The history of optometry can be traced back to the early studies on optics and image formation by the eye. The origins of optometric science date back a few thousand years BC. They even make more money than PAs.

Psychologists with a PHD are highly respected (like DR. Phil on TV). Their program is not science based. Even though they don't always make the big bucks their profession is world renown and has the tradition.

Even a business minded LPN with his or her own successful business can garner more respect than a PA. I can go on and on. Please don't let your ego blind you from the truth. As a PA student don't believe the hype your professors are selling you. Let's not have delusions of grandeur. Everybody else is not less let's not be narrow minded.

I guess all those "fluff" leadership classes in nursing school do come in handy. OOPs I shouldn't have typed that. lol.

The Phd clinical psych programs are science based. Take a look at some of the research and studies that have been done. Regarding Dr. Phil, I don't know about that.

 

[Footpain]

Delete

 

[Footpain]

delete

 

[PSYCHNP]

The Phd clinical psych programs are science based. Take a look at some of the research and studies that have been done. Regarding Dr. Phil, I don't know about that.

Thanks footpain. I see you are an attending, I respect the amount of work you have put into your education. Keep it up we need you out there.

As far as Dr. Phil you can see how he uses the dynamics of psychotherapy and therapeutic communication on his show. As opposed to say, even Oprah. He is a shining star in his given profession. You can definitely see that he is not only a good clinician but a highly successful leader and entreprenuer.

I just don't see how a PA with such a limited amount of time spent studying psychiatry content would be prepared to be an effective therapist/psychotherapist, like a Dr. Phil. I know that psychiatrists, LCSWs, PMHNPs, PSYDs are prepared for such roles (i.e. psychotherapy).

 

[deleted87716]

"Dr. Phil" is not currently licensed to practice. He surrendered his Texas license in 2006 and never attempted to have it reinstated.

What he does today is purely for entertainment purposes.

I suggest you set your standards a little higher.

 

[PSYCHNP]

"Dr. Phil" is not currently licensed to practice. He surrendered his Texas license in 2006 and never attempted to have it reinstated.

What he does today is purely for entertainment purposes.

I suggest you set your standards a little higher.

That is what I mean about being narrow minded. We become professionals and get all of our education to be well rounded people. That is why we study sciences, sociology, english, math, psychology, arts etc. in our undergrad. What on earth would Dr. Phil need a clinical license for? To do the CEUs etc. would be a waste of his valuable time. Besides why would he take on the liability? A license for him would only be an invitation for lawsuites.

Whether or not Dr. Phil has his license or not he still has his education. Something nobody can take away from him. When you get to the level of Oprah and Dr. Phil you get honorary degrees like the one Oprah received from Princeton University. Believe me, Dr. Phil's education prepared him to be a leader and entrepreneur.

FYI: Dr. Phil McGraw makes approximately $45 million per year and, in 2006 was ranked number 22 on Forbes list of richest celebrities.

Anyhow, I will be going back on a hiatus. So, I will not be responding to any questions for a week or two. All the best students, study hard, and remember, the sky is the limit.

 

[Dr Oops]

Thanks for the timely response Emedpa. You are definitely a leader and a role model in your field. It is true that in the last decade many of the MD certification bodies have required recertification examinations for those entering the given field of endeavor.

I also read some of your posts in other threads. It seems as if you are advocating for bridge programs for your colleagues. Good work.

I know the content of such an exam comes easy to you. As I said earlier you are truly a "gifted clinician". I just fear for the PAs out there who have to be controlled and manipulated by credentialing institutions/entities controlled by MDs. Suppose there becomes a glut of PAs? I bet the Medical Boards will raise the requirements of PAs. They could manipulate the testing requirements just to keep your numbers down.

You have absolutely no idea what you are talking and make up half the crap you spew. Doctors have been having to get recerted for well over a decade, more like half a century.

 

[PSYCHNP]

You have absolutely no idea what you are talking and make up half the crap you spew. Doctors have been having to get recerted for well over a decade, more like half a century.

Dr. Oops we were not discussing being recerted, we were talking about a recertification examination.

This comes from the Pychiatric News Journal (2003):

First Exam For Recertification


"Psychiatrists board certified after October 1, 1994, will be required to take and pass a recertification exam every 10 years to maintain board certification. The deadline for applying to take the first exam is October 1.

More than 500 psychiatrists will be eligible for recertification this year, the first among the profession who were initially board certified in 1994 or later and are now required to take an exam every 10 years to maintain board certification.
All those who were certified in general psychiatry after October 1, 1994, do not have lifetime certification. Thus, to maintain their certification, they must apply for, take, and pass a recertification examination. Those who were certified prior to October 1, 1994, do not have to take the recertification exam.
The new exam will be a closed-book, proctored exam on a computer.
That may send shivers up the spine of some, but Deborah Hales, M.D., director of APA'and National Programs, said that the Association is committed to helping members prepare for the exam.
"No one likes to take a test, especially a closed-book exam," she said. "So there's some anxiety about it, and a lot of psychiatrists haven't thought much about it. But it's APA's job to provide members the educational tools to get ready for recertification."

Please note that they wrote that all psychiatrits who were certified in general psychiatry after October 1, 1994, do not have lifetime certification....."

To stengthen one of my earlier points, why are psychiatrists required to only take the exam every 10 years and PAs have to take theirs every 6?

Nonetheless, I am not going to argue this. I don't have to go through all of this red tape and bureaucracy manipulated by MDs anyhow.

Students when you pay your tuition to PA school please know all the facts about what you are getting yourself into.

I am now officially on a hiatus.

 

[deleted6669]

fyi- there is a measure working it's way through the nccpa which will likely pass which will change the pa recert cycle to 10 yrs starting perhaps as early as 2012.

 

[atcpt1]

That is what I mean about being narrow minded. We become professionals and get all of our education to be well rounded people. That is why we study sciences, sociology, english, math, psychology, arts etc. in our undergrad. What on earth would Dr. Phil need a clinical license for? To do the CEUs etc. would be a waste of his valuable time. Besides why would he take on the liability? A license for him would only be an invitation for lawsuites.

Whether or not Dr. Phil has his license or not he still has his education. Something nobody can take away from him. When you get to the level of Oprah and Dr. Phil you get honorary degrees like the one Oprah received from Princeton University. Believe me, Dr. Phil's education prepared him to be a leader and entrepreneur.

FYI: Dr. Phil McGraw makes approximately $45 million per year and, in 2006 was ranked number 22 on Forbes list of richest celebrities.

Anyhow, I will be going back on a hiatus. So, I will not be responding to any questions for a week or two. All the best students, study hard, and remember, the sky is the limit.

Exactly how far back do we have to go to correct all your misconceptions. The average PA salary is higher than NP, although insignificant. My understanding is that approximately 2% of NPs and 2% PA's own their own practice. If accurate, this means that 98% of NP and PA work for physicians or hospitals (making them money)! - it's part of the gig. This isn't exactly some new revelation. In my area, the trend is that the hospital owns the practice and physicians work for the hospitals……

And your chatter of “nurses having their own body of knowledge” is REALLY amusing… and perhaps your most uninspiring parable yet. RN’s get all the respect in the world and should, but NP’s are trying to practice medicine outside the regulations of the medical boards. It’s a thinly veiled political ambition of nursing….

In states that do allow NP independent practice, many (or maybe even all) still require a relationship with a physician for Rx privileges. Further, NP's in any hospital that I have been involved requires co-signature by an attending. Further, it's my understanding that NP's have much more difficulty with hospital privileges due to their ‘soft’ training. As I see and understand it, there really is no such thing as midlevel independent practice. Others have already corrected you on your misunderstandings of how PA’s practice and there oversight. Most PA’s consult with their supervising MD PRN – it’s really a nice feature when you have less training and experience.

I look forward to more "enlightening" comments from you, PsychNP. I truly marvel at your 'soap-box' style of comments towards Footpain (an attending) to "keep up the good work - we need you out there", as though you’re a respected source of encouragement for others.

Stay tuned for another 8th grade writing sample from …..PsychNP

Another of my favorate quotes from PsychNP
"Anyhow, I will be going back on a hiatus. So, I will not be responding to any questions for a week or two. All the best students, study hard, and remember, the sky is the limit"
A hiatus at least until you become more educated would be fine - 4-8 years would do.

 

[deleted87716]

What on earth would Dr. Phil need a clinical license for?

Um...credibility?

 

[fab4fan]

Um...credibility?

Well, dang. He's on the teevee! Ain't that good enough for ya'? You're probably one of them there edumacated snobs, ain't ya'?

 

[Narnian]

hahahah here is Dr. Phils credibility....

http://www.youtube.com/watch?v=93mT-2UWntU

 

[deleted87716]

That was actually pretty funny. Phil can laugh at himself...always a good thing.

Still doesn't mean his opinion is worth a crap in a hat, though.

 

[FutureDoc4]

PSYCHNP,

Thank you.

Thank you for reaffirming my believe that I should never hire an NP or refer to one.

I hope all current medical students are reading your posts and and that it inspires others to support FP MD/DOs and to have professional/collegial relationships with PAs

 

[deleted307836]

"PSYCHNP" reminds me of "PICUNP," who was banned around the time that PSYCHNP joined SDN. Just food for thought .

 

[Coastie]

Narnian I respect your post very much. You see, Advanced Practice Nurses do not want to be doctors. If they did they would go to MD/DO school. That is why we don't study under the Medical Model and we have our own body of knowledge backed by evidence based research.

I just fear for all my pre-medical students who spend so much money on their tuitions. Money is scarce these days. We are now in an economic depression. Reimbursement for healthcare services have become unpredictable. I was reading the newspaper this morning (something us well rounded professionals do) when I found out that you could now get a 3 bedroom home for $95,000 in some parts of this country. Would you want to spend that type of money in a field of endeavor mired in stagnation, opression, and exploitation when student loan debt is the most difficult type to deal with (way worse than auto, home, or credit card debt)?

Allow me to elaborate on this. Webster's dictionary (2000) defines subservient as "useful in an inferior capacity, subordinate." I bet besides all the barriers of the name itself ("physician assistant"), getting your work signed off, having to be watched all the time, lack of OD/MD bridge programs (just one and who can get into it anyway), there are more "hidden" surprises.

Why do PAs have to take the Physician Assistant National Recertification exam, I believe every six years, and MDs don't? I am not talking about CEUs but a full fledge exam. I know some of you out there are saying that's just making us better clinicians. But, look at the inconvenience it will be to stop your busy schedules working in the ER, taking on family problems ect. to study for, then take this exam. Why should PAs have to prepare for such an exam while the MDs, who impose it, are out on their yachts on a Sunday afternoon with the money they made from PA labor in their private practices?

What happens when you are up in age and went to school years prior and have to take an exam in which you have no control over the content. What do you do if you fail, go work at Wal Mart as a door greeter?

MDs are drinking from the fountain of youth without sharing a drop of water with PAs.

I am sorry if the truth hurts, but I will not rest until I tell it. Then again, maybe I will take a break from this, I am getting tired of all of the bickering.

BEST TROLL EVER!

 

[Coastie]

don't know where this came from. there are folks burned out on every profession.
almost every pa I know makes a good salary, most over 90k and many up to 150k( as an aside most of these folks work em, derm, surgery, or ortho, not primary care- a derm pa I know well made 187k last yr working 4.5 days/wk....lots of minor biopsies/ procedures=$$$) his sp makes 500k/yr working 2 days/week.... nationally the avg pa out of school at least 1 yr and working at least 32 hrs/week made 93k last yr.not a bad avg salary....
most pa's get good retirement benefits. the pa's in my group get the same retirement deal as the docs; 25% of yearly income into a mutual fund account we control at the end of each yr so a pa making 100k/yr for example gets 25k/yr in retirement without having to set aside a single cent themselves. this is actually a fairly common arrangement among pa's working for independent er groups( I know 3 local groups in the area that do the same thing). at my last job we got 5%/yr into a 401k + a pension after 5 yrs. I was there 7 yrs and at 65 they will owe me around 1200/mo for the rest of my life. union gig. sweet benefits and pay but scope of practice sucked so I left.

PA training >>>>>>> NP.

Physicians want to hire PA's >>>>>>> NP's.

PA earning potential >>>>>> NP.

PA patient care >>>>>> NP.

Any more questions, psychnp?

 

[PSYCHNP]

hahahah here is Dr. Phils credibility....

http://www.youtube.com/watch?v=93mT-2UWntU

Read Dr. Phil's Biography from his show's website . Just wanted to share it with the students. I think we can all learn a thing or two from this great man. What an inspiration and role model!!

I am now going back on my hiatus....


Dr. Phil McGraw has galvanized millions of people to "get real" about their own behavior and create more positive lives. Dr. Phil, his syndicated, daily one-hour series, is the second highest-rated daytime talk show in the nation. The show has been making headlines and breaking records since its September 2002 launch, when it garnered the highest ratings of any new syndicated show since the launch of The Oprah Winfrey Show.

Dr. Phil uses his "get real" approach to help guests solve their problems by stripping away their emotional clutter, and providing them with the tools they need to move confidently ahead in their lives. Dr. Phil also champions those who suffer from such silent epidemics as domestic violence, child abuse, depression, racism, substance abuse and other health issues that are prevalent in society, but go largely undiscussed by their victims.

During its eight seasons on air Dr. Phil has introduced such ground-breaking series and themes as "Dr. Phil Now," "The Dr. Phil House," "The Ultimate Weight Loss Challenge," "The Dr. Phil Families," "Relationship Rescue Retreat," "Anatomy of a Divorce" and "The Brandon Intervention."

Dr. Phil is also the author of six #1 New York Times bestsellers: Life Strategies: Doing What Works, Doing What Matters; Relationship Rescue: A Seven-Step Strategy for Reconnecting with Your Partner; Self Matters: Creating Your Life From the Inside Out; The Ultimate Weight Solution: The Seven Keys to Weight Loss Freedom; Family First: Your Step-by-Step Plan for Creating a Phenomenal Family and Love Smart: Find the One You Want, Fix the One You Got. Dr. Phil is also the author of the New York Times bestseller The Ultimate Weight Solution Cookbook: Recipes for Weight Loss Freedom as well as The Ultimate Weight Solution Food Guide. His books have been published in 39 languages with over 24 million copies in print. His latest book, Real Life: Preparing for the 7 Most Challenging Days of Your Life, gives readers a solid plan for how to cope with the most demanding days of their lives.

The Dr. Phil Foundation, a nonprofit charitable organization that is committed to helping children and families at risk, is also devoted to rewarding remarkable children who are working hard to overcome tremendous obstacles and give back to their family and community. The Foundation is another tool in Dr. Phil's arsenal to fight problems that cripple our society in subtle but undeniable ways. For more information, visit drphilfoundation.org.

Dr. Phil holds a B.A. from Midwestern State University and an M.A. and Ph.D. in clinical psychology from North Texas State University with a dual area of emphasis in clinical and behavioral medicine.

An avid tennis player, golfer and scuba diver, Dr. Phil lives in Los Angeles with his wife Robin. The couple, married for 34 years, has two sons: Jay and Jordan.

 

[drift]

Read Dr. Phil's Biography from his show's website . Just wanted to share it with the students. I think we can all learn a thing or two from this great man. What an inspiration and role model!!

I am now going back on my hiatus....


Dr. Phil McGraw has galvanized millions of people to "get real" about their own behavior and create more positive lives. Dr. Phil, his syndicated, daily one-hour series, is the second highest-rated daytime talk show in the nation. The show has been making headlines and breaking records since its September 2002 launch, when it garnered the highest ratings of any new syndicated show since the launch of The Oprah Winfrey Show.

Dr. Phil uses his “get real” approach to help guests solve their problems by stripping away their emotional clutter, and providing them with the tools they need to move confidently ahead in their lives. Dr. Phil also champions those who suffer from such silent epidemics as domestic violence, child abuse, depression, racism, substance abuse and other health issues that are prevalent in society, but go largely undiscussed by their victims.

During its eight seasons on air Dr. Phil has introduced such ground-breaking series and themes as "Dr. Phil Now," "The Dr. Phil House," "The Ultimate Weight Loss Challenge," "The Dr. Phil Families," "Relationship Rescue Retreat," "Anatomy of a Divorce" and "The Brandon Intervention."

Dr. Phil is also the author of six #1 New York Times bestsellers: Life Strategies: Doing What Works, Doing What Matters; Relationship Rescue: A Seven-Step Strategy for Reconnecting with Your Partner; Self Matters: Creating Your Life From the Inside Out; The Ultimate Weight Solution: The Seven Keys to Weight Loss Freedom; Family First: Your Step-by-Step Plan for Creating a Phenomenal Family and Love Smart: Find the One You Want, Fix the One You Got. Dr. Phil is also the author of the New York Times bestseller The Ultimate Weight Solution Cookbook: Recipes for Weight Loss Freedom as well as The Ultimate Weight Solution Food Guide. His books have been published in 39 languages with over 24 million copies in print. His latest book, Real Life: Preparing for the 7 Most Challenging Days of Your Life, gives readers a solid plan for how to cope with the most demanding days of their lives.

The Dr. Phil Foundation, a nonprofit charitable organization that is committed to helping children and families at risk, is also devoted to rewarding remarkable children who are working hard to overcome tremendous obstacles and give back to their family and community. The Foundation is another tool in Dr. Phil's arsenal to fight problems that cripple our society in subtle but undeniable ways. For more information, visit drphilfoundation.org.

Dr. Phil holds a B.A. from Midwestern State University and an M.A. and Ph.D. in clinical psychology from North Texas State University with a dual area of emphasis in clinical and behavioral medicine.

An avid tennis player, golfer and scuba diver, Dr. Phil lives in Los Angeles with his wife Robin. The couple, married for 34 years, has two sons: Jay and Jordan.

his life story has zero medical relevance to any point you were (trying) to make. Is this your definition of "evidence-based" science?

 

[Therapist4Chnge]

Read Dr. Phil's Biography from his show's website . Just wanted to share it with the students. I think we can all learn a thing or two from this great man. What an inspiration and role model!!

Wow.

There are hundreds/thousands of psychologists who have made amazing contributions to science, and you pick the guy who sold out and hangs with Oprah?

 

[PSYCHNP]

Wow.

There are hundreds/thousands of psychologists who have made amazing contributions to science, and you pick the guy who sold out and hangs with Oprah?

That's right Therapist. You can't deny the man's greatness.

I am contemplating writing him a letter asking him to drop us a line here on SDN. OOh, I can't wait. I plan on asking him the following questions:

1) How did you manage to parlay your success as a

clinician into having the best talk show on TV?

2) What types of barriers did you face when doing so and
how could someone avoid them?

3) How do you stay motivated after reaching such a high
level of success?

4) What pearls of wisdom can you give our MDs here on
SDN?

If anyone else has any other question for Dr. Phil please don't hesitate to add it. Also, try not to ask silly questions like why you let your clinical license go? Remember who you are talking to, the man is at the level of an Elvis Presley.

{Dr. Phil has been able to parlay his clinical career into being a successful entrepreneur. He has mastered the art of what we call leveraging in business. I don't mean like how MDs open a clinic and hire a bunch of PAs, give them all the low paying patients, make them take all the call, have them see three times as many patients.

Dr. Phil is able to deliver his "product" to millions through a vehicle called prime time television.}

I am now going back on my hiatus so I will no longer be entertaining any questions.

 

[deleted87716]

You also appear confused about the definition of "hiatus."

 

[atcpt1]

Read Dr. Phil's Biography from his show's website . Just wanted to share it with the students. I think we can all learn a thing or two from this great man. What an inspiration and role model!!

I am now going back on my hiatus....


Dr. Phil McGraw has galvanized millions of people to "get real" about their own behavior and create more positive lives. Dr. Phil, his syndicated, daily one-hour series, is the second highest-rated daytime talk show in the nation. The show has been making headlines and breaking records since its September 2002 launch, when it garnered the highest ratings of any new syndicated show since the launch of The Oprah Winfrey Show.

Dr. Phil uses his "get real" approach to help guests solve their problems by stripping away their emotional clutter, and providing them with the tools they need to move confidently ahead in their lives. Dr. Phil also champions those who suffer from such silent epidemics as domestic violence, child abuse, depression, racism, substance abuse and other health issues that are prevalent in society, but go largely undiscussed by their victims.

During its eight seasons on air Dr. Phil has introduced such ground-breaking series and themes as "Dr. Phil Now," "The Dr. Phil House," "The Ultimate Weight Loss Challenge," "The Dr. Phil Families," "Relationship Rescue Retreat," "Anatomy of a Divorce" and "The Brandon Intervention."

Dr. Phil is also the author of six #1 New York Times bestsellers: Life Strategies: Doing What Works, Doing What Matters; Relationship Rescue: A Seven-Step Strategy for Reconnecting with Your Partner; Self Matters: Creating Your Life From the Inside Out; The Ultimate Weight Solution: The Seven Keys to Weight Loss Freedom; Family First: Your Step-by-Step Plan for Creating a Phenomenal Family and Love Smart: Find the One You Want, Fix the One You Got. Dr. Phil is also the author of the New York Times bestseller The Ultimate Weight Solution Cookbook: Recipes for Weight Loss Freedom as well as The Ultimate Weight Solution Food Guide. His books have been published in 39 languages with over 24 million copies in print. His latest book, Real Life: Preparing for the 7 Most Challenging Days of Your Life, gives readers a solid plan for how to cope with the most demanding days of their lives.

The Dr. Phil Foundation, a nonprofit charitable organization that is committed to helping children and families at risk, is also devoted to rewarding remarkable children who are working hard to overcome tremendous obstacles and give back to their family and community. The Foundation is another tool in Dr. Phil's arsenal to fight problems that cripple our society in subtle but undeniable ways. For more information, visit drphilfoundation.org.

Dr. Phil holds a B.A. from Midwestern State University and an M.A. and Ph.D. in clinical psychology from North Texas State University with a dual area of emphasis in clinical and behavioral medicine.

An avid tennis player, golfer and scuba diver, Dr. Phil lives in Los Angeles with his wife Robin. The couple, married for 34 years, has two sons: Jay and Jordan.

In all his "greatness", I don't think Mr. Phil could help you!
You do realize Phil McGraw has a ghost writer?

 

[PSYCHNP]

In all his "greatness", I don't think Mr. Phil could help you!
You do realize Phil McGraw has a ghost writer?

Don't hate, congratulate.

 

[atcpt1]

Don't hate, congratulate.

hi·a·tus (h

-

t

s)
n. pl. hi·a·tus·es or hiatus 1. A gap or interruption in space, time, or continuity; a break.

GO AWAY !

 

[oldiebutgoodie]

Oh, please, please don't judge the entire NP profession by the postings of PSYCHNP. All the NPs I work with (n=10) want NOTHING to do with independent practice, they consult daily with their collaborating physicians, and have no desires to replace physicians. The same with the PAs I work with.

Mary Mundinger did us no favors with her power grab and DNP nonsense.

Although I know the graduate nursing programs are drinking the Kool-aid, and trying to serve it to us, most of us don't want or need independent practice (n=40 in a class I was in).

Okay, I'm going on hiatus now.

Oldiebutgoodie

 

[Charles_Carmichael]

Oh, please, please don't judge the entire NP profession by the postings of PSYCHNP. All the NPs I work with (n=10) want NOTHING to do with independent practice, they consult daily with their collaborating physicians, and have no desires to replace physicians. The same with the PAs I work with.

Mary Mundinger did us no favors with her power grab and DNP nonsense.

Although I know the graduate nursing programs are drinking the Kool-aid, and trying to serve it to us, most of us don't want or need independent practice (n=40 in a class I was in).

Okay, I'm going on hiatus now.

Oldiebutgoodie

Thanks for the post Oldie but, honestly, I don't really know if I believe that the "majority" of nursing midlevels don't want independent practice. I have literally never heard a peep out of NPs/DNPs speaking out against the vocal "minority" who do want independence. All I continue to see from NPs/DNPs and their representative organizations is that they're equivalent/superior to physicians, are cost-effective (I don't understand this one), and that they deserve equal reimbursements as physicians. I have literally never heard a single thing out of the majority other than on anonymous forums.

I really do appreciate your post, but I hope you realize that this "silent majority" of nursing midlevels don't appear to really be doing anything to slow down the actions of the vocal minority. I just don't really believe that the majority of NPs/DNPs don't want independence because I never hear from them.

 

[fab4fan]

Thanks for the post Oldie but, honestly, I don't really know if I believe that the "majority" of nursing midlevels don't want independent practice. I have literally never heard a peep out of NPs/DNPs speaking out against the vocal "minority" who do want independence. All I continue to see from NPs/DNPs and their representative organizations is that they're equivalent/superior to physicians, are cost-effective (I don't understand this one), and that they deserve equal reimbursements as physicians. I have literally never heard a single thing out of the majority other than on anonymous forums.

I really do appreciate your post, but I hope you realize that this "silent majority" of nursing midlevels don't appear to really be doing anything to slow down the actions of the vocal minority. I just don't really believe that the majority of NPs/DNPs don't want independence because I never hear from them.

You probably haven't heard from them because they're too busy working, unlike their agitating "colleagues."

As a side note I saw something the other day that gave me pause. I drove past a physicians' group and saw among the names, "Jane Smith, DNP, CRNP." I guess what made me think twice was the "CRNP" part. I mean, wouldn't you have to be a CRNP to be a DNP? Isn't that overkill? Maybe I don't understand my own profession's credentialing, but it bothered me for some reason.

I guess I've turned to the Dark Side.

 

[core0]

You probably haven't heard from them because they're too busy working, unlike their agitating "colleagues."

As a side note I saw something the other day that gave me pause. I drove past a physicians' group and saw among the names, "Jane Smith, DNP, CRNP." I guess what made me think twice was the "CRNP" part. I mean, wouldn't you have to be a CRNP to be a DNP? Isn't that overkill? Maybe I don't understand my own profession's credentialing, but it bothered me for some reason.

I guess I've turned to the Dark Side.

Same reason that you see BSN, RN. BSN is the degree. RN means that you hold a license to practice nursing in that state. DNP is the degree. I presume that CRNP is the legal nomenclature used for NPs in that particular state. Finally due to the fractured nature of nursing training, you can have a DNP and not be a NP.

David Carpenter, PA-C

 

[fab4fan]

Same reason that you see BSN, RN. BSN is the degree. RN means that you hold a license to practice nursing in that state. DNP is the degree. I presume that CRNP is the legal nomenclature used for NPs in that particular state. Finally due to the fractured nature of nursing training, you can have a DNP and not be a NP.

David Carpenter, PA-C

OK.

fab4fan, RN, OCN, BLS, ACLS, MYOB

 

[Charles_Carmichael]

OK.

fab4fan, RN, OCN, BLS, ACLS, MYOB

You forgot LOL WTF BBQ.

 

[oldiebutgoodie]

Thanks for the post Oldie but, honestly, I don't really know if I believe that the "majority" of nursing midlevels don't want independent practice. I have literally never heard a peep out of NPs/DNPs speaking out against the vocal "minority" who do want independence. All I continue to see from NPs/DNPs and their representative organizations is that they're equivalent/superior to physicians, are cost-effective (I don't understand this one), and that they deserve equal reimbursements as physicians. I have literally never heard a single thing out of the majority other than on anonymous forums.

I really do appreciate your post, but I hope you realize that this "silent majority" of nursing midlevels don't appear to really be doing anything to slow down the actions of the vocal minority. I just don't really believe that the majority of NPs/DNPs don't want independence because I never hear from them.

As fab4fan pointed out, most NPs are busy working. Also, I'm not sure they are aware of the concern the medical community has regarding NP independent practice and the DNPs. One would have to be reading SDN and the AMA web site for the most part.

There is definitely healthy skepticism by the rank and file (in my neck of the woods, anyway) about the DNP. It's such a lame program. I hear through the grapevine that some schools are starting to "look at" the programs and make modifications. Not sure what modifications, though.

What really needs to happen is for the gummint to pay primary care MDs WAY more than they do. It's a sin that dermatologists make 3 times as much as primary care docs (okay, I just pulled that number out of my ass, but it sounds right). Then insurers may follow suit. It is way harder to see a patient with obesity, diabetes, hyperlipidemia, and maybe some thyroid issues thrown in than to do some of the specialties.

Then, there won't be such a need for midlevels to fill in the gaps. But, that probably won't happen.

Whatever. I gotta do laundry now, and further plan the takeover of medicine.

Oldiebutgoodie

 

[zenman]

Same reason that you see BSN, RN. BSN is the degree. RN means that you hold a license to practice nursing in that state. DNP is the degree. I presume that CRNP is the legal nomenclature used for NPs in that particular state. Finally due to the fractured nature of nursing training, you can have a DNP and not be a NP.

David Carpenter, PA-C

Licensure is awarded after completing an educational program and passing national licensure exam. RN

State designation or requirements are usually beyond basic licensure and designate authority and recognition to practice at an advanced level in that state. Each state might require a different designation. Examples are APN, APRN, ARNP, CRNP, CNP, NP, CNS, CS.

Then you have national certification such as from the American Nurses Credentialing Center (ANCC). In my case, PMHNP-BC

For documentation on legal documents, you have to use whatever is required by a particular state, such as, "Jane Doe, RN, APN," or Jane Doe, APN."

A general rule of thumb is to follow your name with the credential that can least be taken away from you, in descending order, with awards or fellowships last. So, Jane Doe, PhD, RN, CRNP.

If I was unlucky enough to have to wear a white coat, I'd put as little as I could get away with on it or my name tag.

If I was listed as a presenter in an educational seminar, I'd list more just so people would have a better idea of where I'm coming from or what kind of preparation I've had.

 

[atcpt1]

OK.

fab4fan, RN, OCN, BLS, ACLS, MYOB

I also find the 'alphabet soup' after a person's name annoying.

The ironly is that the people who like this stuff are usually intellectually handicaped......I know I'm dealing with a tool when I see a persons qualifications displayed this way.

and the whole degree thing is annoying as well....as if it's the degree rather than the profession that garners respect....

there is sophistication and intellect with simplicity

and people don't think patients are confused....i can't figure the nursing nomenclature beyond RN....the RN is the only thing that means anything in my book.

it's like little man syndrome or something.....people without MD's or PhD's like lots of letters and doctor in their title

 

[fab4fan]

You forgot LOL WTF BBQ.

I got a hand cramp, otherwise I would have written that.