Nurses making more than doctors

[Hoody]

It's one specific type of nurse. A type of nurse that will be oversupplied in the coming years because everyone wants to be a CRNA. The average nurse will never make more than the average primary care doctor.

yeah, but the hairdresser down the street makes more money than the secretary up the street. what ever has this world come to! and nurses who want careers? ohz noz!


nurses are taking over the world!!!11!!1!one!!eleventy!!! and they're going to kill everyone with thier lack of training!!!

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[deleted307836]

It's one specific type of nurse. A type of nurse that will be oversupplied in the coming years because everyone wants to be a CRNA. The average nurse will never make more than the average primary care doctor.

... Just like dermatologists are going to be oversupplied, since everyone wants to be one, right?

 

[circulus vitios]

... Just like dermatologists are going to be oversupplied, since everyone wants to be one, right?

I think it is a lot more difficult for the average medical student to become a dermatologist than it is for the average nursing student to become a CRNA.

 

[dru2002]

http://finance.yahoo.com/news/Specialist-nurses-paid-higher-hmoney-2327465018.html?x=0

Old news, but worth repeating.

CRNAs are making more than primary care doctors.

After healthcare reforms goes through, I expect CRNAs to make more than many other specialties as well.

Don't go to medical school.

Leave the profession. All you do is whine. If it is that bad find a new job. Thanks for posting the informative link though. If the whole med school thing doesn't work out I guess its off to CRNA training

 

[Bartelby]

But you know, the article said the average starting pay for a FP doctor was close to $180k. I would not be upset with $180k starting, even if other people without MDs make more.

Is 180k really too little?

 

[TooMuchResearch]

I thought Nilf already had a thread this week.

 

[Hoody]

I think it is a lot more difficult for the average medical student to become a dermatologist than it is for the average nursing student to become a CRNA.

key work being think. think =/= is.

 

[Dissected]

http://finance.yahoo.com/news/Specialist-nurses-paid-higher-hmoney-2327465018.html?x=0

Old news, but worth repeating.

CRNAs are making more than primary care doctors.

After healthcare reforms goes through, I expect CRNAs to make more than many other specialties as well.

Don't go to medical school.

awww crap. Now that I went into healthcare for the money it looks like I chose the wrong degree! Are you seriously a fellow?

 

[deleted307836]

I think it is a lot more difficult for the average medical student to become a dermatologist than it is for the average nursing student to become a CRNA.

But you weren't talking about difficulty of acceptance, you were talking about oversupply. My point was that just because everyone wants to be what is the most competitive in their given field does not mean everyone can get accepted to a program. But you're right, if that were true, there WOULD be a major oversupply!

 

[TheFlashMD]

Did I miss something? Where is source saying that doctors are the only healthcare providers that will be affected by healthcare reform?

Lower reimbursements by Medicare and private insurance means less money for everyone: the hospitals, physicians, nurses, techs, etc.

 

[deleted307836]

Did I miss something? Where is source saying that doctors are the only healthcare providers that will be affected by healthcare reform?

Lower reimbursements by Medicare and private insurance means less money for everyone: the hospitals, physicians, nurses, techs, etc.

This is very true and an often over-looked point.

 

[Bacchus]

I think it is a lot more difficult for the average medical student to become a dermatologist than it is for the average nursing student to become a CRNA.

I would agree with this. Although, as per wiki, it appears its going to get much harder in the coming years. Currently you need at least 1 year of practice in a medical intensive nursing profession and then must complete 2-3 years of school to get a Master's level of education. Doctoral positions are possible. Seems the professional nursing organization is changing (or trying to) the ability to become a CRNA. You will need a doctoral degree and not a master's.

Nurse anesthetists may continue their education to the terminal degree level, either earning a Ph.D., DNAP (Doctor of Nurse Anesthesia Practice), or DNP (Doctor of Nursing Practice). At the terminal degree level, nurse anesthetists have available a wider variety of professional opportunities. They may teach, participate in administration, or pursue research. Currently, the American Association of Colleges of Nursing has endorsed a position statement that will move the current entry level of training for nurse anesthetists in the United States to the Doctor in Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP).[5] This move will affect all advance practice nurses, with the proposed implementation by 2015.[6] The AANA announced in August 2007 support of this advanced clinical degree as an entry level for all nurse anesthetists, but with a target date of 2025. In accordance with traditional grandfathering rules, all those in current practice will not be affected.[5]

 

[Charles_Carmichael]

key work being think. think =/= is.

I would agree with circulus vitios that it's probably much harder to get into derm than it is to get into a CRNA program. To get into derm, you pretty much have to be a superstar in med school. I can't really imagine the competition pool being tougher for getting into CRNA programs.

 

[crestfall]

key work being think. think =/= is.

ahem.. key word being word. j/k haha, couldnt help myself

 

[deleted307836]

People, I would agree with you that it is much more difficult for med students to become a dermatologist than for a nursing student to become a CRNA.

But I don't see how this little factoid has any bearing on anything....

It's not like there are CRNA student spots that go UNFILLED unlike some residency spots in certain specialties. This would be an instance where an increase in the perceived desire of a specialty would increase supply. But it doesn't apply to programs with a set amount of seats that are already being completely filled, unless more schools open that is (SEE: pharmacy).

 

[Bacchus]

If one were to pursue the doctoral degree the training length of time and potential cost could easily reach that of medical school. Anesthesia is riskier than family practice regardless of who is administering. The salary doesn't surprise me that much actually.

 

[illixir]

But you know, the article said the average starting pay for a FP doctor was close to $180k. I would not be upset with $180k starting, even if other people without MDs make more.

Is 180k really too little?

Remember, 173k is the average. Half are making less.

 

[Hoody]

This is very true and an often over-looked point.

I'm willing to bet that ceo's and other admin will somehow still magically benefit though.

 

[badasshairday]

A lot of the various nursing masters degree programs argue that they are, in fact, providing the same services and outcomes as board certified physicians for a fraction of the cost. In other words, we're overtraining ourselves for the job that we do. CRNAs in particular make a very good case: there are over a dozen states where they practce independently of physician supervision and there hasn't been any drastic increase in morbidity or mortality despite the fact that they are basically doing everything an anesthesiologist would do without a board certified physician to consult. Welcome to the free market.

Sure for routine cases, solo-CRNAs are fine. Just like for routine coughs/colds, NPs are fine. You don't see solo-CRNAs at major medical centers in this country, MD's run the show there. You think any patient would take a solo-CRNA for there liver transplant? You can't even do a study to compare morbidity/mortality for complicated cases with patients with multiple morbidities... solo-CRNAs don't touch that stuff, and it would be unethical to do a study on that anyways.

 

[deleted128562]

But you know, the article said the average starting pay for a FP doctor was close to $180k. I would not be upset with $180k starting, even if other people without MDs make more.

Is 180k really too little?

In and of itself, I suppose not. (Although you do have to take significant 6-figure loans into consideration). I think the real point is that you can't very well expect medical students to want to do primary care when they know that their years of work will yield them less pay than something they could have spent 1/2 the time doing.

Think about this: A CRNA is generally 4 years undergrad, 1 year critical care (getting paid) and 2 years CRNA school. Say average pay for a CC nurse is $50K.... so they make 50K over their 7 years of training.

An MD is 4 years undergrad, 4 years med school, 3 years primary care residency. Assume average 50K per year during residency, total training is 11 years and 150K made.

Now you have to consider opportunity cost. The CRNA is making $190K per year for the 4 years that the MD is still training. That's $760,000, minus the extra 100K the MD made during training. This equals A TOTAL OPPORTUNITY COST OF $660,000 FOR BECOMING A FAMILY DOC INSTEAD OF A CRNA!!!! Then add in $10K more per year for being a CRNA over a family doc for a 40 year career - that's $400,000 more in earnings.

Again I will cap this because it is important. AT CURRENT RATES, A CRNA WILL MAKE OVER $1,000,000 MORE LIFETIME THAN A FAMILY DOC WITH FEWER LOANS AND NO PSYCHOTIC MED SCHOOL/RESIDENCY HOURS.

Now, please explain to me why any med student or for that matter any bright high school or undergrad student seeing this article would ever decide to go into primary care? Fact is, it's something I would consider except that I don't think I could stomach the cost. I will more than likely specialize, and probably enough so that I'll feel relatively safe from mid-level creep (ie, doing something with procedures that there is no way in heck you or anyone else would ever let a midlevel do on yourself or your family members). This is the unfortunate way that things are, and until it changes you will absolutely see no improvement in the primary care situation.

 

[Bacchus]

I just posted in Pre-Allo, but supposedly as of 2007 the AANA really is pushing for entry level CRNAs to have a doctoral degree to enter the profession instead of the master's. The change should go in effect around 2025. So, length of training should be right on par with ours.

 

[deleted128562]

Just posted this in allo, but I'll post it here too because I think it is important for pre-meds to understand opportunity costs, etc.

In and of itself, I suppose not. (Although you do have to take significant 6-figure loans into consideration). I think the real point is that you can't very well expect medical students to want to do primary care when they know that their years of work will yield them less pay than something they could have spent 1/2 the time doing.

Think about this: A CRNA is generally 4 years undergrad, 1 year critical care (getting paid) and 2 years CRNA school. Say average pay for a CC nurse is $50K.... so they make 50K over their 7 years of training.

An MD is 4 years undergrad, 4 years med school, 3 years primary care residency. Assume average 50K per year during residency, total training is 11 years and 150K made.

Now you have to consider opportunity cost. The CRNA is making $190K per year for the 4 years that the MD is still training. That's $760,000, minus the extra 100K the MD made during training. This equals A TOTAL OPPORTUNITY COST OF $660,000 FOR BECOMING A FAMILY DOC INSTEAD OF A CRNA!!!! Then add in $10K more per year for being a CRNA over a family doc for a 40 year career - that's $400,000 more in earnings.

Again I will cap this because it is important. AT CURRENT RATES, A CRNA WILL MAKE OVER $1,000,000 MORE LIFETIME THAN A FAMILY DOC WITH FEWER LOANS AND NO PSYCHOTIC MED SCHOOL/RESIDENCY HOURS.

Now, please explain to me why any med student or for that matter any bright high school or undergrad student seeing this article would ever decide to go into primary care? Fact is, it's something I would consider except that I don't think I could stomach the cost. I will more than likely specialize, and probably enough so that I'll feel relatively safe from mid-level creep (ie, doing something with procedures that there is no way in heck you or anyone else would ever let a midlevel do on yourself or your family members). This is the unfortunate way that things are, and until it changes you will absolutely see no improvement in the primary care situation.

 

[badasshairday]

I just posted in Pre-Allo, but supposedly as of 2007 the AANA really is pushing for entry level CRNAs to have a doctoral degree to enter the profession instead of the master's. The change should go in effect around 2025. So, length of training should be right on par with ours.

I think the DNP change is sooner. More like 2015. Also, even if the training is on par in terms of length, it is not the same in rigor. A year of nursing school is not equivalent to a year of medical school.

Whatever though, this profession is getting more screwed every day.

 

[circulus vitios]

Just posted this in allo, but I'll post it here too because I think it is important for pre-meds to understand opportunity costs, etc.

But in the end they're still "just" a nurse. I'm not knocking nurses, but I want to be a doctor because I want to be in control. And like I said, a CRNA oversupply is much more likely than a PCP oversupply physician. New medical schools are opening left and right while residency slots are remaining constant. Plus there's the projected PCP shortage.

I guess none of this applies to me either way because I'm not interested in primary care.

 

[deleted307836]

In and of itself, I suppose not. (Although you do have to take significant 6-figure loans into consideration). I think the real point is that you can't very well expect medical students to want to do primary care when they know that their years of work will yield them less pay than something they could have spent 1/2 the time doing.

Think about this: A CRNA is generally 4 years undergrad, 1 year critical care (getting paid) and 2 years CRNA school. Say average pay for a CC nurse is $50K.... so they make 50K over their 7 years of training.

An MD is 4 years undergrad, 4 years med school, 3 years primary care residency. Assume average 50K per year during residency, total training is 11 years and 150K made.

Now you have to consider opportunity cost. The CRNA is making $190K per year for the 4 years that the MD is still training. That's $760,000, minus the extra 100K the MD made during training. This equals A TOTAL OPPORTUNITY COST OF $660,000 FOR BECOMING A FAMILY DOC INSTEAD OF A CRNA!!!! Then add in $10K more per year for being a CRNA over a family doc for a 40 year career - that's $400,000 more in earnings.

Again I will cap this because it is important. AT CURRENT RATES, A CRNA WILL MAKE OVER $1,000,000 MORE LIFETIME THAN A FAMILY DOC WITH FEWER LOANS AND NO PSYCHOTIC MED SCHOOL/RESIDENCY HOURS.

Now, please explain to me why any med student or for that matter any bright high school or undergrad student seeing this article would ever decide to go into primary care? Fact is, it's something I would consider except that I don't think I could stomach the cost. I will more than likely specialize, and probably enough so that I'll feel relatively safe from mid-level creep (ie, doing something with procedures that there is no way in heck you or anyone else would ever let a midlevel do on yourself or your family members). This is the unfortunate way that things are, and until it changes you will absolutely see no improvement in the primary care situation.

It's good to consider opportunity costs, but his analysis is extremely flawed. If I read that correctly he assumes CRNAs will make 190k each year since they graduate.

First of all, the average CRNA income is more like 140k. The higher number is from a physician recruiting firm that recruits many CRNAs for un-desirable locations that have a much higher salary than the average.

And the average CRNA income being ~140k, HALF are making less than that. Check some jobs sites. There are many CRNA positions in metropolitan areas advertised for 115-125k/year.

But as an aside... if you don't do what you want and what you're really interested in, the decrease in "opportunity costs" is likely not going to make up for your regrets.

 

[Emmet2301]

Uh, so why is this so different from anyone going into Business, Investment Banking or Engineering?

 

[Bacchus]

I think the DNP change is sooner. More like 2015. Also, even if the training is on par in terms of length, it is not the same in rigor. A year of nursing school is not equivalent to a year of medical school.

Whatever though, this profession is getting more screwed every day.

Well at least CRNA schooling is not online. Intubate using your mouse, please. But I understand where you're coming from, definitely.

 

[LadyWolverine]

"If you have surgery in a University Hospital in July or August, you are at risk for being cared for by an MD that has never provided anesthesia solo before."

Why do people always compare a "newly-minted" anesthesia resident to another anesthesia provider who has been working for several years? That provider was newly-minted and learning once, too. I wouldn't want a PGY-2 anesthesia resident administering my anesthesia without supervision any more than I'd want a new PA or NA providing it.

Anyone can put in a tube and a line, give an induction agent, play around with some dials, and keep a person under with a little bit of experience. The difference is that the attending MD anesthesiologist is trained to understand the basic science, physiology, and pharmacology beyond just memorizing drug doses and keeping vitals within a certain range. They are also trained to manage catastrophes (which can, and do, happen - watching the attending surgeon have to emergency cric a patient on the table because the CRNA doesn't have the proper-sized ETT available is pretty frightening). There's a reason that reisdency takes such a long time on top of pre-med and medical school, and demands so many hours. It would be nice if we could all work 40 hours a week with scheduled break time, but then you don't learn as efficiently or as quickly.

 

[Bernoull]

I would love to see a scenario where we have no FPs and boatloads of CRNAs, it sad that these threads always devolve to money. As important as finances are, it's not the be all end all.....

For Nilf, when will u quit this horrible profession??

 

[lazercats]

It's one specific type of nurse. A type of nurse that will be oversupplied in the coming years because everyone wants to be a CRNA. The average nurse will never make more than the average primary care doctor.

That's not how it works. At all

 

[rama kandra]

Its the same reason Atul Gawande refused a chief resident over the attending for his childs surgery. Talk about a smart guy who most likely fell under the spell of emotion.

 

[Ed Bob]

I'm too lazy to post links but they should be easy to find.

"To answer this question we incorporated the results of Silber et al. (2), not Bechtoldt (3) or Forest (4). This study of more than 200,000 patients showed an improved 30-day postoperative mortality rate of 1 patient per 400 anesthetics when anesthesia was delivered with physician anesthesia, P < 0.04. The avoided incremental cost of perioperative death was also incorporated into the model. Considering an actuarial life expectancy of 20 years, the calculated fiscal impact of physician anesthesia, as compared with nurse anesthesia, was a reduction in net health care costs of (&#8722;$2,600) per year-of-life-saved. Pine et al.’s study was published after our manuscript was submitted, but it is worth noting that this investigation showed a more frequent inpatient mortality rate with nurse anesthesia as compared with anesthesia care team practices, 0.46% vs 0.34%, respectively, or an excess inpatient death rate of 1 per 800 anesthetics (5)."

 

[deleted307836]

.

 

[circulus vitios]

That's not how it works. At all

How am I wrong?

 

[deleted307836]

How am I wrong?

It's not like there are CRNA student spots that go UNFILLED unlike some residency spots in certain specialties. This would be an instance where an increase in the perceived desire of a specialty would increase supply. But it doesn't apply to programs with a set amount of seats that are already being completely filled, unless more schools open that is (SEE: pharmacy).

Again, just because something is very desirable, it can not lead to an oversupply if student seats remain static.

 

[TheFlashMD]

How am I wrong?

Simple. You're not.

 

[IMDoc607]

Where is it written that a medical degree entitles you to the highest salary in the hospital? God forbid that nurses make a career for themselves as well. If I were you, I'd be more worried about being raped by CEO's, admins, and human resource personal.

Excellent post.

Having an MD or DO entitles you the highest salary in the hospital when it comes to healthcare NP,PA, CRNA, etc

There will always be adminstrators making more but that is not my point. I look forward to seeing this come back to bite people in the ass.

 

[Saga1]

I've always wonder about doctors lobby

 

[circulus vitios]

Again, just because something is very desirable, it can not lead to an oversupply if student seats remain static.

Could you re-word what you quoted? I'm having trouble comprehending it.

 

[315033]

Money is not everything --- I thought we were doing this for helping people?

If you're really concerned about making money --- go into investment banking or dentistry.

You won't find it in medicine though.

 

[IMDoc607]

Money is not everything --- I thought we were doing this for helping people?

If you're really concerned about making money --- go into investment banking or dentistry.

You won't find it in medicine though.

I'm sick of hearing this. Money is important...accept it

 

[badasshairday]

Money is not everything --- I thought we were doing this for helping people?

You are right, $ isn't everything. But it does not mean we shouldn't be payed a fair compensation.

 

[IMDoc607]

Leave the profession. All you do is whine. If it is that bad find a new job. Thanks for posting the informative link though. If the whole med school thing doesn't work out I guess its off to CRNA training

I love the audacity you guys have. You are sitting here knocking on a fellow. You guys have NO CLUE what it is like to be in medical school and work like an animal. So get off your high horses about "wanting to be a doctor."

I agree....do not go to medical school

 

[IMDoc607]

You are right, $ isn't everything. But it does not mean we shouldn't be payed a fair compensation.

 

[badasshairday]

I love the audacity you guys have. You are sitting here knocking on a fellow. You guys have NO CLUE what it is like to be in medical school and work like an animal. So get off your high horses about "wanting to be a doctor."

Great post. For those of you pre-meds who actually even make it to med school............ you'll see.

 

[45408]

Money is not everything --- I thought we were doing this for helping people?

So why are the CRNAs getting paid so much? Don't nurses just want to help people?

 

[Gigantron]

Nilf,

Your threads annoy me.

Thank you.

The grass is ALWAYS greener on the other side. Anesthesiologists think that these CRNA's are taking their jobs, podiatrists think that MD's and DO's make TOO MUCH, etc. etc.

 

[Geekchick921]

Great post. For those of you pre-meds who actually even make it to med school............ you'll see.

So, are you a bad-ass hair day, or a bad ass-hair day? I would think if you had enough ass hair to have it affect the quality of your day, EVERY day would be a bad ass-hair day.

 

[womp]

On an hourly basis, a pharmacist makes more money than most primary care physicians.

Money is not everything --- I thought we were doing this for helping people?

If you're really concerned about making money --- go into investment banking or dentistry.

You won't find it in medicine though.

That's the kind of attitude that allows every other profession (nurses, pharmacists, hospital administrators, lawyers, insurance bureaucrats, politicians) to take a piece of our collective pie. Please speak for yourself, and yourself only.

 

[vicinihil]

Money is not everything --- I thought we were doing this for helping people?

If you're really concerned about making money --- go into investment banking or dentistry.

You won't find it in medicine though.

Wait 2 years and see what you think.