What you are doing right now is what it takes to be a sharp NP. That’s it.
When you start your first job, you’ll essentially be cut loose to do your own thing. You might have a physician or an experienced NP nearby to bounce questions off of, but to handle the workflow and be remotely productive, you’ll need to have your ducks in a row. Everyone else around you will be in their own offices seeing patients, and you won’t frequently catch them to run a patient by them in the heat of the moment. In most cases, on day 1 you are essentially independent. Given that fact, when choosing between psyche Np and psychiatrist, you should factor in how much money you want to make. If you want a bigger long term haul, then pursue medical school. The price paid for that is lots of time, both in school, as well as in time it takes to pay off your debt after school. At a bare minimum, you’ll be looking at possibly 2 years of school for prereqs (if you are lucky). Those prereqs are a beast, and will disrupt your life as you work and go to school at the same time. That’s why I think it might take even longer than 2 years depending on how much regular life you want to have while you hammer them out. Then you have to figure out how to time your application process so that you don’t have a lot of wasted time while you wait the whole year before medical school starts. Then (unless you go to a 3 year medical school), you have 4 years of medical school, and 3 years of residency.
The expenses include medical school coming in at roughly 50k per year(?.... not sure how much it costs these days). Then living expenses, which with my lifestyle and family would probably cost at least $40,000 per year if we scaled things back a bit. Residency pays better these days, but it’s not the big money that makes a dent in your debt.
Psychiatry can be profitable, to the tune of averaging between $220k-$300k per year, and even more if you build up your own practice, or have some profitable side gigs. You can also hit the ground running at a fast pace and be really productive due to your training, which can bring in bonuses, or else just make it so you can move a lot of revenue through.
As a new NP, I was lucky to land a position paying north of $150k, and I don’t think that is a rarity, even in my low cost of living state. But working in an outpatient role for a large company will probably never pay me more than $180k, ever. I have great benefits, and a good work environment, with plenty of time off. They have very reasonable expectations for my workload. A side gig I have brings in close to $23,000 a year without a lot of time or effort on my part. But I know psychiatrists with side gigs pulling in a lot more than that.
I get the whole “respect” angle that people feel like they would miss out on by foregoing medical school. I guess it depends on how you see that “respect” being manifest. I work seeing patients all day at my job, then I go home. I interact with my provider colleagues, at lunch, meetings, and briefly in passing. I’m treated well, and don’t feel like a second class citizen. On a day to day basis I’m actually more of a money maker because my wages are lower, but reimbursement is similar. Maybe among doctors there is a satisfaction amongst themselves in conversations knowing that they all went through the same hell of medical school, and they can have that exclusive club to themselves while I stay out of those conversations when they come up. Apart from that, a lot of docs have said things that border on envy regarding my pathway to doing what I do. I paid off my school my first year working. I paid off my house the second year. If I go private practice and work for myself and manage to make what my friend does, I should be able to take home over $300k. I won’t do that, but I could. If I hire some NPs and counselors, I could make even more. I do my job and take pride in it. I don’t crave any envy or anything beyond basic respect from any doctors or from the general public. For me, any added glory I’d obtain by being a physician would be a Pyrrhic victory given what I would have to go through to achieve it.
I’m kind of a corporate guy. I like parking in my special parking space and walking into a big building, dealing with large HR, dealing with large IT when I have computer problems. Eating in a large cafeteria every day. Going home and not thinking about anything else until I walk into work the next day. I feel like I get a bit of tempered respect from physicians who at times look at me and feel like they should have gone that route. My guess is that they then look at their cash flow, and it assuages a lot of those pangs of longing. Over the years, I got to spend a lot of time with my family though, and it was quality and quantity. We are lucky enough to live in a place and time when it’s reasonable to achieve a great standard of living. If I made more money, it wouldn’t add much to my standard of living, I’d just have more and nicer things. But I feel like I live better now than a millionaire did 20 years ago. I keep score a different way than a lot of folks.
