Why do people recommend PA to medical students and premeds?

[libertyyne]

As much as I don't like to admit it, I am the type of person that like the prestige associated with being a doc.

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[W19]

But I've realized that home is more important to me than anything and I just can't handle another move emotionally. I could be living a damn good life two years ago as a PA and here I am four years deep with four years to go and off to the middle of nowhere to a specialty I'm starting to feel isn't what I want. I did this to myself though.

I always feel like for some reason you would enjoy more being a CC doc than a psych doc. I have no idea how I got that vibe from the few conversations we have had.

 

[libertyyne]

But I've realized that home is more important to me than anything and I just can't handle another move emotionally. I could be living a damn good life two years ago as a PA and here I am four years deep with four years to go and off to the middle of nowhere to a specialty I'm starting to feel isn't what I want. I did this to myself though.

I understand that feeling, It is temporary tho, once you are done with your residency you can open up shop anywhere in the country. Maybe even see if you cant transfer to the home program and bring your funding with you?

I am sure many people go through similar feelings of buyers remorse and many people switch residencies. You could always find a Family practice residency willing to take you, or an IM, or even something more exotic after first year. This is your path dont feel locked into one way if you have a clear option to go reroute.

 

[libertyyne]

I always feel like for some reason you would enjoy more being a CC doc than a psych doc. I have no idea how I got that vibe from the few conversations we had.

I would probably be happier being a country family medicine doc myself personally. But people enjoy different things and I dont know mad jack that well.

 

[Matthew9Thirtyfive]

But I've realized that home is more important to me than anything and I just can't handle another move emotionally. I could be living a damn good life two years ago as a PA and here I am four years deep with four years to go and off to the middle of nowhere to a specialty I'm starting to feel isn't what I want. I did this to myself though.

It’s temporary, and experiencing things in different parts of the country/world is great for you (and ultimately for your patients). It sucks to have to move somewhere you don’t want to live, but there is always some good to be gained from it. Hang in there.

 

[Mad Jack]

It’s temporary, and experiencing things in different parts of the country/world is great for you (and ultimately for your patients). It sucks to have to move somewhere you don’t want to live, but there is always some good to be gained from it. Hang in there.

I grew up with military parents and I traveled the world already. I had a real home for the first time in my life and I just hate leaving it for four years. Things will probably be fine but god damn it hurts.

 

[libertyyne]

I grew up with military parents and I traveled the world already. I had a real home for the first time in my life and I just hate leaving it for four years. Things will probably be fine but god damn it hurts.

Having moved a lot in my life. I know the exact feeling. What is weird is you can have it even when you are leaving a ****ty situation to go on to a better one.

 

[Matthew9Thirtyfive]

I grew up with military parents and I traveled the world already. I had a real home for the first time in my life and I just hate leaving it for four years. Things will probably be fine but god damn it hurts.

I hear you. I had a really good thing going in San Diego and didn’t want to move out of the country but I had to. It ended up being good for me, even though I hated where I was living. I’m not saying you shouldn’t be sad or upset. I’m just saying not to write off the next four years as miserable.

 

[W19]

I grew up with military parents and I traveled the world already. I had a real home for the first time in my life and I just hate leaving it for four years. Things will probably be fine but god damn it hurts.

I have been living in the same town since I moved to the US... went to med school in a neighboring state but in med school I had the opportunity to go back to my hometown every 6-8 wks. However, I won't be able to do that in residency. So residency will be a challenge for me as well.

 

[dillydilly2]

By spiders they really mean heroin needles, but same difference.

Lol I know. Way to take a joke

 

[GypsyHummus]

Podiatry is gonna be the closest thing to being a physician that you are going to get at this point unless an SMP program takes a chance on you and has automatic acceptance.

If it were me, I would totally take 2 semesters and apply to DPM programs.

Personally, I couldnt stand being a PA. Nothing against them, but I want to have autonomy with my patients. PA is great when you are making 110-130K in your mid 20s to late 30s, but gets tiring quickly in your 40s and 50s when you have a hot shot 30 year old doc fresh out of residency telling you what to do.

Same, but to a lesser extent with doctors of Nurse Practitioner, mainly because the nursing lobby is scary and they will prolly become physicians in the future with same rights and privileges, kind of like how DOs did.

Also look at Dental or Optometry programs.

Checked Podiatry school, while they will take a medical student that withdrew, they will NOT take my science credits (taken in 2004-2005) so i would have to repeat at least 2 semesters of basic science undergrad classes

 

[DubbiDoctor]

I grew up with military parents and I traveled the world already. I had a real home for the first time in my life and I just hate leaving it for four years. Things will probably be fine but god damn it hurts.

I have a friend - a grad from a top 5, one of the biggest brand names in medicine school, who failed to match to his desired residency but matched to his backup, IM, right where his wive lives. Don't know his whole story, but I assume what happened was he failed to match because he only applied to local places, to be near his wife and start raising a family, on the opposite side of the country to where he went to medical school. He seemed pretty down about it, but we all have to make trade-offs.

 

[Giovanotto]

I understand that feeling, It is temporary tho, once you are done with your residency you can open up shop anywhere in the country. Maybe even see if you cant transfer to the home program and bring your funding with you?

I am sure many people go through similar feelings of buyers remorse and many people switch residencies. You could always find a Family practice residency willing to take you, or an IM, or even something more exotic after first year. This is your path dont feel locked into one way if you have a clear option to go reroute.

I know you meant well, but using temporary to describe any stage of medical training just seems cruel to me. 4 years of undergrad? temporary. 4 years of med school? temporary. 4 years of residency? temporary. Life? temporary.

 

[Stagg737]

23 states have given full autonomy to NPs in primary care fields, they can make the same refferals, order the same tests, make diagnosis, sign death certificates and bill to medicare.

Not necessarily the same though. Even in the states where NPs can practice autonomously there are still some limitations like being able to prescribe controlled substances (especially narcotics and stimulants) or perform certain procedures that some FMs do in office like EMGs or botox.

I never said that all NPs make 150+ , I merely pointed that it is fairly common to see pysch NPs recieve that sort of reimbursement.

Not really, according to AANP the average psych NP makes ~102k and 130-140k is the 90th percentile which matches up pretty well with those I've talked to. Those pulling in $150k per year are typically the ones working 55-60 hours per week. For comparison, most psychiatrists will easily clear $200k working less than 40 hours a week, and the ones working 60 hour weeks can easily clear $400k (the only one I know who works that much clears at least $600k).

Life? temporary.

Well it is....

 

[Mad Jack]

Not necessarily the same though. Even in the states where NPs can practice autonomously there are still some limitations like being able to prescribe controlled substances (especially narcotics and stimulants) or perform certain procedures that some FMs do in office like EMGs or botox.



Not really, according to AANP the average psych NP makes ~102k and 130-140k is the 90th percentile which matches up pretty well with those I've talked to. Those pulling in $150k per year are typically the ones working 55-60 hours per week. For comparison, most psychiatrists will easily clear $200k working less than 40 hours a week, and the ones working 60 hour weeks can easily clear $400k (the only one I know who works that much clears at least $600k).



Well it is....

I know one that is pulling 200k working inpatient who has full autonomy and only consults when he feels the need, he's fully interchangeable with his psych counterparts on the schedule. Granted, he's making a great deal less than the psychiatrists there, but like, still solid cash for a guy in his 20s.

 

[Mad Jack]

I know you meant well, but using temporary to describe any stage of medical training just seems cruel to me. 4 years of undergrad? temporary. 4 years of med school? temporary. 4 years of residency? temporary. Life? temporary.

Yeah. Looking at it as a fraction of my remaining pre-retirement years is a bit more functional. It's about 11% of my remaining life, assuming nothing happens. That's a decent chunk, but I live like every day could be my last because I don't want to be that guy who has some bad luck and regrets never living in the now, so every day of any stretch of time during which I feel like I'm not living my life to the fullest is quite painful.

 

[Mad Jack]

All this being said, I've already made peace with things, but given the opportunity to go back, I might have done them very differently

 

[libertyyne]

Not necessarily the same though. Even in the states where NPs can practice autonomously there are still some limitations like being able to prescribe controlled substances (especially narcotics and stimulants) or perform certain procedures that some FMs do in office like EMGs or botox.

Nurse Practitioner Prescriptive Authority

Not really, according to AANP the average psych NP makes ~102k and 130-140k is the 90th percentile which matches up pretty well with those I've talked to. Those pulling in $150k per year are typically the ones working 55-60 hours per week. For comparison, most psychiatrists will easily clear $200k working less than 40 hours a week, and the ones working 60 hour weeks can easily clear $400k (the only one I know who works that much clears at least $600k).



Well it is....

I was just pointing out that salaries in excess of150 do exisit and are not as rare as one would expect.

 

[libertyyne]

I know you meant well, but using temporary to describe any stage of medical training just seems cruel to me. 4 years of undergrad? temporary. 4 years of med school? temporary. 4 years of residency? temporary. Life? temporary.

I'd consider life to be temporary as well. But in the grand scheme of life . 65-70 year life span with 3-4 years is 4-6% of total life . I would hardly call that overwhelming or permenant. You have to enjoy the journey and you are gonna have a bad time if you just think of it as a hoop to jump.but it is far from a death sentence.

 

[Matthew9Thirtyfive]

I know you meant well, but using temporary to describe any stage of medical training just seems cruel to me. 4 years of undergrad? temporary. 4 years of med school? temporary. 4 years of residency? temporary. Life? temporary.

First off, let’s try to avoid hyperbole. Telling someone four years in a program they don’t like is only temporary is not cruel. Second, four years is nothing. He’s going to practice for decades and then be alive for decades more most likely.

 

[DOFOSHO]

MD> DO ~DDS/DMD> PA >>>>> the rest...

The MCAT is what separate MD/DO from these other professions. Most people can get a 3.5+ GPA from a 'podunk' university.

lol. hmmm im in the MICU with acute hypoxic respiratory failure should i call a doctor or a dentist?

 

[siliso]

From my observation it looks like being an NP or PA is like being a resident, forever. Except that they get the least interesting work shunted to them rather than the most difficult/educational. Pays better, obviously, and better hours. I appreciate and respect their clinical assistance and don’t intend to denigrate in any way. But as for me I’d rather Make Decisions. If someday or somewhere the training and scope of practice is identical, then the above wouldn’t apply but it’s so here for now.

 

[GypsyHummus]

Neither, call the Podiatrist

lol. hmmm im in the MICU with acute hypoxic respiratory failure should i call a doctor or a dentist?

 

[Stagg737]

I know one that is pulling 200k working inpatient who has full autonomy and only consults when he feels the need, he's fully interchangeable with his psych counterparts on the schedule. Granted, he's making a great deal less than the psychiatrists there, but like, still solid cash for a guy in his 20s.

Not gonna lie, given the quality of the psych NPs I've met, this legitimately scares me. On the other hand, the only mid-level I've met who I actually feel has the knowledge and skills to work independently is a psych NP, so hopefully he is like her.

Nurse Practitioner Prescriptive Authority

I was just pointing out that salaries in excess of150 do exisit and are not as rare as one would expect.

Not sure what's so wrong about it. The state I'm in allows nurses to work independently but they are not allowed to prescribe controlled substances (aka opioids, stimulants, or botox) and they cannot perform diagnostic tests like EMGs themselves, so you I'm not the one wrong on that one. No, those limitations don't exist in all states where mid-levels have "independence", but thankfully they do in some.

 

[Mad Jack]

Not gonna lie, given the quality of the psych NPs I've met, this legitimately scares me. On the other hand, the only mid-level I've met who I actually feel has the knowledge and skills to work independently is a psych NP, so hopefully he is like her.



Not sure what's so wrong about it. The state I'm in allows nurses to work independently but they are not allowed to prescribe controlled substances (aka opioids, stimulants, or botox) and they cannot perform diagnostic tests like EMGs themselves, so you I'm not the one wrong on that one. No, those limitations don't exist in all states where mid-levels have "independence", but thankfully they do in some.

He's pretty fantastic tbph, but he's probably the exception not the rule.

 

[libertyyne]

Not gonna lie, given the quality of the psych NPs I've met, this legitimately scares me. On the other hand, the only mid-level I've met who I actually feel has the knowledge and skills to work independently is a psych NP, so hopefully he is like her.



Not sure what's so wrong about it. The state I'm in allows nurses to work independently but they are not allowed to prescribe controlled substances (aka opioids, stimulants, or botox) and they cannot perform diagnostic tests like EMGs themselves, so you I'm not the one wrong on that one. No, those limitations don't exist in all states where mid-levels have "independence", but thankfully they do in some.

Take a look at this chart. The limitations in states with full autonomy are basically " have X amount of CE education or register with X body.
Nurse Practitioner Scope of Practice Laws

or this
https://www.ama-assn.org/sites/default/files/media-browser/specialty group/arc/ama-chart-np-prescriptive-authority.pdf


There is not a single state where NPs have autonomy from Physician oversight and do not have the ability to prescribe Schedule II-V drugs.


There are only 7 states where schedule II are not allowed, Those are all states where there is mandatory collaborative agreement necessary to prescribe them. I would hardly call those states where they are allowed to practice independently.

 

[Stagg737]

Take a look at this chart. The limitations in states with full autonomy are basically " have X amount of CE education or register with X body.
Nurse Practitioner Scope of Practice Laws

or this
https://www.ama-assn.org/sites/default/files/media-browser/specialty group/arc/ama-chart-np-prescriptive-authority.pdf


There is not a single state where NPs have autonomy from Physician oversight and do not have the ability to prescribe Schedule II-V drugs.


There are only 7 states where schedule II are not allowed, Those are all states where there is mandatory collaborative agreement necessary to prescribe them. I would hardly call those states where they are allowed to practice independently.

Those are not accurate in terms of the reality of how nurses are practicing. In Missouri, NPs essentially have fully independent practice rights in rural areas but are not allowed to prescribe Schedule 2 drugs like the ones I previously mentioned. Technically, they still have to be in collaborative agreements, but are not legally required to be supervised by a physician or have the physician sign off on any prescriptions they write, the only exception being schedule 2 drugs which they cannot prescribe without a physician signature. So while the law states they aren't practicing independently, in reality they are doing everything that independent NPs do without physicians signing off (prescribing meds, making referrals, performing minor procedures like debridement and wound care, etc).

I know this because I see the fallout from these patients when they end up getting shipped up to the urban hospitals I work at when they deteriorate or when they have to come see a physician to get a schedule 2 prescription refilled. If you want to comb through the fine print, here's a link to the nursing legislation (120 or so pages): https://pr.mo.gov/boards/nursing/npa.pdf

Anecdotal, but I also have a friend form HS in Iowa who is now an NP and has stated he can't legally prescribe opioids. So there's a state with full autonomy where an NP has stated he legally can't. Idk if he's been misinformed, but that's straight from an NP working in a hospital without supervision.

 

[libertyyne]

Those are not accurate in terms of the reality of how nurses are practicing. In Missouri, NPs essentially have fully independent practice rights in rural areas but are not allowed to prescribe Schedule 2 drugs like the ones I previously mentioned. Technically, they still have to be in collaborative agreements, but are not legally required to be supervised by a physician or have the physician sign off on any prescriptions they write, the only exception being schedule 2 drugs which they cannot prescribe without a physician signature. So while the law states they aren't practicing independently, in reality they are doing everything that independent NPs do without physicians signing off (prescribing meds, making referrals, performing minor procedures like debridement and wound care, etc).

I know this because I see the fallout from these patients when they end up getting shipped up to the urban hospitals I work at when they deteriorate or when they have to come see a physician to get a schedule 2 prescription refilled. If you want to comb through the fine print, here's a link to the nursing legislation (120 or so pages): https://pr.mo.gov/boards/nursing/npa.pdf

Anecdotal, but I also have a friend form HS in Iowa who is now an NP and has stated he can't legally prescribe opioids. So there's a state with full autonomy where an NP has stated he legally can't. Idk if he's been misinformed, but that's straight from an NP working in a hospital without supervision.

Im sorry are you trying to say that a state which is not considered full autonomy state is a full autonomy state and then argue that full autonomy states are not allowing NPs to prescribe Schedule II-IV.No one considers Missouri a Full autonomy state. Not the charts I linked before , not the AMA chart and not the AANP. AANP - State Practice Environment . In fact missouri is one of the most restrictive states. where 6 out of the 9 criteria are not met in the barton links I provided earlier.

Your anecdote doesnt really prove anything. Maybe he is misinformed? Maybe you talked to him before legislation was passed? Maybe he works for an organization where the bylaws are more stringent?

The gif was pretty on point if you ask me.

 

[Stagg737]

Im sorry are you trying to say that a state which is not considered full autonomy state is a full autonomy state and then argue that full autonomy states are not allowing NPs to prescribe Schedule II-IV.No one considers Missouri a Full autonomy state. Not the charts I linked before , not the AMA chart and not the AANP. AANP - State Practice Environment . In fact missouri is one of the most restrictive states. where 6 out of the 9 criteria are not met in the barton links I provided earlier.

Your anecdote doesnt really prove anything. Maybe he is misinformed? Maybe you talked to him before legislation was passed? Maybe he works for an organization where the bylaws are more stringent?

The gif was pretty on point if you ask me.

I'm saying that in more than a few geographic areas of Missouri NPs are allowed to practice independently, which is the standard most people I've talked to use when discussing mid-level autonomy, but still cannot prescribe schedule 2s. I never used the phrase "full-autonomy", you did. I was pointing out that there are states where nurses can practice independent of physician supervision and prescribe some medications but not all. I don't think that's much better than full scope.

I talked to my friend about 2 years ago, he said NPs at his hospital could see patients independently but couldn't prescribe certain medications because of the law. Like I said, he could have just been misinformed or the law may have changed. Idk.

 

[DubbiDoctor]

From my observation it looks like being an NP or PA is like being a resident, forever. Except that they get the least interesting work shunted to them rather than the most difficult/educational. Pays better, obviously, and better hours. I appreciate and respect their clinical assistance and don’t intend to denigrate in any way. But as for me I’d rather Make Decisions. If someday or somewhere the training and scope of practice is identical, then the above wouldn’t apply but it’s so here for now.

Are you implying that PAs never make decisions. PAs in primary care make decisions with every patient, which they essentially see autonomously even though they work under a physician. My family practice doctor even said that if he could do it again, he would strongly consider PA.

 

[libertyyne]

I'm saying that in more than a few geographic areas of Missouri NPs are allowed to practice independently, which is the standard most people I've talked to use when discussing mid-level autonomy, but still cannot prescribe schedule 2s. I never used the phrase "full-autonomy", you did. I was pointing out that there are states where nurses can practice independent of physician supervision and prescribe some medications but not all. I don't think that's much better than full scope.

I talked to my friend about 2 years ago, he said NPs at his hospital could see patients independently but couldn't prescribe certain medications because of the law. Like I said, he could have just been misinformed or the law may have changed. Idk.

I said :

Lol this nonesense again. Here is my summary from the last time you brought up chiroquackery.


The next argument you make is shows me that just like math you have very little grasp on logic and reasoning and facts. You stated that primary care NPs do not practice medicine to the full exetent as MD/DO's. Any person who has read even a little about the push to grant full privledges to NPs knows that is FACTUALLY INCORRECT. 23 states have given full autonomy to NPs in primary care fields, they can make the same refferals, order the same tests, make diagnosis, sign death certificates and bill to medicare.

To which you replied and qouted:

Not necessarily the same though. Even in the states where NPs can practice autonomously there are still some limitations like being able to prescribe controlled substances (especially narcotics and stimulants) or perform certain procedures that some FMs do in office like EMGs or botox.




Well it is....

So basically I say in 23 states NPs can do everything a PCP can, and you reply with in "my state they cant". Well your state is not one of those 23 states. I dont know why this is difficult for you to understand that your state is not one of the 23. When I provide you with evidence from credible sources AMA, AANP you say it is wrong. And that in "conversations you have had with people" "your state is the standard for autonomy". IT IS NOT, it is literally listed as one of the worst states for autonomy by AANP.

It is like talking about the weather of northeast and you pointing to California and saying it never snows in northeast since it never snows in southern California.

 

[DubbiDoctor]

Because it's a solid route. Now that I've gone through a lot of this, I can clearly state that medical school was a mistake and I should have gone to PA school. Too late to change my mind, but that's life.

Tbf the only fields where that holds true are primary care, out-patient psych and general anesthesia. In no other field can a midlevel perform the same job as a physician. There will never be midlevels performing surgery independently, taking referrals from primary "providers" for specialty care, determining whether a positive radiology scan is artifactual, or handling the most acute cases in non-rural EDs, where BC physicians can be hired.

 

[naway]

I know 2 med students personally who were pre-PA and and in med school now for this specific reason. They had a great app but didn't have the contact hours or something like that (which they said some HAVE to be paid). Granted they were probably top PA candidates.

It's bizarre how hardly anyone ever mentions this requirement when they present PA as this secret shortcut to many of the same perks as an MD/DO. I would have gone the PA route myself if it wouldn't mean years of accumulating contact hours, by which time I could have already been a medical student. While I was a nontraditional post-bacc student, many people recommended PA to me, and I was all ready to go for it until I learned about the hour requirement. PA and MD/DO are just radically different models. The PA path was originally intended for the more nontraditional students who already had careers in healthcare and were looking to substantially advance their careers. MD/DO programs are more geared towards recent college grads. PA is so often presented as the nontraditional student-friendly option, which is largely true, but it's only friendly to a certain type of nontrad. The student who graduated with a history degree 5 years ago and has recently decided they want to pursue a high-earning position in healthcare is not going to be a good candidate for PA school anytime soon. They can certainly work towards becoming a good candidate, but it's going to take them a lot of time.

 

[Stagg737]

I said :


To which you replied and qouted:

So basically I say in 23 states NPs can do everything a PCP can, and you reply with in "my state they cant". Well your state is not one of those 23 states. I dont know why this is difficult for you to understand that your state is not one of the 23. When I provide you with evidence from credible sources AMA, AANP you say it is wrong. And that in "conversations you have had with people" "your state is the standard for autonomy". IT IS NOT, it is literally listed as one of the worst states for autonomy by AANP.

It is like talking about the weather of northeast and you pointing to California and saying it never snows in northeast since it never snows in southern California.

I never said MO is the standard for autonomy anywhere, I just said that there are plenty of areas in the state where independent practice happens even though the law supposedly forbids it according to your sources. There are plenty of areas of fine print that provide exceptions to the generalizations. I also said that things may have changed since I talked to my friend and said that he may have been misinformed multiple times. I also missed your full autonomy thing, but you're really extrapolating from my comments and making assumptions that I never said. For real though, you should probably chill if you're taking it this seriously. Seems like you're getting way too invested...

 

[libertyyne]

I never said MO is the standard for autonomy anywhere, I just said that there are plenty of areas in the state where independent practice happens even though the law supposedly forbids it according to your sources. There are plenty of areas of fine print that provide exceptions to the generalizations. I also said that things may have changed since I talked to my friend and said that he may have been misinformed multiple times. I also missed your full autonomy thing, but you're really extrapolating from my comments and making assumptions that I never said. For real though, you should probably chill if you're taking it this seriously. Seems like you're getting way too invested...

I'm saying that in more than a few geographic areas of Missouri NPs are allowed to practice independently, which is the standard most people I've talked to use when discussing mid-level autonomy, but still cannot prescribe schedule 2s. I never used the phrase "full-autonomy", you did. I was pointing out that there are states where nurses can practice independent of physician supervision and prescribe some medications but not all. I don't think that's much better than full scope.

I talked to my friend about 2 years ago, he said NPs at his hospital could see patients independently but couldn't prescribe certain medications because of the law. Like I said, he could have just been misinformed or the law may have changed. Idk.

Full autonomy and restricted practice are different things. Your state has restricted practice so even though they seem " autonomous" to you, legally they are not and therefore do not have the ability to prescribe schedule IIs. It is sham oversight or what ever you want to call it.

So just to reiterate. There is NO state where NPs have Full Legal Autonomy where they cannot prescribe schedule II-IVs. And contrary to your initial comment that NPs cannot practice to the full extent that PCPS can in those states, they can. So you were wrong, and its ok to admit that.

 

[Lnsean]

I never said MO is the standard for autonomy anywhere, I just said that there are plenty of areas in the state where independent practice happens even though the law supposedly forbids it according to your sources. There are plenty of areas of fine print that provide exceptions to the generalizations. I also said that things may have changed since I talked to my friend and said that he may have been misinformed multiple times. I also missed your full autonomy thing, but you're really extrapolating from my comments and making assumptions that I never said. For real though, you should probably chill if you're taking it this seriously. Seems like you're getting way too invested...

I mean...attack the argument not the person. He's linked you facts from organizations and all you have as rebuttals are stories of he said she said.

 

[Stagg737]

I mean...attack the argument not the person. He's linked you facts from organizations and all you have as rebuttals are stories of he said she said.

I linked the Missouri state legislation and already said I misread the comment about full autonomy he was freaking out about, so not really sure what else people are looking for. I didn't post a ton of links becuase I was gaving examples of when real life medicine didn't line up with what the links he posted were saying. If people are really so stuck on what's written in paper and ignore what happens right in front of them irl, idk what is even worth discussing because it just falls on deaf ears. I also never attacked him, I just said he should probably chill out given how worked up he seemed to be getting. If you're taking that as a personal attack, idk what to tell you.

 

[Don R]

As much as I don't like to admit it, I am the type of person that like the prestige associated with being a doc.

As a nurse practitioner I don't understand why anybody would do the PA route. So much more autonomy I do everything a position does no collaboration where I am. Excellent salary Etc. I truly don't understand why people become PA's

 

[Don R]

As a nurse practitioner I don't understand why anybody would do the PA route. So much more autonomy I do everything a position does no collaboration where I am. Excellent salary Etc. I truly don't understand why people become PA's

Physician... Sorry for the grammatical error using my speech to text

 

[Don R]

I was just pointing out that salaries in excess of150 do exisit and are not as rare as one would expect.[/QUOTE]

I am very blessed and fortunate I know that however all of the people like myself that are psychiatric NPs and work in the addiction field are making between 100 and $150 per hour... Currently I'm making 300K a year... And if I was willing to move to Wyoming which I'm not I was offered a position at $300 an hour...

 

[Cranjis McBasketball]

As a nurse practitioner I don't understand why anybody would do the PA route. So much more autonomy I do everything a position does no collaboration where I am. Excellent salary Etc. I truly don't understand why people become PA's

Because if you got your bachelors in something, other than nursing, it'll take a lot more years to become an NP instead of the 2 to become a PA. In the end, theyre both mid-level providers with similar salaries and duties

 

[Don R]

Because if you got your bachelors in something, other than nursing, it'll take a lot more years to become an NP instead of the 2 to become a PA. In the end, theyre both mid-level providers with similar salaries and duties

At this point in time NPs only need a master's degree... We should be required to get a dnp but they haven't implemented that yet. So you need a bachelor's + 2 years for your Masters and that's it.

 

[Don R]

Full autonomy and restricted practice are different things. Your state has restricted practice so even though they seem " autonomous" to you, legally they are not and therefore do not have the ability to prescribe schedule IIs. It is sham oversight or what ever you want to call it.

So just to reiterate. There is NO state where NPs have Full Legal Autonomy where they cannot prescribe schedule II-IVs. And contrary to your initial comment that NPs cannot practice to the full extent that PCPS can in those states, they can. So you were wrong, and its ok to admit that.

I prescribe schedule 2 through 5... In Connecticut I don't know what you're talkin about I have no restriction on my privileges as a nurse practitioner

 

[Don R]

Full autonomy and restricted practice are different things. Your state has restricted practice so even though they seem " autonomous" to you, legally they are not and therefore do not have the ability to prescribe schedule IIs. It is sham oversight or what ever you want to call it.

So just to reiterate. There is NO state where NPs have Full Legal Autonomy where they cannot prescribe schedule II-IVs. And contrary to your initial comment that NPs cannot practice to the full extent that PCPS can in those states, they can. So you were wrong, and its ok to admit that.

No he's not he's actually right... 20 states allow nurse practitioners to prescribe schedule 2 through 5 with full autonomy... I don't know where you're getting your information from

 

[cbrons]

I prescribe schedule 2 through 5... In Connecticut I don't know what you're talkin about I have no restriction on my privileges as a nurse practitioner

You make $300,000 per year as a psychiatric NP in Connecticut?

 

[Don R]

Not necessarily the same though. Even in the states where NPs can practice autonomously there are still some limitations like being able to prescribe controlled substances (especially narcotics and stimulants) or perform certain procedures that some FMs do in office like EMGs or botox.



Not really, according to AANP the average psych NP makes ~102k and 130-140k is the 90th percentile which matches up pretty well with those I've talked to. Those pulling in $150k per year are typically the ones working 55-60 hours per week. For comparison, most psychiatrists will easily clear $200k working less than 40 hours a week, and the ones working 60 hour weeks can easily clear $400k (the only one I know who works that much clears at least $600k).



Well it is....

Check this link out... This is for a full-time position I just randomly found by doing a search on indeed...

 

[Don R]

You make $300,000 per year as a psychiatric NP in Connecticut?

Yes sir as a psychiatric nurse practitioner and addiction specialist I get paid $150 per hour... All of my peers make between 100 and even as high as 175 an hour

 

[Don R]

Yes sir as a psychiatric nurse practitioner and addiction specialist I get paid $150 per hour... All of my peers make between 100 and even as high as 175 an hour

I just posted this random thing I found on indeed after a 2-minute search

 

[cbrons]

Yes sir as a psychiatric nurse practitioner and addiction specialist I get paid $150 per hour... All of my peers make between 100 and even as high as 175 an hour

So you make more than 90% of psychiatrists...

..this country....

 

[Cranjis McBasketball]

At this point in time NPs only need a master's degree... We should be required to get a dnp but they haven't implemented that yet. So you need a bachelor's + 2 years for your Masters and that's it.

Thats what I mean though. If I get a bachelors in biology, its better to just do the 2 year masters degree for PA then to commit 6 years to becoming an NP.. In my opinion