why dont you all go to nursing school instead?

[binko]

---

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save this for the adcoms LOL

Hah no way I'm saying that kind of cheesey crap to the adcoms. They'd think it was pure, unadulterated toro caca.

 

[testingpig]

Have you seeen meet the parents??? Come on!!

yes. That is when I decided to become a doctor. But now I feel it would have been best if I went straight into a CUNY NP program out of high school. I could've been a nurse anesthetist by now, making 6figures. If you live frugally and play on the stock market, that's <10yrs to become a millionaire. But I've gone too far now. I paid for a very expensive ugrad education in natural sciences and excelled on mcat. It's only in the movies that someone with exact same mcat score as me suddenly decides that he wants to become a nurse. Actually in that movie it wasn't like that. He first decided to become a nurse. But then he took mcat just to prove that he's smart.

 

[melanoleuca]

ok alot of people in here seem to think that doctors are way superior to NP/PA's in their capacity to practice medicine. If you all really think that then why do you feel so threatened by the PA/NP, if your going to be so much better prepared to practice medicine than them then you have nothing to worry about as far as them encroaching on your "territory".

And don't say your worried for the patients sake b/c i don't buy that.

(mostly because my experiences with NP/PA as a patient have been very good and as far as i know in almost all states NP/PA will have a supervising doctor).

Again let me remind you Im planning to be an MD.

If you all were really worried about patients you might have legitament gripe about clinical psychologists fighting for prescription rights, but complaing that PA/NP are "acting like doctors" is nothing more than an ego trip of somesort.

You see, you're not thinking. For most physicians, the territory that you are so quick to leave undefended is payed for by third-parties; either the government or insurance companies that take their cue from the government, who have no interest whatsoever in medical care at all except that it is cheap and is provided by the least skilled practitioner who is the most likely to follow the rules to keep it cheap. On the government's part, they also want it to be cheap so they can give it away cheaply to cement their political hold on a growing dependency class who will be mollified more by the illusion of quality health care than the cheap reality of it.

I know they feed you the mantra that "midlevels" are some random percentage as qualified as physicians as in "they know and can do 90 percent of what a physician does" but the reality is that they know and can do about 90 percent of the paperwork and their real medical knowledge and skills are vastly inferior to a residency-trained physician's.

As to the other mantra that "midlevels can handle all the simple things," well, sure. My school nurse could handle a lot of the simple things. The problem is that the way reimbursements work, if the mid-levels suck up all the little things, the bread and butter stuff, all that is left for real doctors are the incredibly sick, incredibly complex, incredibly-poorly-reimbursing-for-time-invested patients which is a little unfair to you, the physician...dontcha' think?

In other words, if the school nurse...er...I mean the midlevel can run forty minor back pains and common colds a day through his practice while the physician can only see eight who have a list of medical problems that reads like a pathology textbook the midlevel will come out way ahead. Remember, this is not a market driven thing. The rules for reimbursement are written by the government and forty easy, low risk patients pay a lot more than eight trainwrecks. Doctors are payed by piecework, you understand, not for their time. Remember also that while the level of complexity of a visit dictates reimbursment, it is not a linear scale. Many simple patients pay more than a few seen in the same amount of time...a lot more...which is why Emergency Phyisicans, except that we love trainwrecks, would cringe at a critical care patient who sucks up an hour of their time in which we could deal with five minor complaints and bill three times as much.

My other question is why have midlevels? I guarantee you that any reasonably educated college graduate in any major with four months of medical training can handle most of the paperwork which is the bulk of most mid-level's work. We should economize even more and create a PAA or Physician Assistant Assistant who will know most of what a PA knows (by skipping all of the useless stuff) and can do 90 percent of the PA's job.

I repeat, you folks don't think. All you do is spout propaganda.

 

[melanoleuca]

i was wondering the exact same thing. But this is sort of a prevalent stereotype around this forum:

Everyone knows that a future doctor is by default male 🙄

You know, by convention in written and spoken English it is acceptable to write or say, "he, his, him," and this is considered sex-neutral. Or you can just pick one (his or hers) and go with it. Nothing is sadder or harder on the brain than people who are fastidious in their use of "his/hers" or "he/she" in a ridiculous attempt to avoid offending someone unless it is the completely horrific "s/he."

 

[pietachok]

I wonder if any of the NP and DNP hating people on this thread have actually worked with NPs substantially. The DNP still does not have exactly the same skills as a physician, cannot practice in any state (as far as I know) without some oversight of a physician, and is OF GREAT ASSISTANCE TO PHYSICIANS. The existence of DNPs and NPs does not hinder MD's or DO's or jeopardize our positions as such, it assists us in the treatment of patients.

I work in one of the best medical school-affiliated treatment centers for GI issues, particularly inflammatory bowel diseases (IBD). Some of the physicians have affiliated, off-campus private practices. One such practice has 4 MD's + one NP. Of course, the MD's are the ones who primarily follow/treat the patients, however, b/c of their prestige, they are often booked. When any patient in the practice has a non-emergent issue, but their physician can't see them soon enough, that NP (who is specially focused in IBD) sees that patient in the interim. It keeps the patient more comfortable, healthier, and happier than waiting for an appointment. NP's can get extremely knowledgable about their field due to their well-honed focus. I also know DNP's who basically oversee hospital-based NP's who serve the same function at hospitals. This keeps patients from (1) needlessly going to the emergency room, and (2) getting care that is specialized to their issue.

Studies have shown that patients are using the ER for their general care, rather than simply for emergencies. ER docs are not specialists, so you don't get the best care there for many internal medicine cases. Providing NP's with the potential to get further credentials so that we can qualify that they particularly excel in a certain field will provide a better, safer, healthier alternative for everyone. A patient who knows he/she is having a flare of a chronic condition that is non-emergent should se a credentialed DNP when they can't get an appointment with their doc; right now they are going to the ER...and often that means the doc seeing them has no medical history and has to play it safe which could mean a drastically different course of action! (I just saw a patient today who got 160mg of corticosteroids who should have gotten none due exactly to this type of situation).

 

[airplanes]

Hey, I wouldn't do 30 hour shifts for free. I'd give myself some pretty liberal breaks if there was no monetary incentive to crowd my schedule and rush the patients out of the room after 45 seconds.

But yeah, I actually do plan to spend a lot of time overseas volunteering my services once I'm a doctor. Doing it here too would just save me airfare.

I already have a career that I enjoy, which is webdesign. It's full of learning opportunities, travel opportunities (conferences all over the place), and it's creative and fun. But I actually do want to Help People™ and that's why I'm giving it up to go to med school.

Oh yeah, and I've done that job for free for good causes as well.

What's with the trade mark?

 

[melanoleuca]

I wonder if any of the NP and DNP hating people on this thread have actually worked with NPs substantially. The DNP still does not have exactly the same skills as a physician, cannot practice in any state (as far as I know) without some oversight of a physician, and is OF GREAT ASSISTANCE TO PHYSICIANS. The existence of DNPs and NPs does not hinder MD's or DO's or jeopardize our positions as such, it assists us in the treatment of patients.

I work in one of the best medical school-affiliated treatment centers for GI issues, particularly inflammatory bowel diseases (IBD). Some of the physicians have affiliated, off-campus private practices. One such practice has 4 MD's + one NP. Of course, the MD's are the ones who primarily follow/treat the patients, however, b/c of their prestige, they are often booked. When any patient in the practice has a non-emergent issue, but their physician can't see them soon enough, that NP (who is specially focused in IBD) sees that patient in the interim. It keeps the patient more comfortable, healthier, and happier than waiting for an appointment. NP's can get extremely knowledgable about their field due to their well-honed focus. I also know DNP's who basically oversee hospital-based NP's who serve the same function at hospitals. This keeps patients from (1) needlessly going to the emergency room, and (2) getting care that is specialized to their issue.

Studies have shown that patients are using the ER for their general care, rather than simply for emergencies. ER docs are not specialists, so you don't get the best care there for many internal medicine cases. Providing NP's with the potential to get further credentials so that we can qualify that they particularly excel in a certain field will provide a better, safer, healthier alternative for everyone. A patient who knows he/she is having a flare of a chronic condition that is non-emergent should se a credentialed DNP when they can't get an appointment with their doc; right now they are going to the ER...and often that means the doc seeing them has no medical history and has to play it safe which could mean a drastically different course of action! (I just saw a patient today who got 160mg of corticosteroids who should have gotten none due exactly to this type of situation).

NP training is a joke and many NPs are truly dangerous primarily because they don't even know what they don't know, a character flaw that is generally absent among physicians who are usually and by training keenly aware of their own limitations. But you have exactly nailed the role in which NPs can be of most use, that is, to manage a narrow range of non-emergent conditions in which they have received some extra instruction...but why this needs a special degree or credentials besides, maybe, a certificate of "Advanced Practice Nursing" to mollify the hunger of non-physicians for cheap titles, credientials and other geegaws (for who has not seen the puffed up nurse or allied health professional with six acronyms after their name on their ID badge) is beyond me. If you are going to reduce the treatment of common medical problems to a script or a protocol than the office manager or the billing clerk might as well do it when she is not otherwise busy.

Or is your proposal to train hundreds of NPs, each with highly specialized knowledge in one area, and send every patient to maybe ten or fifteen Splinter Care Facilities to adress each of their medical issues as if they exist in vacuum?

Uh, and Dude, ER docs are specialists. Specialists in Emergency Medicine. Did you not get the memo? Also, and this is going to rock your little world, since a typical Emergency Physician does five months of critical care and four months of internal medicine in his residency we do know a little bit about medicine...or didn't you get that memo. You're a little too wet behind the ears to believe that all of dem' Emergency Room Doctors is stoopid.

 

[Fp02c]

\

 

[niranjan162]

I wonder if any of the NP and DNP hating people on this thread have actually worked with NPs substantially. The DNP still does not have exactly the same skills as a physician, cannot practice in any state (as far as I know) without some oversight of a physician, and is OF GREAT ASSISTANCE TO PHYSICIANS. The existence of DNPs and NPs does not hinder MD's or DO's or jeopardize our positions as such, it assists us in the treatment of patients.

I work in one of the best medical school-affiliated treatment centers for GI issues, particularly inflammatory bowel diseases (IBD). Some of the physicians have affiliated, off-campus private practices. One such practice has 4 MD's + one NP. Of course, the MD's are the ones who primarily follow/treat the patients, however, b/c of their prestige, they are often booked. When any patient in the practice has a non-emergent issue, but their physician can't see them soon enough, that NP (who is specially focused in IBD) sees that patient in the interim. It keeps the patient more comfortable, healthier, and happier than waiting for an appointment. NP's can get extremely knowledgable about their field due to their well-honed focus. I also know DNP's who basically oversee hospital-based NP's who serve the same function at hospitals. This keeps patients from (1) needlessly going to the emergency room, and (2) getting care that is specialized to their issue.

Studies have shown that patients are using the ER for their general care, rather than simply for emergencies. ER docs are not specialists, so you don't get the best care there for many internal medicine cases. Providing NP's with the potential to get further credentials so that we can qualify that they particularly excel in a certain field will provide a better, safer, healthier alternative for everyone. A patient who knows he/she is having a flare of a chronic condition that is non-emergent should se a credentialed DNP when they can't get an appointment with their doc; right now they are going to the ER...and often that means the doc seeing them has no medical history and has to play it safe which could mean a drastically different course of action! (I just saw a patient today who got 160mg of corticosteroids who should have gotten none due exactly to this type of situation).

Not trying to be a dick, but you dont know what youre talking about.

from american academy of NP's

As licensed independent practitioners, nurse practitioners practice autonomously and in collaboration with health care professionals and other individuals to assess, diagnose, treat and manage the patient's health problems\needs. They serve as health care researchers, interdisciplinary consultants and patient advocates."

http://www.aanp.org/NR/rdonlyres/FCA07860-3DA1-46F9-80E6-E93A0972FB0D/0/Scope_of_Practice.pdf

There are several states where nurses can practice without physician supervision.

Hell they sound better than physicians, except for that little bit of training they are missing, and by little bit I mean 2-6 years.

You call out people on ever having worked with them, but you dont know anything about them and probably have not worked with them in a meaningful capacity either.

I dont hate nurses, nobody here was asserting that. My gripe is that they were trained to do nursing, the DNP degree is a joke and is not equal to the training of a physician which many nursing lobbying groups are claiming.

Hmmm the AMA seems to think emergency medicine is a specialty. But you dont, wonder whose right?

http://www.ama-assn.org/ama/pub/education-careers/becoming-physician/choosing-specialty.shtml

Dont let the fact that its first on the list fool you. Keep living in ignorance.

 

[tennisball80]

Nurses are trained to be nurses. They do not practice medicine. Isn't that simple ? Nurses are nurses. They are not doctors. They can't diagnose and order x-rays because they are nurses.

It's a huge mess of just having nurse partitioner. Thousands of IMGs can't event get a job in America. Are you kidding me ? A freaking nurse of 7 years of crappy schooling to practice medicine ?

 

[starfishprime]

Nurses are trained to be nurses. They do not practice medicine. Isn't that simple ? Nurses are nurses. They are not doctors. They can't diagnose and order x-rays because they are nurses.

It's simple to me, and it's simple to you, but remember that the large majority of people are orders of magnitude below in intelligence. I'll let you know when I figure out a solution to this problem.

 

[surftheiop]

It's simple to me, and it's simple to you, but remember that the large majority of people are orders of magnitude below in intelligence. I'll let you know when I figure out a solution to this problem.

So people are orders of magnitude less intelligent than you because they hold a different opinion about a topic? thats logically sound.

Im not saying PA's/NP's are equivalent to physicians, Im just saying certain jobs now down by physicians could definately be done by someone with less schooling. For example, in my personal experience NP's/PA's have greatly increased my health care (ie i can go to my FP anytime I want to see one instead of having to schedule an appointment with a doc for the next day). And my FP doc is a great physician so i think its pretty bold of you all to say he somehow is endangering his patients by bringing a NP to the practice, seems he would know better than you.

Anyhow, I just dont feel my future career is threatened by PA's/NP's , medical specialties are getting so specific with fellowships these days that there is no way PA's/NP's can really endanger any specialty except maybe family practice.

 

[surftheiop]

You see, you're not thinking. For most physicians, the territory that you are so quick to leave undefended is payed for by third-parties; either the government or insurance companies that take their cue from the government, who have no interest whatsoever in medical care at all except that it is cheap and is provided by the least skilled practitioner who is the most likely to follow the rules to keep it cheap. On the government's part, they also want it to be cheap so they can give it away cheaply to cement their political hold on a growing dependency class who will be mollified more by the illusion of quality health care than the cheap reality of it.

I know they feed you the mantra that "midlevels" are some random percentage as qualified as physicians as in "they know and can do 90 percent of what a physician does" but the reality is that they know and can do about 90 percent of the paperwork and their real medical knowledge and skills are vastly inferior to a residency-trained physician's.

As to the other mantra that "midlevels can handle all the simple things," well, sure. My school nurse could handle a lot of the simple things. The problem is that the way reimbursements work, if the mid-levels suck up all the little things, the bread and butter stuff, all that is left for real doctors are the incredibly sick, incredibly complex, incredibly-poorly-reimbursing-for-time-invested patients which is a little unfair to you, the physician...dontcha' think?

In other words, if the school nurse...er...I mean the midlevel can run forty minor back pains and common colds a day through his practice while the physician can only see eight who have a list of medical problems that reads like a pathology textbook the midlevel will come out way ahead. Remember, this is not a market driven thing. The rules for reimbursement are written by the government and forty easy, low risk patients pay a lot more than eight trainwrecks. Doctors are payed by piecework, you understand, not for their time. Remember also that while the level of complexity of a visit dictates reimbursment, it is not a linear scale. Many simple patients pay more than a few seen in the same amount of time...a lot more...which is why Emergency Phyisicans, except that we love trainwrecks, would cringe at a critical care patient who sucks up an hour of their time in which we could deal with five minor complaints and bill three times as much.

My other question is why have midlevels? I guarantee you that any reasonably educated college graduate in any major with four months of medical training can handle most of the paperwork which is the bulk of most mid-level's work. We should economize even more and create a PAA or Physician Assistant Assistant who will know most of what a PA knows (by skipping all of the useless stuff) and can do 90 percent of the PA's job.

I repeat, you folks don't think. All you do is spout propaganda.

Im curious which propaganda im spouting? If anything you could claim I haven't researched the topic thoroughly, seeing as all my claims are based on anecdotal evidence but its hard to spout propaganda when im basing my claims on personal experiences with the health care system.

But like I said earlier, I like the fact I can go to the clinic to get a physical and the NP can sign it instead of making me wait a week to see an MD so he can tell me that its safe for me to volunteer at a hospital.

 

[87138]

Anyhow, I just dont feel my future career is threatened by PA's/NP's , medical specialties are getting so specific with fellowships these days that there is no way PA's/NP's can really endanger any specialty except maybe family practice.

Tell that to the Anesthesiologists.

 

[starfishprime]

So people are orders of magnitude less intelligent than you because they hold a different opinion about a topic? thats logically sound.

Obviously not. I'm simply stating statistics.

 

[highvoltage]

Im not saying PA's/NP's are equivalent to physicians, Im just saying certain jobs now down by physicians could definately be done by someone with less schooling. .

The most simple examination can turn into a big thing if its not caught. There are subtle findings, unique constellation of symptoms, different presentations of common diseases. The only way to understand these and put them in perspective is to do a medical residency. So when one is not aware of these, or if its not in the ddx it will never be caught. If you dont know a condition exists there is no way you can diagnose it. SO this is my problem with mid level providers doing supposedly routine care. Its dangerous.

 

[surftheiop]

Tell that to the Anesthesiologists.

I haven't heard of many unemployed anethesiologists.

Im not saying that NP/PA won't make certain specialties less lucrative, im saying they likely arent going to take over the whole specialty.

And if they do manage to incringe on a specialty its going to be because they are capable of doing the job.

(For example, my friend's dad who is a plastic surgeon has a nurse anthesticist (spelling??) because he feels she is completly capable of doing the required job).

I mean do you really need an anthesiologist in every OR when a whole pack of them are just a code button away? (Obviously it would be most safe to have an anethesiologist in every room, but there is no point in providing only infintesimely safer care if it doubles the cost of every procedure).

 

[surftheiop]

Obviously not. I'm simply stating statistics.

“In God we trust; all others must bring data.” --W. Edwards Deming

Lets see it

 

[87138]

.

 

[tennisball80]

For example, in my personal experience NP's/PA's have greatly increased my health care (ie i can go to my FP anytime I want to see one instead of having to schedule an appointment with a doc for the next day). And my FP doc is a great physician so i think its pretty bold of you all to say he somehow is endangering his patients by bringing a NP to the practice, seems he would know better than you.

Anyhow, I just dont feel my future career is threatened by PA's/NP's , medical specialties are getting so specific with fellowships these days that there is no way PA's/NP's can really endanger any specialty except maybe family practice.

Because NP and PA do not hold a medical degree, they are not entitled for family practice. Do they now about

Anatomy
Physiology
Histology
Biochemistry
Embryology
Neuroanatomy

Pathology
Pharmacology
Microbiology
Immunology

?

No. They can't diagnose and treat a patient. They shoudn't be doing that.

And why you are bringing personal experience ? Who cares ? I am not your friend in real life and other people are not either. Speak about facts please. I don't care about your feelings and it's not my job to care. If you have something interesting facts, please feel free to bring some up.

Your family physician bringing a FP ? Yeah ? maybe because he wants to save money. Maybe he is greedy as hell. Did you know that ? I have a personal example of it. Do you care ? No. Off course you don't.


My suggestion for future health care:
Ban nurse practioners and let them go back to nursing. Not medicine.
Shorten residency program to 1 year instead of 3 years for family practice.
The residency spots will increase to 3 times. Hire those IMGs who have passed USMLE.

 

[usermike8500]

I have to get a physical exam tomorrow. I was told it will be done by a nurse practitioner rather than a physician. I hope I don't have some underlying health problem that wouldn't be recognized by someone with 1/3 the training of a primary care doc. Oh well, I guess this uncertainty is something myself and other patients will have to live with.

 

[binko]

What's with the trade mark?

It's a sort of self-conscious acknowledgement of the cliché in a way that's sort of supposed to be funny.

 

[besmart]

Because NP and PA do not hold a medical degree, they are not entitled for family practice. Do they now about

Anatomy
Physiology
Histology
Biochemistry
Embryology
Neuroanatomy

Pathology
Pharmacology
Microbiology
Immunology

?

No. They can't diagnose and treat a patient. They shoudn't be doing that.

And why you are bringing personal experience ? Who cares ? I am not your friend in real life and other people are not either.

Your family physician bringing a FP ? Yeah ? maybe because he wants to save money. Maybe he is greedy as hell. Did you know that ? I have a personal example of it. Do you care ? No. Off course you don't.


My suggestion for future health care:
Ban nurse practioners and let them go back to nursing. Not medicine.
Shorten residency program to 1 year instead of 3 years for family practice.
The residency spots will increase to 3 times. Hire those IMGs who have passed USMLE.

Where do I start? First, PAs DO study anatomy, pharmacology, pathology, etc. However, they are not trained to be doctors. They are trained to assistant doctors. The more experience and knowledge the PA gains, the more the "supervisor" can give the PA. A smart doctor that has a private practice would be wise to hire a smart PA.

NPs are all over the local clinic. My wife has been to an NP several times to get medication for coughs, UTI, etc. She has never once experience a "stupid" NP. When my wife goes in for her yearly checkup, she always sees the NP. She has never once complained. I've been happy as well. I would be the first person to NOT allow her to be seen by a NP if I thought the NP gave bad care. But I have been well satisfied.

I don't have any problem with PAs or NPs. The problem I have is with DNPs. I want to make sure that DNPs know when to order a tissue sample, when to reffer, not knowing what basic disease symptoms can actually be a sign of something more serious. Those are my main fears. I would love to see NDPs in rural areas where people don't have any access to primary care providers.

 

[surftheiop]

I just realized that I forgot to answer the OP:

Why don't I just go to NP school? In short Its not the proper schooling for my career goals.

(im calling MD's "he"'s here because im a guy)

I feel being a NP would fullfill my main motivations for medicine (mostly wanting a career where I know that everyday I will get the chance to personally improve people's lives) but there is so much more than an MD has to offer over a NP for me.

Many reasons:

Im not really excited by family/general practice.

NP will have to refeer any non-routine patient. From an intellectual standpoint I would much rather be the expert the patient is being refered to.

Also I've seen how in hospital settings that the attending MD is truly a team leader. He works as a team with many levels of medical professionals, all of which have an important role. For procedure heavy specialties when he goes to do a procedure not only is he focused on the part he actually has to perform, he also knows exactly what everyone else in that room is supposed to be doing. If anything un-routine happens then every head in that room (except one) is staring at the attending waiting for guidance.

Im a chemical engineering major at a research oriented school so the thought of going into academics is pretty appealing to me so MD would definately be the way to go if I want both clinical and academic roles.

theres more but im tired.

 

[binko]

when you are working a 30 hour shift at a hosptial there are no breaks. You cant just say oh well im turning my beeper off for my 45 minute lunch. You work and work and work. thats the name of the game. ITS WORK

The hilarity of this post just hit me. Sure, during residency and whatnot, when I'm a peon, I'll probably have some insane long shifts. But no doctors I know work 30 hours regularly, or don't ever get to step around the block for lunch. If you're in that high of a demand, you've got to be pretty damn special.

 

[surftheiop]

I have to get a physical exam tomorrow. I was told it will be done by a nurse practitioner rather than a physician. I hope I don't have some underlying health problem that wouldn't be recognized by someone with 1/3 the training of a primary care doc. Oh well, I guess this uncertainty is something myself and other patients will have to live with.

If it bothers you then pay an MD to do it ?????????????

 

[besmart]

Why not just become an NP? I want to be a pathologist. A pathologist can stress over one particular cell on one particular slide because s/he knows that whatever his diagnosis is would determine the path of treatment and ultimate fate of the patient's health. Pathology is the foundation of all medicine - without pathology we would have no definitive diagnosis. That is a scary thought. The second we have a non trained medical doctor giving out a diagnosis in this nature, medicine is DEAD.

 

[besmart]

The hilarity of this post just hit me. Sure, during residency and whatnot, when I'm a peon, I'll probably have some insane long shifts. But no doctors I know work 30 hours regularly, or don't ever get to step around the block for lunch. If you're in that high of a demand, you've got to be pretty damn special.

Most doctors are not as busy as most people think (hours wise). Most are gone by early evening. Sure some doctors have to stay late because the patients they are assigned to are in the hospital. My local clinic closes the clinic at 5:00 pm. You don't see patients in the clinic after that time. What doctors do after 5:00 pm varies on the patient load (aka paper work that needs to be done, etc) and if they have patients in the hospital. I rarely ever saw a surgeon walking the halls in the hospital floors late at night.

I would say 55 - 65 hours a week is very reasonable work load (hours wise). Parents who work 40+ hours a week go home and work as a mother for hours on end.

 

[surftheiop]

Because NP and PA do not hold a medical degree, they are not entitled for family practice. Do they now about

Anatomy
Physiology
Histology
Biochemistry
Embryology
Neuroanatomy

Pathology
Pharmacology
Microbiology
Immunology

?

No. .

Your credibility is questionable,

Looking at PA curriculum from MUSC


Anatomy including lab with cadaver dissection? Yes
Pathology? Yes
Physiology? Yes
Pharmacology? Yes
Clinical Diagnosis? Yes
Pharmacotheraputics? Yes

Clinical Education/Clerkships?

General Surgery? Yes
Family Medicine? Yes
Emergency Medicine? Yes
Peds? Yes
Women's Health? Yes
Mental Health? Yes
General Medicine? Yes

 

[tennisball80]

Your credibility is questionable,

Looking at PA curriculum from MUSC


Anatomy including lab with cadaver dissection? Yes
Pathology? Yes
Physiology? Yes
Pharmacology? Yes
Clinical Diagnosis? Yes
Pharmacotheraputics? Yes

Clinical Education/Clerkships?

General Surgery? Yes
Family Medicine? Yes
Emergency Medicine? Yes
Peds? Yes
Women's Health? Yes
Mental Health? Yes
General Medicine? Yes

Can they pass USMLE Step 1 + 2 + 3 ? Do you the have the same amount of clinical hours ?

 

[tennisball80]

Also, thank you for everyone who participated this thread actively and engaged in debate. It was nice to see many people's points of view.

I am going to not discuss on this issue anymore.

 

[starfishprime]

“In God we trust; all others must bring data.” --W. Edwards Deming

Lets see it

Consider that 49.99% of people are smarter than the majority of people.

Consider that people of 110 IQ, which is presumably surpassed by the majority of people here, are smarter than 75% of people.

Etc.

QED

 

[binko]

Most doctors are not as busy as most people think (hours wise). Most are gone by early evening. Sure some doctors have to stay late because the patients they are assigned to are in the hospital. My local clinic closes the clinic at 5:00 pm. You don't see patients in the clinic after that time. What doctors do after 5:00 pm varies on the patient load (aka paper work that needs to be done, etc) and if they have patients in the hospital. I rarely ever saw a surgeon walking the halls in the hospital floors late at night.

I would say 55 - 65 hours a week is very reasonable work load (hours wise). Parents who work 40+ hours a week go home and work as a mother for hours on end.

Okay here's my theory: my father has single-handedly created this stereotype of doctors as so incredibly put-upon that they must be superhuman to manage it all. He's on night call for like a week every other month (and gets the days off) and then spends the other 7 weeks complaining about it.

 

[niranjan162]

The OP's questions was to open your eyes to what is happening. Lets dissect your points.

I just realized that I forgot to answer the OP:

Why don't I just go to NP school? In short Its not the proper schooling for my career goals.

(im calling MD's "he"'s here because im a guy)

I feel being a NP would fullfill my main motivations for medicine (mostly wanting a career where I know that everyday I will get the chance to personally improve people's lives) but there is so much more than an MD has to offer over a NP for me.

Most people like NP's more, they have better bedside manner, and have more time to spend with patients.

Goal 1 can be fulfilled by being a NP

Many reasons:

Im not really excited by family/general practice.

Heard of CRNA's? If nursing expands to consume FP, its only a matter of time before they take over other specialties.

Goal 2 can be accomplished by being an NP

NP will have to refeer any non-routine patient. From an intellectual standpoint I would much rather be the expert the patient is being refered to.

Ok, you do know that other doctors refer out to other doctors right? 🙄

Goal 3 can be accomplished by being a NP

Also I've seen how in hospital settings that the attending MD is truly a team leader. He works as a team with many levels of medical professionals, all of which have an important role. For procedure heavy specialties when he goes to do a procedure not only is he focused on the part he actually has to perform, he also knows exactly what everyone else in that room is supposed to be doing. If anything un-routine happens then every head in that room (except one) is staring at the attending waiting for guidance.

NP's have independent practice rights in some states, no attending physician, theres your leadership. Of course when something un-routine happens that patient is pretty screwed, but hey, that patient got to be seen much faster and got to pay slightly less.

Goal 4 accomplished by being an NP

You see where this is going?

NP's have an important place in healthcare, but its under physician supervision, choosing to only look one way while crossing the street is a great way to get hit by a bus. Its ok though, the NP will fix you right up.

 

[niranjan162]

Most doctors are not as busy as most people think (hours wise). Most are gone by early evening. Sure some doctors have to stay late because the patients they are assigned to are in the hospital. My local clinic closes the clinic at 5:00 pm. You don't see patients in the clinic after that time. What doctors do after 5:00 pm varies on the patient load (aka paper work that needs to be done, etc) and if they have patients in the hospital. I rarely ever saw a surgeon walking the halls in the hospital floors late at night.

I would say 55 - 65 hours a week is very reasonable work load (hours wise). Parents who work 40+ hours a week go home and work as a mother for hours on end.

55-65 is more than the average person works. Plus many doctors work more hours. You probably dont see that surgeon cuz hes doing something, surgery maybe?

You dont think there are female doctors who go home and do some mothering? You dont think the male doctors go home and help out with the kids?

Even if youre not doing anything while your on call you still have to be at the hospital or close by, you cant just do whatever you want.

Then theres also the fact that if you do night calls, the whole of next day is gone, recovering from being awake most of the night.

 

[Superman78]

I saw a Physician today for an appointment. The guy was excellent, sharp, knew the answer to every one of my questions. I had read some research about a promising new drug that might be an alternative and he corrected me with more recent research that showed some potential negative side effects of that drug. This is a drug that I had thought was obscure and I never heard of it until coming across it on a website somewhere, and yet to him it was as familiar as anything and he knew all of the most up-to-date research on it. I told him he was way better than Google.

Nurses have their procedures, their checklists, and they are damn good at what they do, but they are incredibly limited in knowledge when compared to a doctor. It's like comparing someone who is very street smart to someone who is even more street smart and also very book smart. They can make only very simple and obvious diagnoses. It's silly to even compare. And the idea that a doctor could potentially not make that much more money than a nurse is absolutely ridiculous to me, after all the goddamn endless hurdles they make us run through to become doctors, and stay doctors, the debt that is incurred, the years in the prime of our lives that are spent sitting in the library.

 

[besmart]

55-65 is more than the average person works. Plus many doctors work more hours. You probably dont see that surgeon cuz hes doing something, surgery maybe?

You dont think there are female doctors who go home and do some mothering? You dont think the male doctors go home and help out with the kids?

Even if youre not doing anything while your on call you still have to be at the hospital or close by, you cant just do whatever you want.

Then theres also the fact that if you do night calls, the whole of next day is gone, recovering from being awake most of the night.

You obviously have not worked with all of the specialties in a clinic. I have. I spent 3 1/2 years taking patients from one location to another full-time. I have a GREAT understanding for the type of hours they put in. The doctors that one would often see late are the rounding specialties and those doctors assigned to handle the out of normal business hour emergencies. That is about all really. Sure there were some nights where a patient needed to go to the cath lab at 6:00 pm, but that was NEVER an every night thing. The emergency room visits, at times, had to be taken to the cath lab, however. But even then, the number of times that was needed was not that often.

Most surgeries are scheduled AHEAD of time. Most surgeries start really early in the morning and most patients that had to go to surgery were already taken there by early afternoon. Sure there were those few late afternoon/night surgeries, but that was not an every night thing.

You also lack an understanding about the living distance from the hospital. To be trauma level 1 certified (or whatever they call it), all doctors that would be involved in such a case had to live in a certain time (distance) from the hospital. Where I worked it was a 20 minute drive in.

After 6:00 pm, most of my work involved working with the emergency room patients, patients still coming out of surgery (recovery room), taking ICU and CCU patients to the MRI and CT.

After 8:00 pm the hospital/clinic becomes a quite place...not much goes on at that time of night. After 10:00 pm most of the people you see around are nurses, residents, and on-call staff.

The critical care doctors are the ones that often had to sleep at the hospital when the patient load in the ICU was full. But even that was not an every month thing.

 

[surftheiop]

Consider that 49.99% of people are smarter than the majority of people.

Consider that people of 110 IQ, which is presumably surpassed by the majority of people here, are smarter than 75% of people.

Etc.

QED

Too easy, I knew this is exactly what you were going to say 😀


IQ can't posibly be used to tell if your orders of magnitude smarter than people b/c its not an absolute scare!

You might be able to claim to be in the 99.99% percentile of intelligence, but this is just a demonstration of HOW MANY people you are smarter than, not a measure of HOW MUCH smarter you are like you claimed.

If you were teleported to a hypothetical world that was made entirely of Savants, according to their IQ scale you would be the dumbest person on the planet, but does that mean that your intelligence changed by orders of magnitude?

Heres an example of how comparitive scales are worthless for backing up claims like you made. For example, you are finding the mass of 1000 rocks.
Lets say you use 1000 rocks, and find the mass of 999 of them to be 1kg and the mass of 1 of them to be 1.1 kg.

This means the 1kg rock is aproximately 10% heavier than the rest of the rocks, but according to your logic we would have to say it is "orders of magnitude" heavier than the other rocks because it is heavier than %99.9 of the other rocks.

 

[surftheiop]

The OP's questions was to open your eyes to what is happening. Lets dissect your points.




Most people like NP's more, they have better bedside manner, and have more time to spend with patients.

Goal 1 can be fulfilled by being a NP





Heard of CRNA's? If nursing expands to consume FP, its only a matter of time before they take over other specialties.

Goal 2 can be accomplished by being an NP



Ok, you do know that other doctors refer out to other doctors right? 🙄

Goal 3 can be accomplished by being a NP



NP's have independent practice rights in some states, no attending physician, theres your leadership. Of course when something un-routine happens that patient is pretty screwed, but hey, that patient got to be seen much faster and got to pay slightly less.

Goal 4 accomplished by being an NP

You see where this is going?

NP's have an important place in healthcare, but its under physician supervision, choosing to only look one way while crossing the street is a great way to get hit by a bus. Its ok though, the NP will fix you right up.

Your dissection skills seem to be lacking!

For example, in goal two I say im not interested in family practice, and you give an example of a single kind of nurse who can do one portion of one specialty. Even then the surgeon is still above the CRNA in OR so the CRNA is clearly not the team leader like im saying I want to be (nor will CRNA ever be, the surgeon is still in charge).

In goal three you say other doctors refer to other doctors, whats your point?

Im saying I want to be specialized enough that I will be the person patients are being refered to, NP can't do fellowships, good luck finding me a psychosomatic psychiatric NP or the like.

Then in point 4 you get absurd and say if an independent NP gets something un-routine the patient is screwed, Im pretty sure a NP could refer the non-routine patient to a specialist just as quick as MD could.

And as far as getting hit by the bus and fixed by NP, please find me some NP doing trauma and plastic surgery independently.

 

[87138]

Too easy, I knew this is exactly what you were going to say 😀


IQ can't posibly be used to tell if your orders of magnitude smarter than people b/c its not an absolute scare!

You might be able to claim to be in the 99.99% percentile of intelligence, but this is just a demonstration of HOW MANY people you are smarter than, not a measure of HOW MUCH smarter you are like you claimed.

If you were teleported to a hypothetical world that was made entirely of Savants, according to their IQ scale you would be the dumbest person on the planet, but does that mean that your intelligence changed by orders of magnitude?

Heres an example of how comparitive scales are worthless for backing up claims like you made. For example, you are finding the mass of 1000 rocks.
Lets say you use 1000 rocks, and find the mass of 999 of them to be 1kg and the mass of 1 of them to be 1.1 kg.

This means the 1kg rock is aproximately 10% heavier than the rest of the rocks, but according to your logic we would have to say it is "orders of magnitude" heavier than the other rocks because it is heavier than %99.9 of the other rocks.

This is an idiotic post and is simply arguing semantics for the sake of arguing.

The original point you're refuting was essentially "lots of people are stupid" which no one in their right mind would argue against. Yet you have twisted it into some sort of personal challenge to interpret it in a highly specific manner so that you can continue to babble on about nothing.

Seriously, just stop.

 

[surftheiop]

This is an idiotic post and is simply arguing semantics for the sake of arguing.

The original point you're refuting was essentially "lots of people are stupid" which no one in their right mind would argue against. Yet you have twisted it into some sort of personal challenge to interpret it in a highly specific manner so that you can continue to babble on about nothing.

Seriously, just stop.

I read it like I saw it, some guy claimed to be orders of magnitude (a highly specific term) smarter than most the world.

This stuff angers me because people like him damage the reputation of MDs everywhere. People hear stuff like that and think that all MD's are incredibly arrogant, have massive egos and god complexes.

Im trying to defend my future profession here (MD), its no wonder im a little worked up.

 

[besmart]

I read it like I saw it, some guy claimed to be orders of magnitude (a highly specific term) smarter than most the world.

This stuff angers me because people like him damage the reputation of MDs everywhere. People hear stuff like that and think that all MD's are incredibly arrogant, have massive egos and god complexes.

Im trying to defend my future profession here (MD), its no wonder im a little worked up.

Agreed. Doctors, on average, are NOT smarter than most other people with a college education (or even some people without a college education). Doctors just have knowledge in an area where most of the population does not. That is why you go to medical school, have a residency, and read textbooks and journal articles (and do research).

 

[aznb0y129]

Agreed. Doctors, on average, are NOT smarter than most other people with a college education (or even some people without a college education). Doctors just have knowledge in an area where most of the population does not. That is why you go to medical school, have a residency, and read textbooks and journal articles (and do research).

The only thing I would say to this is that to enter medical school, most will have a high college GPA (median is 3.6+). I think that makes them smarter than people who graduate from college with a 2.5.

And the area that doctors happen to have knowledge in is highly specialized, to the point that most of the population could not succeed in that field.

 

[surftheiop]

The only thing I would say to this is that to enter medical school, most will have a high college GPA (median is 3.6+). I think that makes them smarter than people who graduate from college with a 2.5.

And the area that doctors happen to have knowledge in is highly specialized, to the point that most of the population could not succeed in that field.

I'll agree with you that doctors are on average smarter than most college graduates, but im saying thats no reason to be arrogant, etc.

I've talked to a bunch of MD's and they have all said something similar,
you only need a baseline intelligence to be a doctor (which is lower than most on SDN would like to admit) after that what really matters is how much you want it.

Most doctors ive talked to say med school isnt hard/rocket science, just alot of material so you just need to sit down and actually learn it, not that the material is really all that difficult.

 

[Kaustikos]

Because NP and PA do not hold a medical degree, they are not entitled for family practice. Do they now about

Pharmacology - lol

No. They can't diagnose and treat a patient. They shoudn't be doing that.

My suggestion for future health care:
Ban nurse practioners and let them go back to nursing. Not medicine.
Shorten residency program to 1 year instead of 3 years for family practice.
The residency spots will increase to 3 times. Hire those IMGs who have passed USMLE.

Ban NP's? Are you that blindsighted that you can't see the advantages NP/PA's offer? The ridiculous benefits of having NP's set up at every Walgreen's/CVS/etc as a form of primarcy care for patients is HUGE. Finding a place for NP's/PA's is what you're missing. They are hugely instrumental in providing the best healthcare ever. I've witnessed the benefit of a PA meeting with patients for a Cardiologist and then informing the Cardiologist of what's what so that the physician can take care of two birds with one stone, so to speak. Take care of a patient while dictating/running through EKGs/stress tests/etc. The quality of the care isn't taken away, or it didn't seem to be imo, as patients were given the time they wanted to discuss what was going on and be heard.

And let's not forget the numerous times I've not had to go to the ER/make an appointment with a doctor for antibiotics/allergy medication when I just had to pay a 30 copay by visiting an NP at walgreen's and then having them fill the RX right there. I'm assuming you're still in high school (hSDN) and so would recommend you talk less and listen more. The argument you present is so outlandish and ignorant that it begs the question of whether or not you really know what you're talking about.


I also bolded pharmacology because I've meet soooooooo many physicians who aren't that well versed in pharmacology.

This is an idiotic post and is simply arguing semantics for the sake of arguing.

The original point you're refuting was essentially "lots of people are stupid" which no one in their right mind would argue against. Yet you have twisted it into some sort of personal challenge to interpret it in a highly specific manner so that you can continue to babble on about nothing.

Seriously, just stop.

You make SDN 9000 times more enjoyable with your posts

 

[besmart]

I'll agree with you that doctors are on average smarter than most college graduates, but im saying thats no reason to be arrogant, etc.

I've talked to a bunch of MD's and they have all said something similar,
you only need a baseline intelligence to be a doctor (which is lower than most on SDN would like to admit) after that what really matters is how much you want it.

Most doctors ive talked to say med school isnt hard/rocket science, just alot of material so you just need to sit down and actually learn it, not that the material is really all that difficult.

Agreed.

 

[Kaustikos]

The only thing I would say to this is that to enter medical school, most will have a high college GPA (median is 3.6+). I think that makes them smarter than people who graduate from college with a 2.5.

And the area that doctors happen to have knowledge in is highly specialized, to the point that most of the population could not succeed in that field.

GPA is not an absolute measure of intelligence. I won't delve on this further because I assume you mean that, on average, someone with a 3.6 is smarter than 2.5. If anything, it indicates strong work ethic and some intelligence, but there is no 100% direct correlation between gpa and intelligence.

 

[besmart]

Ban NP's? Are you that blindsighted that you can't see the advantages NP/PA's offer? The ridiculous benefits of having NP's set up at every Walgreen's/CVS/etc as a form of primarcy care for patients is HUGE. Finding a place for NP's/PA's is what you're missing. They are hugely instrumental in providing the best healthcare ever. I've witnessed the benefit of a PA meeting with patients for a Cardiologist and then informing the Cardiologist of what's what so that the physician can take care of two birds with one stone, so to speak. Take care of a patient while dictating/running through EKGs/stress tests/etc. The quality of the care isn't taken away, or it didn't seem to be imo, as patients were given the time they wanted to discuss what was going on and be heard.

And let's not forget the numerous times I've not had to go to the ER/make an appointment with a doctor for antibiotics/allergy medication when I just had to pay a 30 copay by visiting an NP at walgreen's and then having them fill the RX right there. I'm assuming you're still in high school (hSDN) and so would recommend you talk less and listen more. The argument you present is so outlandish and ignorant that it begs the question of whether or not you really know what you're talking about.


I also bolded pharmacology because I've meet soooooooo many physicians who aren't that well versed in pharmacology.


You make SDN 9000 times more enjoyable with your posts

that is exactly the relationship between the PA and MD have when I worked at a certain clinic. Some of the more jerkish MDs would never leave a PA work with them though, but those MDs were not well liked in general.

 

[aznb0y129]

I'll agree with you that doctors are on average smarter than most college graduates, but im saying thats no reason to be arrogant, etc.

I've talked to a bunch of MD's and they have all said something similar,
you only need a baseline intelligence to be a doctor (which is lower than most on SDN would like to admit) after that what really matters is how much you want it.

Most doctors ive talked to say med school isnt hard/rocket science, just alot of material so you just need to sit down and actually learn it, not that the material is really all that difficult.

Agreed.

GPA is not an absolute measure of intelligence. I won't delve on this further because I assume you mean that, on average, someone with a 3.6 is smarter than 2.5. If anything, it indicates strong work ethic and some intelligence, but there is no 100% direct correlation between gpa and intelligence.

Of course there's not a 100% direct correlation between GPA and intelligence, but I'm saying for the most part, that trend will hold. Obviously doctors shouldn't be walking around like they're the smartest human beings on the planet, but saying that they're not (on average) smarter than the general population is equally asinine.

 

[besmart]

Agreed.



Of course there's not a 100% direct correlation between GPA and intelligence, but I'm saying for the most part, that trend will hold. Obviously doctors shouldn't be walking around like they're the smartest human beings on the planet, but saying that they're not (on average) smarter than the general population is equally asinine.

Doctors are trained in medicine. Accountants are trained to do what they do. Scientists are trained in their specific field. Nurses are trained to be nurses, mostly. Physicists are trained to be physicists. Farmers farm. etc, etc, etc. Most people trained in one field can't do another persons field without the training (or at the very least, independent learning).