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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.
save this for the adcoms LOL
Have you seeen meet the parents??? Come on!!
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.
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 🙄
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.
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).
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).
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."
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.
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.
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.
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. .
Tell that to the Anesthesiologists.
Obviously not. I'm simply stating statistics.
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.
What's with the trade mark?
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.
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
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.
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.
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
In God we trust; all others must bring data. --W. Edwards Deming
Lets see it
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.
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.
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.
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
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.
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.
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).
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.
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.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.
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'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.
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.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.
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
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.
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.
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.