Anyone heard of any NP to MD programs? - page 5

A girl I go to school with said that there is a school in Missouri that has a bridge program for NPs to become MDs. Have any of you heard of a program like this?? :confused: Thanks! Kitty... Read More

  1. by   cgfnp
    Quote from n_g
    Med schools are not starving for students. If the country needs more docs, the schools let in more students...and they start from the beginning. The AAMC has expanded enrollment by 20% in the last few years. The docs can giveth and taketh from ye.
    Compared to yrs ago, they most certainly are starving for students. And so are fam practice residencies. Keep thinking you are on par with God as your last sentence suggests and remember all those rural nobodies that will die without proper primary care because there are no docs to replace the retiring ones. This isn't a hypothetical situation, either. It's happening right here right now.

    You can try to convince God when you meet him... because you can't convince me or anyone else that isn't a traditional med student/grad.

    Or you could just give us NPs complete and total autonomy to open our own rural health clinics without having to pay some doc to sign off. That would be also worse for the patient although I think it would be fine in most cases. Bet you'd rather pick the first option if you were forced to pick one, further strengthening the argument that it's not about the patients benefit at all.
  2. by   happydays352
    In some states like Oregon (obviously where I live) NP's do have autonomy much like you describe. It's just much harder to get paid (at least that's my basic understanding).

    I chose to switch from pre-med to nursing, I would never have made this choice if not for the laws in OR concerning NPs.

    Maybe this model could be expanded and more NP's would be content with their practice instead of looking to medical school. Just a thought.
  3. by   veritas
    the med system is eliteist. and they are not starving for students. even with the mcat and interviews and high GPA required, there is still about 25 to 50 applicants per 1 med school place. so in fact, only about 20% of people who apply to med school can get in. the med program has already down sized a lot to accommodate the "shortage" of docs. it used to be 8 years, and got reduced to 6 years and now you can do it in 3 or 4 years. if it gets anymore cut down, i m not sure how people will fit in all they need to learn. a nursing degree is 3 or 4 years. if med is cut any less than nursing, how will the docs fit all they need to learn into that time? there is A LOT more to learn in med than in nursing! as it is, med students are struggling to fit in everything they need to know in the current 3 or 4 years program. and in the end, they are not as confident as they could be if the program was longer.
  4. by   veritas
    to solve the shortage of doc problem, NPs should be given more power/autonomy. they can't just simply let in more students. plus it costs much more to train a doc than a nurse. they have started to let in more med places in recent years. many programs have expanded places by about 100 to 200 extra spots. they have to maintain the bottleneck in med. otherwise, it could become like brazil, where doctors and nurses are paid the same. who wants to slog to become a doc then if they get paid the same as nurses? and who will work as hard? where will the standard and quality go?
  5. by   core0
    Quote from veritas
    the med system is eliteist. and they are not starving for students. even with the mcat and interviews and high GPA required, there is still about 25 to 50 applicants per 1 med school place. so in fact, only about 20% of people who apply to med school can get in. the med program has already down sized a lot to accommodate the "shortage" of docs. it used to be 8 years, and got reduced to 6 years and now you can do it in 3 or 4 years. if it gets anymore cut down, i m not sure how people will fit in all they need to learn. a nursing degree is 3 or 4 years. if med is cut any less than nursing, how will the docs fit all they need to learn into that time? there is A LOT more to learn in med than in nursing! as it is, med students are struggling to fit in everything they need to know in the current 3 or 4 years program. and in the end, they are not as confident as they could be if the program was longer.
    I think that you need to check your facts. 44% of med school applicants get in. It is over 50% if you discount re-applicants. This also does not include DO programs or overseas schools. Also I am not sure where you got that med school had been shortened. It has been approximately four years since the Flexner report came out. It does require a bachelors (usually) prior to med school but that isn't part of med school.

    There really isn't a shortage of physicians. There is a geographical distribution problem and a specialty distribution problem. The residency system is used to keep the number of specialists relatively low which keeps specialty salary relatively high. There are more applicants for specialty positions than positions. On the other hand there are unfilled family practice, internal medicine and peds spots every year.

    Physicians are ceding the primary care market which can lead to job opportunities but the reason that they are ceding the market is that the reimbursement is low and the practice expenses are high. NPPs are following this model and moving increasingly into specialty care which still leaves a shortage or primary care providers whichever way you cut it.

    David Carpenter, PA-C
  6. by   caldje
    David is right.

    Also, giving NPs more autonomy will not come close to solving the problem. NPs and PAs already have PLENTY of autonomy to function as primary care providers in the vast majority of states. What more autonomy do you want? Having a consulting/supervising physician is necessary, and restrictions on prescription authority is a non issue if you are practicing family practice. The problem is, increasing autonomy does not change the distribution of NPPs just like David described. In fact, increasing autonomy of NPPs may WOSRTEN the shortage because they will also have the legislative allowances that would permit them to earn more in specialties. The answer is increased primary care reimbursement and decreased specialty reimbursement. A shave biopsy by a FP MD pays less than one done by a derm MD. That does not make sense.

    And, giving NPs that authority won't help because NPs are ALREADY complaining they dont get reimbursed the same as physicians. Well, if NPs want to reimbursed the same as physicians, where is the real cost savings here? Why give NPs more authority? It won't help the system at all.
  7. by   cgfnp
    [quote=caldje;2433229]
    David is right.

    Also, giving NPs more autonomy will not come close to solving the problem. NPs and PAs already have PLENTY of autonomy to function as primary care providers in the vast majority of states. What more autonomy do you want?
    Let's see... more autonomy, how about complete so I don't have to have an even higher overhead and startup expense to open a new clinic in a rural place that doesn't have one. Then I see around 5000 people a year who likely wouldn't have seen anyone had a provider not come to their town. Then, I can consult the physicians I refer to regularly as needed, just like I do now.

    Having a consulting/supervising physician is necessary, and restrictions on prescription authority is a non issue if you are practicing family practice. The problem is, increasing autonomy does not change the distribution of NPPs just like David described. In fact, increasing autonomy of NPPs may WOSRTEN the shortage because they will also have the legislative allowances that would permit them to earn more in specialties.
    Yeah, go to one of the completely autonomous states and find a NP who is independently practicing orthopedic surgery.


    And, giving NPs that authority won't help because NPs are ALREADY complaining they dont get reimbursed the same as physicians. Well, if NPs want to reimbursed the same as physicians, where is the real cost savings here? Why give NPs more authority? It won't help the system at all.
    Yeah, I want to get paid family docs wages too for the same services. How dare I... Where's the savings? How about the miles the rural folks have to drive if they don't have a clinic in their town? How about the ERs who have about 70% of their patients that belong in a clinic where the bill to us taxpayers is about 10% the cost. Instead their in the EDs because they can't get into their doctor (or more appropriately the system has led them there like sheep).
    Last edit by sirI on Oct 5, '07 : Reason: TOS for profane language
  8. by   RNCENCCRNNREMTP
    Quote from kittyw
    A girl I go to school with said that there is a school in Missouri that has a bridge program for NPs to become MDs.

    Have any of you heard of a program like this??

    Thanks!
    Kitty
    Yes, it is called medical school.
  9. by   core0
    Quote from caldje
    David is right.

    Also, giving NPs more autonomy will not come close to solving the problem. NPs and PAs already have PLENTY of autonomy to function as primary care providers in the vast majority of states. What more autonomy do you want? Having a consulting/supervising physician is necessary, and restrictions on prescription authority is a non issue if you are practicing family practice. The problem is, increasing autonomy does not change the distribution of NPPs just like David described. In fact, increasing autonomy of NPPs may WOSRTEN the shortage because they will also have the legislative allowances that would permit them to earn more in specialties. The answer is increased primary care reimbursement and decreased specialty reimbursement. A shave biopsy by a FP MD pays less than one done by a derm MD. That does not make sense.

    And, giving NPs that authority won't help because NPs are ALREADY complaining they dont get reimbursed the same as physicians. Well, if NPs want to reimbursed the same as physicians, where is the real cost savings here? Why give NPs more authority? It won't help the system at all.
    NP autonomy won't really worsen primary care shortages. There is no real danger that NPs or anyone else will be allowed to practice specialty medicine independently. The real issue is that NPs go into specialty practice for the same reason that PAs and MDs do, its where the money is. Its also the reason that there is a shortage of providers in rural and underserved areas. People don't want to live there.

    David Carpenter, PA-C
  10. by   core0
    [quote=cgfnp;2433382]
    Quote from caldje

    let's see... more autonomy, how about complete so i don't have to have an even higher overhead and startup expense to open a new clinic in a rural place that doesn't have one. then i see around 5000 people a year who likely wouldn't have seen anyone had a provider not come to their town. then, i can consult the physicians i refer to regularly as needed, just like i do now.

    the problem is there is nothing to prevent you from doing that now. the states that do not require physician participation in practice have the same or worse shortages of health care providers. looking at the data you could make the assumption that np independence causes a health care shortage in a given area (half of the top 10 shortage states are independent np practice states).

    yeah, i want to get paid family docs wages too for the same services. how dare i... where's the savings? how about the miles the rural folks have to drive if they don't have a clinic in their town? how about the ers who have about 70% of their patients that belong in a clinic where the bill to us taxpayers is about 10% the cost. instead their in the eds because they can't get into their doctor (or more appropriately the system has led them there like sheep).
    the reason that health care shortage areas are shortage areas are because people don't want to live there. they are areas with minimal insurance coverage with poor payor bases. there are plenty of jobs available in rural america. the problem is not independence, it is the fact that people generally don't want to live there and the problems with any medical practice in the area.

    david carpenter, pa-c
    Last edit by sirI on Oct 5, '07 : Reason: quoted edited post
  11. by   n_g
    [quote=core0;2433452]
    Quote from cgfnp

    The reason that health care shortage areas are shortage areas are because people don't want to live there. They are areas with minimal insurance coverage with poor payor bases. There are plenty of jobs available in rural America. The problem is not independence, it is the fact that people generally don't want to live there and the problems with any medical practice in the area.

    David Carpenter, PA-C
    Exactly. NP's are no more likely to want to live out in the boonies than docs. People want recreation, culture, museums, etc. Claiming that you need NP autonomy so that they can serve the rural communities is just a red herring.

    The solution is to create incentive for people to want to move to rural communities. Maybe offer more loan forgiveness, bonuses, etc.
  12. by   cgfnp
    [quote=n_g;2434109]
    Quote from core0

    Exactly. NP's are no more likely to want to live out in the boonies than docs. People want recreation, culture, museums, etc. Claiming that you need NP autonomy so that they can serve the rural communities is just a red herring.

    The solution is to create incentive for people to want to move to rural communities. Maybe offer more loan forgiveness, bonuses, etc.
    Wrong again. Autonomy won't give any advantage to fam practice NPs in a place with all the goodies where all the MDs have flooded to. I would much rather practice independently in a rural area than joined at the hip with a MD in museumville.
  13. by   n_g
    [quote=cgfnp;2434128]
    Quote from n_g

    Wrong again. Autonomy won't give any advantage to fam practice NPs in a place with all the goodies where all the MDs have flooded to. I would much rather practice independently in a rural area than joined at the hip with a MD in museumville.
    Good for you for wanting to live rurally. However, your average person doesn't, including MD's, NP's, etc.

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