NP or CRNA

[Espresso girl!]

Hi all:

Wondering about grad school now. I have a heavy background in science-minor in chemistry, grad coursework in anatomy/physiology. Am debating about NP v. CRNA

I am very autonomous, have an entepreneurial background and like responsibility. I have doubts about both...NP as a feel like I would be unchallenged treaty runny noses, earaches, etc. each day, plus, I can't see myself working for someone else such as under a doctor! CRNA cons to me include the ultra sterile environment, lots of machines. Please help! Thanks and bless.

[Papadoc]

Hey Papadoc!

I'm very happy that I decided to go to NP school. I have also attended 1 year of grad school at one of the four accredited Naturopathic Medical Schools in the US (in Arizona). I am very preventive medicine minded, but it was just, in my opinion, not in sync enough with mainstream medicine. I decided that being an NP, and blending my passion for natural medicine would be of great benefit to my patients.

I can understand that you want to go to medical school. I think one must also consider economics when making this decision. What will your debt load be like upon graduation? Consider the interest piled on to that debt, and will it be paid by the time your are 70? An NP can provide primary care, and even develop a specialty. No offense intended, but is it an ego driven need to have the MD behind your name? Do you want to be credentialed to do surgery? What can you not do as an NP, that you can do as an MD, that would make you think you really need to do this?

Take Care!

Hey Brownrice!

Thanks for a quick response:)

I really cannot answer those questions when I'm asking myself. Generally speaking, I think that where I am right now (Brooklyn,NY/NYC) public is not ready to accept NPs as an autonomous practitioner. There is definitely a surplus of all kinds of physicians here, and doing a solo practice, or even some semi-independent set up is not very realistic. I'm sure it's quite possible to find your place "under the sun" as an NP, but in Tri-State area it seems like I'd have to go "against the gradient".There is something that bothers many ppl about non-physician thing.Most of the time it's just a stereotypical thinking. The question is "how practical" in terms of business it is being an NP vs MD/DO. I'm not talking about what you could do legally, I know it's very similar if not the same as a doctor.But the public perception of "My Dr. said...Mylanta:chuckle vs my Nurse (practitioner) said....XYZ" Well, you get the point. There is also billing aspect....I know it's getting better, but there is still a lot of misconceptions, and discrimination by insurance companies. Also I really want to practice preventetive/holistic health, and to be as far away from surgery as humanly possible. But I haven't been to find out what limitations does NP have let's say for administering IV highly concetrated vitamin coctails, chealation,glutathion,playing with bioidentical hormones,establishing contacts and ordering from holistic labs, and pharmacies..etc,provided you have the right training for it. There is a site that you may want to visit if you want to be in preventitive health http://www.ACAM.org, but even there there is a devision for docs, and non-docs. So to answer your question:Yes, absolutely, for me as a guy, ego definitely works as a devil's pick fork:devil: :rotfl:.So I'm still not sure, but the thought of "what if" I should have become a physician, and didn't is absolutely daunting:eek: I'm really stuck with indecision.

Have a good one:)

[Jo Dirt]

I've spent time in the OR and the CRNA's still take orders from doctors.

If you don't like taking orders then better to become a doctor.

[Papadoc]

I've spent time in the OR and the CRNA's still take orders from doctors.

If you don't like taking orders then better to become a doctor.

Even if you become a doctor you'll still be taking orders from the administrators, insurance companies, other doctors etc. I do not if there are any vacancies to become a G-d:chuckle .Then you're set for life:chuckle

[Cyndee, MSN, NP]

Hey Brownrice!

Thanks for a quick response:)

I really cannot answer those questions when I'm asking myself. Generally speaking, I think that where I am right now (Brooklyn,NY/NYC) public is not ready to accept NPs as an autonomous practitioner. There is definitely a surplus of all kinds of physicians here, and doing a solo practice, or even some semi-independent set up is not very realistic. I'm sure it's quite possible to find your place "under the sun" as an NP, but in Tri-State area it seems like I'd have to go "against the gradient".There is something that bothers many ppl about non-physician thing.Most of the time it's just a stereotypical thinking. The question is "how practical" in terms of business it is being an NP vs MD/DO. I'm not talking about what you could do legally, I know it's very similar if not the same as a doctor.But the public perception of "My Dr. said...Mylanta:chuckle vs my Nurse (practitioner) said....XYZ" Well, you get the point. There is also billing aspect....I know it's getting better, but there is still a lot of misconceptions, and discrimination by insurance companies. Also I really want to practice preventetive/holistic health, and to be as far away from surgery as humanly possible. But I haven't been to find out what limitations does NP have let's say for administering IV highly concetrated vitamin coctails, chealation,glutathion,playing with bioidentical hormones,establishing contacts and ordering from holistic labs, and pharmacies..etc,provided you have the right training for it. There is a site that you may want to visit if you want to be in preventitive health www.ACAM.org, but even there there is a devision for docs, and non-docs. So to answer your question:Yes, absolutely, for me as a guy, ego definitely works as a devil's pick fork:devil: :rotfl:.So I'm still not sure, but the thought of "what if" I should have become a physician, and didn't is absolutely daunting:eek: I'm really stuck with indecision.

Have a good one:)

There are a few states where NP's can have their own practices without ANY oversite from a physician. We get our own provider numbers for Medicare, Medicaid and insurance companies. We are reimbursed directly at 85% of the doctors fee schedule. There is power in numbers and the fact is, there are far more NP's graduating from school than MD's. Things are going to change very soon...insurance companies will mandate that patients be seen first by the NP and then referred to the physician (if needed). It's only a matter of time...

[Cyndee, MSN, NP]

Hey Brownrice!

Thanks for a quick response:)

I really cannot answer those questions when I'm asking myself. Generally speaking, I think that where I am right now (Brooklyn,NY/NYC) public is not ready to accept NPs as an autonomous practitioner. There is definitely a surplus of all kinds of physicians here, and doing a solo practice, or even some semi-independent set up is not very realistic. I'm sure it's quite possible to find your place "under the sun" as an NP, but in Tri-State area it seems like I'd have to go "against the gradient".There is something that bothers many ppl about non-physician thing.Most of the time it's just a stereotypical thinking. The question is "how practical" in terms of business it is being an NP vs MD/DO. I'm not talking about what you could do legally, I know it's very similar if not the same as a doctor.But the public perception of "My Dr. said...Mylanta:chuckle vs my Nurse (practitioner) said....XYZ" Well, you get the point. There is also billing aspect....I know it's getting better, but there is still a lot of misconceptions, and discrimination by insurance companies. Also I really want to practice preventetive/holistic health, and to be as far away from surgery as humanly possible. But I haven't been to find out what limitations does NP have let's say for administering IV highly concetrated vitamin coctails, chealation,glutathion,playing with bioidentical hormones,establishing contacts and ordering from holistic labs, and pharmacies..etc,provided you have the right training for it. There is a site that you may want to visit if you want to be in preventitive health www.ACAM.org, but even there there is a devision for docs, and non-docs. So to answer your question:Yes, absolutely, for me as a guy, ego definitely works as a devil's pick fork:devil: :rotfl:.So I'm still not sure, but the thought of "what if" I should have become a physician, and didn't is absolutely daunting:eek: I'm really stuck with indecision.

Have a good one:)

That's interesting that NP's aren't accepted in NYC. I thought nurse practitioners, especially nurse midwives were in "vogue" right now. Several movie stars are choosing nurse midwives to deliver their babies. In Austin, OB-GYNs are practically getting put out of business b/c so many patients are preferring midwives. I sure hope that trend continues!

[Papadoc]

That's interesting that NP's aren't accepted in NYC. I thought nurse practitioners, especially nurse midwives were in "vogue" right now. Several movie stars are choosing nurse midwives to deliver their babies. In Austin, OB-GYNs are practically getting put out of business b/c so many patients are preferring midwives. I sure hope that trend continues!

Hey Cyndee,MSN,NP!

The trend is definitely there for the NPs. I didn't mean to say that public isn't accepting NPs. In NYC we have way too many doctors per sqare foot:lol2: . So, it's kind of hard to do solo practice as an NP. But I know one of my classmates at the Acupuncture school, who is CNM, has her own birthing center and is in partnership with some big GYN guy, who almost dropped OB from his practice (for $$$$ malpractice reason).

But what I want to make sure is if I go NP route, I don't want to find myself 3 years later whining I could've, I should've stayed in med school.It's not like haven't tried the med school. But I want to do preventetive health, with focus on on some holistic approaches, in which I have pretty extensive training. So I'm worrying myself qrazy with that thought. I think that FNP or ANP will work just fine for me, but this "what if..." it's not nearly enough to cover me? I wish I could find some NPs who are doing the things that I want to do, and get some info.

Thanks again for your repply:D

[sirI, MSN, APRN, NP]

But what I want to make sure is if I go NP route, I don't want to find myself 3 years later whining I could've, I should've stayed in med school.It's not like haven't tried the med school. But I want to do preventetive health, with focus on on some holistic approaches, in which I have pretty extensive training. So I'm worrying myself qrazy with that thought. I think that FNP or ANP will work just fine for me, but this "what if..." it's not nearly enough to cover me? I wish I could find some NPs who are doing the things that I want to do, and get some info.

Thanks again for your repply:D

Hi, Papadoc,

We haven't talked in a while. I have been reading your posts all the while, however.

Here's my two cents. As you see, I have highlighted portions of your last post. This is what I think and please remember, it is just my opinion.

Yes, if you seek the FNP track, I do believe you will be able to utilize most of the holistic approach/preventive medicine. You can make almost anything fit IF it is not against the Nurse Practice Act in your state.

BUT.......somehow......and, this is just me........I think you would be happier, more content, and, overall satisfied if you were to go on to med school. Maybe you are seeking that permission.

It's not wrong to feel that way. I went through the "I wonder if??".....after I was in practice as OB-GYN/FNP. I was accepted in med school and decided not to do it. It worked for me and I have not looked back.

Yes, I know that is ME and I cannot answer for you. But, I think you are seeking some type of approval to go back to med school and if so, I think.....no, I believe that is exactly what you should do.

But, you have to make that final decision. You are not going to be wrong either way, Papadoc. You will make a great NP or physician.

Good luck.

[Papadoc]

Hi, Papadoc,

We haven't talked in a while. I have been reading your posts all the while, however.

Here's my two cents. As you see, I have highlighted portions of your last post. This is what I think and please remember, it is just my opinion.

Yes, if you seek the FNP track, I do believe you will be able to utilize most of the holistic approach/preventive medicine. You can make almost anything fit IF it is not against the Nurse Practice Act in your state.

BUT.......somehow......and, this is just me........I think you would be happier, more content, and, overall satisfied if you were to go on to med school. Maybe you are seeking that permission.

It's not wrong to feel that way. I went through the "I wonder if??".....after I was in practice as OB-GYN/FNP. I was accepted in med school and decided not to do it. It worked for me and I have not looked back.

Yes, I know that is ME and I cannot answer for you. But, I think you are seeking some type of approval to go back to med school and if so, I think.....no, I believe that is exactly what you should do.

But, you have to make that final decision. You are not going to be wrong either way, Papadoc. You will make a great NP or physician.

Good luck.

Hey Siri!

Great to hear from you again. Happy Holidays, and Happy New Year!

I was born during The Year of The DOG. Hopefully, it'll be a much better Year for me than it's been. You absolutely hit the nail on the head with all my doubts and "what if's". Of course, ideally I'd love to become a physician. However, I've got my reality check when I started med school in 2004. I withdrew mostly for my personal health reasons, but it's clear that for now, I'm in no shape to take on the med school once again.So it's more like I'm looking to see if anybody will respond who does things similar to what I want to do, having an NP after their name. I know that no education in the World could guarantee personal success, and job satisfaction. The reality of at least 7 years of "hell" and about $200,000+ in debt are a strong deterrent for me. May be my withdrawl from med school happenede for a good reason, not yet known to me. I know I can't be everything to everybody so I just have to pick one direction and get going already. So the FNP seems more realistic and doable for me at 35 y.o with family responsibilities, and the biggest "variable" here...my personal health. I'm just afraid to get myself in such debt:eek: , and not be able to function at the level adequate enough to pay it back.No crystal ball here:o We'll see. Sometimes I think to myself may be I just need to get an MBA, and get out of clinical setting all together.Whatever it is, I just know that the best is yet to come.

Thanks very much for the support.

Have a good one

[sirI, MSN, APRN, NP]

I understand, Papadoc. Well, I cannot relate to your having to set aside your dreams and aspirations due to your physical problems, but, I think you understand what I mean.

I really do believe you will be satisfied with the FNP track. Any other would limit you, IMHO.

Do you know any DO's or other MD's who do this sort of thing that would like to take on an NP with your qualifications in holistic med? I would start seeking them out. They may better be able to answer those Q's for you.

Happy Holidays and Happy New Year to you as well.

[Papadoc]

I understand, Papadoc. Well, I cannot relate to your having to set aside your dreams and aspirations due to your physical problems, but, I think you understand what I mean.

I really do believe you will be satisfied with the FNP track. Any other would limit you, IMHO.

Do you know any DO's or other MD's who do this sort of thing that would like to take on an NP with your qualifications in holistic med? I would start seeking them out. They may better be able to answer those Q's for you.

Happy Holidays and Happy New Year to you as well.

Hi Siri!

Thanks for your repply. I guess the reason why I'm asking so many times pretty much the same Q (in essence NP vs med school) is that I'm hoping to hear some responses from ppl who either do what I want to do, or from those who went throu the same troubles of their soul searching. For me both routes (NP or MD) at this point are nothing more than going from A to B. Back in 2004 when I first started the med school I was a lot more excited it about it. But I realize now that it is hardly my dream or aspiration. It's what needs to be done (argueably) or not.Of course, personal health, family, huge debt are not yet the reasons not to do it, but only if it was a true dream. Regardless of the degree I'll get, I don't want to just do clear cut conventional medicine. I realize that I won't be able to be everything to everybody, and my acupuncture practice is, once again, starting to get quite busy (I pretty much destroyed it myself in 2004 when went to the Carib med schools). I'm really asking myself now...where in the World will I get the time to do both, whether it would be MD or NP? My RN could always give me a "quick fix" if things aren't as smooth in the private practice.May be I alredy have all that I really need, and I should concentrate on it more? May be I'm just chasing my own tail? I'm thinking more and more now that I should stick to one thing that I love, and my patients seem to love me too. They come to me because they couldn't find what I do for them anywhere else (including MDs), and I seem to be that missing link that they are looking for:D

Well, these are definitely growing pains.I'll know what I want to be when I grow up:chuckle

Have a Happy and Healthy New Year!