How truly autonomous are you in your practice? (I think this may vary by state?)
Completely. I have my own practice in a consortium in an independent practice state that recognizes NPs as fully equal to physician providers in every way.
Do you feel well respected? (I've seen some pretty nasty internet talk regarding NPs on various forums, and was wondering if this actually carried over into the real world...)
Yes. I occasionally get grief from a patient, but have never gotten any from professional colleagues. If patients don't want to see me because I am a NP, I'm ok with that. I know they are out there, but I have a full panel so I don't spend much time worrying about people for whom I bear no responsibility and with whom I have no relationship. It comes up about once or twice a year. Since I see about 125 patients a week, that is a pretty small number. A few weeks ago a patient was upset that they had to make the same co-payment to see me that they would any physician provider. They felt the rate should be discounted. They gave the same song and dance to the receptionist who told them if they were paying for years of education on a prorated basis, an appointment with me would cost more, since I hold more degrees than any of the others, lol. I don't waste time arguing with people or pleading with them to respect the NP role. Maybe that patient has a valid point (with regard to medical education because I do believe residency is a wonderful advantage to physicians; it is certainly a debatable topic). However, I don't set the rates, so I don't waste time discussing it. My goal is to stay on time, and I don't want to waste precious minutes debating the finer points of complicated third party payment systems with patients. They need to write to Blue Cross (or whoever), the insurance commissioner or their congressional representative. From physician and PA peers I have enjoyed nothing but collegial and respectful communication and relationships.
and the most important question I have...
Do you feel NP school provided you with a thorough enough knowledge base (or in other words...did you feel comfortable practicing as a relatively new grad NP)?
I felt safe, if not always sure. My rule of thumb has always been, "If I do not figure this out right now, will the patient be harmed?" If the answer is yes I get input from the more experienced NP in the office or one of the physicians. If the answer is no, I do my level best to handle it myself, even if I am sometimes wrong. Ex.-Could that weird finger rash be fungal? They aren't going to die if triamcinolone doesn't do the trick, lol. (Cue obnoxious med student to come in and tell me about how that rash could be fatal, lol).
Looking back, do any of you wish you had became a physician instead? (please no flaming...just an honest question...I'm aware that most NPs probably had no desire to become a physician)
No, but I wish we had a post graduate residency of one year. I have never felt at a disadvantage because I didn't get a human cadaver to dissect in gross anatomy, and I felt my didactic education was more than sufficient. The thing I envy physicians for is their residency, and I wish we had something akin to that opportunity. I don't feel it needs to be a paid residency; I'd gladly have done it for free and paid tuition for the experience. As it is I took the opportunities that were presented to me, and one of those was a 6 month post graduate fellowship in family practice. I learned more there than in the 18 months preceding, for sure. All in all, I had 2,400 hours of clinic time as a NP student before I went to work (and 18 years of critical care experience). That is a fraction of what MDs/DOs get, but about 4x what many of my classmates were able to do, so I was truly lucky. I did another 1,100 hours in endocrinology and cardiology practices as a DNP student. You take what you can get, but it isn't comparable and it is the biggest drawback to being a NP, in my opinion. However, I spread my NP(DNP) education out over 6 years because I wanted to do all of those hours, and I wanted more than the bare minimum. I had that option because my partner makes mad bank, lol. Even so, no, I would not have gone to med school and traditional FP residency under the current paradigm in medicine. I'd have had to give up too much, and the bottom line is that while I'm neither as stupid or as lazy as the occasional med student that pops in here likes to accuse NPs of being, I am selfish. I own that. I would never have made the sacrifices that medical students must for their education. The route I took suited this family the best, and we are all pleased with the course and outcome.
I sincerely hope you will be able to say the same one day. Good luck to you.