Would you still become a NP or would you go the MD route? - page 3

This is my first post, but I've been reading the boards for some time. My question for current NPs is: If you could go back in time, would you still become a NP or would you go the MD route... Read More

  1. by   Goldenfox
    Quote from marzipan01
    There are less residencies than there are medical school graduates. As a result, residency programs choose first from those with MD's then with DO's, then Caribbean (if you're lucky). Most of the time if you go Caribbean (or any foreign school except Canada) these days you have to take a year off to prove yourself, get good internships in the US and pray for the best.




    I used to work with a doctor who was a despicable human being but a very good cardiologist. He went to a Caribbean medical school because no US school would take him (age discrimination, I think). There are some good people coming up through the non-traditional schools.
  2. by   Goldenfox
    If I could do a Ctrl+Alt-Delete I wouldn't go the NP route again. Its not what it used to be. The fly-by-night NP schools have cheapened and diminished our profession. Everybody and their mother is an NP now, and the labor market is beginning to see th fallout.
  3. by   ICUman
    I am seriously considering medical school but pause as I watch the advancement that NP's PA's and CRNA's are making. I don't want to go into medical school and finish finding my job displaced for the "cheaper, more cost effective" alternative that hospitals and clinics are clamoring for.
  4. by   Jules A
    Quote from ICUman
    I am seriously considering medical school but pause as I watch the advancement that NP's PA's and CRNA's are making. I don't want to go into medical school and finish finding my job displaced for the "cheaper, more cost effective" alternative that hospitals and clinics are clamoring for.
    Dude you are a baby and should totally do medical school. Unless you wanted to be a GP, in which case NP or PA is a better choice, it is my opinion that not in our lifetime will specialty Drs be reduced to the NP/PA level or pay scale especially not when someone is as savvy as you will be with regard to negotiations. It is a crap ton of time and money but the job security, respect and knowledge imo would be second to none. PS definitely moonlight during residency to offset some of the lost income.
  5. by   Aromatic
    gp docs still make quite a bit, I wouldnt want to do it really but we get graduates coming in pumping 250k first year from most places but the coastal cities. sometimes less but its not a ridiculous schedule.

    hospitalist gigs arent that bad either really. 7 on 7 off 250-300+K etc.


    ER is the hotspot right now though....
  6. by   ICUman
    Quote from Jules A
    Dude you are a baby and should totally do medical school. Unless you wanted to be a GP, in which case NP or PA is a better choice, it is my opinion that not in our lifetime will specialty Drs be reduced to the NP/PA level or pay scale especially not when someone is as savvy as you will be with regard to negotiations. It is a crap ton of time and money but the job security, respect and knowledge imo would be second to none. PS definitely moonlight during residency to offset some of the lost income.
    Thanks Jules I've put a lot of thought into it. I copied an excerpt from the BLS projections here and was hoping maybe you could provide me some of your thoughts on the following. I know the BLS can prove inaccurate but it still makes me wonder if it's a better decision than the APRN route.

    "Although the demand for physicians and surgeons is expected to continue, some factors will likely temper growth. New technologies will allow physicians to treat more patients in the same amount of time, thereby reducing the number of physicians who would be needed to complete the same tasks. In addition, physician assistants and nurse practitioners can do many of the routine duties of physicians and may be used to reduce costs at hospitals and doctor’s offices.
    Demand for physicians’ services is sensitive to changes in healthcare reimbursement policies. Consumers may seek fewer physician services if changes to health coverage result in higher out-of-pocket costs for them.
    "

    A thought: When I was a new grad RN a year ago, a fellow grad raised his hand and asked our CNO if our hospital hires CRNA's. She said currently, no. However, she then went on to explain that our hospital system will not be renewing the Anesthesiologist contract when it expires in X amount of years, and that CRNA's will fill the void. She said that this is making headway as a national trend and mentioned cost effectiveness but with equal quality/outcomes.

    So you see where I'm going here? I used to be naive and think physician was such an invincible career, in many cases it still is, but in the example I listed it shows that really hospitals will back the almighty dollar and save. So that makes me concerned on really how rock solid of a career choice it may be.

    Also, I feel like I may be a bit on the older side to start medical school? I am currently 25. Aromatic if you don't mind could I inquire your approximate age when you began med school?
  7. by   BostonFNP
    Its true that physicians make more money, however, most also work considerably more hours, and unlike yesteryear, most physicians now are just employees. I couldn't imagine going to medical school right now with the goal of going into a primary care role; the debt is too high for the payoff (exceptions aside).

    I do think there will be a shift in our lifetime to a NP-driven model of primary and preventative care, I think we have already seen it start. I don't think physicians will ever be replaced and I don't think NPs will ever make a salary that approaches physicians on average, though the net may come close in primary care (I am on the same pay scale as my physician partner).

    If I was 20 years old again I would consider medical school if I thought I could make a plush specialty like dermatology, otherwise, I wouldn't consider it right now, I wouldn't have the same quality of life.
  8. by   Jules A
    Quote from ICUman
    "Although the demand for physicians and surgeons is expected to continue, some factors will likely temper growth. New technologies will allow physicians to treat more patients in the same amount of time, thereby reducing the number of physicians who would be needed to complete the same tasks. In addition, physician assistants and nurse practitioners can do many of the routine duties of physicians and may be used to reduce costs at hospitals and doctor’s offices.
    Demand for physicians’ services is sensitive to changes in healthcare reimbursement policies. Consumers may seek fewer physician services if changes to health coverage result in higher out-of-pocket costs for them.
    "
    I would agree with the above but I'm not picturing you as a garden variety GP MD. I'd picture you as young, for the love of God you are 25!, bad ass specialist who is bright and motivated to embark on an exciting complicated area. I can't imagine there will ever be a time when NPs will be the overwhelming majority of a specialist practice especially not without some MD presence. Many of the more complicated specialties still use NPs as a physician extender, gasp, and I don't see that going away in the more complex areas. Even if the demand for physicians slows they are rather savvy with how many new docs they put out every year so I don't see that really becoming a problem. If it does and push comes to shove you could always hire a bunch of NPs to run your practice while you oversee the business and rake in the dough.

    The lifestyle thing that BostonFNP references is worth consideration but for me that would not be a concern and actually in my experience the younger Docs I work with late 30s early 40s are more concerned with that work life balance and are setting boundaries with regard to the 24/7 expectation. In my area psychiatrists are not working weekends any longer, love that and take full advantage of scooping up their left overs at a premium rate lol. ED docs work 4-10s. The pediatrician I know rotates nursery duties with his 5 partners so they aren't taking call as often.
  9. by   Aromatic
    I was 27 when I started. Still 27 haha for a little bit more. Havent seen this tech that will


    decrease need for physicians yet but that doesn’t mean its not coming. Overall, I chose to go


    back since I like the science aspect, and mostly, because physicians have a stronger and more


    protective credentialing body than NPs. It is true that NPs can fill many roles, but they most


    likely wont be able to fill them all, especially specialties. Medicine is getting more and more


    complex every year and even we just scrape the surface in regards to what goes on in the body.


    Since it is getting more complex new specialties are arising every few years, new fellowships,


    etc and specialization will not stop occurring since its too much information for one provider to


    know it all, even when they are a specialist (just look at all the neurology fellowships that have


    come out fairly recently). So physicians will not be going anywhere soon due to increased


    complexity. The days of one specialist per organ system are over.


    Who knows where pay will go though, right now primary care doc pay is going up tho since


    nobody wants to do It and a lot of places have them managing nps and pas so they get much of


    that income too. Supply and demand will keep GP pay up there for at least a while.


    Past all that I do not know, except that non-coastal location people that came from my school


    that do IM or FP get ridiculous offers especially in BFE.


    NP/PA is still a decent choice but again both types of schools are flying up all over the place and


    there is no residency restriction to damper the # of students who go into them. So there is


    always that higher chance that after a while pay will go down, even for Pas, and the hospitals


    and physicians will get to keep more of that money.


    The minus side is you pretty much have to dedicate your life to your job, but if you do not mind


    doing that then physician is the way to go in healthcare.
  10. by   JellyDonut
    If I could go back in time I would never ever ever ever has become a nurse. We pick a career when we are 17-18 when are brains are still all jelly right out of HS. I would go back in time and give the younger me a good swift kick in the butt and tell her to aim higher and think outside of traditional roles. That being said I would not have taken the medical path at all. But this is the path my younger self selected and I am here to make the best of it until I am too old to give a SHXt..or too old to get out of bed.
  11. by   RockMay
    How many NPs took Orgo Chem 1 and 2? How many who tried actually passed?
  12. by   BCgradnurse
    Quote from RockMay
    How many NPs took Orgo Chem 1 and 2? How many who tried actually passed?

    I took both and got As in both. Next question?
  13. by   Jules A
    Quote from BCgradnurse
    I took both and got As in both. Next question?
    Hats off to you I wet my pants throughout whatever general chemistry I was forced to take. So although I should probably have ignored RockMay's last comment the assertion that NPs are less intelligent is insulting and inaccurate. Most are actually fairly bright and while I agree there are more than a few who I don't think are professional, well educated or should be practicing independently that is not NP exclusive. Anyone here who has seen my posts knows how protective I am of my physician colleagues and the high esteem I hold for MD education in general however the truth is I have met more than a few MDs who are total idiots so there's that.

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