Here's a little background: I was pre-med in my undergrad and I got the opportunity to go to Korea for a year to learn acupuncture and get independent study and honors undergraduate credit for it. It was going to be an interesting and unique experience that would also make getting into a good medical school that much easier. Well the plan fell through on the other end, things happened...and then I graduated. The original plan was to go to DO school, but I was still interested in acupuncture. So after much debate, I decided to go to acupuncture school first for several reasons - I figured I wouldn't have to fortitude or time to go to three years of acupuncture school after DO school, and I also knew myself and figured I would be unable to make a paradigm shift after seven more years of reductionistic medicine.
So I went to acupuncture school with the plan of going on to DO school afterwards. But then life happens...got married, got divorced, and then found the perfect girl. After I graduated with my master's in acupuncture, I started researching DO schools but I wasn't too engaged since I was heading to China for a five week acupuncture internship. I figured I would take a fresh look at the situation when I returned.
Two weeks after I got to China, my girlfriend told me that I was going to be a daddy.
After some serious thought (while drinking very cheap Chinese beer), I realized that another seven years might be too much. By chance, one of my fellow classmates was a FNP. We talked a bit and I realized that I could fullfil my dream of having a integrative family practice by going the NP route. The benefits (shorter duration of the program, less intense program, program is essentially paid for by the hospital, more time at home after the program, less overhead costs) far outweighted the negatives (not a doctor, no residency, less training, much fewer patient contacts). Well, at least it did initially.
I am hoping that somebody here might be able to give me some of their insight or possibly point out some variable(s) that I am missing. I know it would be rough on my family to go to medical school, but my fiance is on board with either choice.
Any input would be greatly appreciated.
Edit: I am leaning more towards MD than DO now (thus the thread title).
Specializes in Education, FP, LNC, Forensics, ED, OB.
Josh L.Ac.
So this makes me wonder why become a FNP? If the time involved, or the money required, or the stress on the family, or the difficulty of the program is not an overriding factor, then why would someone choose to be a FNP instead of a FP physician? Is there something I'm missing (since I'm not a nurse or physician yet)?
Why become an FNP? If you are totally devoted to nursing and want a more active role in total patient care including all decisions made as to the dx and/or tx of the patient, then one chooses the advanced practice role.
And if a FNP practices effectively as an autonomous provider, are they practicing the medical model or the nursing model?
Simply explained, both.
Part of my confusion is that I have a recently developed skepticism for the semantic differences between groups. This is further compounded by the fact that many peoplerespond with soundbites when asked about the differences in characteristcs of two groups.
Physician= total respect and acceptance by all peers/colleagues/3rd party reimbursement/public
NP=must earn the respect and acceptance of peers/colleagues/often denied by 3rd party reimbursement/must educate the public regarding the role of the NP
NP=dependent upon physcian collaboration (in many states)
Thanks Siri for your input. If I am understanding you correctly, you are saying that, for a person with my timeline of getting the NP degree + working as a RN, I would need [at least] several years of working under a physician before I was competent enough to see patients on my own. This makes sense to me, but it does raise the following question:
If becoming a competent autonomous FNP requires over 6 years (1 year accelerated BSN + 2.5 years NP school while working as a RN + 3 years working under a physician), what would be the benefit [professionally - not in terms of time, money, family] of taking this route over becoming a FP MD (4 years medical school + 3 years residency)?
There are no professional benefits. Time, money, family are 3 of the biggest reasons for doing FNP over MD in your time frame. And, I can tell you I agree with the others in that you need some patient experience to be autonomous. I'm a year out of FNP school and went straight through like you're planning, and I need more experience to feel comfortable being solo. But, it's the same as a new grad MD.... which is why they have residencies. I suppose the difference I'd be most concerned with is do you want to be a slave (resident physician) for at least 3 yrs working rediculous hours for pennies only to complete your residency to find out you have to start paying at least two grand a month for student loans plus at least two grand a month for malpractice insurance? If the title, prestige, vigorous training, and autonomy are worth that to you, then by all means, go MD/DO. If not, do FNP. Each point weighs differently for each person, so think about each factor, decide, and go with it. Don't look back and be proud of your decision, and you'll be fine either way.
There are no professional benefits. Time, money, family are 3 of the biggest reasons for doing FNP over MD in your time frame. And, I can tell you I agree with the others in that you need some patient experience to be autonomous. I'm a year out of FNP school and went straight through like you're planning, and I need more experience to feel comfortable being solo. But, it's the same as a new grad MD.... which is why they have residencies. I suppose the difference I'd be most concerned with is do you want to be a slave (resident physician) for at least 3 yrs working rediculous hours for pennies only to complete your residency to find out you have to start paying at least two grand a month for student loans plus at least two grand a month for malpractice insurance? If the title, prestige, vigorous training, and autonomy are worth that to you, then by all means, go MD/DO. If not, do FNP. Each point weighs differently for each person, so think about each factor, decide, and go with it. Don't look back and be proud of your decision, and you'll be fine either way.
Hey cgfnp!
I gotta agree with you here my friend. When one does such reality check as I often do for myself, FNP route wins hands down. Especially now that I've done some of the MD training, although under more difficult circumstances (in the Caribbean). Anyway, after repeatedly "hitting the walls" with my head the reality sets in. I'm like Josh, trained in Acupuncture and Orintal Medicine. That alone is a full-time commitment. I'm spending a little more time researching the scope of practice of (F)NP and other NP routes, than before. For the purpouses of doing preventetive medicine FNP appears to be a good fit.I noticed that the field of "holistic" medicine, nutritionally oriented physician etc is really an uncharted territory.Basically most procedures, and labs (check neurotransmitters, heavy metal toxicity, certain nutrient defficiencies etc) are not covered by most insurance plans, and most definitely NOT by medicare/caid. But from the marketing standpoint MD/DO will give you more weight. But when you have to pay about $1700/mo in student loans alone, the expensive procedures, unneccery testing and other revenue-generating perks will be governing the way you practice, IMHO. Things are drying up, and sometimes get ugly with the turf wars, and competition. But if I have to wind up in the same place weather new MD/DO or FNP, then why suffer with more debt? Although these could not be compares in terms of lenghth, debth, and the strength of the education, and recognition. Well, I'm still in doubt :angryfire , but FNP simply makes a lot more of the economic sense, and is closer to reality.
As of right now [HA!], I am going to start and complete the Accelerated BSN program I am slated to begin in August. I am going to take the MCAT in August with minimal prep, just to see how it works (I did the same thing with the ACT and missed 1 question on the science part).
Hopefully before the 1-year program is close to completion I'll have a better perspective on which path to take. Just in case I will prep for the April 07 MCAT and send off all my paperwork to the clearinghouses for DO and MD medical schools.
If I decide to go medical, I'll have a year of nursing training under my belt as well as the hospital experience. It also means I'll be 40 before I have an income...but hey, who expects to retire at 65 anyway? If I decide to go the FNP route, I'll still be on track for that.
[off topic] The wonders to TCM.
I am actually quite skeptical of the claims made by the majority of acupuncturists. As a recent experiment published by Kaptchuk [the man, the myth, the legend] pointed out recently, acupuncture is a very effective delivery system for placebo vs. a sugar pill - I'm not saying that all the effects of acupuncture are d/t placebo obviously, but that we might be able to obtain positive outcomes even if we treat a condition that we probably should have no effect on. Moving on.
My 11 month son woke up with a 102 F fever. I called the health clinic but they were all in a meeting so the triage nurse told me to take him to an urgent care clinic. As I was getting things together, I called my fiance and told her the situation. She talked to her supervisior for a few seconds and then suggested I do some acupuncture - she's in her last quarter of acupuncture school. I said "Bah, I don't see the point in doing acupuncture in a possibly acute situation..." but she said please. So I did.
Using a lancet, I bled LI-11 on the right side. My son cried, then calmed down. Then off we went to the hospital. When they took his temp about 45 minutes later, it was down to 99 F.
It might have been the ride in the car or it might have been the different method for taking his temperature that would account for the difference, but he did feel cooler to the touch at the hospital and was in a much better mood.
So maybe acupuncture can lower fever as well. I doubt I would recommend it to a patient unless there was some concrete evidence (I have a great lawyer but I really don't care to see him in action), but it was nice to see [again] that this acupuncture thing works sometimes.
As of right now [HA!], I am going to start and complete the accelerated BSN program I am slated to begin in August. I am going to take the MCAT in August with minimal prep, just to see how it works (I did the same thing with the ACT and missed 1 question on the science part).
Hopefully before the 1-year program is close to completion I'll have a better perspective on which path to take. Just in case I will prep for the April 07 MCAT and send off all my paperwork to the clearinghouses for DO and MD medical schools.
If I decide to go medical, I'll have a year of nursing training under my belt as well as the hospital experience. It also means I'll be 40 before I have an income...but hey, who expects to retire at 65 anyway? If I decide to go the FNP route, I'll still be on track for that.
[off topic] The wonders to TCM.
I am actually quite skeptical of the claims made by the majority of acupuncturists. As a recent experiment published by Kaptchuk [the man, the myth, the legend] pointed out recently, acupuncture is a very effective delivery system for placebo vs. a sugar pill - I'm not saying that all the effects of acupuncture are d/t placebo obviously, but that we might be able to obtain positive outcomes even if we treat a condition that we probably should have no effect on. Moving on.
My 11 month son woke up with a 102 F fever. I called the health clinic but they were all in a meeting so the triage nurse told me to take him to an urgent care clinic. As I was getting things together, I called my fiance and told her the situation. She talked to her supervisior for a few seconds and then suggested I do some acupuncture - she's in her last quarter of acupuncture school. I said "Bah, I don't see the point in doing acupuncture in a possibly acute situation..." but she said please. So I did.
Using a lancet, I bled LI-11 on the right side. My son cried, then calmed down. Then off we went to the hospital. When they took his temp about 45 minutes later, it was down to 99 F.
It might have been the ride in the car or it might have been the different method for taking his temperature that would account for the difference, but he did feel cooler to the touch at the hospital and was in a much better mood.
So maybe acupuncture can lower fever as well. I doubt I would recommend it to a patient unless there was some concrete evidence (I have a great lawyer but I really don't care to see him in action), but it was nice to see [again] that this acupuncture thing works sometimes.
[/off topic]
Hey Josh!
Ahh, good ol' Ted Kaptchuk. I think "The Web That Has No Weaver" is a must for both acupuncturists-beginners, and the general public as well
You know it's classic. Bleeding Large Intestine 11 clears heat, especially in Yangming syndrome. I thing temp of 102 is pretty "bright" Yang. But for a small child like this Gua Sha would've worked just as good, if not better.Sometimes I have to treat my daughter. I also do indirect moxa with "Tiger Warmer" (Kiiko Matsumoto's toys). Actually, Arya Nielsen is on faculty at Tri-State where I went. If you don't have the book, you can get lots of helpful info here:http://guasha.com/ .
I am actually quite skeptical of the claims made by the majority of acupuncturists. As a recent experiment published by Kaptchuk [the man, the myth, the legend] pointed out recently, acupuncture is a very effective delivery system for placebo vs. a sugar pill - I'm not saying that all the effects of acupuncture are d/t placebo obviously, but that we might be able to obtain positive outcomes even if we treat a condition that we probably should have no effect on. Moving on.
The more I study and cram into my brain, the more I think it's getter safer to substitute PNI for placebo.
Now, I am associated with 6 physicians, internal medicine, surgeon, peds, FP, and rheumatology....... and have complete autonomy. I do ED call as sole HCP and have a thriving practice.
Wait a minute, please tell me you share ER call with the doctors and are not doing it by yourself. Because otherwise you are getting absolutely ripped off. Dont let the doctors control you like that. Each of the members of the organization must share equal ER call.
But, I have no desire to "hang out my shingle" despite my physicians asking me to do so. I can. But, choose not to.
I would, because you are selling yourself short. Open up your own practice and you will make easily double what you are making now. No other people to deal or consult with either, you run the whole show. At your current practice, you dont get to make partnership or make the big business decisions that run the practice. As an autonomous FNP with your own clinic, you have control over everything.
Besides, I am working on my own business as medical-legal consultant as well as clinical practice.
How would you be a consultant? Maybe as the initial malpractice screen, but eventually you would have to hand off the case to a medical doctor who would actually testify in court against hte other doctor.
At any rate, the medical malpractice system is a sham. Juries are generally stupid and have no way to determine whether true medical malpractice occurred. It would be much better if they had a panel of nurses instead of a regular jury. Nurses actually understand medicine and would know for sure whether true medical malpractice occurred.
the reality sets in. I'm like Josh, trained in Acupuncture and Orintal Medicine. That alone is a full-time commitment. I'm spending a little more time researching the scope of practice of (F)NP and other NP routes, than before. For the purpouses of doing preventetive medicine FNP appears to be a good fit.I noticed that the field of "holistic" medicine, nutritionally oriented physician etc is really an uncharted territory.Basically most procedures, and labs (check neurotransmitters, heavy metal toxicity, certain nutrient defficiencies etc) are not covered by most insurance plans, and most definitely NOT by medicare/caid. But from the marketing standpoint MD/DO will give you more weight. But when you have to pay about $1700/mo in student loans alone, the expensive procedures, unneccery testing and other revenue-generating perks will be governing the way you practice, IMHO. Things are drying up, and sometimes get ugly with the turf wars, and competition. But if I have to wind up in the same place weather new MD/DO or FNP, then why suffer with more debt? Although these could not be compares in terms of lenghth, debth, and the strength of the education, and recognition. Well, I'm still in doubt 
, but FNP simply makes a lot more of the economic sense, and is closer to reality.
sirI, MSN, APRN, NP
17 Articles; 45,868 Posts
Why become an FNP? If you are totally devoted to nursing and want a more active role in total patient care including all decisions made as to the dx and/or tx of the patient, then one chooses the advanced practice role.
Simply explained, both.
Physician and/or NP=total patient decision-making
Physician and/or NP=diagnosis, treatment, follow-up, prescription privileges
Physician= total respect and acceptance by all peers/colleagues/3rd party reimbursement/public
NP=must earn the respect and acceptance of peers/colleagues/often denied by 3rd party reimbursement/must educate the public regarding the role of the NP
NP=dependent upon physcian collaboration (in many states)
Physician=total independence
Does this help?