I'm glad I didn't go to med school because...

MS, APRN, BC, FNP · Sep 15, 2006

That's a tough one. One of the big advantages of being an MD is the money thing, but I think that is changing for NPs as they stand up and start demanding what their worth. Other than that, I function as any other primary care provider.

-I only need a collaborating doc for my hospital privileges.

-I can open my own clinic without a doc. I can bill insurances at 85% of what docs bill, but that's a mute point because I'm considering opening a cash only clinic.

-I have my own narcotics license. I'll have to refer to the nurse practice act, but it requires some collaboration with a physician, but it's not a big deal.

Does having a MD make you more competent than an NP? No, not from my experience. I have clients that have left their MD, and much prefer to be under my care. Competence comes with the individual, not a certificate. I am not saying I know everything by any means.

When I first started, there wasn't a week that went by that I didn't want to bury my head in the sand and quit, but that feeling goes away after a couple of years. :wink2: You learn, grow, consult with good docs (rare) and see that your actually helping people. You actually start to see yourself as a primary care provider. I think even MDs have their heads up their butts when they first come out of school.

christvs, DNP, RN, NP · Sep 16, 2006

That's a tough one. One of the big advantages of being an MD is the money thing, but I think that is changing for NPs as they stand up and start demanding what their worth. Other than that, I function as any other primary care provider.
-I only need a collaborating doc for my hospital privileges.
-I can open my own clinic without a doc. I can bill insurances at 85% of what docs bill, but that's a mute point because I'm considering opening a cash only clinic.
-I have my own narcotics license. I'll have to refer to the nurse practice act, but it requires some collaboration with a physician, but it's not a big deal.
Does having a MD make you more competent than an NP? No, not from my experience. I have clients that have left their MD, and much prefer to be under my care. Competence comes with the individual, not a certificate. I am not saying I know everything by any means.
When I first started, there wasn't a week that went by that I didn't want to bury my head in the sand and quit, but that feeling goes away after a couple of years. :wink2: You learn, grow, consult with good docs (rare) and see that your actually helping people. You actually start to see yourself as a primary care provider. I think even MDs have their heads up their butts when they first come out of school.

Hi, I have a question for you. I'm a new NP student (in acute care) and I was just wondering exactly how this collaboration works between the NP and MD. What does it mean exactly? I know what the word collaboration means, but I am confused about how much the MD has to do for you to have your hospital priveledges. Does the MD need to look over your orders here and there? How does it work? Thanks! :)

Spacklehead, MSN, NP · Sep 16, 2006

Christvs,

I'm a NP student, also, and we actually have a course on what you are talking about this semester. The collaboration issue varies by state, so you really need to go to your BON web site and check out the statutes and regulations for APRNs in your state. HTH. :)

MS, APRN, BC, FNP · Sep 16, 2006

Hi, I have a question for you. I'm a new NP student (in acute care) and I was just wondering exactly how this collaboration works between the NP and MD. What does it mean exactly? I know what the word collaboration means, but I am confused about how much the MD has to do for you to have your hospital priveledges. Does the MD need to look over your orders here and there? How does it work? Thanks! :)

I'm not sure about other states, but my doc is just there for me to consult with if needed, and to take over if necassary. At first he may review your charts alot, but as he gets more confident in your care, he may not review them at all. you'll also need to work out a fee to pay him if your a NP in your own private practice. This fee will vary from MD to MD. I think generally it's in the $1,000 a month ball park. Your mileage may vary. It's mutually beneficial for him as you can also take call for him, freeing him up to do other things.

$1,000 a month may seem like alot but keep in mind I collect after all is said and done about 40-45K a month, and the expenses of the clinic are around 20-25K a including his fee (note: I have more staff than I need). I also have a facility that is far larger and more elaborate than any NP would have in their own private practice. After expenses if I were the sole owner operator of this clinic I would make about 240K. I make around 100K+. I wonder where the other approx 140K goes. Oh, I remember now, that goes to the doc that owns it. That other 140K is the price I pay for not having the courage to assume the risk of owning the business myself.

I don't post those numbers to brag or anything like that, but to make other NPs aware of what they may be worth, and how much their employer could be making when they offer 65-85K to their NPs in a private practice. Don't get me wrong. I'm not saying docs shouldn't profit from having a NP in their practice. They do assume the headaches and the risk of running the business. It's really just a question of what's fair profit. I'll leave the answer to that question to the reader.

ERNP · Sep 17, 2006

Because the a lot of the physicians I know went to school for many years only to find out they are miserable with their chosen profession.

I went for a lot of years and found out I like what I am doing.

I can do everything the docs I work with do and everything seems in place.

My student loan bills are lower and I don't make that much less money.

My malpractice coverage is cheaper.

ER patients request to see me from triage (they can see me through the triage window).

FLAgal14 · Sep 20, 2006

Well let's see... I got into med school last year and decided not to go for various reasons:

1) The cost of the programs: I had nightmares about being nearly $300,000 in debt by the time I was done with school - plus the cost of just applying,interviewing, deposits and that stupid MCAT

2) My age - I'm 27 (which isn't too old to go to med school) - but I also want to start a family and I don't know how well that would've worked with finishing residency around 35-36, being $300,000 in debt and having no time to spend with the kids and husband which leads into #3 ....

3) Quality of life - yes being a doctor is glamorous and you can make a lot of money - but there is the headache of the "business" of medicine - running a practice, paying overhead, dealing with insurance companies, paying for staff...and then paying the bills/supporting the family (and paying off that $300,000 debt). It just seems like that there is not much of a quality of life in both med school, residency and as a doctor. I have a friend who just started med school this fall and is only three weeks into school and she's already having panic attacks - and talking to her makes me feel so much better about my decision to not go to med school.

There were a lot of other reasons - but I got really cold feet about it - which signaled to me that maybe it wasn't the best career choice for me.

Papadoc · Sep 21, 2006

Well let's see... I got into med school last year and decided not to go for various reasons:
1) The cost of the programs: I had nightmares about being nearly $300,000 in debt by the time I was done with school - plus the cost of just applying,interviewing, deposits and that stupid MCAT
2) My age - I'm 27 (which isn't too old to go to med school) - but I also want to start a family and I don't know how well that would've worked with finishing residency around 35-36, being $300,000 in debt and having no time to spend with the kids and husband which leads into #3 ....
3) Quality of life - yes being a doctor is glamorous and you can make a lot of money - but there is the headache of the "business" of medicine - running a practice, paying overhead, dealing with insurance companies, paying for staff...and then paying the bills/supporting the family (and paying off that $300,000 debt). It just seems like that there is not much of a quality of life in both med school, residency and as a doctor. I have a friend who just started med school this fall and is only three weeks into school and she's already having panic attacks - and talking to her makes me feel so much better about my decision to not go to med school.
There were a lot of other reasons - but I got really cold feet about it - which signaled to me that maybe it wasn't the best career choice for me.

It all really depends on your specialty. The R.O.A.D (Radiology and Rad/Onc, Ortho, Anesthesiology, and Derm) are doing quite well. $300 g is really running on thehigh side. the average med school debt is around $150K-180K including all the expences, not only tuition. There are many options for MD/DO as well with loan repayments, paid malpractce, and huge bonuses. It all depends on location. Things are drying up all across the board, and they are affecting all of us in the healthcare field. There is plenty of misery to go around for mid-levels too. Having said this...I honestly respect ppl's choices to go or not to go to the medical school, albeit if it is for the right reasons. Going to NP or the PA school is not a short cut for wanting to become a doctor. Sure you could do the same things, especially in IM and FP type of pactices. I've started med school at 34, had to stop for health problems , but am back now at 36. I'm an RN as well, and thought of FNP track long and hard. But I just couldn't ge "what if?" out of my head. With medical school there is no way to know for sure if it's right fit for you or not until you pretty much done with it and are in debt up to your ears. Thus, misery for many folks who found out that being a doctor these days is not that glamourous. After all it's just a job just like any other, but the responsibility is ennormous. Yet, if this is what you really, really want to do, not because, but rather despite everything that goes on in medicine, you will never be happy. I've met so many RNs, PAs, NPs, PTs, Chiros,, ppl from investment banking, IBM top notch programmers...you name it. It's not like they needed a job. Most of the problems are with the sculls full of mush young premeds, who go to med school steight from college. Basically they don't know what they don't know, and when they do it's too late with all the debt and years down thetube.

Anyway, congrats to all of you who know what you want in life. I still don't, and it's driving me nuts.

FLAgal14 · Sep 25, 2006

$300 g is really running on thehigh side. the average med school debt is around $150K-180K including all the expences, not only tuition. There are many options for MD/DO as well with loan repayments, paid malpractce, and huge bonuses.

Well $300 g is counting in my undergrad loans. And the average med school debt is misleading because it takes in the average of all those atttending med school - and there are some that are having military scholarships, NHSC, or are lucky enough to have rich parents to pay for it all - which brings the average debt level down. The school I was going to attend - I would have to take out about 55-60k a year to attend (cost of tuition + living expenses). My friend who just started med school will be $225k in debt by the end. And those loan repayment programs, like the NHSC, only qualify if you go into primary care. If you are lucky enough to get into one of the R.O.A.D specialties you will be fine, but they are very competitive due to the money they make and the lifestyle associated with the specialiteis.

I don't feel like I'm taking a shortcut though by becoming a NP or PA. I am choosing not to sacrifice everything in my life to become a doctor when my true goal is to help people. As long as I'm helping people and have my family time I will be happy. But that is up to each person - what makes them happy at the end of the day. And good luck papadoc on your own journey.

Papadoc · Sep 25, 2006

Well $300 g is counting in my undergrad loans. And the average med school debt is misleading because it takes in the average of all those atttending med school - and there are some that are having military scholarships, NHSC, or are lucky enough to have rich parents to pay for it all - which brings the average debt level down. The school I was going to attend - I would have to take out about 55-60k a year to attend (cost of tuition + living expenses). My friend who just started med school will be $225k in debt by the end. And those loan repayment programs, like the NHSC, only qualify if you go into primary care. If you are lucky enough to get into one of the R.O.A.D specialties you will be fine, but they are very competitive due to the money they make and the lifestyle associated with the specialiteis.
I don't feel like I'm taking a shortcut though by becoming a NP or PA. I am choosing not to sacrifice everything in my life to become a doctor when my true goal is to help people. As long as I'm helping people and have my family time I will be happy. But that is up to each person - what makes them happy at the end of the day. And good luck papadoc on your own journey.

Hey FLAgal14!

Congats on your decision. I have great respect and admiration for people who have this clear sence of direction in life. I'm one of those people who unfortunately don't have that quality. But in my case it's different. I've been helping ppl for the last almost 20 years (and even longer while in the nursing school). There are many students who married, and with kids in the medical school. I even know a few single moms. Wow. It takes guts to go through the madness of med school, and residency. But if nothing else will do...I'd say go for it. Many people enter mid-level careers with the thought of "practicing medicine", and having a shortcut. They often find out that their potential, for whatever reason, is not realized. and they still go on to the medical school. On the other hand, there are quite a few ppl who're done with med school and the residency, and realized that they've made a greatest mistake of thir lives. Many say I should've been NP/PA, but b/c of some major debt they have to stay "married" to the medicine. I'd say there is plenty of place under the sun for everybody, when what we do is based on cooperation vs competition with each other.

Good Luck to you too.

CrazyPremed, MSN, RN, NP · Sep 26, 2006

Many people enter mid-level careers with the thought of "practicing medicine", and having a shortcut. They often find out that their potential, for whatever reason, is not realized. and they still go on to the medical school. On the other hand, there are quite a few ppl who're done with med school and the residency, and realized that they've made a greatest mistake of thir lives. Many say I should've been NP/PA, but b/c of some major debt they have to stay "married" to the medicine. I'd say there is plenty of place under the sun for everybody, when what we do is based on cooperation vs competition with each other.
Good Luck to you too.

Thanks for the post. Great insight.

CrazyPremed

HARRN2b · Sep 28, 2006

I met a wonderful lady who started her NP at the age of 48. She is now 70 and works when she wants to. She also teaches. Sounds wonderful.