Aromatic

Just to add some icing, by your logic, if I dropped out of school now and went back to work as an NP, my ability to provide patient care would be better than if I decided to do family medicine. I mean dang I better just quit studying and attending class/clinicals, my ability to perform is just going to go down hill in medical school :):):):)

Elk, i think you, jules, many others and I are on the same train. We all love NPs but the lack of regulation is killing us. The people who tout NP=MD are scary folk.... to think they can handle everything. its as if at the current state and time, NPs perform better than physicians at primary care. By that logic, if i chose family medicine, I would perform worse and my patients would be less well taken care of in 6 years when i graduate residency in comparison to now. I mean I might as well drop out right? Med school is obviously making me less able...

I am not sure about you but I have a callous on my forehead trying to prove my point. NP education is too lax. Those who do not believe it are delusional and base their case of 15 year old studies. Because things never change right. Worst part is these studies published in like 2003 take info from like 1990-2000, making them even more out dated.....

Never said less education is better, just that people without degrees can be ultra successful, even though most that do not have them are not. You are correct in saying that you can learn everything you need for primary care via an NP education at its current tone, and extra reading. But many people wont do that extra reading. The near guarantee via the physician route is they will not let people through an american medical school and residency without the set of knowledge to manage a PCP practice without help. Whether or not people choose to do what is best for the patient is up to them, but in there minds, somewhere in the past, they were taught what they need to know, even the worst in the class that barely scrape by with 70s. NP education does not give that guarantee, it doesnt stop people from excelling on their own time, and some schools might give that guarantee, but not all do. Some programs graduate downright dangerous graduates that cant even do physical exams and dont even know which medicines are part of which CYP450 enzyme class. To think that the current standardized NP curriculum is adequate is complete ignorance. Of course patients in BFE are going to have better outcomes, its either see any NP or not care at all, so basically anything would improve outcomes. You may be one of those NP who went above and beyond to learn what needed to be learned, if so then your an awesome person for looking out for patients, but there are those who are not, and I have worked with them, its embarrassing. Even the good schools have lowered their admissions standards at many places recently, taking pretty much everybody that applies, while lowering clinical rotation control, thus making those 700 hours worth even less. Unless all NPs can handle everything, on their own, day one, as a family med trained physician should be able to, then it is not universally adequate. Can all NPs day one out of school - read EKGs well enough to determine all the variable heart blocks, and abnormal findings of genetic disorders (the rest should be basic) suture everything that has not gone through muscle/tendon/ligaments drain all types of superficial abscesses manage HTN from stage 1 all the way to complex multimedicine combinations without their patient passing out over 5 minutes read all plain film X rays without need of radiology complex rheumatic workups correctly diagnose headaches without throwing a ct at everybody manage children with various genetic disorders, what they are at risk for, etc apply splints to and know the time frame for referral for all types of tendon lacerations and fractures and which ones need ER care know each bug that causes diarrhea and the exact workup for each with proper time frames understand the results that radiologists provide for all sorts of ct/mri/NM/US, and know when to refer to a surgeon manage all sorts of skin issues without making the patient wait months for a derm appointment. Pretty much all FM residencies at this time have those as requires before you can graduate, in order to cut back on referrals, some docs probably jump the gun, but they know what they should do. I doubt that many NP day one can do all that, especially nowadays. Maybe back 10 years ago when standards were in place, but these online places sure aint gonna set you up in a clinical site that throws all that experience at you in 800 or so hours. Its really scary people think they know it all day one after NP school. Goodness its like the laborers who make fun of engineers, mostly because they are jealous they make more money... I am not even anti-NP, yet I can at least see reason. Need more parameters than just BP and HLD to determine quality of care. At least recent studies. They will never be able to perform a study that is purely NP vs MD with no allowed consultations though since that would be dangerous to the patient in some aspects. I have seen a few that say "little consultation between NP and MD in these patients occurred." How much proof/help is that statement lol! Its gonna be a sad day for patients when walden and kaplan grads work in solo rural health centers and these poor patients trust them with their lives.

Solid anatomy class, physiology class, basic cell bio/genetics, pathology class, then system based review. physical exam class and a standalone pharm class with pharm integrated into the above 1500 clinical hours 1 year fam medicine residency paid at 45k/year with fam med residents. 2 years in the class with last year also in clinicals then off to residency Proctored exams, in house physical exam tests. In 3 years you would have a great primary care provider with the above curricula. Takes out some of the wasted effort in med school and beefs up the standards of NP programs Honestly that would be optimal for primary care. One year experience as a nurse prior to entering.

I spent an hour probing for these studies, they are all out dated. Which they were probably not wrong back in the day before standards dive bombed. But it takes an inherent belief that nurses are intellectually superior to physicians and that their training is better to believe they are able to do the exact same thing in 1/8th the time. The fact that nursing is much less rigorous, less lengthy, admissions standards are not even close to that to medical school and residency, their clinical experiences in many cases is not nearly as guided, shows it is nearly impossible to have the same quality at or near graduation as an FM physician. Rigorous testing is not perfect, but much better than online discussion posts and paper writing. Nursing exp is useful but a residency should be required. What would you say if i said med school graduates should be able to do family medicine without residency? Many of them have spent more hours in clinicals than probably many new NPs have their entire lives (6k hours), since many NPS rush straight through to their NP

We cant judge peoples intelligence just by their level of degree. Plenty of people do amazing without degrees and one could say us degree people required collegiate handholding to succeed. College is just learning old information, those that create new stuff are the real amazing people. New useful stuff anyway. I always had the most respect for engineering people and mathematicians. Medicine and nursing cant hold much a candle to upper level fields such as those. Of course with varience on the type of engineering.

Med students have core rotations which are assigned to you, then we can do electives which arent that hard to find at most places. I mean once I start clinicals I doubt I could get a rotation at MGH, but probably could at most other places just by asking. People are usually more than happy to take med students since hospitals are shooting themselves in the foot and killing future employment prospects if they deny us. They didnt give two hoots about me when I was in NP school though, but where I went we had rotations assigned also but it was harder to get electives.

internet or distance education itself is fine, but many of these schools dont have proctored tests. some do via testing centers or webcam monitoring but many do not. How can you evaluate somebody if they are not tested on it? Writing papers? Not really, you can simply paraphrase everything you read on the internets. I mean the only time i show up in lecture hall is on test days so thats distance learning for med school right? Not to mention 800 clinical hours. I mean does anybody really see everything they need to see and know exactly what to refer out when they graduate? No, they dont. NPs need residencies so they gain more credibility, thus higher salary, and employers dont have to worry about training them. People shouldnt have to learn basic stuff on the job, like, you know, on real patients. Thats supposed to be what schooling is for. Where are the studies comparing new NP vs new physician at? Here are one of the studies that points the deficiencies at many current NP institutions http://www.tafp.org/Media/Default/Downloads/advocacy/scope-education.pdf Of course with time and self study this gap can be closed but in many times it is not. These nursing people who do these studies know to pick the best of the best when comparing to physicians. On average, Toe to toe in a diagnosis royal, i think anybody with common sense knows the physician will come out on top. Does anybody really think they are ready to practice after 500-1000 clinical hours and a basic level patho course along with a basic pharm and a few adult/child diagnosis classes????? Plus if you want to advocate for independence you have to be back it up with proper education (which some schools provide much better than others)

lol best movie ever. I mean best prophecy ever. Back to what jules said. The only way I feel we can get anything done is expose to the public how weak np education standards are, and incit a backlash of lawyers to come in and pick apart the practices of newly minted online crapU nps. We all know it usually takes outside backlash to get anything done (aka flint mich). So since they wont listen, we fight fire with fire, which of course I will once I am done with school since very few people go thru both NP and MD school, most people are wise enough just to pick one route and stick with it lol! 4 years from now maybe Ill be on the top 5 articles of kevinMD lmao Also, why is myoglobin still ranting with his/her big wordisms that do not even make sense. You and ACC should really get together sometime and have a koolaid party, because both yall sucked the pitcher dry on these forums. But hey since you know it all and will probably be the best indebt, mediocre, Hawaii NP provider in the world hats off to you. Just quit with the cliche mission statement type posts that make no sense and have no direction other than to replicate stuff you probably read on waldens motivational "follow your dreams" homepage that gets people all pumped up to send them government debt dollars

No doubt, I wouldnt have gone to college at all, Woulda stayed in my parents basement and done something computer related until I could monitize it. Unfortunately I took the weak route through nursing and now med school. Neither of which are really astounding when it comes to making a huge impact on society. I do not understand why people are so dang proud when they get done with nursing, np, or med school. Its like being happy for being slightly above average. Self education self education self education

If you are dead set on being an np (i agree with jules PA would be better if you dont want to be a nurse at all) I would work in the ER, pick up a good graduate level clinical anatomy book, read up on stuff, then a graduate level physiology course, do the same thing. and please pick a good np school, not on online for profit, your just slapping your future patients in the face by going to one of these degree mills

You cast Banish- it was very effective. AAC disappears into the woods A wild troll has appeared out of the woods, it appears AAC has mutated into a longer winded and slightly more understandable form Myoglobin casts ignorance, it wasnt very effective. You cast Logic, it wasnt very effective. Myoglobin seems to have full resistance to this you retreat into the woods. gotta catch em all. I mean obviously if you are 100k in debt for an undergraduate nursing degree you arent very apt for taking advice from others, but honestly it just shows your monetary and financial knowledge is probably not very strong either. Hey what do I care though, take on more debt from some sucky online for profit and go bankrupt, its not my problem. Keep drinking the coolaid and suffer the consequences and repurcussions. You aint gettin none of ma cownbread. dude, myoglobin, I tell you what. Once you get done with NP school see if you can stand on par with a newly minted family practice physician. NPs are great, but the newer ones, new as in recent graduate without much experience, on average, cannot handle nearly as much as a family practice physician can without having to refer the patient out. The older NPs, for the most part, are pretty wicked and can handle much of anything, but that was before degree saturation and back when programs actually had admissions criteria and required previous nursing experience. You just do not know what you do not know, especially when you say standards have increased. I mean, cmon we stopped taking you serious 12 novel long posts ago. Especially when you want to be just average.

I think jules said it in another post but yeah when im done and your rich and retired you can loan me the money to open up a practice then we can go in business together lol! We will soon start seeing a drop off in quality care provided by NPs. I mean, already most i know do not know when to refer stuff out or even more commonly do it too soon. Order too many tests, etc. With these online programs jeez I dont even know how they learn. And so many graduates think they know it all when they get done because their instructors pump them full of NP=MD mantra.

I literally have no idea what this myoglobin person is ranting about. Usually trail off around the 3rd or 4th line, but I did read one of the posts and it was enough to make me not want to read the others. lol when people wanting to go to NP school start throwing out the "NP are better than MD" argument in all aspects of care type garbage. Its like cmon man, you aint even started, your opinion is worth as much as a fleck of turd on the wall. At least if your gonna type non-sense do it in a readable version so we can properly pick your posts apart like bostonfnp has.

let me know how it pans out after you graduate. How does it go again? I keep forgetting... Person1- "omg im in first semester NP school learning to be a doctor in less time and I can do everything that neurosurgeon can because I worked in the ICU for 5 years blah blah blah doctors are overpaid NP IS THE WAY TO BE!!! yeah nurse power!!!! I am unstoppable and will get paid like 150k bc I am a Dr. Nurse!!! and physicians are overpaid goons!!" Two months later: Person 1- "omg guys I cant find a preceptor, Ive called around all over the place but they only take PA/MD students and I am just so busy writing my paper on patient feelings toward breastfeeding while doing yoga and I dont have time to call around all these places, SOMEBODY HELP" 2 years later: "finally graduated but I failed boards omg!!!!! What did i do wrong??? I did all my school work and wrote fine papers, and one even got published in some journal but I cant pass ahhhh" 6 months later- "Passed boards guys!!!! Heres what i did (inserts terrible study strategy topic post) BUT I CANT FIND A JOB O M G!!!!!! Everybody wants 2 years experience but they wont hire us to get the experience ahhhhhh." 8 months later- "Finally got a job but, I AM MAKING LESS THAN I DID AS A NURSE WHERE IS MY 150K SALARY HELP. I AM SEEING 49 patients a day and have to go home and chart for 5 hours per night ahhhhhhh" Pardon me for the terrible use of parentheses but I have to go study now. TTYL Also, yeah I know, its not the story for everybody, but lololololololol it is for those who are inept and go to Western Governors University of the Feenix/Kaplan and get a roflable education.

Yeah but some NP programs dont teach NPs how to practice correctly in the first place so that 10 years might be of god awful level of care. There isnt much, um, uniformity in NP education. I think we all know that though

supply and demand baby. Hence why i dropped NP and went back to the med school. Cant wait for that pay increase. will prob be at least 100k more if not 150-200. woot woot Residency caps the amount of physicians that can be trained so even if they for some reason open up 500 new med schools you still cant have overflow. Even though they wont open up 500 new med schools because the physician credentialing people know better than the nursing variant how supply/demand works. Twice salary is on the low end too and only for primary care. Specialties it can be like 4-5-6-7-+ x what they pay the NP in the group. Cards Bro raking in 800k where I am from paid his NPs like 95k and they were happy with the 95. I do not forsee NP salaries going up in the future. More supply and lower quality graduates due to many sloppy schools, and people are catching on that many NPs are not ready for practice when they graduate, or really ever. There are some good ones though so not group bashing here.

If you put the word feelings, or flawnce nightngayle in your proposal enough times they will bow down to your project without a question. on a serious note just make it something useful, What problems do you notice in society that we can fix? How can we fix them? What can actually be used in practice? I would do something related to an EHR, technology is interesting and better than some of the silly capstones I have seen people do such as "feelings toward an asthma inhalor," and "patient satisfaction with IM glut injections" Unfortunately I am not kidding.

Yeah it sucks that some schools screw students over by not providing the full education, but you know, usually one of two things happened. 1. they did not do their research. Yes, its hard to find all answers online, but one quick search will show how much some of these schools suck and what not to do. or 2, they were such poor students and workers they just couldnt get into a real school. Survival of the fittest.

Devastated? Please define this word in regards to your feelings. God forbit something seriously terrible happen in your life. Its a minor inconvenience and for your benefit I would move on. Not everybody's dreams play out day one of work.

lol at salary websites. If you take an average of the amount of people in the solar system without looking at specific locations, one would think Jupiter had the highest population.

its hard to say, there are other factors causing problems in this country, not just the type of health care system we have. The lazy mentality many american people have would make many systems fail since it is in our natural brains to want to to the least work to get what we need in life (primitive responses). I am for some sort of healthcare for all, but those who are able to pay up front should be able to get in quicker. This sounds unfair, but hey, socialism isnt a good gig. People with bad lifestyle habits should have to pay more, but screening for all this would be difficult. But to all those who immovably sway one way or the other, how much do you really know about each side? you read the whole thing lol? With less people in the workforce than prior times, which isnt completely either party's fault, nothing will work. Our country as a whole has an epicurean mentality and that really sucks because it drags down everybody else. Unfortunately large groups of people from both sides of the political wingspan are too lazy to provide any benefit to society because we are a bunch of whiny babies who want everything for free. Hence why we should deport people that are a detriment to society and let those in that want to better it so we can become better as a whole but that wont work because either side has their own dumb agenda they wont deviate from. So we are stuck in the best country of the world for now with still lots of problems. Its not a healthcare issue.

Feels great to give people doses of reality but Its always safer to do it anonymously bc yeah people are wimps now adays and america has turned into a soft epicurian society where we arent allowed to say anything bad about anybody and everything is ok because we blame it on genetics and our parents or our boss, etc. Hence why I ream people with the truth on anonymous forums so nobody knows who I am. Another reason 2-4 years of military service should be required for everybody, so they learn to take criticism well. Usually people who do not take criticism well never make it far in life anyway so let them sink their own ship.

gotta peeps dont know what they are getting into when they start med school. we got some peeps in my class that are in for a rude awakening thinking that once residency is over they get to sit on their toosh and do nothing. Still a good career but of course there are better options if money is the sole goal. Most common reasons nurses dont change jobs or try to get out of garbage jobs is they have terrible spending habits. Very few a nurse I have spoken with have any type of savings besides a 401k. Many drive like 60k vehicles on a 50k salary. I mean lol! Same can be said for a lot of docs though too