Oregon equal pay for equal work law has been signed into law in an independent practice state with NP's and PA's getting paid FULL amount from private insurance. This means that a new grad NP's will be paid the same amount as an attending family physician and psychiatrist and also have the same rights and scope of practice as a family physician and psychiatrist.
With the tremendous push for equal pay and for autonomy for PA and NP, is there any reason for medical students to want to go into primary care anymore? I guess my question is, it seems so bizarre that someone would put themselves through hell when they could become a competent provider through the NP route or PA route.
So do you think with these new laws, PA's and NP's will ultimately lead primary care? will these laws drive away medical students from primary care? Is it financially reasonable for a medical student to become a family physician in an equal pay state?
As an sNP, I'm incredibly thrilled and happy at how much progress our profession has made. However, I also understand how some medical students hoping to go into family medicine can feel cheated and grumpy about it. What are ya'll thoughts?
Please cite your sources for these outcomes. Which medical school do you work with? I don't think they will be too please to see you posting on a public forum that an experienced NP can run circles around a PGY1. Let alone advocating for MD's to leave primary care. Further, what do you mean run circles? Sure NP's may have better time management skills and maybe they can handle the work flow better due to their bedside nursing experience. But sit down with those PGY1's and you will find that they are incredible intelligent, critically thinking minds. They may need some assistance at first with work flow/work demands but I've found that most PGY2 can run circles around an experienced NP. I have experience at one of the top teaching hospitals in the country so maybe my perspective varies.
How about this: I will cite some sources, you agree to read them and come back and support that the data has changed your opinion. Agree?
I wouldn't mention which medical school or which nursing school I work for because they both have policies about just that. Why don't you say what top teaching hospital you work for? It doesn't really matter, we both are talking about our professional experience (and our friends' experience). I care much more about the data.
I have never allocated for physicians to leave primary care, though many of them have done that for themselves.
Sure many PGY1s and physicians in general are hard working intelligent people. Many SNPs and NPs (and RNs and PTs and PAs etc) are as well. There is no medicine exclusivity on intelligence. Most PGY1s have lots of theoretical knowledge and minimal practical knowledge on how to apply it. Most SNPs have some knowledge of practical application but need to work on the theoretical knowledge base. There is an inherent difference in front loading vs continuing clinical exposure.
If NP outcomes are equivalent, why does it matter? NP, PA, MD it's all the same right?????
Personally the available data I've seen has not satisfied me that NP outcomes are on par with physicians. In any event these studies were done when NP education required RN experience which I personally feel does make a difference in most cases, not that there aren't outliers, NPs with no RN experience who are good and NPs with years of RN experience who are incompetent but overall because our education is superficial and at the very least brief I feel RN experience is a key component that we won't see going forward. It would appear there is a NP school for anyone who can pay the tuition and frankly that frightens me.
Side note if I had to blindly pick a NP vs PA I'd go with PA because their education is based on the medical model which I feel is superior.
Personally the available data I've seen has not satisfied me that NP outcomes are on par with physicians. In any event these studies were done when NP education required RN experience which I personally feel does make a difference in most cases, not that there aren't outliers, NPs with no RN experience who are good and NPs with years of RN experience who are incompetent but overall because our education is superficial and at the very least brief I feel RN experience is a key component that we won't see going forward. It would appear there is a NP school for anyone who can pay the tuition and frankly that frightens me.
Side note if I had to blindly pick a NP vs PA I'd go with PA because their education is based on the medical model which I feel is superior.
There is really a staggering amount of extant data to dismiss it fully, I think there are now over 300 concordant studies and only two studies I have seen show physician outcomes superior. There are obviously differences these studies do not fully explore. I have to say, personally, I don't think that non-fellowship trained NPs should being doing specialist consults but I have no data to support that other than my professional experience.
We both agree about the number of "shady" NP programs being accredited and their questionable admissions requirements. All the more reason for keeping discussing this and advocating for stricter program scrutiny and more challenging national cert exams.
We don't agree on the RN experience component fully, but I will say that the Yale NP program (which has an excellent clinical reputation) has never required RN experience. We do agree (I would assume) there is a difference between Yale and University of The Internets Online DNP program.
Personally the available data I've seen has not satisfied me that NP outcomes are on par with physicians. In any event these studies were done when NP education required RN experience which I personally feel does make a difference in most cases, not that there aren't outliers, NPs with no RN experience who are good and NPs with years of RN experience who are incompetent but overall because our education is superficial and at the very least brief I feel RN experience is a key component that we won't see going forward. It would appear there is a NP school for anyone who can pay the tuition and frankly that frightens me.
Side note if I had to blindly pick a NP vs PA I'd go with PA because their education is based on the medical model which I feel is superior.
Nailed it! I chose PA school over NP school for this reason. I prefer the traditional medical model. I don't feel online education and discussion boards are appropriate teaching methods for higher level medical education. Not when lives are at stake.
How about this: I will cite some sources, you agree to read them and come back and support that the data has changed your opinion. Agree?
I wouldn't mention which medical school or which nursing school I work for because they both have policies about just that. Why don't you say what top teaching hospital you work for? It doesn't really matter, we both are talking about our professional experience (and our friends' experience). I care much more about the data.
I have never allocated for physicians to leave primary care, though many of them have done that for themselves.
Sure many PGY1s and physicians in general are hard working intelligent people. Many SNPs and NPs (and RNs and PTs and PAs etc) are as well. There is no medicine exclusivity on intelligence. Most PGY1s have lots of theoretical knowledge and minimal practical knowledge on how to apply it. Most SNPs have some knowledge of practical application but need to work on the theoretical knowledge base. There is an inherent difference in front loading vs continuing clinical exposure.
I have already read the research on it. I just wanted you to research it more thoroughly. I never said NP's are not intelligent people. I just don't see how NP's can fully practice independently with such limited education. Sure nurses take A&P and Biochem. At the 1000 college level. This is not the same as the rigorous upper level classes MD's take. This whole thread is about how MD's aren't even needed in primary care. Suggesting that NP's should function independently in primary care. I don't buy that. No the way these online schools churn out new grads like a factory. Honestly, I am appalled that nurses have such an ego that we would go online and proclaim that MD's aren't necessary in primary care. My pediatrician treated me from the time I was born until I moved away to college. He watched me grow up and treated me many times when I was very sick. To suggest that he is not needed in the profession that he dedicated his life to is incredibly disrespectful. 15 years of floor nursing experience, an online degree and some letters behind your name doesn't make you equivalent to a physician. Seriously, reign in that ego and take it down a notch because it doesn't look good for our profession.
And I just have to say, I love the thread where NP's whine about not getting paid as much as physicians. LOL well you have half the education. So it's only fair you get paid less! That's business!
Are you sure you want me to post the thread? You participated in that thread from 2015. I'd really hate to make you eat crow
Link my quote in the thread, if I misspoke I would be happy to correct it. I have no problems 'eating crow' if evidence supports it. I am sure as a scientist you would do the same.
And I just have to say, I love the thread where NP's whine about not getting paid as much as physicians. LOL well you have half the education. So it's only fair you get paid less! That's business!
You are lashing out aren't you!
Just remember, a few years down the road if you become a PA and start working, that these are your thoughts, because it will impact you too. To be honest, PAs have more to complain about than NPs in that regard.
Link my quote in the thread, if I misspoke I would be happy to correct it. I have no problems 'eating crow' if evidence supports it. I am sure as a scientist you would do the same.
You are lashing out aren't you!
Just remember, a few years down the road if you become a PA and start working, that these are your thoughts, because it will impact you too. To be honest, PAs have more to complain about than NPs in that regard.
I have already successfully completed PA but thanks for the advice! I fully understand the impact of my statements. My co workers are glad that I commented on this thread. We were actually talking about it today :)
HBrnGirl
27 Posts
If NP outcomes are equivalent, why does it matter? NP, PA, MD it's all the same right?????