Why DNP and not MD?

CallieNicole · Dec 5, 2015

On the other hand, I also have friends who remained in debt because they were living a high lifestyle as soon as they got hired. It is all up to you but yes, it is worth it so go for it while you are still young. Do not listen to anyone else that tries to dissuade you.

PS. I am planning to get certified to be a Life Coach :) How am I doing?

Bluebolt · Dec 5, 2015

I think those listing astronomical pay for MD's and DO's should do some closer research.

Out of years of practice in the ICU working with hundreds of MD's from many different states and backgrounds/specialties I've only known one who actually broke $400,000 a year. He was a specialist neurosurgeon who was trained in an endovascular approach. The reason he made so much was because he was recruited to rural Tennessee where he was the only neurosurgeon with that training east of that state. He also worked like a dog, 80 days in a row without an off day and was responsible for 4 different PA's. He said that if he moved to a city with amenities, had days off, didn't have to manage all that stress his pay would have dropped.

Just google physician salary and many reputable articles come up from Forbes, Medscape, etc with research data reported from physicians of their annual salary, here is a clip from the article.

"Physicians were asked to provide their compensation for patient care. For employed physicians, patient-care compensation includes salary, bonus, and profit-sharing contributions. For partners, this includes earnings after taxes and deductible business expenses but before income tax. According to this year's Medscape survey, the average compensation for specialists is $284,000 and for a primary care physician (PCP) is $195,000".

Medscape: Medscape Access

[COLOR=#444444]Of course keep in mind these are average rates, that are inflated by the states that pay very high, because cost of living is high. When I worked in Alabama I found out that the Internal Medicine hospitalists were making about $150,000 a year, in Connecticut it was closer to $200,000 because a small 3 bedroom 2 bath home with 1,200 square feet is $400,000 in Connecticut. So it all comes out in the wash really, it's hard to find a place that you can get higher pay but not have to sink that pay into your higher cost of living there. [/COLOR]

Also remember that these rates listed for MD/DO's are gross salary, no income tax removed yet, so just deduct about 1/3 of that number off what they'll actually get. Then add in malpractice insurance, certifications and board testing every so many years that you must pay for.

Then add in the interest that is accruing from the moment you take out these loans for med school, the current rate at Wells Fargo if you're lucky is 5%. So by the time you finish residency you're $300,000 in debt, with interest about 5% accruing on top of that for years now. Maybe if you're above average grossing $200,000 a year which when taxed you'll bring home $140,000, deduct from that your malpractice insurance and professional certification costs. Then add in the fact that you're essentially salary and working 60 hours a week (most MD's) and viola, you have your true life of an MD. Remember they don't get OT so if you're working 60/hrs a week with a net earning of $140,000 a year that equals out to an hourly take home pay of $44.87 an hour. Now lets pay off that $300,000 loans and eat, buy a car and a home, keep wife from shopping, etc.

I'm sorry if this burst anybodies bubble but I've grown up with physicians and their kids and the life is not usually some million dollar home, yachts and vacations fantasy. Sure there will be that 5-10% who specialize in 8 year residencies, have awesome skill, make a name for themselves and can demand very high pay in certain cities willing to pay and they work 70 hours a week. That is not the norm and if you go into medical school thinking that is your future, think again.

Also keep in mind that currently I know two physicians who have retired early because they say that insurance companies (Medicare especially) has stopped reimbursing to the point that they're losing tons of money. The work level and stress level of it all was just not worth them staying in practice and dealing with the new crackdown by insurance companies. MD's are terrified of Obamacare and the future of healthcare and salaries are greatly being impacted by insurances.

I've had many MD's say that CRNA is a smart route to go and that they wish they had done it, want to break down why?

Salary.com states the median annual salary of a CRNA as $167,412, although some make over $200,000

Degree takes 2-3 years to complete

No residency required

From my research the estimated average student loan debt is less than $130,000 (Mayo clinic states for their program it's usually less than $70,000)

You work a 40 to 45 hour work week with full holidays and benefits.

Insurance companies do not dictate your job or your direct earnings.

Many hospitals carry malpractice insurance for you (Also stated by The Mayo Clinic)

If you break it down hourly like I did for MD's with an average gross income of $170,000 with 1/3 off for taxes you get around $119,000 net take home, divide that by 45 hours a week equals $50.8/hr.

Of course these are rough estimates based off average listed salaries and typical work weeks, these things can vary and are just an average. The purpose is to show you how pay is not what you think it is when you see a big number and haven't broke it down yet.

I'm sure this post sounds like I'm extrememly biased against MD's to all those who don't know me. Actually I was selected with 19 other young scholars from the state of Alabama in our undergrad to complete a Med School internship at UAB, one of the top med schools in the country. I spent two months living on campus, going to lectures, doing rounds with the 3rd and 4th year med students and attendings, writing research papers, presenting topics on healthcare to the faculty and students, MCAT testing, etc. We were groomed to enter into their Med School with an advantage and they also tried to incorporate a desire to serve the poor and the rural medically underserved community. After it was all done I was heavily swayed in that direction but after research I chose this as a better path for me. My old friends and interns are mostly in residency now and I appreciate them and their role as they appreciate my role.

Just go into your career in healthcare, whatever you choose, with real knowledge of both sides of the coin.

If you are doing MD for the money then you better make sure you're the brilliant of the brilliant because you will have to beat out every other smart med student wanting that specialty residency. Then be sure you're willing to work 60 or more hours a week for the rest of your career.

synaptic · Dec 5, 2015

sounds like they are getting shammed i woulda made 165k+ this year working 42 hours a week if i would have continued working. My bosses made 2-3x that as docs with less work. If you don't believe me ill pm you a copy of my paystub up to august showing almost 120k for little over half a years work

I know what all the docs make in my rural southeast area and the only ones not making 200k are the attending at the local residency (who might work 10 hours per week) or docs that don't work period.

Varies by location of course.

A physician hospitalist make 150k? Thats what i did as an np covering IM floors and ICU at night and made that. Our hospital makes well over 300k

Really, I do not know where you get your numbers from because either 1. your lying or 2. they are totally getting shammed hard.

Rural medicine makes bank, even though it isn't all about the money.

CallieNicole · Dec 5, 2015

Advises like Bluebolt's was exactly the reasons why I did not pursue medical school and now I know, I was given completely the wrong information.

Physicians do not like to state how much they really make because of lawsuits and they do not want to saturate their market for fear of their salary going down.

I know the truth because I have first hand information.

CallieNicole · Dec 5, 2015

Also, tuition interest is 1% to 2.5%. You can easily pay your loan off if you are smart. And dont forget, in residency you get paid $60,000 annual.

AndersRN · Dec 5, 2015

Advises like Bluebolt's was exactly the reasons why I did not pursue medical school and now I know, I was given completely the wrong information.
Physicians do not like to state how much they really make because of lawsuits and they do not want to saturate their market for fear of their salary going down.
I know the truth because I have first hand information.

Google is way off when it comes to physicians' salary... Even MGMA is off since they also use MD/DO who work part time and in academia...

Bluebolt is someone who is doing a DNP and think he will be able to go around healthcare settings and introduce himself as 'doctor'... The truth is that some hospitals and even some states forbid that..

allnurses Guide · Dec 5, 2015

Google is way off when it comes to physicians' salary... Even MGMA is off since they use MD/DO who work part time and in academia...
Bluebolt is someone who is doing a DNP and think he will be able to go around healthcare settings and introduce himself as 'doctor'... The truth is that some hospitals and even some states forbid that..

Oh yes, the world is going to end because a nurse who has earned a doctorate actually uses that title when introducing themselves.

Where is the outrage over other non-physicians calling themselves Doctor in the hospital setting such as dentists, podiatrists, and psychologists?.

AndersRN · Dec 5, 2015

Oh yes, the world is going to end because a nurse who has earned a doctorate actually uses that title when introducing themselves.
Where is the outrage over other non-physicians calling themselves Doctor in the hospital setting such as dentists, podiatrists, and psychologists?.

I am just stating what I have seen based on my experience working as a nurse... It's confusing to patients since the role of NP vs. MD/DO overlaps so much. The place I work forbid that...

People are not outraged and they should not be. However, the hospital is already a confusing environment for many patients... It's probably wise to come up with these measures... It would not be ok for a phlebotomist who has PhD in literature to introduce him/herself as doctor in healthcare settings...

allnurses Guide · Dec 5, 2015

I am just stating what I have seen based on my experience working as a nurse... It's confusing to patients since the role of NP vs. MD/DO overlaps so much. The place I work forbid that...
People are not outraged and they should not be. However, the hospital is already a confusing environment for many patients... It's probably wise to come up with these measures... It would not be ok for a phlebotomist who has PhD in literature to introduce him/herself as doctor in healthcare settings...

So let us not educate patients to the real world, but lets continue to propagate the lie that physicians are the only type of healthcare providers that have earned a doctorate.

Where is the outrage when medical students and physician residents pass themselves off as physicians and attendings? Where is the outrage over other types of providers using the title doctor? Do you really think most patients understand that a psychologist isn't a psychiatrist, a podiatrist isn't the same thing as an orthopod, or that OMFS is most times a dentist not a physician?

It may or may not cause some confusion to patients when a nurse states I am Dr. X your midwife/FNP/CRNA etc, but it also gives that person the chance to explain the difference between a physician and an APRN. What it does not do when a doctoral prepared APRN calls themselves doctor is cause detriment to patient safety that some people like to claim.

Also, despite the lies that a lot people like to spread about APRNs that earn their doctorate APRNs are not trying to claim they are physicians or eradicate the medical profession. It is nothing more than unbridled prejudice and egotism when one group refuses to allow another group the same rights that they have based on academic achievement i.e. calling yourself Doctor after earning a Doctorate.

synaptic · Dec 5, 2015

I remember all of my nursing professors wanted to be called doctor, which in the classroom is ok. We had one that got her Dr degree midway through our program, who taught in our labs. She got mad when people didn't call her doctor after she got it. If you want to call yourself doctor just for ego reasons your pretty much a fool. If you want to so you benefit to patient, that is great. Ego is bad enough in healthcare, all we need is everybody calling themselves doctor.

I just would want to avoid the conversation with patients or physicians who you may have to work with where you have to explain yourself.

I think that would be a way to get on the bad side of a lot of physicians....

who knows I'm midline between if its ok or not. But usually only like dentists, pods, and physicians call themselves doctor in healthcare settings it seems.

allnurses Guide · Dec 5, 2015

I remember all of my nursing professors wanted to be called doctor, which in the classroom is ok. We had one that got her Dr degree midway through our program, who taught in our labs. She got mad when people didn't call her doctor after she got it. If you want to call yourself doctor just for ego reasons your pretty much a fool. If you want to so you benefit to patient, that is great. Ego is bad enough in healthcare, all we need is everybody calling themselves doctor.
I just would want to avoid the conversation with patients or physicians who you may have to work with where you have to explain yourself.
I think that would be a way to get on the bad side of a lot of physicians....
who knows I'm midline between if its ok or not. But usually only like dentists, pods, and physicians call themselves doctor in healthcare settings it seems.

It is good to know that all physicians, dentists, podiatrists, and psychologists that use the title doctor only do it for their ego.... How does the title doctor ever benefit the patient?

No one is ever outraged about someone being called a Doctor in the healthcare setting until it is nurse then the world might as well have ended.

AndersRN · Dec 5, 2015

Also, despite the lies that a lot people like to spread about APRNs that earn their doctorate APRNs are not trying to claim they are physicians or eradicate the medical profession. It is nothing more than unbridled prejudice and egotism when one group refuses to allow another group the same rights that they have based on academic achievement i.e. calling yourself Doctor after earning a Doctorate.

I am not aware that physicians are against NP calling themselves doctors anywhere else except healthcare setting, because it's confusing... Lets be real here! There were many NP with PhD degree that were not pushing the for the 'doctor' title in healthcare settings... We all understand what's going on here!

I was not against it until I had to clarify so many times to patients that DNP are not 'doctors'.... even if that DNP just introduced him/herself to these patients as: 'I am doctor [insert], I am a nurse practitioner...' Now I don't spend the little time I have explaining the nuances except telling these patients 'he/she is not a doctor.' I pretty much :sarcastic: when a few of them do that.