Nurse Practitioners (DNP) the new DO?

[Mjolner]

That still doesn't mean you have a shortage.

If it were SOLELY a distribution issue you would have many, many physicians in big cities that just can't find any patients at all to compensate for the fact there are so many patients in rural areas that can't get a physician.

Plus the downward pressure on salaries would be MUCH more significant in more desirable locations.

It's supply and demand and if we have exceeded the demand and there was no longer a supply issue we'd be in the same situation the lawyers are struggling with.

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[VA Hopeful Dr]

If it were SOLELY a distribution issue you would have many, many physicians in big cities that just can't find any patients at all to compensate for the fact there are so many patients in rural areas that can't get a physician.

Plus the downward pressure on salaries would be MUCH more significant in more desirable locations.

It's supply and demand and if we have exceeded the demand and there was no longer a supply issue we'd be in the same situation the lawyers are struggling with.

Uhh, the salary difference between shortage/rural and desirable big cities IS incredibly significant.

And the difference is not so stark that doctors in NYC can't find any patients, but that their patients can all get same-day appointments while rural folks wait 1-2 months.

You really fail to see that there can be graduations to supply and demand between "everything is perfectly balanced" and "lawyer level oversupply"

 

[feeling-dizzy]

Let be real, if you study your ass off for at least 8 yrs + 3-4 years residency, you would want to live in nice city (Beverly Hill? or San Francisco?) to enjoy life to the fullest. Who would live in rural with farm, cornfield, and scarecrows ? (except the nature-lover liberals, of course)

 

[PlasticGirl17]

Would be interested in any recent sources showing evidence for either a physician shortage vs distribution problem, or something supporting both/neither, if anyone has some good ones handy. Thanks.

 

[Mjolner]

Uhh, the salary difference between shortage/rural and desirable big cities IS incredibly significant.

And the difference is not so stark that doctors in NYC can't find any patients, but that their patients can all get same-day appointments while rural folks wait 1-2 months.

You really fail to see that there can be graduations to supply and demand between "everything is perfectly balanced" and "lawyer level oversupply"

The salary difference doesn't show a true oversupply in urban areas, just approaching a balance. You don't pay someone six figures when you have a crowd waiting to take their job. Sure. There is a distribution problem as well. I am the one who said there are both. I'm just arguing that it isn't JUST a distribution problem.
That they can fill their days with patients means that the supply and demand is balanced at best in cities and that they can't get an appointment for 1-2 months in rural areas shows a lack of supply of doctors.

I am going to go out on a limb here and say that hospitals aren't going to hire doctors beyond a model that works economically for them so family practice docs are probably seeing ~30 patients a day there. I mean if everyone is working in the cities, why would hospitals feel they need to make more attractive working conditions for doctors when there are soooo many others just waiting to snatch up their job?

So about balanced in big cities and short in rural areas. That is a shortage my friend AND a distribution problem. Like I originally said.

 

[Mjolner]

Would be interested in any recent sources showing evidence for either a physician shortage vs distribution problem, or something supporting both/neither, if anyone has some good ones handy. Thanks.

The problem is no one likes anyone's sources.
Some don't trust the AMA. It seems like everyone has a compensation survey they prefer over the others and they often disagree fairly significantly. And how are we defining big city? Everyone would want it defined in their favor.

 

[Tommyguns89]

Let be real, if you study your ass off for at least 8 yrs + 3-4 years residency, you would want to live in nice city (Beverly Hill? or San Francisco?) to enjoy life to the fullest. Who would live in rural with farm, cornfield, and scarecrows ? (except the nature-lover liberals, of course)

I plan on living in a relatively rural area. It is just a personal preference but I think for me its because my earliest memories are from living in a rural area, with a lot of land and a small lake in the backyard. Life in that environment to me just seems so much more peaceful than city life.

 

[Psai]

If it were SOLELY a distribution issue you would have many, many physicians in big cities that just can't find any patients at all to compensate for the fact there are so many patients in rural areas that can't get a physician.

Plus the downward pressure on salaries would be MUCH more significant in more desirable locations.

It's supply and demand and if we have exceeded the demand and there was no longer a supply issue we'd be in the same situation the lawyers are struggling with.

If getting paid three times less is not a significant downward pressure then i don't know what is

 

[VA Hopeful Dr]

The salary difference doesn't show a true oversupply in urban areas, just approaching a balance. You don't pay someone six figures when you have a crowd waiting to take their job. Sure. There is a distribution problem as well. I am the one who said there are both. I'm just arguing that it isn't JUST a distribution problem.
That they can fill their days with patients means that the supply and demand is balanced at best in cities and that they can't get an appointment for 1-2 months in rural areas shows a lack of supply of doctors.

I am going to go out on a limb here and say that hospitals aren't going to hire doctors beyond a model that works economically for them so family practice docs are probably seeing ~30 patients a day there. I mean if everyone is working in the cities, why would hospitals feel they need to make more attractive working conditions for doctors when there are soooo many others just waiting to snatch up their job?

So about balanced in big cities and short in rural areas. That is a shortage my friend AND a distribution problem. Like I originally said.

You very much pay someone 6 figures for a physician job, otherwise no one will take it. But you can offer insultingly low 6 figures in places like New York and people will take that but wouldn't in Nebraska. If you are paying literally half for a doc in New York what you have to pay them in Wisconsin, I think that's telling.

Interestingly, and more where my knowledge kicks in, if we got doctors back into clinical medicine (ie. no more weight loss clinics, medical spas, government/pharmaceutical consulting, and so on) and kept them from retiring early like is the trend (20 years ago you hardly ever met retired physicians in their fifties/early 60s, now its quite common) the shortage/distribution problem would mostly fix itself. You'll always have some issue getting people into super rural areas, but that's true of every field not just ours.

 

[MADNEMO]

.

 

[Mjolner]

If getting paid three times less is not a significant downward pressure then i don't know what is

I want to see sources where physicians are being paid three times less. That is a bold figure.
So if average salary for FM is ~180 you're saying that in cities they're making 90k and in rural areas they're making 270?
Cause I don't see average salaries going anywhere near that in major cities.

 

[Mjolner]

You very much pay someone 6 figures for a physician job, otherwise no one will take it. But you can offer insultingly low 6 figures in places like New York and people will take that but wouldn't in Nebraska. If you are paying literally half for a doc in New York what you have to pay them in Wisconsin, I think that's telling.

Interestingly, and more where my knowledge kicks in, if we got doctors back into clinical medicine (ie. no more weight loss clinics, medical spas, government/pharmaceutical consulting, and so on) and kept them from retiring early like is the trend (20 years ago you hardly ever met retired physicians in their fifties/early 60s, now its quite common) the shortage/distribution problem would mostly fix itself. You'll always have some issue getting people into super rural areas, but that's true of every field not just ours.

So you agree it's a shortage AND distribution problem? If so, we agree.

 

[Psai]

I want to see sources where physicians are being paid three times less. That is a bold figure.
So if average salary for FM is ~180 you're saying that in cities they're making 90k and in rural areas they're making 270?
Cause I don't see average salaries going anywhere near that in major cities.

Word of mouth. Doctors in rural private practice in my field can easily make more than 3x those in big cities. It's not exactly a secret. I don't need to prove anything to you, you can either choose to believe me or not. It doesn't matter to me either way. Also, that's not how averages work.

 

[deleted407021]

Let be real, if you study your ass off for at least 8 yrs + 3-4 years residency, you would want to live in nice city (Beverly Hill? or San Francisco?) to enjoy life to the fullest. Who would live in rural with farm, cornfield, and scarecrows ? (except the nature-lover liberals, of course)

Sarcasm?

People like me who find large cities to be as annoying as loud people who never shut up. I certainly don't like the idea of leaving our rural communities in the hands of NPs only.

Plus rural specialists make teh $$$

 

[Mjolner]

Word of mouth.

I see a lot of that in JAMA.
Wait. I don't. If only I could figure out why that's the case...

 

[W19]

Word of mouth. Doctors in rural private practice in my field can easily make more than 3x those in big cities. It's not exactly a secret. I don't need to prove anything to you, you can either choose to believe me or not. It doesn't matter to me either way. Also, that's not how averages work.

Are you saying Anesthesiologists can make over 1 mil in rural America?

 

[Psai]

I see a lot of that in JAMA.
Wait. I don't. If only I could figure out why that's the case...

lmao feel free to look at all of the compensation surveys you want kiddo. I'll take reputation over usnews rankings any day of the week
Then again, I guess you'd know better than me, being 3 months into medical school and all

 

[NickNaylor]

I see a lot of that in JAMA.
Wait. I don't. If only I could figure out why that's the case...

I've posted data pointing to the distribution vs. shortage several times, so feel free to review my post history and find those sources because I don't feel like pulling it up yet again.

The tl;dr is that the physicians per capita figure for the US nationally is on par with many "good" national systems (or at least those that are generally praised). There is, however, great inequity at the local and regional level for physicians, with some areas having physicians per capita numbers significantly higher than most countries and some that are on par with third world countries. Thus, if you were to simply spread out all of those physicians currently practicing evenly among the population, we would be perfectly fine. The problem is that that doesn't happen (see @feeling-dizzy's post for a great example of this) because most physicians don't want to work in rural areas.

This says nothing about the future, where we may very well need to train more physicians to prepare for the onslaught of dying baby boomers. I'm talking about current figures.

 

[maxxor]

Word of mouth. Doctors in rural private practice in my field can easily make more than 3x those in big cities. It's not exactly a secret. I don't need to prove anything to you, you can either choose to believe me or not. It doesn't matter to me either way. Also, that's not how averages work.

What is your field?

I've posted this elsewhere, but I think it's relevant to this thread, too.

Are you talking rural primary care? Because if you are in any sort of specialty, you need volume to maintain your collections. "Rural" as in true rural does not have the population basis to support a a subspecialty surgeon or even an IM sub specialist. Not everyone in a 500-700 population town is going to need a nephrologist, allergist, or an ENT. Primary care has the volume for sure, but not anything specialized. They need to be in a larger city (Pittsburgh) to derive the referral base needed to see enough patients to pay the bills. That's the big unfortunate secret of specialization. Yes you can make more money than primary care, but you have to live in an area that has the referral base so you have the luxury of limiting your practice. Not every area can sustain that.

 

[dozitgetchahi]

What is your field?

I've posted this elsewhere, but I think it's relevant to this thread, too.

Are you talking rural primary care? Because if you are in any sort of specialty, you need volume to maintain your collections. "Rural" as in true rural does not have the population basis to support a a subspecialty surgeon or even an IM sub specialist. Not everyone in a 500-700 population town is going to need a nephrologist, allergist, or an ENT. Primary care has the volume for sure, but not anything specialized. They need to be in a larger city (Pittsburgh) to derive the referral base needed to see enough patients to pay the bills. That's the big unfortunate secret of specialization. Yes you can make more money than primary care, but you have to live in an area that has the referral base so you have the luxury of limiting your practice. Not every area can sustain that.

Uh, no.

I'm going into rheumatology. In my state, there's about a 4 hour gap between major cities. For a long time, there were no rheumatologists in this gap and people drove hours to either large city to see one.

Two years ago, a rheumatologist opened his doors about halfway between the cities. His volume? It's absolutely ****ing booming because now people don't have to drive as far to get to the big cities anymore to see a rheumatologist. He's booked out for >4 months.

 

[maxxor]

Uh, no.

I'm going into rheumatology. In my state, there's about a 4 hour gap between major cities. For a long time, there were no rheumatologists in this gap and people drove hours to either large city to see one.

Two years ago, a rheumatologist opened his doors about halfway between the cities. His volume? It's absolutely ****ing booming because now people don't have to drive as far to get to the big cities anymore to see a rheumatologist. He's booked out for >4 months.

Are you west of the Mississippi?

 

[Psai]

What is your field?

I've posted this elsewhere, but I think it's relevant to this thread, too.

Are you talking rural primary care? Because if you are in any sort of specialty, you need volume to maintain your collections. "Rural" as in true rural does not have the population basis to support a a subspecialty surgeon or even an IM sub specialist. Not everyone in a 500-700 population town is going to need a nephrologist, allergist, or an ENT. Primary care has the volume for sure, but not anything specialized. They need to be in a larger city (Pittsburgh) to derive the referral base needed to see enough patients to pay the bills. That's the big unfortunate secret of specialization. Yes you can make more money than primary care, but you have to live in an area that has the referral base so you have the luxury of limiting your practice. Not every area can sustain that.

Anesthesiology

 

[VA Hopeful Dr]

I want to see sources where physicians are being paid three times less. That is a bold figure.
So if average salary for FM is ~180 you're saying that in cities they're making 90k and in rural areas they're making 270?
Cause I don't see average salaries going anywhere near that in major cities.

Three times? I haven't seen that. Double? I absolutely see that on a daily basis from recruiter e-mails.

 

[VA Hopeful Dr]

So you agree it's a shortage AND distribution problem? If so, we agree.

Not really, I just don't limit distribution to purely geographical. In my area, you can get a next day new patient appointment with cardiology but have to wait 2 months for a general internist. That, to my thinking, is a distribution problem but not a geographic one.

 

[maxxor]

Anesthesiology

Good luck finding a rural patient base with a good payer mix for anesthesia. Rural "critical access" hospitals are all about CRNAs.

 

[Psai]

Good luck finding a rural patient base with a good payer mix for anesthesia. Rural "critical access" hospitals are all about CRNAs.

You know this from experience?

 

[Mjolner]

Not really, I just don't limit distribution to purely geographical. In my area, you can get a next day new patient appointment with cardiology but have to wait 2 months for a general internist. That, to my thinking, is a distribution problem but not a geographic one.

I'll back that too

 

[Mjolner]

You know this from experience?

Maybe he knows about it from "word of mouth"

 

[Psai]

Maybe he knows about it from "word of mouth"

While I'm sure you thought your quip was exceptionally clever, as you go along you will find that what your trusted mentors tell you is worth listening to. Or maybe you won't, considering that I've never even heard of your school.

 

[ToldYouSo]

Other than that, why we are talking chemistry accumen otherwise. That stuff isn't relevant. My chemistry can be 100x weaker than any pharm's chem and it doesn't count for anything in the wards/office. It is important to know the clinically relevant stuff (i.e. it doesn't matter if you know a million irrelevant things about drugs).

Be careful with this line of reasoning, as it's the exact argument some make for why the lack of "arbitrary medical minutia" isn't a big deal when it comes to NP's practicing independently; e.g. knowing the kreb's cycle doesn't change the fact that you treat patient x with drug y... either the knowledge is important or it isn't. And IMO chemistry is important even for clinical practice (giving isoniazid to a slow acetylator). In fact, you see this sort of argument come up in a LOT of fields. In my college math classes I'd hear people asking why they needed to know calculus if they don't use it in the real world. Even in engineering, most of the complicated topics you learn aren't going to be used in a typical cubicle job where you have desktop programs and spreadsheets running the calculations for you because no one is actually doing pencil and paper diff eq's by hand as part of their job.

 

[Mjolner]

While I'm sure you thought your quip was exceptionally clever, as you go along you will find that what your trusted mentors tell you is worth listening to. Or maybe you won't, considering that I've never even heard of your school.

I'm sorry. I didn't realize you went to Harvard. Or was it Hopkins?

 

[WingedOx]

What is your field?

I've posted this elsewhere, but I think it's relevant to this thread, too.

Are you talking rural primary care? Because if you are in any sort of specialty, you need volume to maintain your collections. "Rural" as in true rural does not have the population basis to support a a subspecialty surgeon or even an IM sub specialist. Not everyone in a 500-700 population town is going to need a nephrologist, allergist, or an ENT. Primary care has the volume for sure, but not anything specialized. They need to be in a larger city (Pittsburgh) to derive the referral base needed to see enough patients to pay the bills. That's the big unfortunate secret of specialization. Yes you can make more money than primary care, but you have to live in an area that has the referral base so you have the luxury of limiting your practice. Not every area can sustain that.

You're being awfully concrete with regard to this discussion. I'll stick to PA, since that's the state you brought up. If you open an office in some random town on I-99 north of Williamsport, of course a specialist isn't going to have a base; but to say that you aren't going to have a sufficient referral base for ENT, etc in a city smaller than Pittsburgh is just a poor knowledge of geography, forget public health.

Are you really trying to say that you couldn't have a thriving ENT or allergy practice in Reading, York, or Danville?

 

[PhillyMed777]

Be careful with this line of reasoning, as it's the exact argument some make for why the lack of "arbitrary medical minutia" isn't a big deal when it comes to NP's practicing independently; e.g. knowing the kreb's cycle doesn't change the fact that you treat patient x with drug y... either the knowledge is important or it isn't. And IMO chemistry is important even for clinical practice (giving isoniazid to a slow acetylator). In fact, you see this sort of argument come up in a LOT of fields. In my college math classes I'd hear people asking why they needed to know calculus if they don't use it in the real world. Even in engineering, most of the complicated topics you learn aren't going to be used in a typical cubicle job where you have desktop programs and spreadsheets running the calculations for you because no one is actually doing pencil and paper diff eq's by hand as part of their job.

If you actually followed the conversation, you would note that we were talking about chemistry at a Pharm level which is far beyond what you are thinking of. If you think any of that is relevant, you haven't studied what I am talking about. Try taking an undergrad multivariable calculus based physical chemistry course and please tell me if you think that's relevant in the slightest.

I am an extremely strong believer in having basic sciences down like none other. Your statement however regarding knowing chemistry I am guessing comes from the fact that you've never studied chemistry, at least at a respectable level, that goes beyond gen chem or orgo chem. Anyone that actually studied that stuff would understand why it's irrelevant.

 

[ToldYouSo]

If you actually followed the conversation, you would note that we were talking about chemistry at a Pharm level which is far beyond what you are thinking of. If you think any of that is relevant, you haven't studied what I am talking about. Try taking an undergrad multivariable calculus based physical chemistry course and please tell me if you think that's relevant in the slightest.

I am an extremely strong believer in having basic sciences down like none other. Your statement however regarding knowing chemistry I am guessing comes from the fact that you've never studied chemistry, at least at a respectable level, that goes beyond gen chem or orgo chem. Anyone that actually studied that stuff would understand why it's irrelevant.

I did take pchem as well as a much harder inorganic chem that had pchem as a pre-req. I did like how you added the "multivariable calc" part as if any pchem class is taught without it.

 

[ToldYouSo]

To address your post (disregarding condescending comments otherwise) the same way you decide what material is or isn't relevant is the same argument other allied health providers use when they try to justify why they can treat patients independently. How much of our curriculum is really going to be put to direct use in patient care? This is true for all fields where you don't use x % of what you learned in college. The value is not so much in the material as in the act of having learned it has intrinsic value in itself.

 

[maxxor]

You're being awfully concrete with regard to this discussion. I'll stick to PA, since that's the state you brought up. If you open an office in some random town on I-99 north of Williamsport, of course a specialist isn't going to have a base; but to say that you aren't going to have a sufficient referral base for ENT, etc in a city smaller than Pittsburgh is just a poor knowledge of geography, forget public health.

Are you really trying to say that you couldn't have a thriving ENT or allergy practice in Reading, York, or Danville?

I'm saying you're overestimating how isolated you really are. Danville is literally the headquarters of Geisinger, a huge conglomerate and multi specialty group practice. Why would patients come to your solo specialty practice when they could just as easily go to Geisinger? And what's to keep Geisinger from gobbling you up?

Areas that are sufficiently "out of the way" yet with enough patients for a specialty physician to maintain a practice are harder to find than you think. Primary care? Certainly.

 

[tvelocity514]

I have actually asked a recent DNP grad about this. She believes it is ethical to introduce herself as 'doctor' because her doctorate degree is directly related to her role as a healthcare provider, whereas a PhD would be unrelated. She also pointed out that 'doctor' in colloquial usage does not mean "MD" or "physician", but simply a practitioner licensed to provide medical diagnosis and treatment services who possesses a doctorate level of education, which is her role / degree as a DNP family nurse practitioner, therefore it is entirely appropriate for her to use that title.

So, I actually was curious about part of this because this happened to me. My friend is about to graduate chiropractic school and she made a comment about how she will be Doctor of chiro and I'll be a physician. And I was like yeah I'll be a doctor. And she said, "no, a doctor doesn't mean MD. That's what a physician is". I was like alrighty then lol. Is this common knowledge and I just missed it somehow? I thought I could be called a doctor or a physician and people would know I had my MD... But I guess not?


Edit: I'm also curious about the future of healthcare if DNP's do become autonomous. Wouldn't this turn away people applying to Med school who wanted to go into primary care if they could get their bsn in undergrad and do 2 years post grad instead of 7(4 Med , 3 residency) to do the same job? Granted, I would still want the knowledge, but I'm not sure 5 years of loans/interest is worth it if DNP's technically can do the same stuff as a pediatrician.

 

[WingedOx]

I'm saying you're overestimating how isolated you really are. Danville is literally the headquarters of Geisinger, a huge conglomerate and multi specialty group practice. Why would patients come to your solo specialty practice when they could just as easily go to Geisinger? And what's to keep Geisinger from gobbling you up?

Areas that are sufficiently "out of the way" yet with enough patients for a specialty physician to maintain a practice are harder to find than you think. Primary care? Certainly.

who implied that @Psai specifically talking about solo practice? I mentioned Danville for obvious reasons of highlighting the sheer number of patients even in isolated areas...

 

[maxxor]

who implied that @Psai specifically talking about solo practice? I mentioned Danville for obvious reasons of highlighting the sheer number of patients even in isolated areas...

True. Anesthesia doesn't typically do solo practice.

However the point remains, when you have megasystems, individual physician compensation tends to go down as consolidation goes up and referral networks prevent referral outside the "system". It's better to be in an area with competing systems. That typically occurs in suburban areas just outside of really large cities, not so much in really rural areas.

 

[Carbocation1]

Even MDs are admitting that DNP/CRNA = MD:

"For any anesthesiologist who has worked with CRNAs, the results should come as no surprise. Though we hate to admit it, most of them are every bit as competent as MDAs."

http://www.blog.greatzs.com/2010/08/crnas-anesthesiologists-we-only-have.html

 

[DrMaccoman]

http://www.ncbi.nlm.nih.gov/pubmed/10632281

This is one of the most highly cited articles saying NP are equivalent to MD/DO in terms of patient care. The nursing unions always refer to published research articles such as the one listed. HOWEVER, a quick look at the FIRST AUTHOR of the paper turns out to be a Nurse Practitioner herself. I say it's a conflict of interest that the first author of this paper, a proponent of NP education, is a NP herself.

 

[Psai]

http://www.ncbi.nlm.nih.gov/pubmed/10632281

This is one of the most highly cited articles saying NP are equivalent to MD/DO in terms of patient care. The nursing unions always refer to published research articles such as the one listed. HOWEVER, a quick look at the FIRST AUTHOR of the paper turns out to be a Nurse Practitioner herself. I say it's a conflict of interest that the first author of this paper, a proponent of NP education, is a NP herself.

It's an incredibly crappy article. A 15 set satisfaction questionnaire? 1 year follow up? Lmao. It's very telling that nursing groups promote garbage like this. Any medical student can tear it apart

 

[VA Hopeful Dr]

Even MDs are admitting that DNP/CRNA = MD:

"For any anesthesiologist who has worked with CRNAs, the results should come as no surprise. Though we hate to admit it, most of them are every bit as competent as MDAs."

http://www.blog.greatzs.com/2010/08/crnas-anesthesiologists-we-only-have.html

Not that I really have a dog in this fight, but I can find an MD who will be on record admitting to just about anything. A single blog by what MIGHT be an actual MD isn't exactly compelling.

 

[WingedOx]

but I can find an MD who will be on record admitting to just about anything

ain't that the truth...

 

[chipwhitley]

Edit: I'm also curious about the future of healthcare if DNP's do become autonomous. Wouldn't this turn away people applying to Med school who wanted to go into primary care if they could get their bsn in undergrad and do 2 years post grad instead of 7(4 Med , 3 residency) to do the same job? Granted, I would still want the knowledge, but I'm not sure 5 years of loans/interest is worth it if DNP's technically can do the same stuff as a pediatrician.

Yeah, I mean if I wanted to do primary care and I was doing this all over agian, I'd get a DNP degree, save the money and time, and learn the rest on my own while getting paid a full salary.

 

[TheTao]

Yeah, I mean if I wanted to do primary care and I was doing this all over agian, I'd get a DNP degree, save the money and time, and learn the rest on my own while getting paid a full salary.

I said this about primary care, FP in particular, many years ago. Except that when you do the math in terms of the years of training required to become a DNP, you may as well go to med school and become a "real" doctor.

IMHO DNPs are poised to become the "affirmative action admits" of the late 20th century. One day in the near future, everything they do will be strenuously judged and questioned no matter how good they really are.

 

[chipwhitley]

I said this about primary care, FP in particular, many years ago. Except that when you do the math in terms of the years of training required to become a DNP, you may as well go to med school and become a "real" doctor.

IMHO DNPs are poised to become the "affirmative action admits" of the late 20th century. One day in the near future, everything they do will be strenuously judged and questioned no matter how good they really are.

Actually if you do one of the fast-track direct admit programs you can finish a lot quicker than the traditional DNP route. And even if you go the traditional DNP route, you get paid the entire time because you're working a real job while you're going to DNP school. Not to mention it's a lot easier to get into and far less stressful.

 

[EMEDCALI]

Found this thread while preparing a lecture for NPs. I work with scribes as an EM physician. The scribes are nearly all applying to med school and I was curious what type of conversations were happening on this forum these days. I never contributed to this forum then, but I will this one time here to pass the time with my nightshift induced insomnia.

Consider my situation as an answer:

I am a DO who works in EM. I went to an allopathic residency and was one of the chief residents. I mainly work with graduates of USC. The difference between DO and MD: who cares?

I also have NPs at my site and their role in the future of medicine is unquestioned. However, they see lower acuity patients, and the docs get paid more than 3x their hourly rate. The difference between physicians and NPs: well, that's simply a naive comparison. Why not compare LPNs and RNs or EMTs and Paramedics? It's a totally different level of pay, practice, and training.

Note that the overlap of skills and scope of practice exists across everyone. All of these providers (EMT, LPN, paramedic, RN, NP, PA, MD/DO) know how to take a blood pressure. Many know hypertension meds. Some can dispense and a few can prescribe. Truthfully, in some way all these providers "treat" patients. However, the only two that get paid the same rate, have the same scope of practice, and have the same graduate education/residency training are the ones we call physicians.

For all the applicants out there applying to schools and still worrying about DO vs. MD... Consider why you are trying to become a physician? If it's to treat patients as a physician go to medical school. If you also really care about the letters, apply only to allopathic schools. Either way, good luck.

 

[67552931811]

Even MDs are admitting that DNP/CRNA = MD:

"For any anesthesiologist who has worked with CRNAs, the results should come as no surprise. Though we hate to admit it, most of them are every bit as competent as MDAs."

http://www.blog.greatzs.com/2010/08/crnas-anesthesiologists-we-only-have.html

I have NEVER heard a physician, much less an anesthesiologist, refer to an anesthesiologist as an MDA before. But, of course, it's a random person on the internet with a blog so he/she MUST be a real doctor

 

[Mad Jack]

It has a 'D' on the end.

I'd prefer to say, "They end it with the D" myself