Originally Posted by DocRocket
Originally Posted by George_De_Vries_3rd


In general:

An new RN now generally has a BSN (bach of sci nrsg), maybe a Masters, can even have a PhD. There are well-paying jobs.
Guessing here $40-80k+/yr depending. Acts on phys orders unless in capacity of admin.

A nurse practitioner is an RN who goes on advanced training in “general practice” might have a Master degree. Could have a PhD. They are often called ARNP and are in many specialties. Many have at least an MS and more and more, a PhD or other terminal degree. Some of these like nurse anesthesia are at about the top of the anticipated income pyramid; ie, $150k -300/annum depending. Many states give them prescriptive authority and they can practice autonomously. Can also work under a physic.

A Phys Assist does roughly the same, or can, as the above but is more limited in the spheres they can work (ie, cannot do anesthesia for one thing); becomes a PA-C — physician assistant - certified. Surgeons, particularly orthopods, use these in the OR and in the clinic. Can work under a physic or autonomously with physic as back-up.

MD’s and DO’s are physicians and depending upon specialty and post-grad training earn varying incomes from $150k to much higher.

Health care is becoming more and more dependent on “extenders” or nurse practitioners or phys assist’s as a matter of logistics and economy.


Pretty much what I've seen. We use ANP's and PA's (grouped together as APP's, Advanced Practice Providers) in every ER I work in these days, and we couldn't get by without 'em. Their scope of practice is limited, and rightly so, but as Kevin pointed out previously, a specialty APP will know more about that specialty field than most MD's who aren't in that field, so their value to you as a patient can be really high.

I have steered a couple of young people away from medical school in recent years, advising them to get their bachelor's degree in nursing, then get an advanced degree as a nurse-anesthetist or ANP as a more cost-effective alternative. Most young docs I talk to these days graduate with more than $300K in student loan debt, which will take decades to pay off at current pay rates. Doctor salaries aren't what they used to be (compared to other professions) as corporate medicine becomes the norm and MBA's make most of the decisions.

I have a graph that I show to people who complain about "the high cost of doctors" which shows the growth in total health care costs compared to the costs of doctors' fees and to the costs of administrators salaries. Administrators have skyrocketed in numbers and in salaries in the past 20 years, doctors have been almost stagnant in both areas. The reason health care costs so much today is that people who do nothing to deliver healthcare are taking over the system.

This is why 60 cents or more out of every health care dollar spent goes to administrative and regulatory costs. Bureaucracy.



Excellent posts Doc and George.

Now, as to that last highlighted sentence of yours Doc.

HOW DO WE FIX THAT????

I'm nearing Medicare age so I've seen many changes in my health care delivery systems I'm not particularly happy about. And the bureaucracy determining my treatment options and timing thereof are surely one of the most detested changes I've seen.

Any ideas how to address this issue? Without going "UnAmerican" and removing the profit motive driving the corporate changes to the system that is. That would surely piss off a lot of people here. wink

Geno


The desert is a true treasure for him who seeks refuge from men and the evil of men.
In it is contentment
In it is death and all you seek
(Quoted from "The Bleeding of the Stone" Ibrahim Al-Koni)

member of the cabal of dysfunctional squirrels?