Home Forums Hunting & Shooting Hunter's Campfire who can update us on the medical profession?

I’m a Family nurse practitioner, work emergency department exclusively. Have done hospitalist/internal medicine but didn’t care for it.
Been in medicine for 12 years

My best friend works cardiology as a nurse practitioner, and I can assure you he knows way more about cardiology than most doctors that aren’t cardiologist

Physicians assistant vs NP? Both are basically interchangeable truth be told. Just two different routes to get to the same place. There are minor differences, but I have never worked anywhere that they did any different job or were paid any different. PA go into school with little to no medical experience. NP is expected to have experience and be knowledgeable going into school. So the training in school is a little different at times based upon what you are expected to already know.

In my ER there are 7 mid level( NP and PA). 4 of which are NP and 3 are PA. All can do the same job and are very good at it. We see everything from simple colds to strokes and heart attacks. Same as the docs.

Training time for both is about the same.
about 2 years for prerequisites, 3-4 years for BSN, 2 years for masters training. Expect it to take 6-8 years depending on the school


Pay wise it varies across the board depending on the field you work in, how busy your site is, and the patient population( are they indigent and have no insurance and cannot pay, or do they have insurance and will pay the copay or deductible).

Good thing about ER is we don’t care if you can pay or have insurance, we just do what needs to be done. We honestly don’t even know if you have insurance or not as providers in ER unless your a psychiatric patient( have to know to get you to a facility if needed)

Avg pay here for Mid levels is probably 95000-100000. Upper end is around 170000. My company pays extremely well and offers incentive bonuses based on productivity, patient satisfaction, and metrics.

Nurses with a masters of nursing but are not nurse practitioners make significantly less here. 65000-80000 at best.

To me I love patient care, hated management. So it’s worth it to me to be a FNP, and my job pays pays twice as much as a masters prepared RN doing education and management.


Where is medicine going in the future. Hard to tell honestly. Sometimes good changes come about and I think things are looking up for the future, but most of medicine is managed by corporate management groups that are hell bent on making big profits. Which doesn’t lend itself to good patient care


If you have specific ?’s shoot me a PM. Be happy to discuss. Done it all from CNA, floor nursing, ICU, nursing management, to emergency nurse practitioner. So I have a good bit of experience

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When I was in my mid 40's, I needed a DOT physical. The company sent me to a new clinic they'd just contracted with. I was sitting on the table in a hospital gown when a knock dead blond came in. She said "Hi, I'm Dr Evans. I'll be doing your physical." I got the whole thing, finger wave included. All I could do is grit my teeth and say 'Willy, behave yourself." He did.

My son is an RN in a large clinic in Seattle. He's considered going back to school to become an NP but he says he wouldn't make enough extra money to be worth it. He also looked at becoming a PA but he doesn't want to be under a doctor's thumb like that. He says an NP has a lot more freedom.

If you see an NP or a PA, is 'doctor' the correct title to give them? They're not full fledged doctors but what else would you call them?

remember. Just being a MD doesn’t mean they have more knowledge of every specific field. I can assure you a FNP/PA working in a specialty field knows more about that specialty than most doctors not working in that specific field. I see it every day.

The trick is remembering your training and your personal limitations. Don’t try to be a hero, have humility, and know when to consult people with more experienc or knowledge. That’s why we have specialty trained providers

You would rather have a emergency PA or FNP working on you if your in cardiac arrest than most primary care doctors or a urologist for example. I’m way better at wound repair than most docs I work with in the ER. I do it multiple times every day, they do not do that regularly.

You wouldn’t want someone like me managing your chronic diabetes, heart disease, atrial fibrillation, or hypertension in the office. I’m not experienced in doing that. I was trained in it, and know the disease processes well I assure you. I am not up to date on best practice in managing these things anymore though.

We get a lot of people in the ER that think they know what is wrong because they read it on google or web md. Every once in a while they got it right, but not typically. We can’t start with huge work ups for every complaint, but sometimes it is medically indicated to do so. Knowing the indications and signs/symptoms helps

Almost every simple abscess that comes to the ER says I think I have a spider bite. Its typically not a spider bite I assure you

A ER saying from way back is “ hunting horses, not zebras”. Sometimes there is a zebra out there though and it’s your job to identify it. Sometimes despite your best efforts it will elude you

In medicine we do not go by doctor as a PA or FNP. I usually just go by name and introduce myself as Kevin your nurse practitioner today

In school some nursing instructors or professors go by doctor such and such. Mainly just being pompous I always thought

appreciate all the inputs. my mom always saw a PA, and almost never saw a doctor. the PA had a packet of blank prescripts in her coat and signed by the Doctor for whatever came along. the Doctor worked at her other clinic in a nearby town.

NP makes alot here .$100,000 plus (might be $150,000)

They can write scripts. Im gonna say 6-8 years of schooling.

Local older nurse practitioner started her own private practice several years ago. Within a couple of years she was putting a hurting the also local satellite clinic owned by a hospital located in a nearby town and headed by a MD.

The hospital offers the nurse practitioner the position as head of the said satellite clinic. Apparently the deal was too lucrative for her to pass up and she accepted it.

Next thing you know after moving over to the satellite clinic her office visits almost doubled in price, she started writing more and more prescriptions for specific brand name medicines instead of generic equivalents, all tests were run through the hospital that owned the clinic at severely increased prices, etc., etc.

After a few years of working under the hospital's corporate mentality I guess being the caring person she is had had all she could stomach and went back to private practice again.

How did it change the way you feel if you don’t mind to elaborate. Always appreciate hearing opinions from people who have been through chronic illnesses. Helps to understand their perspective when you do what I do.

I don’t believe healthcare is all perfect and roses, I assure you. I have cared for numerous foreigners and work with quite a few every day. Some from countries with socialized medicine, some from 3rd world countries.

Medical care ain’t all that bad here though. One guy had his mother come here from England. Diagnosed with stg 3 cancer. Told hospice was best option, and that they wouldn’t do radiation and chemo due to prognosis. She got radiation, chemo, and two surgeries. Been 12 years now and she is at this point cancer free. She was 52 when diagnosed. In England they would have let her die

A lot of pollyanna nursing students aspire to work in neonatal. Yeah....whatever.



Then they find themselves wiping asses on New Year's Eve as a cna.

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Sounds good

my Dr at the VA where I go is one of the best looking female Drs I have seen yet. and she seems to want me to live forever.

Hell, you can better diagnose yourself with google and YouTube these days.

Don't need no stinking doctor pushin pills on me.

My 10th grade daughter wanted to be a doc, i steered her toward PA, without excluding doc.
Pa's make real good money without as much schooling, or liability.
One thing that convinced her.
I had a routine blood pressure type appt, the PA was an attractive 24 or 25 year old woman.
J went back, and we chatted with her.
She loved her job, did most of what a Doc did, made a real nice income, and was making money while the potential docs were still
bleeding money, they didn't have.



This is what I have learned about the differences.
Of course, this applies to Pa, your state rules may vary.
Nurse Practitioner can hang a shingle and act autonomously, with the implied $rewards and liability liabilities.
A P/A operates under the supervision of a Doc, who is somewhat liable for the PA's actions.
That does not preclude a PA from working solo in a facility.

No. Call them by their first name or Mr./Ms, same as they call you.

On a somewhat related note, I had an e-mail exchange with a NYT reporter regarding their use of the Doctor title. I was told that their editorial policy is to use it only for medical doctors, not PhDs and other doctoral degree holders. When I asked why that didn't apply to the Reverend Doctor Martin Luther King, Jr., or Kavenaugh accuser psychology professor Christine Blasey Ford, she got real testy and refused to discuss it any further.

Paul

Were you born ignorant and belligerent or did you have to practice?

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