Anonymous wrote:NPs generally max out around $150k and many make 90k. That's after spending $150k for schooling beyond a bachelors.

It's a flexible career but it's not a money maker. Hard to live off those salaries (becomes a homeowner, etc) in an area like the DMV unless you're married to another income.

Most NPs are women, after all. Odds are they're married to a higher-earning man.

I'm just a regular patient but my experience with PAs has been much better than NPs. PAs seem to have more medical knowledge while NPs are more generalists. There IS a difference.

Anonymous wrote:PAs can't write prescriptions and NPs can.

I see a PA and she writes me prescriptions. Maybe that have to be approved by the MD that she works with, but she's the only person I see, and I get the medicines....

Great for Emory

Anonymous wrote:

Anonymous wrote:PAs can't write prescriptions and NPs can.

CRNAs, too, that's another excellent nursing career path.

I am a CRNA! Best job in the world. I work 3 8hr shifts a week and make 300,000 (there’s a critical anesthesia shortage). Been doing it for 15 years. Long road to get here but highly recommend.

Anonymous wrote:why not doctor? it embarassing to explain yourself and i always request a doctor over a pa. maybe ok in cvs minute clininc

What does it mean?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Nurses like becoming NPs because it pays better and they have more freedom (can prescribe meds).

I have had good and bad experiences with NPs. In theory they improve the system by handling cases that might be too simple or straightforward for a doctor. And they do generally get to spend more time with patients, making them a good option for a PCP (PCN?) where not being rushed can be helpful.

However I have had very negative experiences with NP specialists. I do not feel the training fir their specialty is sufficient and they can have unearned confidence, especially in diagnosis. I've had a gyn NP miss major symptoms, for instance.

There is a reason medical training for fir doctors is as long as it is. It's inconvenient, for them and fir patients, because it leads to doctor shortages. But I'm not convinced replacing a bunch of MD roles with NPs is going to solve things, especially with the current fairly low requirements for training and school to get specialized NP licenses.

I'm telling you, it does not pay that much better in 2026 than a hospital-based RN who works 8 hours of overtime a month (ie, works 38 hours a week instead of full-time / 36 hours a week). Maybe the differential was bigger pre 2010. Not now

I think a lot of this has little to do with money but more autonomy/lifestyle. Our daughter is a nurse in a hospital, and with crisis pay for extra shifts, makes a phenomenal amount of money on top of already strong salary. But she is young so shift work isn't too rough now. But when she has a family, the NP route is an appealing option.

Frankly this makes no sense. Being an RN is far more flexible as you can work evenings, nights, weekends, one day per week, two days per week, weekends only etc. You can have coworkers cover for you at the last minute. Tons of mothers do it for this reason.


In contrast, there are few jobs as inflexible as seeing patients in an office as an NP or MD. Your schedule comes out and patients are booked 3-6 months in advance. there is no taking last minute time off if your child has a kindergarten program or a high school sports game. There is no leaving early or doing any off shift hours.


I'm an RN turned NP married to an MD and I've raised (am raising) 3 kids.

Anonymous wrote:Nurses like becoming NPs because it pays better and they have more freedom (can prescribe meds).

I have had good and bad experiences with NPs. In theory they improve the system by handling cases that might be too simple or straightforward for a doctor. And they do generally get to spend more time with patients, making them a good option for a PCP (PCN?) where not being rushed can be helpful.

However I have had very negative experiences with NP specialists. I do not feel the training fir their specialty is sufficient and they can have unearned confidence, especially in diagnosis. I've had a gyn NP miss major symptoms, for instance.

There is a reason medical training for fir doctors is as long as it is. It's inconvenient, for them and fir patients, because it leads to doctor shortages. But I'm not convinced replacing a bunch of MD roles with NPs is going to solve things, especially with the current fairly low requirements for training and school to get specialized NP licenses.

+1

Doctor(Hospital Medicine) here who works and supervises both PAs and NPs on a daily basis. I find that for new grads PA>>>NPs. Pa’s are better trained. I love my NPs who were nurses for many years before becoming an NP, but that is not the norm anymore. Most go through straight to NP school and have the bare minimum clinical hours to pass.

As for the comment on Midlevels in specialists offices. I hate when I refer a patient to a specialist and they get their initial consultation with a midlevel. I know more medicine than that midlevel especially since they don’t have to train in that specialty before getting a job. They are essentially learning on the Job. They can be in the ER for 6 months then decide they want to do derm and just switch. Then switch to GI. There is no mandated training, no certification exams. Why would I trust them with my complex patient who needs a specialist. Their role should be easy followups or post-op visits, not diagnosing complex patients. Those poorly trained often diagnose with a shotgun approach, over ordering tests and labs until something hits. This is because they don’t have the same foundational knowledge a physician has to know which tests to order. It increases the cost of doing medicine and is frustrating to patients.

Anonymous wrote:

Anonymous wrote:Nurses like becoming NPs because it pays better and they have more freedom (can prescribe meds).

I have had good and bad experiences with NPs. In theory they improve the system by handling cases that might be too simple or straightforward for a doctor. And they do generally get to spend more time with patients, making them a good option for a PCP (PCN?) where not being rushed can be helpful.

However I have had very negative experiences with NP specialists. I do not feel the training fir their specialty is sufficient and they can have unearned confidence, especially in diagnosis. I've had a gyn NP miss major symptoms, for instance.

There is a reason medical training for fir doctors is as long as it is. It's inconvenient, for them and fir patients, because it leads to doctor shortages. But I'm not convinced replacing a bunch of MD roles with NPs is going to solve things, especially with the current fairly low requirements for training and school to get specialized NP licenses.

I'm telling you, it does not pay that much better in 2026 than a hospital-based RN who works 8 hours of overtime a month (ie, works 38 hours a week instead of full-time / 36 hours a week). Maybe the differential was bigger pre 2010. Not now

I think a lot of this has little to do with money but more autonomy/lifestyle. Our daughter is a nurse in a hospital, and with crisis pay for extra shifts, makes a phenomenal amount of money on top of already strong salary. But she is young so shift work isn't too rough now. But when she has a family, the NP route is an appealing option.

Anonymous wrote:Nurses like becoming NPs because it pays better and they have more freedom (can prescribe meds).

I have had good and bad experiences with NPs. In theory they improve the system by handling cases that might be too simple or straightforward for a doctor. And they do generally get to spend more time with patients, making them a good option for a PCP (PCN?) where not being rushed can be helpful.

However I have had very negative experiences with NP specialists. I do not feel the training fir their specialty is sufficient and they can have unearned confidence, especially in diagnosis. I've had a gyn NP miss major symptoms, for instance.

There is a reason medical training for fir doctors is as long as it is. It's inconvenient, for them and fir patients, because it leads to doctor shortages. But I'm not convinced replacing a bunch of MD roles with NPs is going to solve things, especially with the current fairly low requirements for training and school to get specialized NP licenses.

I'm telling you, it does not pay that much better in 2026 than a hospital-based RN who works 8 hours of overtime a month (ie, works 38 hours a week instead of full-time / 36 hours a week). Maybe the differential was bigger pre 2010. Not now

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I've been an NP for 14 years. The market has become oversaturated. There are too many pay to play online-mostly programs that churn out subpar practitioners that are ill prepared for the job. I have heard multiple times that we are headed toward an APP (NP/PA) surplus and a physician deficit.

It was an awesome opportunity for me in 2012 but not sure I'd recommend for my kids. Also I have a masters degree and the entry degree for most NP programs is now a doctorate (DNP) which is more time and money.

Not sure what healthcare path I would advise my children btw. Nursing is physically and emotionally draining. Pharmacy seems most likely to be AI replaced. Physician maybe but it is a huge time and money commitment.

I’m a nurse (RN) and I agree with all of the above. Way too many online diploma mills churning out NPs who have no business being advanced practitioners. Seriously. I have co-workers graduating NP programs who I wouldn’t trust to take care of a chia pet. Many are having a hard time finding jobs after or figure they make same amount of money as an RN with some overtime. PA schools prepare folks much better in terms of pathophysiology and pharm. I think it used to be a great career choice but it’s losing its legitimacy among healthcare providers because of the lowering of standards.

My spouse is a physician who has worked with many PAs and NPs over the years and complains about NPs all the time. Says PAs are much better prepared.

Well if they aren't paid more, why would they choose the PA route over the NP route?

Traditionally, PAs and NPs approached healthcare in 2 different ways. PAs go the medical route, while NPs would go the nursing route (meaning a more holistic view than just looking for a medical solution to the problem).

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes, because many places use them interchangeably with physicians and pay them a lot less. This is a knock on our horrendous healthcare system, not NPs.

This is true. And the office bills more as if you’re seeing the MD, because in most states the MD must theoretically sign off on the plan of care determined by the NP.

I decided not to go the NP route when I saw how overworked they are in most clinical settings. Whether that’s a CVS or a MedSTAR Hospital.

I make only $15,000 less a year as a seasoned RN because their pay band is getting compressed as the NP cohort grows exponentially. Not worth the increased stress and liability.

What liability? The whole reason MD's supervise is because they're liable.

?? NPs don't need supervision.

I saw a NP last week for my primary care visit and left feeling like the whole thing could have been done by AI. They looked at my BP, weight, listened to my breathing, checked which vaccines I needed and which cancer screenings, wrote a ref for blood work, and answered a few questions on a very very basic level (would get better answers by googling and looking at mayo website, honestly). They don’t have time or maybe skill set to do real conversations and care, so you might as well see a robot screen at this point.

I feel like automation and AI will take over the lower level rote medical care and we’ll need people to do things like clean bed pans, or do the high level stuff that needs more judgement. My parent had a visiting wound care nurse that was great — stuff like that which is very hands on will likely survive.

why not doctor? it embarassing to explain yourself and i always request a doctor over a pa. maybe ok in cvs minute clininc

Hard to think of a career that has higher burnout than nursing. Very stressful and the money often fails to compensate in the end.