I will forever be grateful to the NP who correctly diagnosed me with a failing gallbladder when three (male) doctors, including a gastroenterologist, insisted it was just heartburn. She was willing to look past the fact that I didn't fit the profile and actually listened to me and my symptoms.

I used to see a wonderful PA for my primary care and was so sad when she moved. She never hesitated to get a MD consult when needed, and she was so responsive when I had a medical emergency and wound up in the ER and then discharged with vague "call a neurologist" instructions. Saw me right away the next day, connected me with a neurologist who could see me the following week, and really went above and beyond to make sure I was getting the care I needed.

Anonymous wrote:

Anonymous wrote:I really think that's the future of health care, OP. I will not see an MD unless I have no choice. I always choose a NP or PA as our PCP. The level of care is consistently so much better. Go for it!

Not to derail the OP's thread, but to respond to this post: Just be sure you recognize that the level of training of NPs and PAs is nowhere near that of physicians before you write off MD/DOs completely. Some NP programs involve online degrees for people with no prior nursing background. The total number of clinical hours required by some NP/PA training programs is less than what an MD/DO would complete in just a month or two of residency training (=3 years plus), yet in some states they can practice independently.

This is completely untrue. You cannot get a NP without having a BSN and clinical experience first. Most programs require 2 years of floor nursing before you apply. Some require 2 years of floor nursing in specific fields (ie. if you want to do anasthesiology, you have to do 2 years in ICU first).

You can get an MSN with no clinical experience, but that doesn't make you an NP. It makes you an RN. NP training is very specific.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am an MD and realize that NP and PA office care will become the wave of the further. I support this and think its great. I do want to point out that NP and PA programs are significantly less education that MD/DO programs. This is leading to some tension in my industry because sometimes a PA in a busy practice can make almost as much as the physical itself if its a low paying field like peds or family med. Im a female surgeon so me dealing with pissed off old men because I am making good money doesn't bother me though! Healthcare is changing guys!

I am in full support of NPs and PAs when used in the model that their training intended, to work under the supervision of a (more highly trained) physician. In that model: yes absolutely, that's medicine of the future. The tension in primary care fields is not about salaries, but rather inappropriate scope of practice. The lower level of training does not prepare NPs and PAs for independent practice, yet they are increasingly used that way by health systems because they are "cheaper", i.e. their salaries are lower than physicians, in contrast to your point.

I'm neither an NP, PA, MD but disagree with your statement. You will only be able to hold on to your "turf" for a while longer. Keep telling yourself that your "MD" degree entitles you to supervise others who may be trained and licensed to provide front end care. Many states already permit NPs to practice solo - and more states are coming on board. I don't believe a PA can practice solo or write prescriptions in ANY state however. The facts are that PA and NPs are replacing the traditional family doc.

I wrote the post you quoted. You clearly have some kind of ax to grind here. I'm not even sure what your point is in relation to mine. Yes, many states are increasingly allowing NPs to practice solo, so I agree with you there. But that doesn't make it OK from a patient safety standpoint. It's happening despite the fact that NPs have significantly less training than MDs. Some NP programs don't even require a background in nursing, despite public perception that they are nurses with more advanced training. There's a perception that primary care docs are just gatekeepers to refer to specialists to do the "real" thinking, sign off on paperwork and refill basic prescriptions. In reality, it's a field that requires the broadest range of up to date medical knowledge to recognize normal from abnormal, and to begin the medical evaluation for anything concerning. Framed that way, you better believe I would rather my primary care doc to be highly knowledgeable and not someone practicing independently with an online degree and a bare minimum of clinical experience.

Anonymous wrote:

Anonymous wrote:I am an MD and realize that NP and PA office care will become the wave of the further. I support this and think its great. I do want to point out that NP and PA programs are significantly less education that MD/DO programs. This is leading to some tension in my industry because sometimes a PA in a busy practice can make almost as much as the physical itself if its a low paying field like peds or family med. Im a female surgeon so me dealing with pissed off old men because I am making good money doesn't bother me though! Healthcare is changing guys!

I am in full support of NPs and PAs when used in the model that their training intended, to work under the supervision of a (more highly trained) physician. In that model: yes absolutely, that's medicine of the future. The tension in primary care fields is not about salaries, but rather inappropriate scope of practice. The lower level of training does not prepare NPs and PAs for independent practice, yet they are increasingly used that way by health systems because they are "cheaper", i.e. their salaries are lower than physicians, in contrast to your point.

I'm neither an NP, PA, MD but disagree with your statement. You will only be able to hold on to your "turf" for a while longer. Keep telling yourself that your "MD" degree entitles you to supervise others who may be trained and licensed to provide front end care. Many states already permit NPs to practice solo - and more states are coming on board. I don't believe a PA can practice solo or write prescriptions in ANY state however. The facts are that PA and NPs are replacing the traditional family doc.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am an MD and realize that NP and PA office care will become the wave of the further. I support this and think its great. I do want to point out that NP and PA programs are significantly less education that MD/DO programs. This is leading to some tension in my industry because sometimes a PA in a busy practice can make almost as much as the physical itself if its a low paying field like peds or family med. Im a female surgeon so me dealing with pissed off old men because I am making good money doesn't bother me though! Healthcare is changing guys!

I am in full support of NPs and PAs when used in the model that their training intended, to work under the supervision of a (more highly trained) physician. In that model: yes absolutely, that's medicine of the future. The tension in primary care fields is not about salaries, but rather inappropriate scope of practice. The lower level of training does not prepare NPs and PAs for independent practice, yet they are increasingly used that way by health systems because they are "cheaper", i.e. their salaries are lower than physicians, in contrast to your point.

+1. I would be not comfortable at all getting routinely examined by a NP or PA. The years of valuable training counts for something in my book. Bedside manner and the sweety-sweety talk that a lot of people fall for from NPs and PAs is not something I really care about. Give me a competent, no bullshit MD any day.

+1000. I'll take a jerk MD who I know is highly competent over a warm-fuzzy NP/PA who is practicing out of scope. I'm not there to make friends, I'm there to get medical advice!

I agree- for my medical appointments I want to see a doctor. For very basic sick appointments I am okay with a NP or PA.

Great option for people who want to focus on patient care and are not motivated by prestige. As a PA, you'll get to spend far more time with patients than a physician, and have to deal with far less bureaucratic BS. Fewer years of school, more emphasis on practical bedside care.

From a patient's perspective (mine, at least), that's what matters for primary care. I don't need a superstar physician trained to diagnose the rarest of diseases to conduct my annual exams. I need someone who actually has the time to listen to what I'm saying, answer questions, sign off on another year's prescription for BC, and notice if something seems out of whack enough to deserve a second look by a specialist. I'm a patient of one of those large medical associates groups, and I always choose a PA (or NP) rather than a physician for routine appointments.

Disclaimer: My father is a PA (military-trained), and he has a LOT of the knowledge of a general physician but was always home in time for dinner. Makes a healthy six-figure salary in a LCOL area, and says he never regretted not going to medical school because being a PA has given him the best balance of patient care, income, and lifestyle.

I have yet to meet a PA who did not have high job satisfaction.

Just keep in mind if you care about what others think...It's kind of like the small liberal arts college of the medical profession. The average person you meet on the street might be like...."Oh, an assistant to the physician? That's nice. You mean like a secretary?" But people who are in the know will be like, "OMG, EXCELLENT career choice."

Anonymous wrote:A PA making $200K or $250K (both mentioned in this thread) is a 99.9% salary for a PA.

This is like saying, "you should go into law, I know a lawyer making 3 million dollars a year".

This is DCUM

Anonymous wrote:I know a PA who earns $250k and works 3 days a week (hospital setting assisting a surgical team). I think it's a sweet gig.

which state?

A PA making $200K or $250K (both mentioned in this thread) is a 99.9% salary for a PA.

This is like saying, "you should go into law, I know a lawyer making 3 million dollars a year".