And that’s what happens, particularly online. No one is better than anyone.” You are correct. The cost in dollars, time, mental health, physical health, and the lives of caregivers is the price that is being paid for being “well-trained”, not to mention selecting for and rewarding those that have a tendency towards being unfeeling zombies. Remaining silent is never the solution. Yes. Then start an antibiotic with no culture, doesn’t work, have to RX stronger antibiotic, and keep contributing to the “little” antibiotic resistant problem we have because Practitioners DONT check/send culture and sensitivity and just give patients blanket broad spectrum antibiotics. ADDENDUM 11/29: This is my advice for Ethan. I cannot believe that someone who claims to be an advocate for physicians would write something like this. 85% of DNP programs today are research/admin focused, not clinical. The main difference is a nurse practitioner doesn't go to medical school and makes less money. They do not know what they do not know and in many cases are harming patients. I will outline a short article stating why YOU should NOT pursue a nurse practitioner degree, EVEN if you already have a bachelor's degree. For these reasons, the occupation is among the most popular specialized nursing roles. There are also intangibles that accompany being a physician. 8) Get in touch with all of the other independent providers. We always need to be thinking below the surface so we don’t miss things that can be harmful. If I were Ethan and my goal is to open an ideal clinic in my neighborhood in the next year or two he should absolutely pursue an NP degree. 4) My wife insisted on seeing a business plan before she would support me. If you think anyone else would benefit from this you can post it anonymously. Do I want an experienced hospitalist NP to talk to also? My GPA is around a 3.4-3.5 and I can't do AP physics. And it has been a symbiotic relationship for the most part–everyone respects each other’s roles. Surely that makes a huge difference. Countless coverage in the ER/Trauma center. There is plenty of research that supports NP practice as being more affordable, safe and effective. and 3000 clinical, that’s before residency. In my experience as a patient I found more primary care MD’s to be to arrogant to give decent care than the “mid-levels.” More of the PA’s, and NP’s treated me like a human being with health concerns. Sure they can do the pap or treat the UTI but they most definitely need to have a supervising physician. However, I think as a whole physicians are more adept at thinking beyond those algorithms and catching the finer details in care and building on the foundations they have. I tell my patients that we are on a team consisting of the themselves, my supervising doctor, and me and that they are the captain of their team because it is their bodies and their lives that we’re treating and that they have the final decision on what happens. There are more than enough patients for all of us so trying to stay in a space to not be burned out and leave the profession to survive is the answer. Love many of the things you brought up. Happy that I can bring NPs, NDs, RNs, MDs, DOs, and even veterinarians and LMTs together at my retreats. He just needed a little clarity and a sounding board, like we all do at times. It’s good to think that the negatives will go once I take that first step. Say what you want, schooling does not prepare anyone to do anything well. Ethan: Basically, my struggle is this: I am a current RN and would like to do primary care in the future (family medicine). Those rotations would have been best for an FP+OB or someone who wants to pursue neonatology or peds. I am a third year family medicine resident, mom of 2 children (5 yo and 1 yo), and wife of a full time ICU nurse. I kept thinking you were about to reveal the punchline of a cynical joke. The medical board is there to protect the MDs and the patients. Most PAs I know go on to medical knowing that staying as an PA is short lived and frustrating. I also have a lot of external factors including taking care of an ill father- leaving me to take care of my family as I am the eldest. Pediatrics, internal medicine, family medicine, ob-gyn, surgery, and psychiatry – the standard clinical rotations in medical school – are all integral to being a great family medicine doctor. I protested this. Well this has changed but until we all work as a team without the bullying in health care, there will be a divide between MD’s and NP’s. My daughter is a ED Physician and my PCP, who I love is a family medicine physician. The reality is that virtually every PA that I have known has been very well trained with a depth of knowledge that is superior to virtually every NP that I have come into contact with. It’s a field where we need bright, compassionate, articulate individuals. But as an NP in the ED, care is going to be passed off to a physician and there will be limits in what they are allowed to do (ex: take care of coding patient, etc). I came into the profession when medical care was and still is undergoing big transformations, not sure for the better. As an NP what do you see as the difference? There are many communities that don’t have medical care…..NPs have a purpose. We all have so much In terms of FNP certification, we do have to pass a national certification exam but we have two options: AANP or AANC. Thanks so much for reaching out! Thanks for leading the way—hopefully the rest of us can follow suit. I am lucky to practice in Washington State and regularly collaborate with some of the most amazing physicians and NP’s and feel very supported. I also did suffer terrible depression and pulled myself out the wrong way, all by myself. I have more words, but these are only ones I can let out right now because I have 60 unfinished notes haunting me. They all have pros and cons. I even got two *free* AEDs that just need batteries (if the batteries are dead the agency just throws them away because they can’t get batteries where they are going). Depends on each person’s propensity, life stage, resiliency, background/history, etc. There have been times I have asked myself the same question… Was all this time, debt, strain on family, and exhaustion worth it? It’s very depressing to read through all the hateful comments in this discussion… It’s pretty clear that generally speaking NPs/PAs make about half of what MDs do while working in the same offices (which is fair because they had to go through half the amount of education). We all need sometimes an extra pair of eyes or ears or hands to confirm our diagnoses. Wow Pamela Wimble. Take a look at the annual Gallup poll results for the past decade, and you’ll discover that the nursing profession continuously holds top honors for ethics and honesty. Because I am 30 and settled with a partner, I have decided that the medical school model would be too tumultuous for me at this point, and that if I dedicate myself, I can have an equal impact on people’s lives via the nurse model of training. I agree. You bet is does. Wow! Of course. PA school can be really tough. Knowing myself I think I would clearly be able to see all of the advantages of the rigorous training that physicians go through. 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