I was just curious if anyone who sifts through these threads of which are geared twords healthcare professionals is a P.A. If so, let me know in a replay because I have some questions in reference to your occupation.

I'm currently in Pre-med school and am thinking about ditching the major due to the unknown fact, after I enrolled, that medicine is not a major. It's a life, and aside from it, while in school, you can't have one if you want to do well.

Hey, why don't you think about becoming an RN instead?

This is a more fulfilling career and you get to practice and become registered in your own right. As far as I know PA's cannot practice in their own right, but only under the direction of a doc. Would you not want more independence, I know I would?

Good luck

Premed is pretty awful; I know.

Physician Assistants (sometimes called "Physician Associates") can do a lot of interesting and worthwhile work. They're more common in some parts of the country than others. In some states they have prescriptive authority; some states don't offer that privilege.

Although I considered becoming a PA, I chose to become a nurse practitioner instead. If you already have a bachelor's degree, the schooling is three years (I'm entering the last year.)

There are a lot of advantages to being a nurse practitioner. Yeah, I hesitated because I'm a guy and didn't want to be called "nurse," but it doesn't bother me anymore. Nurse practitioners--unlike PA's--have their own licenses. We can open up our own offices if we want. Like PA's, we can prescribe our own medicaitons in most cases, and we don't need a doctor present to approve our work.

It's a perfect match for me. I'm interested in preventive medicine, which is a focal point of nurse practitioner work.

These are tough decisions and it took me a long time to find the right place in health care. Feel free to ask more questions.

Good luck!

Mats.

I've looked into becoming a Nurse, but their role within the medical field just isn't appealing to me. In short, it's not a challenge. I mean, sure, taking BP's, starting IV's, suturing, intubating, and inserting catheders along with a broad range of other medical tasks is all fun & games. I do most of that stuff as a volunteer EMT-CC. But in the end, their duties aren't a critical demand, as is the ability and expectation of an M.D to make a clinical diagnosis. Now that's a challenge!

However, I'm curious. What exactly is the difference between a NP and a PA? Because as I've read in numerous mecial books. A PA is able to perform about 80% of the medical demands that an M.D does. I am aware that a PA has to work under the supervision of an M.D, but other then that, what's the difference, and also, what's the common denominator?

GriffinS09,

The biggest difference between PA's and NP's is their licensure. A PA practices under a doctor's license; the PA is just "extending" the practice of an MD. (Not that there's anything wrong with that.)

Nurse Practitioners are independently licensed. We're our own thing--there is no doctor. For billing reasons, NP's work with doctors and bill under the MD's name, but that's becoming less common.

The other difference is in training. Nurse Practitioners are trained to emphasize patient education and preventive services. Although PA's do this too, it's not a fundamental feature of their practice.

There are also differences in practice settings. NP's typically work in primary care, outpatient areas. Although many PA's are in primary care too, it's more common to find PA's in hospital settings.

A lot of the distinction depends on what state you live in. Here in Ohio, Nurse Practitioners are more numerous and have more prescribing privileges than PA's.

If you're interested in formulating clinical diagnoses, that is a cornerstone of both professions.

If it gives you an idea, this is what I do as an NP student. Last night, I had clinic from 6:00 to 10:00. I saw...
4 patients who needed sports and school physicals
1 with sinusitis
1 with a possibly broken foot
1 with a testicular injury
1 with a viral skin infection.
The responsibility was entirely mine to do the history and physical exam, formulate a diagnosis, develop a plan, write prescriptions and order x-rays and labs. I still have to get an NP or MD signature on my work because I'm not licensed until May. But only in one case did I ask for an attending to actually see a patient in person.

Thank's for the information!

I think the best course of action is for me to shadow both professions for a short while. Get a better understanding of their daily routines, and overall job description.

However, I do have another question. It's only logical that an NP does not have the realm of extensive knowledge as an M.D, yet they can open their own practice? That confuses me.

Let's say that that you open your onw practice, and, your presented with a patient that you can't diagnose due to the fact that an M.D is the only one who can do so. What do you do? Say "Sorry, I can't help you, go see an M.D"?

As I'm sure there are thing's you can't do that an M.D can. What do you do in those situations? Taking into concideration you have your own practice without an M.D present.

Excellent plan!
It can be difficult to get shadow opportunities, but be patient. Look around and see if there is a free clinic in Rochester; free clinics often provide good opportunities to get your feet wet.

It's true that I have cases that go above my level of knowledge, so I refer those patients to an MD. But medicine is called a "practice" for a reason--doctors, PA's, and NP's all have times when we get in over our heads. That's why I like group practices with a mix of different professionals; we all work and learn together.

In Ohio, Nurse Practitioners list one or more "Collaborating Physicians." Just the name of someone who we can consult in case we have questions.

Remember too that there are areas in which nurse practitioners have expertise that doctors do not have. For example, I have a lot of background in smoking cessation. So an MD with whom I often work relies on me for information about that. I also work a lot in tuberculosis prevention, so she comes to me with questions in that area too.

One of the other differences is that nurse practitioners often see different types of cases than physicians. For example, the physician I work with particularly enjoys patients with unusual diseases. I prefer patients who are not sick but who I can help lose weight, stop smoking, etc.

Go ahead and keep asking questions... It's good to know that you're keeping an open mind.

Shadowing any medical profession won't be much of a task for me. Believe it or not, I have 3 M.D's in my family. Along with one in medical school, one nurse, and one Paramedic. Both of my parents practice medicine in Neuro Surgery & Emergency Medicine. My brother, who plans to pursue practice within pediatrics, is in his last year of medical school. My grandfather, an Anesthesiologist. Sister being a nurse and her husband a Paramedic.

I'm sure your curious as to why I turn to this board for advice, seeing as in how I'm surrounded by a wealth of knowledge. Most people, I think, tend to look at me as if I'm forced into following tradition. Maybe I'm under pressure to pursue a cereer within medicine due to the background I have and, or possible pressure put on me to obtain a life that my family would be most proud of.

While any average, judgmental person might assume that, the fact is, such an assumption is far from the truth. I was raised to believe I can be anything I want with 100% support and guidance from my family. However, I don't see my family as an easy way to make my entrance into the medical field easier. I have always liked to do thing's the hard way, because in the end, I 'm always left with tough lessons of which serve well.

I have no token of appreciation for the advantage I might posses in my situation. My family is just a bunch of people trying to make a living, nothing more. It is my quest, and my quest alone to break away from my advantages and learn on my own, without the expected and constant offer of guidance from those who surround me. (There is no shortcut to any place worth going)

So, I venture out on my own. And it is only then that I feel fortunate.

"Now you have the power to prevent me from graduating, and getting the white coat. But you cant stop my spirit, you can't stop me from studying. Whatever your decision, here today, I still will become the best damn Doctor this world has ever seen. So you have a choice gentlemen. You can have me as a professional colleague, passionate. Or you can have me as an outspoken outsider. Either way I'll probably be viewed as a thorn. But I promise you one thing gentlemen. I am a thorn that will not go away." ~Patch Adams

What made you want to practice medicine Mfree?
Why single out the role of an NP out of the vast array of other possibilities?

Being an RN is not a challenge apparently you know nothing about nursing. There is more to nursing than taking BP's and starting IV's. Nurses need critical thinking skills. the doctors aren't at the bedside the RN is The nurse is the one who reports the patient's conition to the physician, the one who holds the patients hand, the nurse is the one who makes the assessment. Don't say nursing isn't a challenge, until you have done it. I love Being an RN and I wish more physicians would be nurses first.

GriffinS,

I know how you feel. I'm the only one in my family who is NOT called "Doctor." Interestingly, all of them are PhDs.

I grew up under enormous pressure to become a doctor. Likewise, I went to an undergraduate institution in which every guy was either premed or prelaw. There were no other options. All but a handful of my college friends became doctors.

I decided to become an NP based on a lot of factors. First was that I know a lot of unhappy doctors--really unhappy. Medicine consumes every part of your life and they don't like that. Also, it costs around $200,000 to go to med school, so many of my friends are now worried about debt.

It's also hell to get accepted to med school. The competition is fierce and it's a vicious numbers game. I was sick of classmates who cheated or used sex to get better grades. And the environment after you're in to med school can be ridiculously competitive. It's out-of-control.

After college, I went decided to get a masters in epidemiology and public health. It was one of the best things I ever did. I loved it and did very, very well. I learned all about the science behind health care, got a grip on all of the different mechanisms of human disease, and so forth.

During the time that I earned my MPH, I met several PA's and NP's. They seemed to have a great quality of life, liked their jobs, and had great career opportunities. I met one NP and I thought, "I WANT her job."

Like I've mentioned before, I like that NP's usually work with outpatients. I don't especially like the hospital and that's where doctors spend all their time (at least for the first 7-10 years). My career goal is to keep people OUT of the hospital.

Yeah, there were tradeoffs. My family REALLY went nuts. But my dad is starting to change his mind and realize that I made a smart move by becoming an NP.

For a while I was jealous of med students, jealous of being called "Doctor," but now I love it that my patients call me by my first name. It's awesome.

I've found that patients care about what you're like as a person and as a clinician, not what your title is.

Anyway, I'm glad that we're talking about it, whatever you end up doing. (Also, my middle name is Griffin.)

Mfree,

Well, lucky thing I found 2 P.A who will let me shadow them, because I did it today with one of them and he is the most bitter man I have ever met. Complain, complain, complain! I was supposed to shadow for 3 hours, I left after 1. I have my appoitment with the other P.A next week, so I hope it goes better. I'll keep you posted.

Once I am done shadowing a P.A, I'll be looking for an N.P.