Becoming a physician.

Cadavers didn't stay fresh in the post??

 

While we are discussing mid-level providers, let us not also forget the nurse practitioners. All the nurse practitioner programs I am aware of require a minimum of a BSN as an entry credential. Almost all of the nurse practitioner programs grant a MSN at the end of the program.

Depending upon which state they are licensed in, nurse practitioners have the ability of setting up an independent practice, whereas PAs virtually always work under the oversight of a physician.

It is a touchy subject in the mid-level provider community as to whom is better trained or who provides a better level of care vs. a PA or NP. I am unaware of any studies, not published by either the PA or NP groups, that finds any actual difference in quality of care.

Almost all the NPs I have met are female and a slight majority of the PAs are male. Insofar as many PAs come from a emergency medical services or military background, many PAs tend to congregate in emergency care, urgent care or the surgical specialities. Many NPs tend to congregate in primary care such as family practice, ob/gyn, internal medicine or pediatrics. These are broad generalizations, mind you, but largely accurate.

The best paid mid-level providers tend to be the midwives (almost all of them female NPs), the CRNAs (anesthesia nurse practitioners) or surgical PAs in ortho, vascular or cardio-thoracic.

At my large medical clinic, where I am one of the administrators, we have about 35 mid-level providers: 20 PAs and 15 NPs. Mid-level providers can be extremely profitable for a clinic considering what they are paid vs. what they bill out.

PS: My wife was a senior corpsman in the Navy and did several tours as an IDC: independent duty corpsman. This is a 'sea-going' physicians assistant that provides the medical care on the smaller ships such as destroyers, submarines, frigates, and on shore commands as well. George Washington University has a very popular PA program designed for IDCs that takes 12-18 months and results in civilian licensure as a PA. My wife opted to pursue administration instead and went for her MHA.

 

Here's an old post by some dude named oxpecker: http://forums.degreeinfo.com/showthread.php?s=&threadid=9327

The school noted in that thread is the following: http://www.ivimeds.org/

 

It's not an online medical school, but Kaplan Medical does have a web-based review course for USMLE Step 1, with 8 volumes of lecture notes. Perhaps they have the same for Step 2.

 

Michael Lloyd,

Thank you for a REALLY interesting post!

 

watch out

Dr. Bear:

Please don't mention DL and MD in the same breath........ur....sentence................ur.........writing...........oh......
whatever! Dean H. will have a drop in his BP. (kidding)

dl_MBA:

There are very solid initiatives out there that offer some DL Basic Science components; although as our resident DO has pointed out, Clinical Sciences can only be done in a Class III Hospital that offers all of the services.

If you plan to practice medicine inside of the USA then you do not want to enroll in a Basic Sciences off campus program; it may cost you, under the "Hughson Legislation Act "

The reason you "might" be able to complete your MD Degree in (3) years plus + ,offshore, is that most schools do not have "summers" where you are off for (3) months at a time, instead quarters are continuous.

IVI MEDS and very soon (IVI - NURSE ) is a well sought out consortium of Medical Schools that beleive in DL.

 

I can understand what you say about the more finer aspects of medicine. I worked for a doctor in college that had similar stories to tell about patients sending him televisins, presents, trips, etc....and he was a great guy to boot.

I do question the money, though. Where I live, the most exclusive areas are filled with nothing but physicians. These mansions are in the million dollar neighborhood and more. So, if salaries really did stay stagnant then their desires to build the hugest homes in the area didn't quite stay in the dregs with those wages. To me, this means they are making more money than ever...not staying stagnated.

 

Medical income varies tremendously by specialty. Primary care will generally not make you rich. Some medical subspecialties, radiology and some surgical specialties have a much better chance of making you well-off. If you want a well-paid medical specialty that has very little emergency call, and allows a Monday-Friday 9 to 5 practice, start applying now to dermatology residencies.

This is why Mr. Lloyd secretly fantasizes about meeting a red-haired 40 year old interventional radiologist, preferably female. She will probably be making $ 250-350 K per year by that time in her career, thus making it unnecessary for Mr. Lloyd to work!

Mrs. Lloyd is very, very unsupportive of Mr. Lloyd's fantasy and tends to roll her eyes when it is discussed.....

 

Radiology is a good one for hours and money. (but ask the radiologists who have seen less work lately due to outsourcing). I know two OB/GYN's married to one another. I bet between them they are pulling in a million/year. That is a good one for wealth building but the hours are a killer.

You would think that a high powered field like pulmonology might be a good field. However, my brother is one and he says that it's THE medicare field for sure and he can't do anything without the government sayso. It's got crummy hours and most of his patients are dying from either smoking or black lung. When we visit him he is ALWAYS being called into the hospital's ICU. He just passed his certs for sleep medicine. He's trying to jump into that for better hours and better pay. He's never been one for fancy homes and such. Lives in a 2K sq foot ranch house, works at his church a lot, and enjoys his family. His one concern about medicine is that his career choice made him miss his family for so many years.

I work with a pathologist that got tired of the grind. You would think that a pathologist might have nice hours. But, even his job had it's share of junk...and his hospitals were always trying to mess him over, he says. So, he came into the corporate world and says he, and his wife, love it. Regular hours and better benefits.

Yes. I can see how Mrs. Lloyd would be unsupportive. Better get a new fantasy.

 

Some of you guys hit the nail on the head. There are wealthy doctors out there that own mansions and multiple Porsches. However, I can pretty much guarantee these doctors are not straight primary care physicians. They may own a string of physical therapy offices, practice dermatology, practice plastic surgery, or maybe they married a wealthy spouse. But I, as a primary care physician that just loves his job, I'll never be rich.

Please understand... I do not resent the fact that payments are down and that I will make (relatively speaking) less than doctors of the past. What I do resent, however, is the perception that because I'm a physician then I must be wealthy.

 

I have a question on a field

I like to know if anyone knows about invasive cardiology ....

I heard it is a very lucrative field with minimal amount of money for malpractice insurance invested.....

There isnt any surgery done to patients and the pay is great !!!!

Can anyone direct me to more sources on this career or profession ?

Alan