DO vs PA/NP? Is it worth it?

[ZB60]

There are days I wish I would have at least decided to get a BSN in undergrad. It is IMO a more useful degree than the Biology degree I received. If medical school wouldn’t have worked out, my immediate alternatives would have been much more limited. Also, the ability to do a few nursing shifts here and there would have been a nice boost in income. In the end it should all work out, but if something were to happen where I couldn’t finish school, I still don’t have a clear cut way to make money to pay my loans back.

[Hatton]

My opinion is be the best you can be.  If you have good grades and MCATS go to medical school.  If you find you have to really study hard to get reasonable grades for undergraduate then do not go to medical school.

[VagabondMD]

Some of this comes down to the extent that you (OP) consider being a healer, a calling vs. a profession vs. a career.

If your primary motivation is to be a healer, any option would suffice, and perhaps the less expensive option with the shorter time to entry is desirable.

If your primary motivation is to have a profession, this muddies the water a bit. An NP is certainly a health care professional, but not with the same stature of a physician. If this does not trouble you now, then perhaps the NP/PA route is acceptable, acknowledging that it might bother you later.

Finally, if you wish to have a career in medicine, with no limitations, an MD is the way to go. There are MDs that are CEOs of hospitals and integrated health care networks, who have executive jobs in insurance and biomedical companies, who have senior roles in their Departments, Hospitals, and practices. If any of this appeals to you, getting there from an NP background is extremely unlikely.

[Zaphod]

The White Coat Investor wrote:

ifonlyFI wrote:

I sadly don’t recommend becoming a pcp or a pediatrician as a PA or NP can make the same amount of money doing the same job.

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I disagree that it is the same job. Patients may view them as doing the same job, but physicians who refer to PCPs and receive referrals from them certainly do not. My interaction with a physician PCP is far more collegial than my interactions with APP PCPs and UC PCPs. I’m far more likely to be “rescuing the patient” in those situations. I think it takes some significant education and experience to realize they are not doing the same job, not at all. Just like in the ED, the complicated cases are the role of the physician while the uncomplicated cases are the role of an appropriately supervised APP. Although I agree it is difficult for patients to tell the difference.

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However they get similar pay, less responsibility and oversight. Go figure.

[Kamban]

MPMD wrote:

Did the person you were talking said the didn’t think being an osteopath was worth it or they didn’t think being a doc was worth it? Those are kind of 2 different scenarios. If they or you meant that MD > PA/NP > DO, that’s just… weird.

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I took it as the OP feeling if being a physician was worth it compared to NP / PA.

His relative and one other DO here felt that if you are going to be a physician, do not go to DO school; instead to to a MD school.

My take on it is if money is a primary issue and the OP does not want to take on a big student loan, going the RN and then NP or CRNA route would be less expensive and more lucrative than being PCP in an area with poor reimbursement.

As to the DO versus MD, if MD is available choose that and if not, do DO. In the end it does not matter unless you want academic position at Harvard or Yale. In fact, in PP setting once you get into residency no one cares where you even got your MD from.

 

[MPMD]

The White Coat Investor wrote:

ifonlyFI wrote:

I sadly don’t recommend becoming a pcp or a pediatrician as a PA or NP can make the same amount of money doing the same job.

Click to expand…

I disagree that it is the same job. Patients may view them as doing the same job, but physicians who refer to PCPs and receive referrals from them certainly do not. My interaction with a physician PCP is far more collegial than my interactions with APP PCPs and UC PCPs. I’m far more likely to be “rescuing the patient” in those situations. I think it takes some significant education and experience to realize they are not doing the same job, not at all. Just like in the ED, the complicated cases are the role of the physician while the uncomplicated cases are the role of an appropriately supervised APP. Although I agree it is difficult for patients to tell the difference.

Click to expand...

I completely agree. I'm actually generally not able to get a non-physician primary care provider to call me back on a patient.

We may be headed towards more parity in these positions but we aren't there yet.

[G]

The White Coat Investor wrote:

ifonlyFI wrote:

I sadly don’t recommend becoming a pcp or a pediatrician as a PA or NP can make the same amount of money doing the same job.

Click to expand…

I disagree that it is the same job. Patients may view them as doing the same job, but physicians who refer to PCPs and receive referrals from them certainly do not. My interaction with a physician PCP is far more collegial than my interactions with APP PCPs and UC PCPs. I’m far more likely to be “rescuing the patient” in those situations. I think it takes some significant education and experience to realize they are not doing the same job, not at all. Just like in the ED, the complicated cases are the role of the physician while the uncomplicated cases are the role of an appropriately supervised APP. Although I agree it is difficult for patients to tell the difference.

Click to expand...

ditto

[The White Coat Investor]

ifonlyFI wrote:

I sadly don’t recommend becoming a pcp or a pediatrician as a PA or NP can make the same amount of money doing the same job.

Click to expand...

I disagree that it is the same job. Patients may view them as doing the same job, but physicians who refer to PCPs and receive referrals from them certainly do not. My interaction with a physician PCP is far more collegial than my interactions with APP PCPs and UC PCPs. I'm far more likely to be "rescuing the patient" in those situations. I think it takes some significant education and experience to realize they are not doing the same job, not at all. Just like in the ED, the complicated cases are the role of the physician while the uncomplicated cases are the role of an appropriately supervised APP. Although I agree it is difficult for patients to tell the difference.

[ifonlyFI]

I typically advise students to become a MD and pick a subspecialty worthwhile to you and your interests.  I sadly don't recommend becoming a pcp or a pediatrician as a PA or NP can make the same amount of money doing the same job.

With the MD degree, you have innumerable career possibilities.  It is a very valuable degree even outside of clinical medicine

[childay]

What specialty is your relative?

You can easily look up the income of various specialties and NP/PA.  Certainly there is variation on both sides.  I know of APRNs making more than PCPs in lower-paid locations for instance.

As someone suggested I would post your GPA etc so we can have an idea about likelihood of getting into a good MD or DO program (which will affect possible income).  If for instance one is a marginal candidate and may only get into a Caribbean medical school, then the calculation becomes quite different than otherwise.

The MS4 posting above about scope of practice and autonomy is perhaps uninformed.  In many states these issues are not such a difference in recent years and one may expect that trend to continue, depending on specialty.  Whether that is appropriate is certainly up for much debate.  But from a purely financial standpoint one might consider the responsibilities etc to be similar regardless of degree, depending on circumstances.

[VagabondMD]

If it were me, and I could not be an MD, I would find something else to do. You will never call the shots as a NP or PA, and your upside will be capped. As a DO, your opportunities are also limited (less so than an NP/PA, but still limited.

I liked math a lot, and this actuary thing sounds pretty interesting. The only actuary I know is so cool that he is on FIRE.

[Hatton]

CRNAs seem to make a lot of money and have real responsibility. In my hospital they make more than a lot of primary care docs.

[ENT Doc]

I took it as a question of whether being a doctor (of any type) is worth it.  So probably should be restated as:

MD/DO vs PA/NP

[MPMD]

i'm a little bit confused what the OP is asking:

1. DO vs. PA/NP

2. physician vs. PA/NP

Did the person you were talking said the didn't think being an osteopath was worth it or they didn't think being a doc was worth it? Those are kind of 2 different scenarios.

If they or you meant that MD > PA/NP > DO, that's just... weird.

[The White Coat Investor]

This decision is like the military decision. Join the military because you want to be a military doc, not for the money. Become a doc or a PA because you want to be a doc or a PA, not because of the money. The money works out either way. Docs make enough to pay off doctor sized loans. PAs make enough to pay off PA sized loans. You just need to live like a resident as you come out of school and get the loans paid off 2-5 years afterward.

Personally, I would have hated being a PA and not getting to be the "captain of the ship." I think most docs feel the same way. If that sort of thing doesn't bother you, then go to PA school. It's certainly a fine career.