DO vs PA/NP? Is it worth it?

[newgal9813]

I graduated with a biochemistry degree a couple of years ago. Currently I have been working in the medical field and paying down my undergrad debt aggressively (almost done). During my younger years I wasn't as money conscious and went to a prestigious name brand school without giving much thought about tuition cost. This explains my mindset about why I tend to be a bit more money conscious now. Originally my plan was to apply to MD or DO school, but I had a conversation with a relative of mines who is a DO. She told me that if she would have done it again she would have gone to PA school. This made me think whether it is worth it to go all the way and become a full fledge physician?

Would taking on all that debt in addition to the length of time be worth it? Would it be better to become a PA or NP especially with how future of healthcare is going towards? I don't come from a wealthy family so I will be taking out loans and supporting myself financially. Would love to hear your opinions.

[jpa]

4th year med student here. There's a huge difference IMO between physician vs PA/NP ,namely autonomy and scope of practice.  What do you actually want to do? The $$ is there to pay off your loans, particularly if you can get in your state med school. In fact, if your concern is $$, I would suggest considering taking an extra year to take a MCAT prep course, so that you can get in your state MD school (this is coming from a DO student).  Of course, then you'll lose an extra year of salary, but looking back, I wish i would have considered this.

[DMFA]

If you really want to be a physician, then you can only be a physician.  Anything else is not going to cut it for you.  If being the decision-maker is what you want to be, then everything else is going to be a disappointment for you.

MD vs DO school is a moot point.  End points are the same, save for very few situations such as neurosurgery.  Go to a school you want to go to, and ideally, one that won't put you into too much debt like a public school.  Every place is going to have something you don't want to put up with, whether it's a research requirement, some silly staff, a suboptimal location, or osteopathy (sorry to my fellow DOs, I'm just not into it).  Assuming you actually get through med school and residency, and you make a few right decisions (minimize debt as much as possible, try to go to a cheaper school and lower cost-of-living, choose a well-paying specialty if you're into it), the debt will be taken care of in a few years once you finish training.

If that doesn't matter to you, then yeah, be a PA.  PAs can have great lifestyles, work capacity, and incomes, especially given the lower amount of debt they have to incur.  Two or three years, and then make six figures...that (in a vacuum) beats four years, then at least three years of getting paid garbage while your debts accrue, and then finally make some acceptable money.

You're anonymous enough here - care to share your measurables?  Undergrad GPA, MCAT score, research publications, work experiences?  Could give a shoot-from-the-hip estimate about feasibility of getting into school.

[Zaphod]

Was thinking how today how well one could do with the right mindset as a nurse. Just go straight into traveling (if not tied down with fam) make bank, do whatever. Plentiful positions making over 100k with almost all expenses paid. Its crazy.

NPs have just fine autonomy depending on the state, this will only increase and cant be stopped.

[Gamma Knives]

I agree that you should decide what you want to do based on the job; you can be successful with either. But this is a finance site, so, from a purely finance standpoint, it depends a lot on what you field you go into if you become a physician. Some medical specialties generally make enough that the extra years are worth it over your career. On the other hand if you go into primary care and work as employee physician the difference in your pay versus a midlevel may not be worth it. DO graduates do tend to go more into primary care than MD but it is not mandatory.

[SValleyMD]

If I was going into primary care I would just be a rural PA and call it good. Could hit 150-200k. I could handle the hit to the ego.

But the md pathway sure allows a lot more options and I don't regret it at all

[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.

[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.

[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

[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.

[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.

[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.

[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

[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.

[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