I cant decide on which Medical field of study

[ICANHITHIMMAN]

I think medicine is a neat field; as an ER PA, I'm biased.

If you're young, single, and have the time and aren't concerned about stuck in one specialty, I'd consider medical school. Otherwise, without a nursing degree, PA training is a no-brainer.

Let's face it...physicians are captains of the ship in medicine. They are more comfortable with PA's because we are trained like they were and are tied to a dependent practice model acknowledging physician leadership.

Degree creep is crazy in healthcare. A doctorate to practice as a pharmacist, physical therapist, NP? Seems like blatant "doctor" envy to me.

Jake

Well thanks for responding. After this semester I am applying to Saint John Fisher school of nursing for my BA then depending on how much money I have left in my GI bill I will apply for the masters program. Should have enough have not used it.

[WS6]

Hay guys I'm at a cross roads in my schooling. I'm 3 years out of the mil and have been going to school for a few years now. I want to go into the medical field but I cant decide which diciploine to focus and I need to start applying to programs.

I'm considering Nurse Practitioner or Physician Assistant I know some of you here are EMTs, Medics, Corpsman, PAs and Doctors can you tell me what you think? I want to do more trama related stuff so whats the best choice.

I dont want to go to medical school right now, I'm not even considering it at this point. I live in Rochester NY so there is no shortage of great schools in the area and with the GI bill its a no brainer.

Jon

RN,BSN here. I work Stepdown and SICU. We are a surgical hospital and don't get much trauma, but you don't have to work at a surgical hospital. Work ER at a place like LSU or other state hospital, and you will get your fill of it.

As I am a nurse, and none of the other you have mentioned, obviously I advise nursing if you think you would like it. Talk to a few people in all those professions, etc. and see what jives best with you.

Lots of "clashing of ranks" in a hospital. Just don't get involved in it. Respect everyone, expect (and show that you expect) respect from everyone. This has never failed me yet. Everyone from MD's to house-keeping smiles and says "hey, how are you?" when they see me, unless I see and greet them first.

[panzerr]

Think twice before becoming a PA. Licensure can be a hassle state to state and everything you do has to be signed off by an MD.

Dentistry is a good line of work so long as you don't have chronic thoracolumbar or cervical-thoracic problems (think being hunched over someone day after day). The work evenvironment would be much more laid back than a hospital and you would likely make more money than many MDs.

Chiropractic is what I am going in to and honestly I wouldn't suggest it unless you get the VA to pay for school (that's what I did). Many of my mates are looking at $200,000 in loans and so far the government only forgives loans for MDs, even though DCs are primary care physicians as well (little known fact). You also need to be business savvy as a Chiro because as of yet if a hospital has a DC on staff it is unusual so you will probably end up in private practice....although this is one of the aspects that drew me to the profession. This means if you aren't personable you will likely fail and default on your student loans because people will not like you and thus not seek out your care.

[Hmac]

Think twice before becoming a PA. Licensure can be a hassle state to state and everything you do has to be signed off by an MD.

Maybe it varies state to state. I work with PA's, and while I'm obligated to take responsibility for their work, I certainly don't have to sign off on everything, or even anything, that they do.

Chiropractic .....

[kiwi57]

Re:

". . . After this semester I am applying to Saint John Fisher school of nursing for my BA . . ."


ICANHITHIMMAN,

Congratulations on arriving at a decision—must be a relief. The nice thing about becoming a BSN is that you can choose from a wide variety of settings to practice in after graduation. You can remain an RN, apply to be an advanced practice nurse or try the physician assistant route. Each will be a possibility with a BSN background.

During your training, you will have ample opportunity to talk with many nurses, docs and PAs about your next step. As I mentioned before, one of the best questions to ask people you grow to respect would be: “if you had it to do all over again, would you do the same thing?” If they reply “no”, find out why and what they would have done instead.

Of course, their replies have to be taken with a grain of salt because burn out is not uncommon in some of the health professions. Someone else’s job satisfaction is no guarantee of your own—but keep your ears open for recurring themes. I hope I’m not coming off as preachy, but this has been a helpful question in my experience.

Hmac,

Your comment is spot-on, co-signature and supervision requirements for PAs vary by state. With very few exceptions, state professional licensing rules have improved significantly in the 30 years I’ve been a PA. In Utah, it is up to the doc and the PA to decide. As you know, what’s really important for any clinician is that they understand their limits and feel no hesitation to ask for help when caring for a patient.

Kiwi57

[ICANHITHIMMAN]

Think twice before becoming a PA. Licensure can be a hassle state to state and everything you do has to be signed off by an MD.

Dentistry is a good line of work so long as you don't have chronic thoracolumbar or cervical-thoracic problems (think being hunched over someone day after day). The work evenvironment would be much more laid back than a hospital and you would likely make more money than many MDs.

Chiropractic is what I am going in to and honestly I wouldn't suggest it unless you get the VA to pay for school (that's what I did). Many of my mates are looking at $200,000 in loans and so far the government only forgives loans for MDs, even though DCs are primary care physicians as well (little known fact). You also need to be business savvy as a Chiro because as of yet if a hospital has a DC on staff it is unusual so you will probably end up in private practice....although this is one of the aspects that drew me to the profession. This means if you aren't personable you will likely fail and default on your student loans because people will not like you and thus not seek out your care.

I could never ever ever look in peoples mouths all day. I have a thing now when I speek to people if they dont take care of there teeth I cant even look them in the eye.

[ICANHITHIMMAN]

RN,BSN here. I work Stepdown and SICU. We are a surgical hospital and don't get much trauma, but you don't have to work at a surgical hospital. Work ER at a place like LSU or other state hospital, and you will get your fill of it.

As I am a nurse, and none of the other you have mentioned, obviously I advise nursing if you think you would like it. Talk to a few people in all those professions, etc. and see what jives best with you.

Lots of "clashing of ranks" in a hospital. Just don't get involved in it. Respect everyone, expect (and show that you expect) respect from everyone. This has never failed me yet. Everyone from MD's to house-keeping smiles and says "hey, how are you?" when they see me, unless I see and greet them first.

Thanks for the advice I have heard there is in fighting at some places

[Sensei]

One important and growing aspect of medicine is the notion of patient satisfaction and customer service. Most patients who visit a doctor's office, ER, or have any other contact with a healthcare professional will receive a patient satisfaction survey. These surveys are increasingly used to determine provider compensation, and CMS (Center for Medicare Services) will soon use patient satisfaction scores as a factor in hospital reimbursement for in-patient admissions.

Now, I'm not opposed to measuring or rewarding customer service. However, most of patients are not customers in the usual sense. For example, about 1/4 of my patients have Medicare, 1/4 have Medicaid, 1/3 have private insurance, and the rest have no coverage (or any intention of paying a bill). That means about 70% of the people who walk in the ER have no personal incentive to ration their care because someone else is paying for all or most of their bill. Yet, all of them will get a survey, and their response will influence the provider's compensation. In other words, these surveys largely measure consumer rather than customer satisfaction in that the consumers have no stake in the game. Imagine if Walmart gave a customer service survey to shoplifters (the equivalevt of giving a survey to someone who steals a provider's intellectual property by not paying a bill).

This has a very detrimental effect on resource utilization, over-prescription of antibiotics, and inappropriate use of controlled substances. For example, are you really not going to order that head CT for the kid with a head bump brought by a neurotic mother, or not prescribe antibiotics for a kid's cold after the mom says she thinks he needs a Z-pack? Well, the answer to both of those patients is "no" - but you better have the social skills to do it in a way that does not cost you a lot of money.

This means that medicine is increasingly becoming more of a customer service industry and less of a technical field. None of my partners fret over malpractice; it is the emerging customer service aspects of medicine that gives most of us ulcers. You better understand that before you committ to the personal and financial sacrifice.

[ICANHITHIMMAN]

Wow good info and thanks for sharing

[WS6]

One important and growing aspect of medicine is the notion of patient satisfaction and customer service. Most patients who visit a doctor's office, ER, or have any other contact with a healthcare professional will receive a patient satisfaction survey. These surveys are increasingly used to determine provider compensation, and CMS (Center for Medicare Services) will soon use patient satisfaction scores as a factor in hospital reimbursement for in-patient admissions.

Now, I'm not opposed to measuring or rewarding customer service. However, most of patients are not customers in the usual sense. For example, about 1/4 of my patients have Medicare, 1/4 have Medicaid, 1/3 have private insurance, and the rest have no coverage (or any intention of paying a bill). That means about 70% of the people who walk in the ER have no personal incentive to ration their care because someone else is paying for all or most of their bill. Yet, all of them will get a survey, and their response will influence the provider's compensation. In other words, these surveys largely measure consumer rather than customer satisfaction in that the consumers have no stake in the game. Imagine if Walmart gave a customer service survey to shoplifters (the equivalevt of giving a survey to someone who steals a provider's intellectual property by not paying a bill).

This has a very detrimental effect on resource utilization, over-prescription of antibiotics, and inappropriate use of controlled substances. For example, are you really not going to order that head CT for the kid with a head bump brought by a neurotic mother, or not prescribe antibiotics for a kid's cold after the mom says she thinks he needs a Z-pack? Well, the answer to both of those patients is "no" - but you better have the social skills to do it in a way that does not cost you a lot of money.

This means that medicine is increasingly becoming more of a customer service industry and less of a technical field. None of my partners fret over malpractice; it is the emerging customer service aspects of medicine that gives most of us ulcers. You better understand that before you committ to the personal and financial sacrifice.

I think that the ultimate thing to remember is:

People what what they think is best for themselves.
The goal of healthcare is to teach people what is best for themselves--in a friendly, non-confrontational manner, which is most effective when the patient feels that they themselves have, by their own wit, come to the conclusion that you have steered them toward.

A healthcare provider that can manage this, be it a nurse like me, or a PA like others, or an MD like others, will always have an easier go at things.

A lot of regulation in healthcare is aimed at preventing "lowest common denominator" type mistakes. It's only going to get more confusing, more red-tape oriented, and ultimately more costly. Think about this before becoming a private-practice MD.