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Practicing medicine with online degree


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I am having a hard time deciding if PA school is right for me. There is something that keeps bothering me and that's the fact that nurse practitioners can get their degree online not to mention BSN. Many jobs postings and articles use PA and NP as the same and some speak of NP as a better degree because of laws. I have 2 questions: Why are PAs viewed as the same level as NPs, while NPs get an online degree, it seems that online is easier? Also how does this play out in the real world, are NPs viewed as equals or even superior? Thanks for any discussion on this, I have searched the net but have found nothing about this particular issue.

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Most NPs do not go to online school.  I have worked with a lot of NPs and they have all been great.  NPs are viewed as equal to a PA where I work and probably at most offices.  I think way too many people get all worked up about the PA vs NP thing and it is not worth being worried about it. Also, I believe some PA schools are considering offering online programs. Who knows if an online school is easier?  What makes it easier?  What about sitting in a classroom makes the content easier?  They still do rotations and I assume other hands on training.

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Okay, well none of the NPs I know went to an online school.  Either way I am not concerned about it.  Perhaps employers will not like it and they will chose to hire the PA who went to an actual campus vs a NP who did an online program. I am pretty sure Yale was planning on offering an online PA program? 

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Okay, well none of the NPs I know went to an online school. Either way I am not concerned about it. Perhaps employers will not like it and they will chose to hire the PA who went to an actual campus vs a NP who did an online program. I am pretty sure Yale was planning on offering an online PA program?

Employers tend to prefer NPs because the physicians can't be held liable many states and they don't have to review charts of NPs.

 

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I am not sure what the original post is asking?  Is she choosing between PA and NP?  I think if you are already a RN you might as well become an NP.  Otherwise PA is a better option.  Probably in some situations maybe being a NP is a better option, like in states where they can practice without supervision.  Other physicians may prefer PAs.  I have worked had 5 different PA positions in 2 different states and I have never ran into a situation where a physician or practice only want to hire a NP or only wants to hire a PA.  Actually, they only time I have seen an ad for only a NP is at the Florida CVS minute clinic and apparently maybe the VA will start doing this?  As long as you are not the one going to an online program I don't see what the concern is. It seems to me that most employers don't really care too much on the exact school you went to.  Some may not even realize a school is online vs classroom.

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APRN's can take a small portion of their didactic work online.  However they certainly have mandatory course-work in person, and obviously clinical rotations can not be performed online.

 

I have loved just about every APRN I work with and do view them as equals.

 

From what I have observed in the state of Connecticut:

1)  PA-C's are generally better compensated than APRN's (not sure why, but won't complain).  

2)  APRN's can practice independently of a physician, whereas obviously a PA-C must work under the license of a physician.  (Honestly I am glad to have oversight from a physician when needed).  

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Employers tend to prefer NPs because the physicians can't be held liable many states and they don't have to review charts of NPs.

 

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What employers?  The vast majority of the hospital networks I have heard of in states where NPs have independence still have physician oversight on NP work.  The Docs are still on the hook.

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What employers? The vast majority of the hospital networks I have heard of in states where NPs have independence still have physician oversight on NP work. The Docs are still on the hook.

Northern California at least. Santa Clara County only hires NP for the most part in primary care roles. Ucsf doesn't hire PAs. Stanford prefers NP. We are pushed into EM, private family practice, and surgery. NPs do not have to have attending sign every chart. One of my buddies whose a pediatrician told me he had to stop precepting PAS and start precepting NPs because a PA will never have a job there.

 

My ER , we train fellows and one told me her school favored NPs over PAs because of liabilty issues.

 

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No undergraduate should consider entering the PA field. The opportunities for PAs are now always inferior to those of MDs, DOs and NPs. Sure, it is true that PA education is superior (more rigorous) than NP education. In the end, it doesn't matter because NPs will get more job offers, more easily get employment and be more highly favored for employment. They are not winning on merit. We can all agree on that. They win by virtue of their political power and the accomplishments of their lobby. To even think that PAs are competing with NPs is a farce. It isn't a fair fight. We always lose and we continue to fall behind. I keep saying, if you are an undergraduate, go to medical school if able to gain admission (MD or DO, it doesn't matter). If you are over thirty, go to NP school. 

 

Summarize again

1. Number of states with independent practice? NPs 22; PAs 0

2. VA granted right of independent practice? NPs yes; PAs no

3. Unnecessary reboarding every ten years? NPs no; PAs yes

 

Hands down winner is NPs. I am being called a doomsayer but I feel confident that the PA profession will not be in existence in ten years. Those who hype the profession the most are those who have something to gain from new entrants; the NCCPA, the AAPA and the growing list of PA programs without any proper infrastructure or relationships to have a program. 

 

One last point on the "online" criticism. Have any of you paid any attention to how medical students are educated? Except for labs, they do all of their didactic lectures online. Many never go to campus. They utilize Osmosis to integrate the lecture with preloaded lectures, crowd sourced exam questions and flashcards. They form online study groups within Osmosis with others in their program. They rarely go to a campus. I find this far superior than what I did when I went to watch my PA professors struggle to explain the material that they read the night before lecture yet barely understood themselves. My school has a long history of producing graduates and the teaching in the classroom was abysmal. Online improves the quality by orders of magnitude.

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Northern California at least. Santa Clara County only hires NP for the most part in primary care roles. Ucsf doesn't hire PAs. Stanford prefers NP. We are pushed into EM, private family practice, and surgery. NPs do not have to have attending sign every chart. One of my buddies whose a pediatrician told me he had to stop precepting PAS and start precepting NPs because a PA will never have a job there.

 

My ER , we train fellows and one told me her school favored NPs over PAs because of liabilty issues.

 

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California cannot and should never be used as an indicator of what is going on in the other 50 states.

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Summarize again

1. Number of states with independent practice? NPs 22; PAs 0

2. VA granted right of independent practice? NPs yes; PAs no

3. Unnecessary reboarding every ten years? NPs no; PAs yes

Oh this is dumb....

1- Amount of NPs in practice for themselves? <1%  Independent practice only makes you more dangerous with the level of education you have.  Rock on.

2- PA independent practice in the VA is coming.  The nursing lobby is huge.  It does well to have a lobby of RN dollars driving NP practice.   Good for you

3- Reboarding is a reason why most physicians in surgical specialties where they need a partner who is on top of their game prefer PAs.

 

To say that the PA profession isn't going to be anywhere in 10 years is beyond stupid and baseless.  If the profession wasn't a threat, you wouldn't be a member on the board here trolling.

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You got me there. California sucks. No offense Californians.

 

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I'm not hating.  The nursing lobby is strong there.  In the states where Physicians have the bulk of the control over healthcare, PAs are thriving.  PAs are thriving even in nursing heavy states, it's just playing the game and biding time.  A new PA school pops up every week it seems.  Soon the numbers will be strong enough to balance some things out.

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Oh this is dumb....

1- Amount of NPs in practice for themselves? <1%  Independent practice only makes you more dangerous with the level of education you have.  Rock on.

2- PA independent practice in the VA is coming.  The nursing lobby is huge.  It does well to have a lobby of RN dollars driving NP practice.   Good for you

3- Reboarding is a reason why most physicians in surgical specialties where they need a partner who is on top of their game prefer PAs.

 

To say that the PA profession isn't going to be anywhere in 10 years is beyond stupid and baseless.  If the profession wasn't a threat, you wouldn't be a member on the board here trolling.

 

 

Uh...that poster claims to be a PA...

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Minority reports aren't necessarily trolls. The definition of troll from wikipedia is "one who sows discord on the internet by starting arguments or upsetting people by posting inflammatory, extraneous or off-topic messages in an online community with the intent of provoking readers into an emotional response or otherwise disrupting normal on topic discussion.

 

Agreed that my views might be discordant and presenting them could be construed as "sowing." Agreed that while this is the internet , I don't hope to start an argument; I avoid them at all costs. Agree with "provoking an emotional response" but the response I want to provoke is to coalesce PAs around the goal of winning practice independence and elimination of reboarding. Disagree with "off topic messages" since the subject is NP vs PA education quality. I focus on the premise that PA growth and enthusiasm emanates from sources who themselves are beneficiaries of the increase in our ranks; that is NCCPA, AAPA and PA programs. 

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.........

I have never quoted an ellipse before. We have to appreciate the prevailing sentiment here. It goes like this. "If you have views that sharply diverge from our own views, you were never one of us." I am one of you and hope to point you in a new direction. I would like to suggest that EMEDPA wants to use "ibid" over the grammatical ellipse "..."

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It is just a significantly baseless claim to say that taking exams every decade and the absence of independent practice is going to make us a non-existent profession in a decade.  That's farcical.  That's an adjective defined as "of or resembling a farce, especially because of absurd or ridiculous aspects."  If you're a PA who thinks that independent practice is the way ahead, then by all means advocate that but doing so by crying wolf isn't going to work.

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Interesting thread.  Want to chime in on one thing.  The subject of didactics on the Internet (or "interwebs" if you prefer.).  As an NP, your arguments as PA's is better regarding clinical time.  The on-line vs. on-ground debate for didactics is stupid. Just...stupid.  I can't count the ways of how stupid it is.  Just a few brief examples...

 

(1) Many (if not most) medical students skip their in-person lectures in med school regularly

(2) Of those that attend, they (and often, you) are being lectured by someone who speaks poor English

(3) In PA school, ask yourself (even if neither 1 or 2 apply above), are you better served listening to someone read a power point, or working through the material yourself?

(4) What is inherently superior to listening to someone regurgitate a memorized lecture in person vs. on-line?

(5) As has been noted in this thread, but seems to be completely ignored, is that 0% of any NP student's clinical training is on-line.

(6) On-line training for didactics inherently offer more opportunities for interactive learning than sitting in a class of students watching a power-point slide being read by a "professor."

(7) Commuting an hour or more to sit in a cramped classroom to hear someone regurgitate a memorized lecture is a waste of time and money. It disallows more interactive and deeper learning than can be accomplished "on-line," by (a) discouraging interaction, (b) discouraging the asking of questions, (c ) discouraging working through material at a pace suitable for the learner (whether faster or slower), (d) wasting time (and money) by commuting, and (e) preventing students from learning at slower or faster paces in situations were certain students can blow past certain material vs. others who need more time with it.  Why should a former RT in PA school have to sit through 120 minutes of pulmonary physiology just so the former CNA in PA school can grasp it (for example)?

 

That's just for didactics.  I'm happy to revisit (once again) differences in clinical training, specifically clinical time and experience of PA's vs. NP's.  But that is really another matter.

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my concern is the lack of hands on practice for clinical exam skills online np(and now pa...yale) programs. we spent an entire week practicing the neuro exam in small groups. some of these programs have students meet on campus 1 weekend/semester. if that semester includes the physical exam course they are supposed to cram 12-16 WEEKS worth of practice into 2 days? sure , you can practice on your spouse, etc at home, but that's not the same as doing the exams on someone who can critique you in real time because they know the material too....

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