Misconception about a PA Doctorate

[MICURN]

Haha, whoa PACdan. Take a chill pill.

 

I completely agree that passing yourself off as a physician when you're not is a sham no matter what your profession is. Pharmacy, nursing, dentistry (and now PAs).

 

Not cocky. True. I have the prerequisites, and therefore choice, to apply to any of those programs. If you're not an RN with ICU experience, you don't. Them's the facts.

 

And you know what I'm saying here. Now you're sounding cocky. Haha.

[cinntsp]

 

If PA programs had stricter entry requirements (I just can't relearn the basics all over again with kids that have no clue how to even take a BP) a better title and a more independent practice, I'd probably be all in.

 

Yeah, the other PA students would totally hold you back.  You should become an NP since you already know how to take a manual BP and will surely only need 250 clinical hours.

[PACdan]

Haha, whoa PACdan. Take a chill pill.

 

Hey now, you're not licensed to prescribe medication! :)

 

As for your view points, you're kinda pissing into the wind on this board. I respect NPs, I worked with many and many in training. But, all else being equal, the training does not compare to that of a PA.

[MICURN]

Yeah, the other PA students would totally hold you back.  You should become an NP since you already know how to take a manual BP and will surely only need 250 clinical hours.

Haha! Everyone is so touchy! You have to know what I'm saying here. Would you want to sit through a lecture or lab where you were being taught things you already knew? Come on now.

 

This is probably gonna burn your arse but look at crna programs. They require ICU experience so they can skip basic ideas and skills. They don't have to cover CC meds, ABG interpretation, hemodynamic monitoring, etc.

 

That's all I'm saying. Do I think in general pa programs have a better educational process. I suppose. I think the Acute Care NP programs are starting to act accordingly. In general I think clinical hours are the big difference but that's really for FNP and psych programs. They're pretty poor in general and most RNs know it whether they want to admit it or not.

 

I do think that there are some NP programs that are just as good as the best PA programs. I do, however, think there are more subpar NP programs.

 

If we could mix NP and PA school and practice, we'd be golden. But we can't.

[MICURN]

Hey now, you're not licensed to prescribe medication! :)

Haha! I am, however, pretty good at suggesting what meds are needed for a patient. ;)

[PACdan]

The CRNA is a very specific niche. A PA wouldn't show up and say they know more than the CRNA in anesthesia. Overall, in the many other aspects of medicine, they do. Hence the generalist training (along the physician model) with specialization afterwards on the job or through residency.

 

The NP or CRNA specializes from an RN / nursing model. There in lies a big difference.

[LT_Oneal_PAC]

Haha! Everyone is so touchy! You have to know what I'm saying here. Would you want to sit through a lecture or lab where you were being taught things you already knew? Come on now.

 

This is probably gonna burn your arse but look at crna programs. They require ICU experience so they can skip basic ideas and skills. They don't have to cover CC meds, ABG interpretation, hemodynamic monitoring, etc.

 

That's all I'm saying. Do I think in general pa programs have a better educational process. I suppose. I think the Acute Care NP programs are starting to act accordingly. In general I think clinical hours are the big difference but that's really for FNP and psych programs. They're pretty poor in general and most RNs know it whether they want to admit it or not.

 

I do think that there are some NP programs that are just as good as the best PA programs. I do, however, think there are more subpar NP programs.

 

If we could mix NP and PA school and practice, we'd be golden. But we can't.

Very little of PA school would be a repeat of what you know. NP school, now that was a repeat of what I knew as a experienced nurse. The only comparable education is CRNA with the difference being PAs are generalist. I will agree that there is significant downside to PA as far as politics go, which needs to change.

 

O'neal PA-S, RN, BSN, CCRN, TNCC

Cvicu RN x 5 years. Former NP student, former anesthesia student.

[MICURN]

Hey O'neal

 

Do you mind if I ask why you left CRNA school and went for pa? I ask because I think I would like CRNA education the most (keeping with the critical care and heavy pharmacology) but unless I found the perfect job I doubt I would be completely satisfied for my entire career. If I did PA or ACNP I'd like ICU or ER but I don't want to just be fast track or under the thumb of my SP. I guess I'm afraid of my career being dependent on someone else to such a degree.

[True Anomaly]

Interesting that you say a DNP is not a nurse practitioner, MICURN, when the leading advocate and one of the founders of the whole concept of the DNP, Mary Mundinger, wrote this article in Forbes in 2007- linking DNPs to nurse practitioners:

 

http://http://www.forbes.com/2007/11/27/nurses-doctors-practice-oped-cx_mom_1128nurses.html?partner=alerts

 

Here's a quote directly from her article:

 

"Along with a doctorate and the title of “doctor,” the fact that a nurse practitioner has fulfilled this certification requirement will instill confidence in patients that DNPs have the expertise to serve as their health-care provider of choice.

Nurse practitioners are reimbursed by Medicare and Medicaid in every state, but only variably by commercial insurance carriers. That is certain to change soon, as these DNP graduates prove they are the logical choice to become the new comprehensive-care clinicians."

 

So...are DNP's not nurse practitioners still? 

[MICURN]

I had posted that a dnp is not necessarily a nurse practitioner (they can do pure research or be a clinical nurse specialists for example). Ventana said that was incorrect, that DNPs were all nurse practitioners. I again said that was not the case. I have many friends who have gotten or are getting their DNPs with no intention or option of being a NP. Do most people associate DNP with NP. Of course. It was designed to be a clinical doctorate. Most RNs pursuing them intend to be or already are NPs.

 

And mundinger is crazy. Haha.

 

Here's the deal. I am not all for one particular pathway to becoming a non physician provider. Each have BIG positives and BIG negatives. Obviously those of you who have already chosen PA will play up the positives and down play the negatives. And the same with those on a certain other website which shall go unnamed. Haha. I was just trying to clarify an idea for someone.

[LT_Oneal_PAC]

Hey O'neal

 

Do you mind if I ask why you left CRNA school and went for pa? I ask because I think I would like CRNA education the most (keeping with the critical care and heavy pharmacology) but unless I found the perfect job I doubt I would be completely satisfied for my entire career. If I did PA or ACNP I'd like ICU or ER but I don't want to just be fast track or under the thumb of my SP. I guess I'm afraid of my career being dependent on someone else to such a degree.

I went on a mission trip to Honduras as a student where a CRNA didn't show. Was given a box of narcs, basically given an honorary title of CRNA for the week and told to get to work. It was awesome being completely independent, but then I also realized how useless I was. So many people needed medical care, but I didn't know how to set a fracture, diagnose plantar fasciitis, treat prostatitis. More often than not, I was just waiting for someone needing a block or surgery. I loved anesthesia. Few things are cooler than feeling like a mad scientist manipulating Hemodynamics with ease, optimizing ventilation to prevent atelectasis and maintaining CO2 levels, properly narcotize patients so they took deep controlled breaths and smiled when you pulled the tube. But more than that I didn't want to feel so limited in my scope again. I had done an ACNP program to make myself look good for CRNA school and it was terrible. I'll always admit it might have just been my school, but it was at the largest medical center in my corner of the US. Realize though that ACNP is just acute care, which the floor qualifies. It's not as much CC and ER as you think unless it's a program like Vandy that specifically has tracks for that. So NP was out. I had a daughter on the way and more prereqs to fill for MD, so it was out. Was really impressed by the PAs in surgery, well most anyway. So I decided I would do PA since it had the kind of training I wanted. I'll be in the navy so autonomy is not a problem. I do hope legislation gets better. I will say I was told on confidence of one state that was going to push for something PAs have never gotten before and I'm very hopeful for the future. Also there are many CC and EM residencies for PAs that I guarantee would put you way ahead of anybody except maybe a BC physician in that specialty.

 

Edit: autocorrect changed narcotized to Narco toxins. Not right

[LT_Oneal_PAC]

Interesting that you say a DNP is not a nurse practitioner, MICURN, when the leading advocate and one of the founders of the whole concept of the DNP, Mary Mundinger, wrote this article in Forbes in 2007- linking DNPs to nurse practitioners:

 

http://www.forbes.com/2007/11/27/nurses-doctors-practice-oped-cx_mom_1128nurses.html?partner=alerts

 

Here's a quote directly from her article:

 

"Along with a doctorate and the title of “doctor,” the fact that a nurse practitioner has fulfilled this certification requirement will instill confidence in patients that DNPs have the expertise to serve as their health-care provider of choice.

Nurse practitioners are reimbursed by Medicare and Medicaid in every state, but only variably by commercial insurance carriers. That is certain to change soon, as these DNP graduates prove they are the logical choice to become the new comprehensive-care clinicians."

 

So...are DNP's not nurse practitioners still?

It's confusing but he's right. DNP is a degree with tracks in admin, education, and clinical (NP). They are often used interchangeably, but shouldn't.

 

As to the 2015 DNP requirement, it was actually only a recommendation. The NLN is actually against it last I checked. I promise there will be MSN nps for a long time.

 

Also someone said 2 year online DNP. This doesn't exist. It's minimum 3 years "full time". Granted they count full time as 9 credits.

[CoastalPalm]

Interesting that you say a DNP is not a nurse practitioner, MICURN, when the leading advocate and one of the founders of the whole concept of the DNP, Mary Mundinger, wrote this article in Forbes in 2007- linking DNPs to nurse practitioners:

 

http://www.forbes.com/2007/11/27/nurses-doctors-practice-oped-cx_mom_1128nurses.html?partner=alerts

 

Here's a quote directly from her article:

 

"Along with a doctorate and the title of “doctor,” the fact that a nurse practitioner has fulfilled this certification requirement will instill confidence in patients that DNPs have the expertise to serve as their health-care provider of choice.

Nurse practitioners are reimbursed by Medicare and Medicaid in every state, but only variably by commercial insurance carriers. That is certain to change soon, as these DNP graduates prove they are the logical choice to become the new comprehensive-care clinicians."

 

So...are DNP's not nurse practitioners still? 

 

Lets see if I can help:

 

DNP=Doctor of Nursing Practice.  This degree can be completed post-BSN or post-MSN.  Many DNP programs include the NP, CNM or CRNA curriculum, in addition to the DNP courses (which seem to be focused on clinical leadership, though a number also have additional clinical content/experience, such as the Columbia DNP program).  These DNP programs are for those that are not already NPs/CRNAs/etc.  Admission to the post-MSN DNP programs seems to be open to applicants with MSN degrees in advanced practice nursing (NP/CNM/CRNA/CNS), as well as those that have MSN degrees in nursing education, etc.  These DNP programs do not create NPs/CRNAs/etc.  Therefore, not all DNPs are advanced practice nurses.

 

DNP programs that can be completed fully online do not include any clinical rotations, and therefore do not create NPs.  Any NP program (whether MSN or DNP) that has an online component will also have offline clinical experiences for the degree. 

[skyblu]

My only confusion was how one could go to school part time (mostly online) for two years after a Bachelor's and end up with a doctorate.

 

If that were the case, my full time, no summers off, in class from 8-5 every day and clinical rotations for over a year Master's program might as well have conferred me the title of Queen of the Universe.

 

Seriously. Why don't we (masters-level PAs) all have a doctorate if all it takes is a few months of post-bachelor's education?

[MICURN]

My only confusion was how one could go to school part time (mostly online) for two years after a Bachelor's and end up with a doctorate. If that were the case, my full time, no summers off, in class from 8-5 every day and clinical rotations for over a year Master's program might as well have conferred me the title of Queen of the Universe. Seriously. Why don't we (masters-level PAs) all have a doctorate if all it takes is a few months of post-bachelor's education?

Again. There's no such thing. Re-read the above posts. It's a minimum 3 years post BSN for a DNP. Summer semesters and all. Part time equals a little over 4 years.

[PACdan]

My only confusion was how one could go to school part time (mostly online) for two years after a Bachelor's and end up with a doctorate.

 

If that were the case, my full time, no summers off, in class from 8-5 every day and clinical rotations for over a year Master's program might as well have conferred me the title of Queen of the Universe.

 

Seriously. Why don't we (masters-level PAs) all have a doctorate if all it takes is a few months of post-bachelor's education?

 

The number of graduate credits taken at PA Master's programs is well in the doctoral range when compared with PhDs or JDs. Yet we are not conferred a "doctorate". I assume this is tied to the evolution of the PA profession and an attempt to not direct compete/ cause confusion with MDs.

[True Anomaly]

Okay- thanks for the clarification everyone.  It seemed a bit confusing to me.  And I agree Mundinger has some screws loose in general

[MICURN]

I went on a mission trip to Honduras as a student where a CRNA didn't show. Was given a box of narcs, basically given an honorary title of CRNA for the week and told to get to work. It was awesome being completely independent, but then I also realized how useless I was. So many people needed medical care, but I didn't know how to set a fracture, diagnose plantar fasciitis, treat prostatitis. More often than not, I was just waiting for someone needing a block or surgery. I loved anesthesia. Few things are cooler than feeling like a mad scientist manipulating Hemodynamics with ease, optimizing ventilation to prevent atelectasis and maintaining CO2 levels, properly narcotize patients so they took deep controlled breaths and smiled when you pulled the tube. But more than that I didn't want to feel so limited in my scope again. I had done an ACNP program to make myself look good for CRNA school and it was terrible. I'll always admit it might have just been my school, but it was at the largest medical center in my corner of the US. Realize though that ACNP is just acute care, which the floor qualifies. It's not as much CC and ER as you think unless it's a program like Vandy that specifically has tracks for that. So NP was out. I had a daughter on the way and more prereqs to fill for MD, so it was out. Was really impressed by the PAs in surgery, well most anyway. So I decided I would do PA since it had the kind of training I wanted. I'll be in the navy so autonomy is not a problem. I do hope legislation gets better. I will say I was told on confidence of one state that was going to push for something PAs have never gotten before and I'm very hopeful for the future. Also there are many CC and EM residencies for PAs that I guarantee would put you way ahead of anybody except maybe a BC physician in that specialty.

 

Edit: autocorrect changed narcotized to Narco toxins. Not right

Your concerns sound very similar to mine although I'd really rather not start a program and realize it after the fact. So the ACNP program I'm looking at requires a minimum of 1500 clinical hours from talking to the PD. Not as many as a PA program but they aren't concerned with training GENERALISTS. It includes diverse clinicals within that framework such as cardiopulmonary, oncology, medical and surgical ICUs and trauma. It's a very we'll respected program with a CC residency program for NP and PA attached which I would plan on doing. My biggest apprehension is being pigeon holed into hospital work only. Who knows if maybe one day I'll want to find an easier job. But, I don't like the political atmosphere for PAs or the direction the profession seems to be headed (take it with a grain of salt as I'm an outsider). The crna program sounds top notch. All the students in it I've talked to love it. But I feel like once I graduated I'd feel limited as well. And I'm not sure how much the salary is drawing me in to be honest.

[CoastalPalm]

Your concerns sound very similar to mine although I'd really rather not start a program and realize it after the fact. So the ACNP program I'm looking at requires a minimum of 1500 clinical hours from talking to the PD. Not as many as a PA program but they aren't concerned with training GENERALISTS. It includes diverse clinicals within that framework such as cardiopulmonary, oncology, medical and surgical ICUs and trauma. It's a very we'll respected program with a CC residency program for NP and PA attached which I would plan on doing. My biggest apprehension is being pigeon holed into hospital work only. Who knows if maybe one day I'll want to find an easier job. But, I don't like the political atmosphere for PAs or the direction the profession seems to be headed (take it with a grain of salt as I'm an outsider). The crna program sounds top notch. All the students in it I've talked to love it. But I feel like once I graduated I'd feel limited as well. And I'm not sure how much the salary is drawing me in to be honest.

 

Sounds like a good program.  From what I understand, ACNPs, in addition to practicing in the impatient setting (the floors, critical care units, trauma, hospitalist services, etc), also practice in specialty clinics, FWIW. 

 

I personally thought very seriously about PA vs nursing, and decided on the nursing route (I'll decide on ACNP vs CRNA when I get there, but I understand your point of view on that.  I personally have no interest in family practice).  I love PA education, but I love nursing for the reasons you've mentioned (hopefully more states will move to PAs being in collaborative practice, and not supervision).  Further, I think that if one completes a solid BSN program, has solid RN experience, and completes a solid NP program, one will be in a good place as a provider.  Plus, as you mention, there are NP residency/fellowship programs (though not as many as PA residency programs, at this point).

[dtaylor1747]

What do we think of Lynchburg College's Doctor of Medicine degree option?

[Gordon, PA-C]

What do we think of Lynchburg College's Doctor of Medicine degree option?

 

It's a money grab for suckers.

 

Somebody needs to call Lynchburg and ask them this:

 

Let me get this straight, I have to go to school for 1 year longer than a regular PA program, I have to incur another 50k in debt, and all I get for that is that I get to call myself "doctor" without any additional independence?  

 

Let me ask you something.....are you FUCKING NUTS??

 

There is ZERO reason to go into extra debt for this "doctorate" that gives you absolutely nothing that a bachelor's trained PA cant do already.  Please tell me people arent seriously considering going into extra debt for zero benefit.

[cinntsp]

It's a money grab for suckers.

 

Somebody needs to call Lynchburg and ask them this:

 

Let me get this straight, I have to go to school for 1 year longer than a regular PA program, I have to incur another 50k in debt, and all I get for that is that I get to call myself "doctor" without any additional independence?  

 

Let me ask you something.....are you FUCKING NUTS??

 

There is ZERO reason to go into extra debt for this "doctorate" that gives you absolutely nothing that a bachelor's trained PA cant do already.  Please tell me people arent seriously considering going into extra debt for zero benefit.

 

My understanding is that the doctorate portion contains a clinical component, which can be beneficial if designed right.

[Gordon, PA-C]

My understanding is that the doctorate portion contains a clinical component, which can be beneficial if designed right.

 

Spoken like a true academic -- "it is beneficial for us to charge you tuition for extra years for stuff in the sheer interest of learning"

 

It is typical that third rate institutions like Lynchburg (never heard of this podunk school before) are trying to start new programs like this as a money grab and a way to get free publicity.  

[turtlesrule]

a PA graduate can participate in a post-graduate residency, get the clinical experience, and get a stipend. The stipend may not equal a full salary but its not more tuition. Unfortunately their availability is limited.

[Gordon, PA-C]

a PA graduate can participate in a post-graduate residency, get the clinical experience, and get a stipend. The stipend may not equal a full salary but its not more tuition. Unfortunately their availability is limited.

 

According to their website, there is "9 months additional instruction, coursework in leadership, and a clinical fellowship"

 

The "fellowship" part may be paid but I can guarantee you the coursework is tuition based.