Friday, December 20, 2013

A woman asks, "Should I be a nurse practitioner or a doctor?"

She writes [email edited for length]:
I don’t ever do this sort of thing, but your blog seems to be pretty legit, so I guess I’ll go ahead this once.[Quite a testimonial for my blog, don't you think?] I’m a post-undergraduate student seeking to become either a nurse (with likely continuation to a nurse practitioner [NP] degree) or a doctor.  The problem is I don’t know which way I should go.

I know I have the ability to get through medical school, but I’m not sure if it is worth it as far as cost and benefit is concerned.  I do, however, like the idea of the autonomy that comes with being a doctor rather than a nurse.  I have a very analytical mind, and would enjoy the diagnosing and problem-solving that comes with being a doctor.  In fact, I’m not sure I would be happy without the authority to determine and pursue treatment I had researched myself.

On the other hand, I really like interacting with patients and getting to know them personally. Ideally, I want a job where I help people solve their medical issues, diagnose, have autonomy, and interact regularly with patients.  My main question is, does this happen more as a nurse practitioner or doctor?

I’d also like to know if you think medical school is worth it with the rising cost of education and likely fall in salary (at least in the US with Obamacare). I’m practical and even if medical school is really what I want, I cannot justify going after a degree that won’t be worth the cost. On the same note, if there is a great shortage of doctors, will NPs be stepping up into doctors’ roles more often? Is such a role assumption legitimate? And what will this mean for the medical community and individuals going into medicine?

[Note: She is in her early 20s with very little debt right now, will finance future education with loans, is not married, but eventually wants to have a family.]

Thanks for the kind words about the blog. 

Here's what I think. It sounds like you want to do primary care. If that is so, why go to medical school? You might want to consider becoming a physician assistant (PA) too. The NP or PA route will be far less expensive. You will be able to start practicing sooner, which means earning real money and paying off any debts instead of deferring. 

Future doctor shortage or not, I think nurse practitioners and PAs will dominate primary care and also be given more autonomy. It is inevitable. The truth is, many PAs and NPs are not very closely supervised even now.

I hope that others will comment.