Fri Jan 19, 2007 4:18 pm
Larry,
You bring up several points against being a doctor (i.e. litigation, insurance companies, etc.) Although these are valid points, they cannot be applied across the board and applied to every physician in every locale.
I am an Emergency Medicine physician. I get paid a salary, and so my income does not directly rely on procedures, insurance companies, or the patient's ability to pay out of pocket. Of course, if the hospital doesn't get paid from insurance companies, etc., one could argue that this would trickle down and eventually the physicians wouldn't get paid, either. This is a scenario that is not likely to occur with emergency medicine physicians. There will always be a need for ER docs, so long as people keep hurting themselves. Technology won't replace me.
Besides, I have a contract that guarantees my salary.
Emergency medicine physicans have certain "luxuries" not afforded to a lot of other physicians. When I want a test done, I do it. I do not wait for insurance companies to authorize it. Of course, I do practice responsible medicine, and only order tests that I believe are necessary. Besides, there are a ton of hospital committees that do nothing but analyze our every move, making sure we don't order MRI's for scraped knees. <shrug> I haven't had a problem yet, and in fact we get bonuses for productivity...
There is currently a shortage of physicians for primary care. Medical schools are increasing their enrollment in response. This is a big deal...increasing class sizes. It is not done lightly (i.e., my alma mater now takes 205 students a year. It used to be 125). This required all kinds of things - hiring more prof's to teach, bigger classrooms, bigger anatomy labs, etc. Their accreditation had to be reviewed and authorized for more students...etc, etc...
As far as being a PA - Personally, I would advise against becoming a PA. PA's do a lot of the same things the doctors do, but get paid significantly less. I make probably 3-4 times that of a PA (of course, I went to school a HELL of a lot longer than a PA). Also, PA's often get pimped out for scut work. No fun. Some people, however, don't want to be a doctor. They don't want the responsibility. They don't want to commit 12+ years of their life to school, and probably 250k in student loans (not to mention "lost wages" for all those years). PA or NP would probably be perfect for this type of individual. Just not for me...
Assuming the paramedic has 2 years of college (which is not always the case), paramedic to PA would take about 5 years. Paramedic to RN would take about 2 years, and paramedic to doctor would take 10+ years.
To somewhat answer gowhitesox99's question - If paramedic pay is 1x, RN pay would be ~2x, PA ~3x, and doctor anywhere from 5 to 10x, depending on specialty, etc. But again, keep in mind student loans and "lost wages", as mentioned above.
Nurses get paid (a lot) more than medics because they are typically higer educated and have a HUGE collective voice across the nation that sets high standards with wages that are commensurate with those standards.
Having been a paramedic for many years before medical school, I know exactly where you're coming from, Larry. And yes, paramedics don't get paid shit. It is too young of a profession, and there are too many people willing to work for relatively low wages. Supply vs. demand...
There are huge differences amongst paramedics, too...in terms of clinical knowledge, professionalism, etc. Yes, it is true that some are big time "whackers", with lights and sirens all over their personal vechicles, sleeping in parking lots, living off fast food, etc. But, there are others who clearly don't fit this picture and might be "cutting themselves short" as a career paramedic. To each their own...
Hey ferret_fubar, if RN's and Medics should get pro ball players' salaries, what should I get?
Heh heh...
.
.
.
.
Gee, this thread got off track a little. What was it about again? Oh yeah - water intoxication can kil you.
Looking forward to Larry's response. All this medical talk is interesting!!!
--Dr. Yooper
(and damn fucking proud of it).
You bring up several points against being a doctor (i.e. litigation, insurance companies, etc.) Although these are valid points, they cannot be applied across the board and applied to every physician in every locale.
I am an Emergency Medicine physician. I get paid a salary, and so my income does not directly rely on procedures, insurance companies, or the patient's ability to pay out of pocket. Of course, if the hospital doesn't get paid from insurance companies, etc., one could argue that this would trickle down and eventually the physicians wouldn't get paid, either. This is a scenario that is not likely to occur with emergency medicine physicians. There will always be a need for ER docs, so long as people keep hurting themselves. Technology won't replace me.
Besides, I have a contract that guarantees my salary.
Emergency medicine physicans have certain "luxuries" not afforded to a lot of other physicians. When I want a test done, I do it. I do not wait for insurance companies to authorize it. Of course, I do practice responsible medicine, and only order tests that I believe are necessary. Besides, there are a ton of hospital committees that do nothing but analyze our every move, making sure we don't order MRI's for scraped knees. <shrug> I haven't had a problem yet, and in fact we get bonuses for productivity...
There is currently a shortage of physicians for primary care. Medical schools are increasing their enrollment in response. This is a big deal...increasing class sizes. It is not done lightly (i.e., my alma mater now takes 205 students a year. It used to be 125). This required all kinds of things - hiring more prof's to teach, bigger classrooms, bigger anatomy labs, etc. Their accreditation had to be reviewed and authorized for more students...etc, etc...
As far as being a PA - Personally, I would advise against becoming a PA. PA's do a lot of the same things the doctors do, but get paid significantly less. I make probably 3-4 times that of a PA (of course, I went to school a HELL of a lot longer than a PA). Also, PA's often get pimped out for scut work. No fun. Some people, however, don't want to be a doctor. They don't want the responsibility. They don't want to commit 12+ years of their life to school, and probably 250k in student loans (not to mention "lost wages" for all those years). PA or NP would probably be perfect for this type of individual. Just not for me...
Assuming the paramedic has 2 years of college (which is not always the case), paramedic to PA would take about 5 years. Paramedic to RN would take about 2 years, and paramedic to doctor would take 10+ years.
To somewhat answer gowhitesox99's question - If paramedic pay is 1x, RN pay would be ~2x, PA ~3x, and doctor anywhere from 5 to 10x, depending on specialty, etc. But again, keep in mind student loans and "lost wages", as mentioned above.
Nurses get paid (a lot) more than medics because they are typically higer educated and have a HUGE collective voice across the nation that sets high standards with wages that are commensurate with those standards.
Having been a paramedic for many years before medical school, I know exactly where you're coming from, Larry. And yes, paramedics don't get paid shit. It is too young of a profession, and there are too many people willing to work for relatively low wages. Supply vs. demand...
There are huge differences amongst paramedics, too...in terms of clinical knowledge, professionalism, etc. Yes, it is true that some are big time "whackers", with lights and sirens all over their personal vechicles, sleeping in parking lots, living off fast food, etc. But, there are others who clearly don't fit this picture and might be "cutting themselves short" as a career paramedic. To each their own...
Hey ferret_fubar, if RN's and Medics should get pro ball players' salaries, what should I get?
Heh heh...
.
.
.
.
Gee, this thread got off track a little. What was it about again? Oh yeah - water intoxication can kil you.
Looking forward to Larry's response. All this medical talk is interesting!!!
--Dr. Yooper
(and damn fucking proud of it).
Fri Jan 19, 2007 5:40 pm
You have to really want it for other reasons then just money. I've known people who are paramedics, and some who are firefighters, and the stories they tell me about arriving on accident scenes pretty much froze my blood. There's no way in hell I could deal with some of the stuff (death, horrible injuries including children and infants). One day of that and I'd need therapy for life. It's seems like you need a mixture of compassion to want the job in the first place and a sort of hard heart to do the job.
Fri Jan 19, 2007 5:41 pm
Yooper- to clarify my statement- sports is only a game and when they started paying sports players millions, they forgot it was just a game (Babe Ruth made under 35,000 a year and he loved the GAME, not the money) However, paramedics risk their lives ( sorry, I dont know too many doctors who go in the middle of a domestic situation to save a life), nurses do everything in the middle (I assume its demanding being the in between) and doctors deal with the spilt second decisions that could save someones life (and still get sued). Each one of you is equally important in saving a patients life. Hmmm, all a ball player does is play ball, and if he doesnt get enough money, he whines about it. My statment was merely, we should be appreciating the people who deserve it, not the high and mighty who play a sport. (no offense, I love baseball)
Fri Jan 19, 2007 6:56 pm
No no ferret_fubar...my statement was meant to be tongue-in-cheek. My sarcasm button must have been broken.
I was a paramedic for many years, so I'm all too familiar with the dangers. I have a picture of my ambulance with 17 bullet holes in the side. And yes - I was in it, curled up in a little ball, wishing that my vest covered more than just my torso. In the meantime, the little gang-banger that I just scraped up off the middle of the street is screaming at me "don't let them kill me!!" while he is flinging his HIV-ridden blood all of the place. Had I let him die in the middle of the street, those guys wouldn't have come after us. They shot up the ambulance hoping to kill off the guy they just wounded. In gang life, you shoot to kill...not shoot and leave wounded.
Oh, and thank you for the compliments for those of us in the medical field. It's appreciated. All too often it is a thank-less job....so...thank you!
I was a paramedic for many years, so I'm all too familiar with the dangers. I have a picture of my ambulance with 17 bullet holes in the side. And yes - I was in it, curled up in a little ball, wishing that my vest covered more than just my torso. In the meantime, the little gang-banger that I just scraped up off the middle of the street is screaming at me "don't let them kill me!!" while he is flinging his HIV-ridden blood all of the place. Had I let him die in the middle of the street, those guys wouldn't have come after us. They shot up the ambulance hoping to kill off the guy they just wounded. In gang life, you shoot to kill...not shoot and leave wounded.
Oh, and thank you for the compliments for those of us in the medical field. It's appreciated. All too often it is a thank-less job....so...thank you!
Fri Jan 19, 2007 8:00 pm
Lets look at the stereotype you have given us and see how I fit in…
You say I am adrenaline addicted, not exactly
I rarely get excited about a call, I remain calm and cool throughout the incident, and it just comes naturally.
My personality type is ESTP or “The Promoter” see http://keirsey.com
The short version is people with this temperament like to walk into chaos and sort it out.
That’s what I do well, and that’s why I do it well.
As for the fast food, most of the time it’s all I have time for, so I try to pack a lunch, I work in a high volume system 10-12 calls in 12 hour shift doesn’t leave much down time, or time to eat.
Not sure where the sleeping in the grocery store parking lot came from??? Must be over my head, I just don’t get it.
As for pissing where noone can see me, I prefer privacy when I go to the bathroom, but that just me.
Something else I want to get out of the way. There are doctors, PA’s, nurses, paramedics, and EMT’s, that aren’t worth a crap and I wouldn’t let them work on my dog. There are bad people in every profession not just healthcare.
I can assure you I am a “real healthcare professional” just as much as you are. I take pride in my work, education, and knowledge. And I assure you there is a lot more to being a good paramedic than just airway, IV, and get them to the ER. If it wasn’t for good paramedics you wouldn’t have as many patients to take care of because they would be going to the morgue instead of the ICU. I am well aware of what an ICU nurse should know, I work closely with the critical care school our nurses must take before they can work in the ICU, and paramedics are trained in a lot of the same things.
Now finally, let me explain what I mean when I say, “step down”
I am used to assessing, diagnosing, and treating my patients without anyone’s approval or permission. I assess and I make the treatment decision all on my own. Now it’s not like I am practicing medicine on my own, I have guidelines to follow, standing orders etc. and I function under a medical directors license. However I work at a very progressive system, and have a lot of freedom to treat the patient as I see fit (read responsibility) If I feel the need I can call a doctor on the radio, and get treatment advise, and sometimes do, but 99% of the time I make the decision on my own.
Now think of me used to operating independently working as a Nurse not able to do anything without a doctor’s order. Some units are a little different; the ED and ICU nurses can do some things on standing order but the majority of nurses have to have an order before they can do what the patient needs.
Now this isn’t because paramedics are better than nurses. It’s about the environment we work in. Nurses have the luxury of having a doctor on site; the doctor just walks over and assesses the patient, and then tells the nurse what to do. Even though most GOOD nurses knew what the patient needed before the doctor came over, they can’t do anything about it until the doctor says so. This is not practical in my environment, when the doctor is nowhere near the patient. We have to make the treatment decisions.
The only way to continue to work independently is either NP, PA, or doctor. To me being a nurse is stepping backwards because I have to wait for someone else to tell me what to do. Not a step backward in education or knowledge just in how I would function.
And finally I apologize if I offended you with the comment, it was not meant to be a reflection on your skills or knowledge.
On another note, you’re kinda feisty; your passionate about your job and you stand up for yourself…I like that
Many more posts I want to reply to in this thread but that’s all for now, got to get back to the slopes
You say I am adrenaline addicted, not exactly
I rarely get excited about a call, I remain calm and cool throughout the incident, and it just comes naturally.
My personality type is ESTP or “The Promoter” see http://keirsey.com
The short version is people with this temperament like to walk into chaos and sort it out.
That’s what I do well, and that’s why I do it well.
As for the fast food, most of the time it’s all I have time for, so I try to pack a lunch, I work in a high volume system 10-12 calls in 12 hour shift doesn’t leave much down time, or time to eat.
Not sure where the sleeping in the grocery store parking lot came from??? Must be over my head, I just don’t get it.
As for pissing where noone can see me, I prefer privacy when I go to the bathroom, but that just me.
Something else I want to get out of the way. There are doctors, PA’s, nurses, paramedics, and EMT’s, that aren’t worth a crap and I wouldn’t let them work on my dog. There are bad people in every profession not just healthcare.
I can assure you I am a “real healthcare professional” just as much as you are. I take pride in my work, education, and knowledge. And I assure you there is a lot more to being a good paramedic than just airway, IV, and get them to the ER. If it wasn’t for good paramedics you wouldn’t have as many patients to take care of because they would be going to the morgue instead of the ICU. I am well aware of what an ICU nurse should know, I work closely with the critical care school our nurses must take before they can work in the ICU, and paramedics are trained in a lot of the same things.
Now finally, let me explain what I mean when I say, “step down”
I am used to assessing, diagnosing, and treating my patients without anyone’s approval or permission. I assess and I make the treatment decision all on my own. Now it’s not like I am practicing medicine on my own, I have guidelines to follow, standing orders etc. and I function under a medical directors license. However I work at a very progressive system, and have a lot of freedom to treat the patient as I see fit (read responsibility) If I feel the need I can call a doctor on the radio, and get treatment advise, and sometimes do, but 99% of the time I make the decision on my own.
Now think of me used to operating independently working as a Nurse not able to do anything without a doctor’s order. Some units are a little different; the ED and ICU nurses can do some things on standing order but the majority of nurses have to have an order before they can do what the patient needs.
Now this isn’t because paramedics are better than nurses. It’s about the environment we work in. Nurses have the luxury of having a doctor on site; the doctor just walks over and assesses the patient, and then tells the nurse what to do. Even though most GOOD nurses knew what the patient needed before the doctor came over, they can’t do anything about it until the doctor says so. This is not practical in my environment, when the doctor is nowhere near the patient. We have to make the treatment decisions.
The only way to continue to work independently is either NP, PA, or doctor. To me being a nurse is stepping backwards because I have to wait for someone else to tell me what to do. Not a step backward in education or knowledge just in how I would function.
And finally I apologize if I offended you with the comment, it was not meant to be a reflection on your skills or knowledge.
On another note, you’re kinda feisty; your passionate about your job and you stand up for yourself…I like that
Many more posts I want to reply to in this thread but that’s all for now, got to get back to the slopes
Fri Jan 19, 2007 8:45 pm
Well thanks for the explaination, but I disagree. I think with your assessment skills and educational background you'd make a excellent nurse maybe not the med-surg variety because you are correct about having to wait for MD orders but in ICU... situations change, you react, then notify the MD and receive more orders. I probably didn't so much take offense as it's just what my hubby calls ICU bitchyness, or them-that-knew.(when something bad happened he heard an ICU nurse say I knew that was going to happen.) So when I heard step down from paramedic my feathers puffed up!
My situation is I'm married to an internal medicine hospitalist and before that he was a clinic doc. His care has become more and more dictated by health insurance companies. I'm not going to go into cost effective medicine (according the insurance companies). I agree with your point that with all the strikes MD is an unfavorable choice. Malpractice insurance rates are ridiculous, work load is high, compensation is ok, but somewhere along the lines we've given the lay people a say about what they think they need, and when the outcomes are bad they blame the MD for the bad decisions they've made about their care.
I am a product of my ICU environment and couldn't think of any other job more satisfing. Sorry about the stereo-typing.
Shred till you're dead man! Enjoy the slopes!
My situation is I'm married to an internal medicine hospitalist and before that he was a clinic doc. His care has become more and more dictated by health insurance companies. I'm not going to go into cost effective medicine (according the insurance companies). I agree with your point that with all the strikes MD is an unfavorable choice. Malpractice insurance rates are ridiculous, work load is high, compensation is ok, but somewhere along the lines we've given the lay people a say about what they think they need, and when the outcomes are bad they blame the MD for the bad decisions they've made about their care.
I am a product of my ICU environment and couldn't think of any other job more satisfing. Sorry about the stereo-typing.
Shred till you're dead man! Enjoy the slopes!
Sat Jan 20, 2007 2:24 am
<----started in Lifeguarding and EMS and now am a political scientist and public adminstrator...soon to be lawyer (Yoopers favorite kind of people!), so I guess you could say Ive had the best of both worlds.
Sat Jan 20, 2007 8:18 am
I want a Wii. Do I have to type six paragraphs backing up my career choices. 
Sat Jan 20, 2007 2:13 pm
Originally posted by [ECGN] BTT
I want a Wii. Do I have to type six paragraphs backing up my career choices.
"Hammer, nails and wood." There you go Tony just cut and paste this over 6 paragraphs.