Personal Insight: Why I Chose MD Over NP or PA

As a physician, my journey led me down a path that eventually culminated in becoming a medical doctor (MD) rather than a nurse practitioner (NP) or physician assistant (PA). The decision was driven by various factors, such as the unique opportunities and responsibilities inherent in an MD degree, the lack of surgical training for NPs and PAs, and the desire to be the head of the medical team.

Why Not NP or PA?

Firstly, obtaining the MD (Doctor of Medicine) degree grants the license to perform operations, a capability that neither NPs nor PAs possess. Many hospitals require surgeons, and only a handful of US physicians train in surgery, making this a significant distinction between the three roles. This inability to operate is, to paraphrase the automotive maxim, “there is no substitute” for surgery.

My Background and Journey

My path to becoming an MD began long before the widespread adoption of NPs and PAs in the healthcare system. By the time these roles were established, I had already pursued a career as a teacher in Chicago’s public schools. Early in my teaching career, a pivotal incident occurred when I intervened to prevent a student from committing a violent act. The shock and learning that came with this event led my sisters, both nurses, to encourage me to consider medical school over nursing school.

Decision Factors

I had always aspired to become a physician from a young age. My early childhood dreams were fueled by a desire to be a doctor. During medical school, I also weighed the decision to apply for dental school, another field with promising career prospects, but ultimately decided on medical school due to the greater opportunity it offered to be the expert and take charge of patient care.

The Role of Physician Assistant (PA)

While I trained as a PA earlier in my career, I found the limitations of the role unsatisfactory. Becoming a PA meant practicing at the forefront but with less autonomy than a full-fledged physician. By the time I became a PA, new knowledge and skills had evolved, making my role less about being the expert and more about serving under the supervision of a physician. I found this restrictive and disagreeable, leading me to pursue a path that allowed me more significant responsibility.

PA Career Reflection

During my time as a PA, I accumulated substantial experience, including high-pressure roles like performing emergency medical procedures. Although my PA salary was competitive, the role did not meet my long-term aspirations. Over the years, my expertise and salary increased, leading me to eventually build a successful career and retire to focus on personal passions like sheep farming. My decision to retire did not come from dissatisfaction with the profession itself but rather from a desire for a life focused on family and other interests.

Personal Advice to Future Healthcare Providers

My advice to aspiring healthcare providers is to choose the path that aligns with the desire to be the best. Becoming a physician is no different; it requires a deep commitment to learning and continual improvement. Embrace the best medical schools and study with diligence. Learn from every mistake, whether yours or someone else's. Never stop growing and learning, for your patients and your profession rely on your expertise to provide the best possible care.