Sure. Practical knowledge/experience is often more important than formal education/theoretical knowledge. That scenario has numerous corollaries in a wide variety of professions over hundreds of years; the Platoon Sergeant vs his brand-new 2nd Lieutenant, the experienced surgical PA vs his/her supervising surgeon just out of residency. Nothing new or particularly revelatory about any of that.

HMc

And then there are the real heroes: the nurse's who ran the Arctic nursing stations prior to the 80s. They did everything. I mean "everything", and were scathingly contemptuous of the newly-minted physicians doing a rotation in the north for northern services who would be flown in for clinics a week out of 52. I've seen those young men examining a patient, with the nurse watching them, and then privately and desperately asking her what he should do and how he should do it. Those women were formidable. They had it all over the physicians, but for pay, and status.

Now: https://www.wildmed.com/newsletter/on_his_own.html

Some states do require an advanced degree (MS) to be licensed as an NP. That doesn't translate to more salary, however. Nurse Practitioners are almost universally relegated to primary care roles since that's about the only training they get, whereas PAs do virtually anything in medicine - their training includes rotations in all of the major specialities. The scope of the PA's license generally encompasses anything their supervising physician is willing to accept responsibility for. NP's are more rigidly limited by their license. It would be unusual to ever find an NP in the Emergency Department taking primary care of emergencies, or in the Operating Room, for example, but those are common roles for PA's. And as is true in all of medicine, procedural specialties are more highly reimbursed and consequently PA's, especially surgical PA's, tend to get paid more than NP's, who are primary care only, even if they set up their own independant practice if that's allowed by their state.

Most insurance companies don't pay as much for a patient being cared for by a PA or NP as they do for seeing a real doctor in a primary care role. And my PA can't bill as high a surgical assist fee from some (not all) insurance companies as one of my partner's can. The difference, if there is one, is not that great, however. An MD assistant would bill (or insurance companies typically reimburse) 17% of the surgeon's fee, whereas a PA might only be able to bill 12-15%. Anyway, that direct reimbursement doesn't represent my PA's real value to me - her value is that I can scrub out and start the next case while she is closing the first one, or that she can see my post-op patients (which we don't get paid for) which frees my schedule to see new consults. These are not things that a NP could do for me.

The rules of practice/scope of license also vary by state. In most, neither PA's nor NPs have to have their orders or prescriptions co-signed.

HMc

By the way, there are other areas of Advanced Practice Nursing beyond Nurse Practitioner. Perhaps the best-known of these are Certified Registered Nurse Anesthetists (CRNA). They are a different kettle of fish altogether. In many states, they (like NP's) can practice independantly and don't require physician supervision. *Unlike* NP's it would not be even remotely unusual for a CRNA to be getting paid well over $100,000 per year.

HMc

Interesting analogy: the military and medicine.

Not part of this discussion but also interesting is that all of this, my story and the web story--the Twin Otter, the pilot, the medivac nurse, the nursing station nurse, and a third party to accompany, equipment, nursing station staff, flight deadhead: all paid for by Canada's universal healthcare system.

For comparison. They also actively seek summer replacements. The north is a fantastic for single women; and for kids.
https://www.hlthss.gov.nt.ca/Careers/.../nursejobs.asp

Yes. Thank god for you Robert. You're the glue that holds the whole system and its benighted participants together.

HMc

Hierarchies exist everywhere, in almost every field of human endeavor. Occasional anomalies within those hierarchies are inevitable.

HMc

Just saying some of us get it from all sides. The young have the excuse of being inexperienced and the old are just buying time to retire and are on cruise control.

Back to the original question. Why are there so many job openings in the healthcare arena.

Part of the reason is that our current state of medical care and environmental toxicit creates further disease that requires treatment. Since they don't really know how to cure anything they just layer disease upon disease.

No education is given to diet, exercise or how to avoid the use of drugs. No education is given internally cleaning the body.

All drugs cause disease. I you don't believe me just look at any drug in a Physicians Desk Reference. So now a whole new world of disease is created by prescribed medicines.

Candida infection is now rampant in our country, (USA) from overuse of antibiotics and steriods. Candida is behind many allergy and fatigue problems and may be behind some cancers or other chronic malfunctions as the body struggles to adapt to this fungus the immune system is stressed.

We also have more disease and need for healthcare workers because our world has become so toxic that cancer and other chronic disease have become common place.

The more drugs, the more toxicity, the more belief that drugs will solve the problem the more healthcare practitioners you will need. Everyone seems to want to put the responsibility for heath into the hands of someone other than themselves. They can sit and slouch all day, drink beer, use pesticides, take antibiotics, never go in the sun, watch violence on tv, take artificial sweeteners, use aluminum pots, eat processed foods with chemical additives, drink flouradated water and then dare to wonder why they get sick and then think they should be able to pay somebody to fix it.

Amazing!

Amazing!!!

Good answer, that about sums it up. I would say the bottom line is that the drug companies need an outlet for their drug sales. So the medical profession grows to meet that demand. And the more it grows, the more toxic drugs we consume, the sicker we get, and the more health care we need. It's an endless cycle of growth.

100 times more powerful, 1,000 times safer.

I am weary tonight. Go for it Shapshfter!

Warmly,
Arrow

We live in a "Debt Based Economy"

In other words, the more debt, the more money will be printed,
therefore, the more "expansion" of the economy....blah, blah, blah.

I'm not trying to change this forum, but the current, easiest way
to "expand" (read, print money) is to play the health care card.

After all, we are all getting older, and we all know that old people
need doctors, drugs, hospitals, nursing homes, etc.

Until the politicos come up with a better card to play, go for the
health care industry.

In the 60's, it was the aerospace industry. (let's go to the moon)

In the 70's, it was the military industry, (let's go to war-Vietmnam)

In the 80-90's, it was the internet. (let's get online)

Now we're back to war and technology. Nano everything.
(could be a indication of things to come)

Health care seems safe for a few years. Take the money & run!

Well its pretty simple...the whole population is just growing older and older, nobody is dying off like they used to. Plus, medical field jobs now are so high tech and the training, or in a doctors case medical schooling can take years, and put people in debt before the even find a job, plus its super stressful, because your dealing with someones life in your hands. Your always worried if someone is going to sue the pants off of you and ruin you. I know I wouldnt want anything to do with the medical field! What a nightmare profession.