Mayo Clinic, an institution that prides itself on being one of the best in the world, is paying midlevel providers in training more than doctors in training. 

PA/NP fellow: 77,000 

PGY 1- 72,565

PGY 2- 75,093

PGY 3-78,199

Physicians are responsible for the most complex patient cases and are expected to know more than anyone else in the room. They sacrifice years of their lives (relationships, hobbies, kids, home ownership), and for many, go into debt to pursue this path. And yet, despite all of this, Mayo has decided that midlevels—whose training is a fraction of that of a doctor—deserve a bigger paycheck. This is an insult to every doctor.

Mayo, you should know better.

You position yourself as a leader in healthcare, but you’re sending a clear message: the years of sacrifice, the intellectual rigor, the emotional toll that doctors in training go through means less than the financial convenience of training midlevels. This kind of pay discrepancy devalues the medical profession, and honestly, it’s downright disrespectful.

This is more than just a payroll issue; it’s a values issue. It’s about recognizing the true worth of highly trained professionals and investing in them accordingly. Mayo should be setting the example, but instead, they’re perpetuating a system that undervalues the most rigorous path in healthcare.

Advocating for yourself is just as important as advocating for the patient.

Upvote101Downvote6Go to commentsShare

IR fellow puts in a chest tube using CT for small located effusion. Couple hours later get a message from ICU NP “Just so your team knows there is a small pneumo on CXR”. There was not a diagnostic read yet. This NP sent me her amateur incorrect interpretation of a CXR. There was not a pneumothorax the patient was super rotated with some Mach lines. I thought the NP was just dumb and told her there was no pneumo and another DR read out the CXR as such. I didn’t think much about it but had to chart round on the patient this morning. This NP order 2 additional CXRs within 2 hours “concern for post chest tube pneumo” as indication and both were negative. So this NP thought that her interpretation of a CXR on a non diagnostic monitor was better than mine, my IR attending, and 2 additional DRs till a 3rd CXR comes back negative. I feel like everything I’ve worked for in residency has been so disrespected.

I am a senior resident and recently had a rotation in the neonatal intensive care unit where I was straight up supervised by an NP for a weekend shift. She acted as my attending so I was forced to present to her on rounds and she proceeded to fuck up all the plans (as there was no actual attending oversight). The NP logged into the role as the “attending” and even held the fellow/attending pager for the entire day. An NP was supervising residents and acting as an attending for ICU LEVEL patients!! Is this even legal?

The reason midlevels think they’re smarter than residents is because they see residents get eviscerated on rounds and in the hall, while they never have their knowledge tested. If we could just start a culture of attendings pimping midlevels they would learn real quick just how much they know.

I know this is a common frustration on this sub, but I am just fed up today. I have an overbooked schedule and it says in the comments "ob ok overbook per dr W." This "Dr W" is one of our nurse practitioners. Like if anything, our schedulers should know she isn't a physician.

I love our NPs most of the time. They help so much with our schedules, but I am just tired of patients and other practitioners calling NPs "Dr. So-and-so." This NP is also known to take on more high risk pts than she probably should, so maybe I am just frustrated with her.

Idk, just needed to vent.

Edit to add: This NP had the day off today while we as residents did not. Love that she can overbook my clinic, take the day off today, and still makes more than me 😒

Family member of a patient in our ICU is a “ICU NP” and told us she doesn’t feel comfortable having residents see her family member, only wants attendings

The lack of self-awareness is just 🤡

Had surgery today and the “Anesthesiologist” shows up and states “I’m Dr. so and so, your anesthesiologist” and we go over consents, procedure etc. During the entire encounter her badge was flipped around thus preventing me from seeing her credentials but honestly I thought nothing of it.

Fast forward to visiting my patient portal after surgery: she was actually a CRNA.

To be clear, I didn’t have have a problem with a CRNA performing the anesthesia as this was an outpatient, low-risk surgery. However, this CRNA introduced herself as Doctor, stated that she was the Anesthesiologist and hid her badge the entire time. This was easily the highest level of intentional masquerading as a physician that I’ve ever encountered.

Any advice on how to appropriately handle this and where to report her to is appreciated.

Had an NP refer a patient to me for an "ADHD evaluation." I treat a lot of ADHD, I'm very comfortable diagnosing it. This guy had crystal clear bipolar disorder, not ADHD. I started him on the appropriate medication and sent the note to his NP. Patient cancelled his follow up appointment with me today so I checked on Epic to see what's going on. I see a note from his NP saying "Patient was diagnosed with bipolar disorder by an ADHD provider, not a bipolar provider. Will place a referral to bipolar specialist."

So this guy is going to be on a waistlist for months to be seen in our bipolar clinic to finally then get started on a mood stabilizer.

https://www.ama-assn.org/practice-management/scope-practice/amid-doctor-shortage-nps-and-pas-seemed-fix-data-s-nope

I'm FM. Got a patient who said she was very fatigued throughout the day and was having difficulty waking up after being started on both trazodone and mirtazapine for insomnia. She reported the prescriber told her "this combination may 'snow' you at first but you'll get use to it". I asked who she was following with and what do you know, it's a nurse practitioner.

BUT GET THIS. The NP has a masters in MIDWIFERY and then got a "post-masters psychiatric nurse practitioner certificate". I look this person up on linkedin, and they worked as an RN for 1 year. Rest of work was as a CNA for 4 years lol. Their official job title is "Psychiatric Mental Health Nurse Practitioner" with a degree in MIDWIFERY, psychiatry certificate, and a whopping 1 year RN experience.

Unacceptable. NP profession needs to be phased out and replaced with PAs entirely. Standards are nonexistent in this field. "Come as you are, leave as you were" with an alphabet soup of lettering added to your name afterwards. Seriously, "BA, MSN, RN, CNM, PMHNP-BC" is what is behind this person's name. This sad reality for healthcare has to change.

Patients regularly get referred to me from their “doctor” and I am very deliberate in clarifying with them and making reference to to their referring nurse. If NPs are going to continue to muddy the waters, it is up to doctors to make clear who these patients are seeing. I also refer to them as the ___ nurse in my documentation. I don’t understand why calling them nurses is considered a dirty word when they all went to nursing school, followed by more nursing school.

I overheard an RN who is in an online NP program telling a patient about her program. The patient asked her, “what will you be able to do after you graduate?” She responded with the line above.

Nurse practitioners are nurses not doctors, they shouldn't be seeing patients like they're Doctors. Who's bright idea was this? What's next using garbage men as doctors?

Just a NP who enjoys this sub. Thought this would be fun.

Within the first few minutes, they're explaining why the last doctor left and that he hired someone new and an NP says,

"If I may, I’m a nurse practitioner, I’ve had the same amount of training as a doctor. I'm legally qualified to be head medic."

That sentence about training was enough for me to shut the damn show off. Shitting on doctors within the first few minutes. No wonder this is what the public thinks of NPs vs doctors.

Change my mind…..Feel like it’s more and more common that other professions in medicine that have Doctorate level degree options but are not physicians introduce themselves as doctor to patients in the hospital and it kinda feels like fraud to me. With the exception of a DDS that did an oral surgery residency they definitely fall in the category of hospital workers who can call themselves Doctor. If I missed a degree that also allows you to be listed under the primary physician option in whatever EMR you use then you can be included as well but pretty sure there isn’t any.

I could just be biased since I’m a tired PGY-2 Surgery Resident and had to spend 20 minutes towards the end of a 17 hour work day explaining to a patient that the “doctor” who recommended a different procedure than the one we are doing is a physical therapist not a surgeon.

No more residents or students in the physicians lounge but NPs and PAs are still permitted

I recently graduated medical school and have posted on social media my accomplishment of becoming a doctor. It is a big deal. I worked very hard and the first doctor in my family.

Well, I have a social media friend who has also recently graduated. All her family and friends are congratulating her on becoming a doctor. They are astonished and amazed. She keeps saying Dr. blablabla. Not once has she posted she is a nurse practitioner and got her doctorate in nursing. I am not discounting her successes at all but it is very misleading. Most people do not understand the difference when she is just calling herself “doctor.”

I was a NP before med school and just find this incredibly annoying. Vent over.

If a nurse practitioner can make 6-figures and practice independently with a fraction of the training, why should residents allow $50k salary out of medical school?

Edit: let me rephrase the question since this ? has shown to hit a soft spot on the defeated resident population — if someone was acting on your behalf, advocating for you/us as doctors at all stages of our careers but particularity the point mentioned, what do you think should be done? What effective MD advocacy ideas do you have for?

Saw a patient in clinic yesterday who came for AC management in pregnancy. I’m reviewing her chart and see that she initially presented with c/o leg pain while she was on birth control. She was seen by an NP in the ED and an X-ray was ordered. X-ray was negative so she discharged her on NSAIDs. The patient returned 2 days later with chest pain and syncope and found to have a massive PE and obviously a LE DVT.

How in the actual eff are these clowns allowed to practice independently!!! She is so damn lucky the patient survived this.

And no, she did not have MD/DO supervision. In this hospital, midlevels are allowed to see low “acuity patients” on their own.

Edited to clarify scenario.

Quote from the nurse midwife. This was in response to the patient asking, "so what exactly is your role? Are you a doctor?" And you already know she put that hard emphasis on "just like OB doctors."

Everyone wanna call themselves a doctor but ain't nobody wanna lift no heavy ass books. So cringe.

I live in California. I was in a clinical setting yesterday, and a nurse referred to the NP as a doctor. The NP then referred to himself as a doctor. Can an NP lose their license by misrepresenting their qualifications? What’s the best process for reporting something like this?