Doctors blackballing NPs/DNPs

boomer28 · Dec 7, 2007

I too was disturbed by a lot of the comments made on the SDN website about NPs. Apparently some medical students have a misunderstanding about the value of nurses and NPs and what it is that they do. I have a feeling that they will eventually figure it out . The fact of the matter is that hospitals and doctors offices are hiring more NPs than ever, so they need to face the facts. I'm currently working on my MSN to become an FNP (and maybe a DNP!) and I am not worried about negativity from med students or physicians because I am confident in my abilities to be a good practitioner and I will not tolerate being disrespected. I say hey, if you want to be rude, that's just fine. It will make your patients prefer to see me... no one wants to go see a rude physician. Actually, I am looking forward to working with physicians on a collaborative basis because I think it will end up helping provide better healthcare to my patients whether I decide to work in a hospital or a family practice.

Trauma Columnist · Dec 9, 2007

And...you have to remember that medical STUDENTS do become older and wiser and then the animosity that they throw around can come back to bite them.

lol

sign me....an old and embattled advanced practice nurse who the medical students CONSULT - tee hee hee

Mexarican · Apr 13, 2008

ok lets be real here...we all have our opinions about this...but let's be real and look at things objectively...this is it...

This won't happen...simply because at the end of the day...money talks. It is always about the bottom line in the end in this country. For one, hiring NPs is cheaper for Doctor groups. But that's not even the biggest factor... in the whole scheme of things this is actually a very very small detail. Doctor's can only blame themselves for the need for midlevel providers...there not filling the need and the market demands it! There are less and less Med students going into areas of general practice in order to fulfill the basic medical, management, preventative needs of patients. Also more and more med students, to their own fault, are choosing to go into specialties and leaving the general practice to who?!?! They all want to be specialists but no one wants to do the heavy lifting...general practice. Being a doctor used to be a noble profession back in the old old days...it used to be that living comfortably was all that was needed, now everyone wants to be rich, that isn't going to happen unless you specialize. take a look at the areas that med students are going into...just research and look. There isn't a shortage of doctors, just a shortage of doctors who want to do internal medicine or general practices...yea the ones that won't make you rich!! With all that education it doesn't pay to go into general practice or internal medicine. Those are the practices that keep people out of the ER because they catch things before they escalate, they 'nip things in the bud' sort of speak they teach, at least some do, preventative care. But if it keeps getting more and more expensive because MDs need make more to keep their practices afloat then what?? At the end of the day...we could all complain about this and that, huff and scuff, but the bottom line will always be the same...the market demands it and who ever is willing to do it...will fill the need! Midlevel providers are here to stay...forever! NPs fill a void that is ever increasing...and it isn't going away anytime soon. Blackballing NPs won't work for the simple fact that in the future there won't be as many MDs in general practice to do the blackballing. You don't have to search to long to find an article that talks about the shortage of MDs in this area of practice. So in the end...when it's all said and done...NPs will continue to thrive not because MDs had some sort of say in it, but because the market demands it and it will be driven by the all mighty dollar! :smokin:

mex

n_g · Apr 13, 2008

You're missing two important facts:

1) Doctors can hire either NP's or PA's. If DNP's have the same role as PA's, who's smarter for spending two less years in school and indebtedness.

2) There will be 5000 more med school grads by 2012 over 2004 levels.

I wouldn't be so overconfident about the future.

elkpark · Apr 13, 2008

I'm currently working on my MSN to become an FNP (and maybe a DNP!) and I am not worried about negativity from med students or physicians because I am confident in my abilities to be a good practitioner and I will not tolerate being disrespected.

Unfortunately, it's not about being "disrespected," it's about not being able to find a job. I wish Dr. Mundinger would shut the !@#$ up and quit doing all these interviews and articles about "doctor nurses," and how they're so much better than any other healthcare practitioner. In the first place, they haven't been around long enough for anyone to be able to say that with any validity; in the second place, I haven't seen or heard anything about the new DNP programs that suggests they're providing superior clinical education compared to existing MSN NP programs; and, in the third place, every time she opens her mouth, she's just poking the entire medical community with a big ol' stick.

core0 · Apr 13, 2008

Unfortunately, it's not about being "disrespected," it's about not being able to find a job. I wish Dr. Mundinger would shut the !@#$ up and quit doing all these interviews and articles about "doctor nurses," and how they're so much better than any other healthcare practitioner. In the first place, they haven't been around long enough for anyone to be able to say that with any validity; in the second place, I haven't seen or heard anything about the new DNP programs that suggests they're providing superior clinical education compared to existing MSN NP programs; and, in the third place, every time she opens her mouth, she's just poking the entire medical community with a big ol' stick.

Even better, according to the state of NY BON she's not licensed as an NP. According to her CV her doctorate is in public health (at least that the conventional interpretation of DrPH). Not sure who she is speaking for when she talks about NPs. Kind of like Tonto and the Lone Ranger.

David Carpenter, PA-C

elkpark · Apr 13, 2008

Even better, according to the state of NY BON she's not licensed as an NP. According to her CV her doctorate is in public health (at least that the conventional interpretation of DrPH). Not sure who she is speaking for when she talks about NPs. Kind of like Tonto and the Lone Ranger.
David Carpenter, PA-C

Yeah, but she's the Dean of the SON at Columbia and they're all whipped up about having developed the DNP idea in the first place, so I'm sure she's speaking as a general-purpose cheerleader for the concept (and, to some extent, marketing her school's program at the same time). I'm sure doing this kind of publicity is considered part of her job (yet another reason why I will never take an administrative job ... :rolleyes: )

SteveNNP, MSN, NP · Apr 14, 2008

I agree with pretty much everyone so far.... Mundinger has thrown midlevels under the doctors bus...While SDN has its value, most of the aforementioned threads were started or derailed by med students or 1-2nd yr residents who still haven't got a clue, just like many of our nursing students. I find myself having several "forehead-smack" moments while reading some of their posts.

I think that the MDs, PAs and NPs out there practicing have a pretty good idea of where their scope and daily practice fits in our medical system's hierarchy. Personally I am pursuing a NNP career to advance my skills and scope of practice, not to think of myself as some pseudo-doc. Who wants all that call-time, long hours, years of substandard pay, years and years of education, and a huge medical school debt? Not me. My brother is getting ready to apply to med school, and has no idea of what goes on in the "real world" of medicine. I hope he understands the responsibility that comes with the prestige.

I think most midlevels do not purport to equate themselves with physicians. A lot of med students and residents (heck, even some attendings) do appreciate the practical experience that NPs and PAs bring to the team..

justme1972 · Apr 14, 2008

I don't ever believe that doctors can be replaced.

I want to be an NP eventually, but you cannot have the same expert knowledge in 2 to 3 years versus 10. You just can't. It's not the same curriculum. Not even close.

There is a place in healthcare for both professions. Both NP's and physicians have their "niche".

Trauma Columnist · Apr 14, 2008

Those that say that midlevels are not physicians are so right. If we wanted to be physicians,we would have gone to med school. However, as midlevels we do help take some of the burden off the physician. Personally, though my job wouldn't change if I got a DNP or some other type of doctorate. I wouldn't get anymore pay nor would I do more work.

prairienp · Apr 14, 2008

yeah, but she's the dean of the son at columbia and they're all whipped up about having developed the dnp idea in the first place, so i'm sure she's speaking as a general-purpose cheerleader for the concept (and, to some extent, marketing her school's program at the same time). i'm sure doing this kind of publicity is considered part of her job (yet another reason why i will never take an administrative job ... )

her program was the drnp not the dnp. i understand columbia has recently or will soon switch the drnp title to dnp. she is not speaking for any national organization that i am aware of. i don't think you will find nonpf, aanp or other np organization providing support either overtly or covertly. she is representing her program and her self only.

a good analogy would be the md "dr. anthony colatonio" who is talking about a long island hospital - and of a physician assistant accused of botching invasive procedures killing 3 patients. the article was in the ny post and a while later he was on fox news saying the same thing. should we now feel that all mds have determined that pas botch invasive procedures? any review should quickly provide a better understanding, dr. colatonio is not supported by the hospital, peers or any other sane person that i could find. we need to understand the source of the discussion and respond appropriately.

elkpark · Apr 14, 2008

her program was the drnp not the dnp. i understand columbia has recently or will soon switch the drnp title to dnp. she is not speaking for any national organization that i am aware of. i don't think you will find nonpf, aanp or other np organization providing support either overtly or covertly. she is representing her program and her self only.
a good analogy would be the md "dr. anthony colatonio" who is talking about a long island hospital - and of a physician assistant accused of botching invasive procedures killing 3 patients. the article was in the ny post and a while later he was on fox news saying the same thing. should we now feel that all mds have determined that pas botch invasive procedures? any review should quickly provide a better understanding, dr. colatonio is not supported by the hospital, peers or any other sane person that i could find. we need to understand the source of the discussion and respond appropriately.

i agree with you, and i think perhaps you misunderstood me. i was simply responding to dave's comment about who mundinger is speaking for about nps when she isn't one. yes, columbia developed the first doctoral np degree, which they have initially called drnp, but the consensus from the rest of academia is to be consistent with "dnp" as the name of these programs (lord knows, we have far too many names for nursing doctorates already! :rolleyes: ) i understand she is not speaking for any "national organization" (and that the national np groups are not supporting the whole "mandatory dnp" concept -- good for them!). she is speaking as the dean of a school that has pioneered the concept and offers the degree; a legitimate (and large!) part of a dean's job is to promote public awareness of the school and interest in the degree programs that it offers, and i presume that is her rationale for all her efforts and public comments to "sell" the concept. i certainly didn't mean to suggest that i agree with or support her position, or that anyone should consider her a definitive or authoritative voice on the subject -- i think i was pretty clear about that when i said earlier that i wish she'd shut the !@#$ up! :)