Doctors blackballing NPs/DNPs - page 4
by mslinzyann 5,485 Views | 38 Comments
Lately I've been on a particular board dedicated to doctors and student doctors and there has been a lot of talk about/ a lot of fear about DNPs and NPs in general. Many of the doctors and pre-med students on the board have even... Read More
- 0Apr 14, '08 by prairienpQuote from core0For example this passage isn't real supportive "Nurse practitioners aren't the same as doctors, nor do we purport that DNPs will be. Patients who see nurse practitioners will tell you the difference and express their satisfaction with nurse practitioners, who have a different approach to managing patients while using the same evidence-based standards of care used by physicians. Nurse practitioners will continue to provide person-centered, high-quality care to the patients we serve. Doctoral education will enhance our already important clinical contributions. "I agree with you that Dr. Colatonio doesn't really represent anyone but himself. However, nobody has stated that Dr. Mundinger's group does not represent DNPs. The only comment by a NP organization (NONPF) to the WSJ article essentially affirmed her position. Given the fractitious nature of NP certification, there is no reason that the abcc will go away. Instead either the abcc will become the voice of DNPs (and with passage of time NPs) or other competing voices will develop. It really is indicative of not only the lack of a clear voice but also a lack of planning by leaders in nursing education. While its true that originally the certification came after the educational program, the fact that no NP group has done even the most basic of planning has allowed a group with a specific agenda to hijack the process.
If I considered this a competition ie between PAs and NPs I would be happy. Unfortunately the more likely outcome is that some very talented NPs will become casualties along the way.
David Carpenter, PA-C
Joanne Pohl, Ph.D. APRN, BC, FAAN
National Organization of Nurse Practitioner Faculties
Ann Arbor, Mich.
Dr. Pohl's first sentence is clear, and quite different from Dr. Mundinger's Colombia's position. To suggest a lack of planning isn't very fair, the planning may not be overt, how do you know there has been "no basic planning"? NONPF has many gifted members, nursing as a whole usually plans everything to death. The problem is often we have too many plans.
Lets continue the analogy with Dr. Colatonio. What major MD organization has said he does not represent MDs?
I am giving credit to the major MD organizations, they are considering their responses. With time outliers disappear, simply a blip that needs to be disregarded. With healthcare changing so rapidly, with Socialized medicine being discussed with increasing potential, nobody should be blackballing anybody.
- 0Apr 14, '08 by juan de la cruz GuideQuote from core0I see nowhere in the press releases, even the ones that quote Dr. Mundinger herself, that independent specialty care is being sought after by the DNP movement including the one ABCC is proposing. This is another way rumors are being spread out to scare physicians and confuse them on the issues. NP's in primary care have already been able to establish independent practice in some states even before the advent of the DNP. Admitting priviledges and the ability to consult specialty physicians (as the Wall Street Journal article mentions) is a primary care role. There is nothing this DNP certification business by ABCC is adding to the mix other than the fact that this new certification program is totally ignoring the other advanced practice nursing groups and does not take into account the fact that there are various NP specializations and some are not in primary care or cover all age groups.They are supportive now but how supportive are they going to be when a board member of a certifying agency for NPs is saying that NPs should have all the priveleges of physician including independent practice and specialty practice. The experience of the CRNAs should show that the support can rapidly dry up when directly challenged.
David Carpenter, PA-C
If primary care in the FNP model is the goal of ABCC's DNP certification, then more power to them. We need more primary care providers who will go to areas where physicians refuse to be present. We need a comprehensive health care provider who will be cost effective and will do the job just as good as the physician. I challenge any physician to speak up and say that they disagree with this proposal. Many physicians where I work have said for the record that family practice can be dealt with just as well by a non-physician provider.
We NP's in acute care should not feel threatened in my opinion. We are not going to be casualties as you have mentioned. I have not come across any NP who works in an acute care setting or a specialty practice who is not part of a physician-NP collaboration model. These relationships have been established for a long time. I don't see our physician collaborators being swayed otherwise and turning against us just because of political issues like this. We care for our patients enough that fracturing that relationship is not worth it.
- 0Apr 15, '08 by LTNurseI don't understand the big issue about the DNP because it's the best thing I have heard in years which will add further credibility to the profession. DNP's aren't and will never be MD's but I do feel that for a profession such as NP it's important to have a Doctors degree. Many other professions such as Pharmacy adopted the Doctors degree as a requirement and it wasn't a big deal. Why does it have to be a problem for NP's? I eventually hope to get a DNP and I feel very proud to be a part of such a pioneering initiative. I read a comment at another site that DNP isn't a four year degree and it isn't if a person already has a MSN because they take it into account the years spent to complete the MSN but if starting out with a BSN it's in fact a four year degree just like medical students who go to school for four years after their BS. I'm not comparing NP's to MD's; I’m just trying to validate the degree.
There will always be people who don't agree with this degree or many other things, for example I just recently heard an MD at the break room saying that DO's get to do too much and they shouldn’t because they weren't MD's. Isn't this absurd? As far as I know DO's are physicians just like MD's (again I'm not comparing MD's and DO's to NP's; I'm just trying to make a point that there are always people who will disagree). Anyways I hope you get my point.
- 0What would happen if a NP or any other mid level did the 2 years of medical curriculum med students do? If all practitioners had that base, maybe there wouldn't be the big strife there is now. All that would be different would be the clinical rotations. Maybe NP school could do 2 years of med school curriculum and 1 year of nursing stuff, and the last year a residency.
- 1Apr 18, '08 by traumaRUs AdminNo offense jzzy88 but the first two years of med school are not the same type of education that that is provided to APNs. The whole concept is that advanced practice NURSES are not wanting to by PHYSICIANS. If I had wanted to be a physician, I would have gone to med school. As it is, I wanted to be a nurse, so I went to nursing school. There is no strife between nurses and physicians unless folks are looking to make trouble. Physicians and nurses do different jobs and TOGETHER they contribute to the total care of the patient.
- 2Apr 18, '08 by juan de la cruz GuideQuote from jzzy88I have another idea, let's call that program medical school.What would happen if a NP or any other mid level did the 2 years of medical curriculum med students do? If all practitioners had that base, maybe there wouldn't be the big strife there is now. All that would be different would be the clinical rotations. Maybe NP school could do 2 years of med school curriculum and 1 year of nursing stuff, and the last year a residency.
- 0I've heard from other APNs on this site that they think NPs are "practicing medicine". I don't know what practicing medicine and don't know enough about nursing to know what practicing nursing is either. I do know that pathophysiology, pharmacology, physical assessment skills are taught in both nursing and medical school. Two years of med school go into depth with anatomy, physio, patho, and pharm. That is really quite generic to me and I think that nursing school tries to provide some of that in their nursing curriculum, just a different blend. What I am suggesting is that NPs could delve just as deep into the medical science part of health care and also learn how to apply those skills as a nurse. The idea that nursing and medicine are two totally different fields, that practicing nursing is only that, and practicing medicine is only that, is a misconception. The lines are often blurred.
- 1Apr 18, '08 by traumaRUs Adminjzzy88 - again - can you give me a source for this info? I've been a nurse for well over 16 years and been an APN for 2 years now - the sciences of medicine and nursing ARE different. Maybe I'm not understanding what you are saying. This conflict that you are discussing just isn't found often in the real world of medicine and nursing. In all this time being a nurse, I really haven't come across much strife.
- 0What I'm referring to is the anatomy, physiology, pathophysiology, pharmacology, part of bio-medical science. The anatomy doesn't change because it's taught in a nursing school, right? It may be less involved, but it's the same stuff. The pathophysiology of HIV does not change because it's taught at a nursing school or a medical school, it's still the mechanism of HIV infection. Medical schools go deeper into the biochemistry of the disease process than nursing schools go into. That's the difference though is depth. If nursing schools went into more depth with the pathophysiology, or even as much depth, it would be the same stuff, exactly. I don't know if that makes things clearer or not. Thanks for all of your thoughts and response to my posts.