[Hopefull2009]

Originally Posted by silas2642

Yep, I'm a first year med student. I'm going to have to stand by my position when I say that a nurse practitioner's clinical advice does not carry the same weight as an attending physicians. I say this not only as a med student, but as the family member of loved ones who have been through some serious illnesses and as a healthcare worker who has worked with PA's and NPs. Sorry if it hurts some egos, but it's true. You can't compare a physician's training with a nurse practitioner's-- the physician has far more rigorous training. As for all these studies that show that NP's provide equal or superior care vs. physicians, those studies have also been showed to be pretty flawed. If I recall correctly, the P value was enormous, the follow-up was for a very brief time, and the physicians they compared the NP's against were residents.

As for patients and their families being confused by the roles of the staff in the hospital-- I don't see how you guys don't get how this is a problem. God, I'm a med student and there are times where I have a hard time spotting the doctors from the nurses from the NP's from the techs. It can be hard when you have all these different people coming in, they're all wearing white coats, with stethoscopes in their pockets. Add to that nurses calling themselves doctors. But wait, "I'm a nurse too."

I have to hand it to Mary Mundinger and her crowd, though. Mid-levels have managed to break through into the world of medicine-- you are now able to practice the field of medicine independently in six years (you could probably do most of your education via the net too!), and be called "doctor" in the end, setting up your own practice with a watered down education. Bravo.

Silas, I hate to be the one to break this to you...but the term DOCTOR is NOT exclusive to physicians. Like another poster said, there are different types of doctors...Medical Doctors, Doctors of Philosophy, Doctors of Nursing Practice.

You had better believe that anyone that has earned this title by completing a doctorate level of education in their chosen field has the LEGAL right to use it.

If the AMA wants to exclusively use the term doctor, then why in the world have they not petitioned the states for this so-called right?

It's because that is NOT what the term doctor means. So when you graduate, in order to not confuse your patients, you need to introduce yourself as "Mr. Smith, and I'm a medical doctor"...just so they don't think you are only a PhD and full of fluff and theory.

However...when you finish your first year of med school...they'll be learn'in ya.

[HeyJude]

Silas,
Unless you have been to nursing school and medical school, is there any way to know which is more rigorous?

I cannot tell you how many times I have been right and a physician has been wrong. Do I rub it anyone's face? No, because that's not the point. But I have to wonder what kind of training residents are receiving when an OB/Gyn resident - a doctor - admitted to me that he did not know that milk ducts extended to the pectoral wall and into the armpit. THAT makes me pause.

Good luck. You are going to need it. And come back to us after a few pimping sessions.

[DutchgirlRN]

My husband had robotic surgery for Adneocarcinoma of the prostate a couple of weeks ago, at Vanderbilt no less.

The next morning the urology surgical resident (who had been in the OR) came in to examine my husband. I asked him where the urethral astamosis was. He looked at me like I was nuts. "The urethra wasn't cut". I didn't say a word. Later the surgeon came around and I asked him the same question. He said the astamosis was at the base of the bladder because they had taken the bladder neck for pathology. I thanked him and never mentioned the resident. I figured in good time he'll find out he was wrong

[silas2642]

All right, you win. I forgot that less education is more, and thus I bow to you oh knowing lords. I'm done now.

[mercyteapot]

Originally Posted by silas2642

All right, you win. I forgot that less education is more, and thus I bow to you oh knowing lords. I'm done now.

Well, good for you. That wasn't so hard now, was it?

[fluphenazine]

I think we have digressed a bit from the topic at hand.

NP training is not comparable to MD training, mainly because of enormous inconsistencies in the preparation of advanced practice nurses. One poster noted that we have four years of nursing school, two years of masters preparation and often considerable experience as RNs. I find that this traditional route is rarely the case. The trend seems to be towards students proceeding straight to graduate training. Even the two years of master's preparation, mostly due to its heavy emphasis on so-called nursing theory as opposed to actual practice, pales in comparison to the clinical training received by our MD counterparts. I doubt that the DNP will add anything meaningful, except for the illusion of more respect. The existence of online NP classes certainly does not help in inspiring confidence or garnering legitimacy. My own story illustrates the myriad, unstandardized ways in which one might become an APN. I have a bachelor's in economics and several years experience as a business consultant. I finished my MSN/NP (MH/Psych) in a three year program at UCSF. I feel confident in my skills, but some of my colleagues going into acute care felt quite unprepared. Let's defend our profession because we have a measurable, substantial impact on our patients. But let us also be honest.

My husband will begin his residency in Internal Medicine this July; and after sticking with him through medical school, I can say anecdotally that there is no comparison when it comes to the rigorousness of the MD curriculum -- both in demands on time and quality of content. (And we still have residency and fellowship to go!). Few nurses in their training will be subject to the intense experience of grueling weeks that are supposed to be capped at 80 hours but rarely are.

I think that when a DNP introduces herself as "Doctor" while in the clinical setting, there is of course a part of her that demands recognition for educational accomplishment. But at the same time, unconscious or not, there is a small egoistic desire to draw from the prestige of being called doctor -- a prestige that is there in large part because of the cultural value and expectations we have placed on the role of the physician, who for many in our country is synonymous with "doctor."

As for me, I am proud to introduce myself to each of my patients -- mouthful or not -- as Nurse Practitioner Fluphenazine.

[dhigbee]

What about Nurp Fluphenazine?

[n_g]

In the end, this is all about ego for the DNP who wants to call herself "doctor". Because the ones who think that the DNP will make them equivalent to physicians are living in fantasyland. Let's all thank Mundinger for wasting two more years of our lives.

[DutchgirlRN]

Originally Posted by n_g

In the end, this is all about ego for the DNP who wants to call herself "doctor". Because the ones who think that the DNP will make them equivalent to physicians are living in fantasyland. Let's all thank Mundinger for wasting two more years of our lives.

I don't know whose end you're referring to but it draws no conclusion for me. I think that's an unfair statement.

[dhigbee]

You know, I plan to keep doing my job (which I do very well), without too much concern over a couple trolls of questionable understanding and/or background telling me I'm no good, or at least "not as good" as a Medical Deity. As a FNP, I happen to be married to a family practice physician, who was often amazed at the depth and difficulty of my training. He's one of my biggest fans.

This is not a game, or a competition. It's definitely not the democratic primary, so the smears are not necessary. It's about working together to do the best we can to provide high quality care to patients that need it.

Dana