PMFB misspoke above. The DNP is most certainly a terminal professional degree. I know this because I
hold one, lol. I am a FNP in independent practice. My scope is determined by the state and is independent of the DNP. MSN NP providers here are also independent providers. Our (all NPs) scope of practice is equal to physicians, as is our base pay and bonus structure here (in our company). They way the salary structure is set up is a bit complicated to explain. The physicians do make a tad bit more, but they do because their residency is considered (rightly so) experience. A "new" medical doctor having completed a residency has 3 or 4 years experience. That puts them on the second tier of the salary schedule. A new NP doesn't have that and starts out on the first tier. In 3 years, that same MD/DO is still on the 2nd tier, and the NP moves up, and then they are earning the same base. Depending upon who earns more bonuses, it is possible for the NP then to 'out earn' the physician. Also, different specialties have different bases. Family practice does not earn the same base as dermatology, obviously. I can bonus my little heart out, I am never going to out earn the dermatologists, no matter how many doctorates I have.
In this state FNPs are not restricted to primary care and many of my colleagues do work as hospitalists or as acute in-patient providers. All of the above is a luxury of location, location, location, lol. It would not be different for me, at this time,
if I held the MSN instead. As I do hold a doctorate degree, I am eligible to run for office within my company after 5 years of service. I have zero interest in doing so, but providers with masters degrees are ineligible. There is money involved there, as much as an additional $75k a year depending upon the position, which may be a motivator to some. I feel I work enough hours as it is. I don't need what amounts to another part-time job, lol.
I understand some DNPs are not APNs, but I have never met one personally that is not a NP, CRNA or CNM. I am a Duke DNP graduate; of the 20 students in my class, all 20 were APNs, but quite a few were dual faculty/providers. I have a number of classmates who have secured tenure track positions at top tier schools
with their DNP. I do not know how many Universities are doing so, but I believe we are beyond the tipping point and so if you have an interest in academia, it should prove helpful to you. Back in the day when I was in nursing administration, it was my MBA that was believed valuable. I think those are a dime a dozen now. I am really not 'in the know' about what the current capitol is in nursing administration land. Having been through a DNP program, I do not see it's applicability to administration myself, so I can see why people hoping to use the degree to parlay to a hospital administration career are frustrated. It seems like a poor choice; probably a degree in health care administration would have been more pragmatic. In any event, while versatile, it is (IMO) best suited to those with some active clinical practice.
Your question, specifically, is how does it differ from the MD. The easy answer is that MD is a Doctor of Medicine and a DNP is a Doctor of Nursing. The honest answer is complex. The best way to answer the question I think
you are really asking: what is the difference in day to day practice? Answer: it depends. It depends where you are. Where I am, no difference at all. We are completely interchangeable. In, say, Alabama? A world
of difference. I've never been to Alabama, but from what I have read, a DNP and $5 will buy you a latte. The role and scope of a APN are determined by the state practice act, not the degree.
I think that is the most frequently misunderstood aspect.
If you are trying to choose a path for yourself, there are many variables to consider. I don't think one is a better career path than the other, but I do see good rationale for different people to choose one or the other in differing circumstances. I think you have to ask yourself what it is that you want to be doing, where and when you envision yourself doing it, and what obstacles are you aware of at the present time that have to be planned for immediately? What resources do you have? Those answers would frame the way I would make my initial choices.
I love my DNP. It is the smartest thing I ever did educationally speaking, and I feel tremendously enriched by the experience. I know I
am a better NP because of the experience than I would have been without it, and I know that I am a better business person as well. Since I am running my own practice inside a consortium, this has been critically important. I am also an innovator and taking that leap, sticking my neck out there and doing something "outside the box," so radically different from what all of my colleagues do, especially as a new NP, is not something I would be confident enough to have attempted without the experience provided by my DNP work. I also had some extremely valuable experiences in school that prepared me for my current passion, which had me in front of my state legislature speaking about my innovation, it's successes (and failures) and advocating for it's implementation on a wider level. How many NPs with 3 years experience are primed to do that? Some perhaps, but lets be frank, not a lot. My DNP education equipped me and inspired me. I firmly believe I got an outstanding educational experience that has prepared me to do great things for my patients and community. I strongly recommend every NP consider it.
The DNP is controversial, and maybe it is not for everyone. It is not "fluff" (that characterization would be offensive if it were not so steeped in ignorance); it is both vastly more rigorous and rewarding than you could anticipate. The naysayers are correct in that it is not necessary
for competent advanced practice, but IMO it is ideal for the actualization of the individual NP, as well as the profession as a whole. Good luck to you!