DNP & MD :What's the Difference?

Nurses General Nursing

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PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Not sure what you mean by this. Anyone who holds a doctorate in nursing has earned the highest degree you can take in nursing, which is the definition of "terminal degree," and they are certainly prepared for the "particular profession" of nursing, the same as someone who has earned an MD is prepared to practice medicine. Specialization or advanced practice nursing doesn't really enter into the question.

(However, I'm certainly not defending on-line proprietary nursing programs -- I think they make us all look bad ...)

*** But the DNP did not prepare them for a particular profession in the way the MD does physicians. These were already professional nurses before they went back to get their DNP. A person can not be a physician in the USA without a MD or DO degree (for the purposes of this discusion I am going to ignore the BMBS and other degrees earned by physicians in other countries) thus making the MD a terminal professional degree. An staff RN who earns a DNP that doesn't prepare him for a different profession (like NP or CRNA or CNM) doesn't seem to me to be a terminnal professional degree. I accept if I am incorrect but it sure doesn't seem right to me.

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NRSKarenRN, BSN, RN

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DNP= Doctorate in Nursing Practice--concentration can vary from Nurse Practitioner, Administration, Nurse Anesthesia, Nursing Education.

The DNP is designed for nurses seeking a terminal degree in nursing practice and offers an alternative to research-focused doctoral programs. DNP-prepared nurses will be well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNSc and other research-focused nursing doctorates.

The title of Doctor is common to many disciplines and is not the domain of any one health profession. Many APRNs currently hold doctoral degrees and are addressed as doctors, which is similar to how clinical psychologists, dentists, podiatrists, and other experts are addressed. Like other providers, DNPs would be expected to display their credentials to insure that patients understand their preparation as a nursing provider.

https://www.aacn.nche.edu/dnp/talking-points

Details visit:

The Essentials of Doctoral Education for Advanced Nursing Practice

I. Scientific Underpinnings for Practice 8

II. Organizational and Systems Leadership for Quality Improvement and Systems Thinking 9

III. Clinical Scholarship and Analytical Methods for Evidence-Based Practice 11

IV. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care 12

V. Health Care Policy for Advocacy in Health Care 13

VI. Interprofessional Collaboration for Improving Patient and Population Health Outcomes 14

VII. Clinical Prevention and Population Health for Improving the Nation's Health 15

VIII. Advanced Nursing Practice

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!

Thanks for your response Blue Devil as I was hoping someone who held a DNP would respond. I have quite a few milestones to overcome in my career (as well as my own personal milestones) before I become a DNP. Some of my professors are also DNPs and often times discuss their level of independence, one also works in private practice or own her own clinic (cannot remember). Right now my motivation to move towards the DNP is my own inner knowing that I will at some point become bored, want more of a challenge, and seek greater advancement opportunities.

What you've shared here helped a lot and is inspiring.

Specializes in FNP, ONP.

I think the bottom line is that when you earn your DNP, you will be able to do/be whatever you want. And the real advantage is you have time to real do some self discovery and decide what that is. The opportunities will be endless: practice, writing, research, teaching, informatics, advising, policy, politics/advocacy, you name it. I don't think there will be anything you can not do. In part because that level of achievement speaks for itself and opens doors. Additionally, there is a tremendous amount of professional networking that occurs at this level. There are so few doctorally prepared nurses, sometimes it seems as if we almost all know each other, at least by name, lol. Every time I go to a conference and meet people at the little wine and cheese shindigs, or chat them up at the informal poster presentations, I always recognize some names from the journals and the whitepapers, always! It is just a small, small world. I hope to meet you at one of the shindigs one of these days. Keep at it, you'll get there!

Regards,

B.D.

I think the bottom line is that when you earn your DNP, you will be able to do/be whatever you want. And the real advantage is you have time to real do some self discovery and decide what that is. The opportunities will be endless: practice, writing, research, teaching, informatics, advising, policy, politics/advocacy, you name it. I don't think there will be anything you can not do. In part because that level of achievement speaks for itself and opens doors. Additionally, there is a tremendous amount of professional networking that occurs at this level. There are so few doctorally prepared nurses, sometimes it seems as if we almost all know each other, at least by name, lol. Every time I go to a conference and meet people at the little wine and cheese shindigs, or chat them up at the informal poster presentations, I always recognize some names from the journals and the whitepapers, always! It is just a small, small world. I hope to meet you at one of the shindigs one of these days. Keep at it, you'll get there!

Regards,

B.D.

lol Thank you, Doctor. :)

elkpark

14,633 Posts

Some of my professors are also DNPs and often times discuss their level of independence, one also works in private practice or own her own clinic (cannot remember).

Please note that, as of now, as far as I know (and someone please correct me if I'm wrong -- I never want to be giving out bad info), there is no state in the US where a DNP-prepared NP (or CRNA, CNM, or CNS) has greater independence or scope of practice than a Master's-prepared individual in the same role. There are plenty of Master's-prepared NPs who own and operate their own practices.

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

The DNP is controversial, and maybe it is not for everyone. QUOTE]

*** I honestly do not think the DNP is controversial. What I see as controversial is the the notion held by some influencial groups and people that DNP should be required for entry into advanced nurse practice.

rnagy

1 Post

Please nobody else comment unless you are willing to bet your life on what you are talking about. I am so sick of the confusion over what a DNP is from the outside world let alone this nonsense coming from those (claiming to be) "nurses!" How embarrassing!

Thank you BlueDevil for being the only one on this thread with any credibility to speak on behalf of this topic

elkpark

14,633 Posts

Please nobody else comment unless you are willing to bet your life on what you are talking about. I am so sick of the confusion over what a DNP is from the outside world let alone this nonsense coming from those (claiming to be) "nurses!" How embarrassing!

Thank you BlueDevil for being the only one on this thread with any credibility to speak on behalf of this topic

Did you happen to notice this was a nearly five year old thread? (Until you bumped it, that is ...)

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