"Why didn't you go to medical school?"

[shannonFNP]

Sorry for the provocative title :)

I'm mostly curious what your responses are when a patient asks you:

• "Why did you become an NP instead of a doctor?"
  
• & "What's the difference between a NP and a MD?"
  

During my clinical rotations (which are now COMPLETE!! Just waiting for that diploma), I've answered these questions ad nauseum to patients who were interested in my training. After giving a clever, premeditated answer that is both thorough and informative, it is still followed up by, "so you were an RN and now will be a nurse practitioner soon: are you going to go to medical school next?" & "what's the difference?" DOH!

Maybe my response isn't as clear as I'd like. Or maybe I'm just fighting the good fight against misinformation of NPs and it's just going to take more time. Either way, I'd love to hear how you respond to these questions!

[PatMac10,RN, RN]

Perhaps but it doesn't seem demeaning to me. I wouldn't take offense to it, as if it were a derogatory term. It seems like more of an umbrella term for providers like NPs and PAs. I've heard the term when talking with plenty of NPs and not one of them said anything negative about it.[/quote']

I don't see the "offense" in it either, personally. To each his/her own though.

[Annaiya, NP]

I don't see the "offense" in it either, personally. To each his/her own though.

The offense is in the fact that it tries to create a hierarchy among the roles when there should be none. Every member of the health care team is important and the structure needs to reflect a team environment, not a top-down environment. Just as BostonFNP said, by using the term mid-levels, it implies there are high-levels and low-levels. Considering that puts nursing as either mid or low-levels it is demeaning to the profession. We all know the importance of the role of nurses, we certainly should not be thought of as low-levels!

[PatMac10,RN, RN]

The offense is in the fact that it tries to create a hierarchy among the roles when there should be none. Every member of the health care team is important and the structure needs to reflect a team environment, not a top-down environment. Just as BostonFNP said, by using the term mid-levels, it implies there are high-levels and low-levels. Considering that puts nursing as either mid or low-levels it is demeaning to the profession. We all know the importance of the role of nurses, we certainly should not be thought of as low-levels!

What you say makes sense. It's just that its never been viewed that way, by me, or many I know and work with, that way. The best thing to call NP are Nurse Practitioners, what they are or providers.

[BritFNP]

Unfortunately, people know what a PA is and I've answered this way.

[Ms Lee Diu]

We need to all be careful with the way we word things. I understand that you take pride in offering patient-centered care, but making statements like "I want to be a NP and not a MD/PA because I care about more than just the condition and I want to care for the patient's entire well-being" has the implication that MDs do not care for the entire patient. That kind of a sweeping blanket statement is really not fair. I have worked with many MDs who are very empathetic and caring providers, and I've worked with NPs who are not. Its not a characteristic that is limited to one profession, but rather it depends on the individual provider deciding to practice empathetically.

What's more, it does not reflect the medical community well when we give reasons that put our fellow professionals down. I say keep it positive and leave out the jabs. Simply changing the phrase to "I chose NP because its a profession that allows me to be an empathetic provider" effectively communicates your message without bringing others down. Thoughts?

[PatMac10,RN, RN]

We need to all be careful with the way we word things. I understand that you take pride in offering patient-centered care, but making statements like "I want to be a NP and not a MD/PA because I care about more than just the condition and I want to care for the patient's entire well-being" has the implication that MDs do not care for the entire patient. That kind of a sweeping blanket statement is really not fair. I have worked with many MDs who are very empathetic and caring providers, and I've worked with NPs who are not. Its not a characteristic that is limited to one profession, but rather it depends on the individual provider deciding to practice empathetically.

What's more, it does not reflect the medical community well when we give reasons that put our fellow professionals down. I say keep it positive and leave out the jabs. Simply changing the phrase to "I chose NP because its a profession that allows me to be an empathetic provider" effectively communicates your message without bringing others down. Thoughts?

Good point.

[BostonFNP, APRN]

We need to all be careful with the way we word things. I understand that you take pride in offering patient-centered care, but making statements like "I want to be a NP and not a MD/PA because I care about more than just the condition and I want to care for the patient's entire well-being" has the implication that MDs do not care for the entire patient. That kind of a sweeping blanket statement is really not fair. I have worked with many MDs who are very empathetic and caring providers, and I've worked with NPs who are not. Its not a characteristic that is limited to one profession, but rather it depends on the individual provider deciding to practice empathetically.

What's more, it does not reflect the medical community well when we give reasons that put our fellow professionals down. I say keep it positive and leave out the jabs. Simply changing the phrase to "I chose NP because its a profession that allows me to be an empathetic provider" effectively communicates your message without bringing others down. Thoughts?

Doesn't that imply other providers are not empathetic in the same manner?

[Ms Lee Diu]

I guess in my mind it doesn't imply that. It is "a" profession that allows empathetic practice, not "the"(one and only) profession that allows it.

But, I am certainly not that great with the English language, so there could be a better way of saying it. Either way, I hope the main point I was trying to convey was clear.

[traumaRUs, MSN, APRN]

In the 7 + yrs I've been an APN, I've only been asked once why APN versus MD and it was at a medical board meeting for credentialing at a small community hospital. The Chief Medical Officer asked me why I didn't become an MD? I replied that there was little future for a 50 y/o med student! (and yes...I did get credentialed - lol)

As to mid-level provider - this is what our practice refers to us (PAs, FNPs, and me a CNS). I certainly prefer it over physician extender which sounds nasty!

[CountyRat]

The offense is in the fact that it tries to create a hierarchy among the roles when there should be none.

Thank you for sharing your point of view, Annaiya, you make some good points. I do have a different point of view about hierarchies in medicine. From where I look at it, there is a hierarchy in medicine, and for good reason. I do not think that medicine is a democratic, egalitarian institution; but rather, a meritocracy in which authority is granted on the basis of knowledge and experience. If that is true, doctors are at the top of the hierarchy because they have more education and training than other healthcare providers.

However, I think that your main point was that all of us occupy positions of importance and, ideally, work as a team in which every team member's contribution is valued, and every team member is shown respect, and I certainly agree with you on that.

Just the view from where I sit.