MD, DO, NP, DC, OD -- Who deserves the title PCP? - page 2

our professional scope of practice asserts that our role is to assess, diagnose, and treat in health and illness - head to toe, physical and behavioral. from assessing, diagnosing, treating -... Read More

  1. by   ayndim
    Quote from ep71
    What does that have to do with anything. I know what optometrists ophthalmologists and opticians are and do. Optometrists diagnose diseases of the eye. they treat diagnosed diseases of the eye. It only takes two years to be an Optician. it takes 8 yrs to be an optometrist. They are indeed Primary Care Physicians. I understand that NP's diagnose some illnesses and treat some diseases. but they are still nurses. I'm aware that optometrist don't attend medical school but they are Primary Care Physicians. You obviously don't know what an Optometrist actually does. An optician prescribes glasses, an Optometrist DIAGNOSES AND TREATS DISEASES of the eye. An Ophthalmologist performs surgery of the eye. What you see in wal-mart is not a true reflection of an Optometrist. They are indeed Physicians in every sense of the word. You can't just go to school for two years and go to Optometry School. You have to have a BS/BA degree. You have to take Medical School prerequisites. You have to be extremely competitive.
    B**LS**T optometrist are physicians. They serve a purpose but no way are they PCP. They can provide primary VISION care only. They can't treat my cold, give a pap or anything else! Optometrists may treat some eye disease but they are limited and this is not allowed in every state. NP's also have to have a BS plus experience. And it is also competitive. Many pharmacists have PharmD degrees just like optometrists have doctor of Optometry degrees but that does not make them a physician. My childrens godfather has a doctor of theology but no one would say he is a physician. No nurse is "just a nurse." And I do know what the difference is between the three. But you cannot be a physician in this country unless you attend MEDICAL (not optometry or chiropractic) school. And so what if you need a bs/ba to get into optometry school. You also need one to get into law school. And they get a Juris doctrate. But they are still not physicians.
  2. by   gwenith
    Reminder - NO personal attacks!!
  3. by   Kabin
    Hopefully my healthcare coverage is never so bad that I would need to rely on an optometrist to diagnose and treat potential eye diseases.

    Just to get back on the original topic, I think there is some validity to the argument that NPs should receive more recognition for the large responsibility and importance of the job.
  4. by   Kabin
    I went to the US Bureau of Labor Statistics website (http://www.bls.gov/oes/2003/may/oes290000.htm) and sure enough, there are no Nurse Practitioner statistics nor even an occupational listing. There is however a occupational listings for all the docs, including chiropracty and optometry. There are also occupational listings for PAs, RNs, LPNs, and surgical techs. Hey, even massage therapists have a US occupational listing with goverment statistics. For some strange reason, NPs are invisible to the US government. This seems like a valid issue that needs to be addressed.
  5. by   RN_Amy
    Quote from Kabin
    Hopefully my healthcare coverage is never so bad that I would need to rely on an optometrist to diagnose and treat potential eye diseases.

    Just to get back on the original topic, I think there is some validity to the argument that NPs should receive more recognition for the large responsibility and importance of the job.
    So you never want to "rely" (due to lack of money) on an optometrist wiith seemingly mediocre eduction/experience (ie. no medical degree) to diagnose and treat potential eye disease yet you would "rely" on a NP (who is also NOT a physician, no matter how much they want to) to diagnose and treat other medical problems and illnesses?

    I agree with ep71.... reeks of hypocrisy to me...
  6. by   RN_Amy
    Quote from ayndim
    A optometrist is not a MD and is NO WHERE CLOSE to being one. On the other hand NP's are skilled medical professionals. I see a NP and she can do most things, prescribe meds and order the same tests as a PCP can. When my infant was ill and in the ER he saw a NP. Don't kid yourself, chiropractors or optometrists are nowhere near an MD or a NP. :angryfire

    NP's have a BSN followed by a MSN. That is a minimum of six years of education. Plus, they have to have at least one years experience in nursing. And most schools want more than that.
    NP can prescribe meds and orders tests... MOST things... ie. most things a MD would normally do... because a NP is quasi-physician... to use the term " wannabe doctor" may be a little to close to the bone for a few reading this thread....

    And optometrists and chiropractors are no where near MD's and NP you say? I would like the opinions of the medical fraternity as to the rank of NP's... I'm sure they wouldn't be sitting up on the pedestal along side MD's where you have so inappropriately put them.... with 1 year of nursing experience and a non-medical masters degree....

    I have said it before... if you want to be a physician go to medical school... if not stop trying to be something your not...

    PS. I would be curious to know who would be first to jump up and down and instigate a law suit if any misdiagnoses occurred by a *shock horror* NP?
    Last edit by RN_Amy on May 8, '04
  7. by   Kabin
    Quote from RN_Amy
    So you never want to "rely" (due to lack of money) on an optometrist wiith seemingly mediocre eduction/experience (ie. no medical degree) to diagnose and treat potential eye disease yet you would "rely" on a NP (who is also NOT a physician, no matter how much they want to) to diagnose and treat other medical problems and illnesses?

    I agree with ep71.... reeks of hypocrisy to me...
    If you're confused about something I said, I'd recommend first asking a question rather than draw on a simplistic conclusion that suites your hidden agenda.
  8. by   RN_Amy
    Quote from Kabin
    If you're confused about something I said, I'd recommend first asking a question rather than draw on a simplistic conclusion that suites your hidden agenda.
    Okay then Kabin, how would describe you not wanting to "rely" on an optometrist who isn't medically trained yet put all faith in the medical ability of a NP... who doesn't have a medical degree?

    I don't have a hidden agenda, I am just trying to make some sense of some of your previous comments.
  9. by   zenman
    Posted by RN AMY: PS. I would be curious to know who would be first to jump up and down and instigate a law suit if any misdiagnoses occurred by a *shock horror* NP?
    Haven't NPs proven to be as safe and effective as MDs?
  10. by   Kabin
    Quote from RN_Amy
    how would describe you not wanting to "rely" on an optometrist who isn't medically trained yet put all faith in the medical ability of a NP...
    Once again you make simplistic assumptions... I have never stated I would "put all faith in the medical ability of a NP." In the future I won't be responding to your seemingly cynical hyperbole.

    As is with most Americans, I'm fortunate enough to have a primary care doc that I selected for my primary care needs. If there is any problem he makes the first call. If it is out of his area, such as an eye disease, I will be referred to an ophthalmologist. For my vision corrective needs, I go any optometrist I want. I do not seek vision disease needs by an optometrist.
    Last edit by Kabin on May 9, '04
  11. by   ep71
    Quote from zenman
    Haven't NPs proven to be as safe and effective as MDs?
    You can't compare the practice of a nursing specialty to the practice of Medicine. You can compare certain Nursing Specialties to Medical Specialties (Nurse Anesthetist to Anesthesiologist, NP to Primary care Physicians), but you can't compare one specialty of nursing to the whole entire profession of Medicine. That's what you're doing when you say, "Haven't NP's proven to be as safe and effective as MD's." MD is not one specialty, it's an entire profession. Just because you practice similarly to a medical specialist doesn't mean you should have the privileges of the entire profession.
    Last edit by ep71 on May 9, '04
  12. by   CardiacNP01
    It seems (to me anyway) that this discussion may have become more about the "status" and "recognition" versus quality of care. There are a couple of points I'd like to make.



    1.) I somewhat agree with the first post. However, as a nurse practitioner, I've never been caught up in the "recognition game" (for lack of a better term). I don't view NPs as being better or lesser qualified than any other health care provider. I do agree that it can be frustrating to have to acquire a physician's signature in order for certain services to be provided to the patient. Yet, it's only frustrating from the viewpoint that efficiency in providing care is compromised by unnecessary steps. For instance, to order supplemental oxygen (considered a medication) for a patient with severe COPD, a physician's signature is required. Yet, in most cases, the patient (often times with cardiomyopathy) should have been placed on O2 long ago. Many times it was an oversight by the physician who didn't take the time to order pulmonary function tests or even a SaO2 at rest and with exertion. This is only one example, which brings me to my next point.



    2. Regarding the issue of NPs acquiring expanded privileges and/or being considered "a wanna-be doctor", I suggest that much of the public (and many physicians) are grossly informed and/or unaware of the scope of practice of NPs. Additionally, far too many people "pigeon hole" a person based on their credentials and educational background. For example, let's say you have numerous comorbidities (i.e., cardiomyopathy, NIDDM, HTN, COPD, renal insufficiency, and major depression). You are given the choice of seeing a general practitioner versus a nurse practitioner within the same practice. Each person has roughly15 years of experience. The knee jerk reaction for those not very familiar with NPs would be to choose the physician simply because he has a degree in medicine. Yet, the fact remains that there are tens of thousands of physicians within this country who have been deemed grossly incompetent. I have manytimes corrected physicians who inadvertently prescribed potentially lethal medicines to patients. Additionally, I have many times discontinued and/or changed medicines and even cancelled potentially dangerous diagnostic tests because of their poor judgment. Thus, while there need to be certain standards, a "degree" certainly doesn't define the quality of care you will receive. With that, NPs should indeed share most of the same privileges of primary care physicians. Yet, they clearly should not have the same privileges as a surgeon, cardiologist, neurologist, etc. (and the first post didn't suggest they should either). However, an internist certainly should not be attempting to perform a cholecystectomy or even a cardiac catheterization.



    I've enjoyed the other posts. Great comments.
  13. by   gwenith
    The difference between Australian and American Health care delivery is no where more evident than between the roles of Nurse Practitioner and MD.

    See we don't need MD signature to order oxygen - so in some ways we the average nurse are more independent in our practice - however we don't have CRNA's or even very many NP - we certainly don't have FNP's.

    It is like comparing apples to oranges.

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