MD, DO, NP, DC, OD -- Who deserves the title PCP? - page 7

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   Lambert5883
    Quote from ep71
    i just fully read your post and i have to say you're way out of line. if you want all of the privileges of a dr., become one. i do understand your desire to be respected for being a competent professional but you chose the role you decided to lead and that's just the way things are. you're not a dr., and you shouldn't have the full privileges of one. no offense to the nurse practitioner profession but to give a nurse practitioner the same privileges as a pediatric neurosurgeon is simply absurd. that's basically what you're asking for. i understand that you want to have more responsibility as a primary care provider but the privileges that you're asking for extend much farther than those of your current profession. you're asking to be put on the same playing field as a cardiologist, internist, pediatric oncologist, cardiothoracic surgeon and all of the other medical specialist that perform the duties that you are requesting. it's simply out of the question.
    you need to read carefully what the poster is stating. the poster is specifically noting the similarities in scope of practice between pcp's and np's, not surgeons and sub specialists. i wholeheartedly agree with the poster's sentiments.
  2. by   cgfnp
    Quote from cgfnp
    Don't worry about all the computer crap. To make these forums fun you have to realize that everyone who posts regularly and is serious instead of using it for fun is only taking advantage of the depersonalization and perceived anomynity of it, so they're saying on here what they really wouldn't say in real life. Most are just spouting off to make themselves feel better for whatever they are. Just find it amuzing as I do and go about your day.

    If you get into this stuff seriously, it's only gonna piss you off because that's mostly what people who come to these things try to do. It could be a great source of networking and info, but for the most part, they're battlefields for pissing matches. Have fun!!!
    Wow that's terrific early morning spelling... :chuckle
  3. by   Lambert5883
    What is it to practice within the Nursing/Medicine/PA Model? If anyone can elaborate in detail, as one previous poster had suggested, it would be quite welcomed.
  4. by   Danielle4
    Quote from kristinwiz
    While I assume that your comments truly are not meant to propegate the "nurses above all others mentality", this has indeed become the result of your post. I am a new member, and frankly, shocked by the ego that pervades some of these forums. Any shrink will tell you that those who brag the most are those who have the most insecurity issues. Those who are secure in their profession and abilities don't seek out the (perceived) faults in others. You have much free time to look up inaccurate information regarding other professions.

    You state that chiropractors don't have bachelor's degrees? They absolutely DO have a bachelors, and then at least four & FIVE years of graduate study before their degree is conferred. Note, I am not a chiropractor.

    You also state that there is little difference between NPs and MDs/DOs. Can you be serious? The fact that they are physicians and NPs are not should be enough to clarify this misstatement. Why try to inflate our own egos with names and titles and labels? If we are insecure, we need to go to medical school and EARN the title that physicians have spent 12 + years (and hundreds of thousands of dollars) of their lives to achieve. Until we have met that challenge ourselves, we have limited room to point fingers. Even the newbie intern is still a DOC. Yes, they may have a long road to travel to reach true competency, but how proficent were you as a student nurse? Did you not have questions, make mistakes, and defer to your supervisor when you were in trouble? Did you never make a medication error in your early years? "those who live in glass houses...."

    I also notice that nowhere in your list of "the enemy" do you even mention your clinician counterparts, the PAs. Nor do you refer to them as equal to NPs in any sense. You must realize that NPs and PAs function in essentially the same capacity. Except for the fact that PAs are trained similar to physicians in their model of medical education. They practice medicine, while NPs practice advanced nursing - not medicine. How can anyone who practices nursing, not medicine, have any claims to be comparable to a physician? This point can't be argued, because NPs have created their own Nursing Board to regulate their practice, claiming that doctors cannot/should not regulate nursing practice. If you want to start claiming to practice medicine, you had better start answering to your state's medical board instead. In my opinion, the creation of your state nursing boards was brilliant! What better way to refuse to be regulated by physicians then by claiming to refute the practice of medicine while embracing that of advanced nursing? It is only because of your nursing boards that NPs have any of the priviledges they enjoy today. Rx and Dx rights certainly would NEVER have been granted to you by the state medical boards, you realize.

    You can't have it both ways - either you practice medicine or you practice nursing. Keep up the claim that you practice medicine and see how fast the state medical boards react....you would be wise to not s&^% where you eat!

    Most jobs are even advertised for both NP/PA because they are essentially similar professions - MidLevel Practitioners, Primary Care Providers, whatever name you ascribe to them doesn't really matter. It's the care that is provided which SHOULD be the concern of all practitioners.

    We would do well to join forces with those whose goals match our own. Think about joining the American College of Clinicians.
    Thank you Kristinwiz. I agree with you completely!
  5. by   bethm
    [quote=ep71]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.[/quote/]

    perhaps you should research your stance before you start bashing the nursing profession. not only are nps as safe and effective as primary care physicians, they receive better ratings from the patient opinion questionares.
    as reported in the journal of the american medical association, after one year, no significant differences were found in the health status or health services utilization of patients in the two study groups. phase ii of the study, conducted under this rwjf grant, built on the original project by collecting additional data to see if the findings were maintained over an additional year. the researchers conducted 756 interviews (with 439 np patients and 318 md patients from the original study) between april 1998 and december 1999, representing a 66.3% response rate. these interviews included questionnaires on health status, specific medical conditions, satisfaction, and health services utilization. the researchers validated health services utilization data with hospital data and some medicaid data. researchers found that patients who were assigned to nps were similar demographically to patients assigned to mds, and that in the year before this data collection, 33.3% of patients received care only at the assigned clinic; 6.3% received care at the assigned clinic and another provider; 27.1% only sought care elsewhere; and 32.4% did not seek primary health care at all. after the grant ended, the researchers also analyzed two sub-samples of patients who received primary care from the practices to which they were randomly assigned. the researchers concluded that the sub-sample analyses confirm the preliminary results: in an ambulatory care situation where nps have the same authority, responsibility, productivity, and administrative requirements as mds, patient outcomes are comparable.

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