MD, DO, NP, DC, OD -- Who deserves the title Physician? - page 5

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  1. by   HeartsOpenWide
    Quote from mav80
    2.5 gpa, 65 college credit hours? Those are the bare minimum requirements any prospective optometry student need to even be considered for admission. The average gpa to get into optometry school is a 3.3 (same gpa to get into DO school) with a 330 out of 400 on their entrance exam (almost the same test pre-dental students take). Nearly 90% of all optometry students have a 4 year degree or higher. You are looking at 8 years of college to become an optometrist.

    .
    One could argue the same fore the RN..."Only a 2.5 GPA is required to get in. Only an ASN is required (in some state they do not even have to have a degree at all, just a diploma). Licensing? One test only a few hours long. These people can assess, write nursing DX, administer all forms of medication from narcotics to chemo, they can inject, give blood, and so much more; all with out even having to have a degree in some states, a ASN at minimum in most. An ASN???? Even a Bachelors degree is a dime a dozen these days!"
  2. by   FoodForThought
    Just some thoughts: ODs CAN prescribe medications in all 50 states (even narcotics, which the last time I checked NPs couldn't do in all 50 states ;0), most have college degrees (and at the very least have to have numerous pre-req courses including two semesters of gen chem and two semesters of organic chemistry, calculus, statistics, at least a year of biology, etc), and nobody in their right mind sees a chiropractor for anything other than back issues (even then it's iffy, you'd be better off seeing a DO that actively utilizes OMM in their practice).

    Also, the NP scope of responsibility is not larger than that of an MD/DO, OD, DDS/DMD, or DPM. All of them, in all 50 states, are solely responsible for their medical decisions because they have no other official oversight on their day-to-day medical decisions while in many states, NPs have a physician that bears the bulk of any mistakes they make. Particularly for MDs/DOs, this translates into high malpractice insurance rates, while NPs face relatively low rates. If you want autonomy and equality, in all 50 states, pay the same rates.

    Additionally, what are the pass-rates on the optional, experimental DNP certification exam that is loosely-based on the USMLE Step 3 exam (minimal overlap between the two exams includes stuff both SHOULD know while the bulk is stuff specific to each profession) taken by and must be passed by ALL MDs? Somewhere in the ballpark of 50% in 2008 and in 2009, an impressive 57% (American Board of Comprehensive Care FAQs). That seems to demonstrate that the "wet-behind-the-ears" MDs are more competent for their role than the "wet-behind-the-ears" DNPs that were bold enough to take the exam are for theirs.

    I don't believe that all "physicians" as recognized by the U.S. government are competent, nor do I believe that all advanced-practice nurses are incompetent, however I do believe a number of the arguments presented in this article are ludicrous at best.
    Last edit by FoodForThought on Oct 9, '10
  3. by   Ellen NP
    Not all physicians pass the USMLE exams on the first attempt and I am uncertain as to what the pass rate presented really represents.

    I am NOT a supporter of the current DNP as an entry level for NP's. I do not believe that the curricula which I have seen adds to clinical expertise.

    I am an NP. I don't pretend to be a physician or that my education is equivalent to that of a physician. I am, however, well-educated, experienced, and competent in my specialty. I, like the resident and attending physicians with whom I work, call consultants from other specialties because they have expertise that we do not. They, on the other hand, call US when they need our expertise. Our Psychiatry Consultation Liaison Service is comprised of 3 NP's and 2 MD's. Together we serve a busy academic medical center. We consult each other on a regular basis. Our patients and those consulting us are well served by all of us precisely because we respect each other's education and experience as well as that of our consultees.

    I do not understand the continuing need for the different disciplines to argue and degrade each other. We have overlapping as well as unique skills. We need each other and our patients need us to work together. Let's look at what we do that works and try to to optimize our education and working relationships.
  4. by   Ellen NP
    I completely agree with you. Osteopathic and allopathic medical school curricula are virtually indistinguishable with the exception that osteopathic physcians are also trained in OMM and, in general, seem to be more wholistic in their approach. All the residency programs in our academic, major medical center accept both MD and DO education.
  5. by   Boatswain2PA
    Quote from Ellen NP
    I do not understand the continuing need for the different disciplines to argue and degrade each other. We have overlapping as well as unique skills. We need each other and our patients need us to work together. Let's look at what we do that works and try to to optimize our education and working relationships.
    Ellen - there are arguements because people disagree. Maybe you don't consider a DNP calling him/herself a "Doctor" enough of a problem to instigate an argument from you...but let me give you an analagous scenario which likely would: What if a LPN/LVN, who has roughly one-quarter of your education, decided she should be called a nurse practitioner because she is, indeed, practicing nursing? Or, what if a CNA decided he/she should be called a nurse because, well, they are performing nursing duties??

    The role of the nurse practitioner is of vital importance to our healthcare system. But the captain of the healthcare team is, and should be, a (real) DOCTOR. For anyone other than a Physician to present themselves as a Doctor in a healthcare setting is wrong.
  6. by   elkpark
    Quote from Boatswain2PA
    Ellen - there are arguements because people disagree. Maybe you don't consider a DNP calling him/herself a "Doctor" enough of a problem to instigate an argument from you...but let me give you an analagous scenario which likely would: What if a LPN/LVN, who has roughly one-quarter of your education, decided she should be called a nurse practitioner because she is, indeed, practicing nursing? Or, what if a CNA decided he/she should be called a nurse because, well, they are performing nursing duties??

    The role of the nurse practitioner is of vital importance to our healthcare system. But the captain of the healthcare team is, and should be, a (real) DOCTOR. For anyone other than a Physician to present themselves as a Doctor in a healthcare setting is wrong.
    "Doctor" is a honorific for anyone who has earned a doctoral degree, not a job description. None of this would be an issue if physicians hadn't decided long ago that they own the exclusive rights to the term "doctor," which they do not, in healthcare settings or anywhere else. Your "analagous scenario" is not analagous because, in this case, we are discussing groups of people who have all earned doctoral degrees. You are comparing that to people simply choosing to call themselves a title they haven't earned.

    I've worked for decades in mental health settings (inpatient and outpatient) in which psychologists have introduced themselves as "I'm Dr. XYZ, the psychologist," without anyone, including the clients, being confused about the situation and who was what, and without anyone, including the physicians, suggesting that that was inappropriate or problematic. I fail to see how the situation with doctorally-prepared NPs is any different.
  7. by   Boatswain2PA
    For hundreds of years sick or injured patients have sought the care of a "doctor". This is not because physicians have inappropriately claimed sole use of the moniker, it is because patients GAVE it to them. Yes, there are some other professions who somewhat muddy the water - psychologists, optometrists, podiatrists, chiropractors, etc....but those practitioners don't generally find themselves in the position of walking into a patient's room in a MEDICAL clinic/ED/ICU/etc and inroducing themselves as Doctor. If a pt goes to the "eye doctor" they know s/he's not a "real doctor". Same with a chiro...they're not a "real doctor" either and the lay person knows it.

    Now, there are not many formal restrictions on using the term "Doctor" in these settings (yet!!), so DNPs can introduce themselves to patients as Doctor Smith if they want. The same goes with the janitor who has a PhD in creative writing. With the exception of a few places this is legal. Fortunately, in these same places it is legal for everyone else in the room to openly laugh at you if you choose to do so.

    Oh, and one more thought on the "honorific" title that some DNPs all-of-a-sudden want to use. For those of you who think it is appropriate to introduce yourself as "Doctor Smith, Nurse Practitioner" to patients...why didn't they introduce themselves as "Master Smith, Nurse Practitioner" before they got their doctorates?

    Maybe that "honorific" thing doesn't have anything to do with it. Maybe you just want the stature of being called Doctor in a medical setting without earning it?
  8. by   zenman
    Quote from elkpark
    I've worked for decades in mental health settings (inpatient and outpatient) in which psychologists have introduced themselves as "I'm Dr. XYZ, the psychologist," without anyone, including the clients, being confused about the situation and who was what, and without anyone, including the physicians, suggesting that that was inappropriate or problematic. I fail to see how the situation with doctorally-prepared NPs is any different.
    Same for me, and in physical medicine and rehab and never a problem. A physician has earned a clinical doctorate, some say not a real doctorate as they mostly have no formal research training other than mentorship, at least all the ones I've asked.
  9. by   Ellen NP
    I don't have a problem with a doctorally prepared NP, PT, RPH, whatever being called "doctor". I would have a problem with them being called, "physician." If CNA, LPN, RN calls themselves, "NP," and they are not an NP, that is illegal just as it is if I call myself a physician. I realize that people seem to think that, "doctor," is synonomous with,"physician," and that no one else should be addressed as such. Tell that to all the other doctorally prepared individuals who have earned their degrees.

    We need to educate our patients regarding our roles and titles. PT, OT, RPH, etc. are all moving to doctoral preparation for entry level practice. More room for confusion, more need for clarification and education. If someone calls me, " DR. A", I correct them. If they call me a PA, I correct them. That said, I doubt that I would use the title of,'doctor,' if I did complete a doctoral program. I introduce myself by my full name and explain that I am the NP from Psychiatry.
  10. by   Boatswain2PA
    Quote from Ellen NP
    I don't have a problem with a doctorally prepared NP, PT, RPH, whatever being called "doctor". ...............................More room for confusion, more need for clarification and education. If someone calls me, " DR. A", I correct them. If they call me a PA, I correct them. That said, I doubt that I would use the title of,'doctor,' if I did complete a doctoral program. I introduce myself by my full name and explain that I am the NP from Psychiatry.
    I don't have a big problem with it either. Most people need some humor injected into their everyday life. If a nurse wants to introduce themselves as a "doctor" it gives the rest of us a reason to laugh.

    Your last paragraph is perfect. If someone earns a doctorate it is quite an achievement, but that achievement shouldn't be used to confuse patients just to stoke their ego.
  11. by   caligirl79
    I realize the need for recognition; however, no matter what area of healthcare you choose to practice in, each area has value. And anyone that decides to take on the role of "healthcare provider" needs make it a point to continue learning - and that includes from each other. If you ever find yourself thinking that you know more than the person that's standing next to you (whether MD, DO, DC, PharmD, RN, NP, RT, etc.) it might be time for a change in your professional life. I'm just saying...

    (pride and conceit do not belong in healthcare!!!)

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