NP's are okay to see if you have a cold, BUT... - page 5

I want to become a nurse practitioner. At least, I'm pretty sure I do. I can't say with 100% certainty but it is definitely something I am interested in. I think I would like having my own clinic... Read More

  1. by   gauge14iv
    It is true that there are egos in every profession - I can say that I have worked with as many or more prima don/donna nurses, power hungry managers and geek tripping programmers as balloon head MD's.

    But then...Im not so sure that's as much ego as it is delusion LOL
  2. by   cjcsoon2bnp
    I'm a student studying to get his RN at a community college but eventually I hope to go on and get my Master's and become an Emergency Room NP or maybe a Family NP and open my own clinic I'm sure I have the least amount of experience or knowledge on here about the subject but I would like to add something.


    I don't think that anyone here is trying to say an NP = MD (or at least they shouldn't be) and I don't think that anyone is claiming that the level of medical knowledge is the same either (as long as your comparing practitioners with the same level of experience.) I think most of us know on this board that healthcare is so much more than just medical knowledge. I think the knowledge of nursing is also a huge part of healthcare that sometimes is underestimated by physicians. And we can all agree that nursing knowledge is something that a nurse practitioner has plenty of experience with. With those things in mind can we agree to disagree...


    The letters MD do not distinguish someone as some sort of demigod, physicians are human beings just like the rest of us and they are capable of mistakes (as are nurse practitioners.) You will find that there are some very good physicians who are all about their patients and providing the best care possible and you will find that there are physicians who aren't so great for one reason or another (their ego, lack of common sense etc.) But the same can be said about nurse practitioners, you will find some really great NP's who do justice to the profession and there will be some nurse practitioners that aren't what you would expect (with some of the same flaws that "bad" physicians have.) One thing I have noticed in many discussions on the scope of practice for nurse practitioners is that some people seem to make it a war of physicians (or physicians assistants, PA's) versus nurse practitioners and I don't think that's right. Physicians and Nurse Practitioners are part of a medical team, each with their own responsibilities and scope of practice, they work together to provide the best possible care for their patients while working off each others strengths. Suppose you have a physician and a nurse practitioner that work in a clinic together and while the nurse practitioner may ask the physician to consult on an irregular lab result or difficult diagnosis the physician might ask the nurse practitioner to assist with counseling the family of a patient with a particular diagnosis. It really shouldn't be a competition for who outranks who and who and so forth. Despite the disagreements in this discussion, I'm sure you will find that in many (any probably most) cases nurse practitioners and physicians are able to collaborate to provide the best care for their patients with little debate. I think that the future for nurse practitioners is a bright one because of our ever-growing need for highly trained and capable individuals in the healthcare field, especially in the area of nursing. I know that there is also debate among healthcare professions because some people believe that the scope of practice for nurse practitioners is “creeping into physician territory” (as some would put it) and they fear that in the future the problem will only be worse. But personally I think that with our healthcare system changing and evolving as it is, what’s required of nurses, nurse practitioners, physicians, physicians assistants and just about everybody else in the healthcare field will require evolving and more “out of the box” thinking. I’m sorry if I got a bit off topic. Feel free to comment.
  3. by   CrazyPremed
    Quote from StikyNoteRightr
    I'm a student studying to get his RN at a community college but eventually I hope to go on and get my Master's and become an Emergency Room NP or maybe a Family NP and open my own clinic I'm sure I have the least amount of experience or knowledge on here about the subject but I would like to add something.


    I don't think that anyone here is trying to say an NP = MD (or at least they shouldn't be) and I don't think that anyone is claiming that the level of medical knowledge is the same either (as long as your comparing practitioners with the same level of experience.) I think most of us know on this board that healthcare is so much more than just medical knowledge. I think the knowledge of nursing is also a huge part of healthcare that sometimes is underestimated by physicians. And we can all agree that nursing knowledge is something that a nurse practitioner has plenty of experience with. With those things in mind can we agree to disagree...


    The letters MD do not distinguish someone as some sort of demigod, physicians are human beings just like the rest of us and they are capable of mistakes (as are nurse practitioners.) You will find that there are some very good physicians who are all about their patients and providing the best care possible and you will find that there are physicians who aren't so great for one reason or another (their ego, lack of common sense etc.) But the same can be said about nurse practitioners, you will find some really great NP's who do justice to the profession and there will be some nurse practitioners that aren't what you would expect (with some of the same flaws that "bad" physicians have.) One thing I have noticed in many discussions on the scope of practice for nurse practitioners is that some people seem to make it a war of physicians (or physicians assistants, PA's) versus nurse practitioners and I don't think that's right. Physicians and Nurse Practitioners are part of a medical team, each with their own responsibilities and scope of practice, they work together to provide the best possible care for their patients while working off each others strengths. Suppose you have a physician and a nurse practitioner that work in a clinic together and while the nurse practitioner may ask the physician to consult on an irregular lab result or difficult diagnosis the physician might ask the nurse practitioner to assist with counseling the family of a patient with a particular diagnosis. It really shouldn't be a competition for who outranks who and who and so forth. Despite the disagreements in this discussion, I'm sure you will find that in many (any probably most) cases nurse practitioners and physicians are able to collaborate to provide the best care for their patients with little debate. I think that the future for nurse practitioners is a bright one because of our ever-growing need for highly trained and capable individuals in the healthcare field, especially in the area of nursing. I know that there is also debate among healthcare professions because some people believe that the scope of practice for nurse practitioners is "creeping into physician territory" (as some would put it) and they fear that in the future the problem will only be worse. But personally I think that with our healthcare system changing and evolving as it is, what's required of nurses, nurse practitioners, physicians, physicians assistants and just about everybody else in the healthcare field will require evolving and more "out of the box" thinking. I'm sorry if I got a bit off topic. Feel free to comment.
    Now THAT'S idealistic. Good post.

    CrazyPremed
  4. by   cjcsoon2bnp
    Quote from CrazyPremed
    Now THAT'S idealistic. Good post.

    CrazyPremed
    Does idealistic translate into nieve? Its ok if it does, I'm here to learn. I know that I don't have alot of experience in the field or anything but from the few nurse practitioners I've met they have said that they haven't had that many problems while working with physicians. I'm sure what I said was idealistic but I don't think it was too far fetched, of course there will be problems and some tension but I think that physicians and nurse practitioners can be grown up enough to that aside to best serve their patients.
  5. by   gauge14iv
    It is a great post - and while the situation as you describe it is ideal - it also is not unattainable or unrealistic. It all depends on the players who make up the team. People who set their egos aside on all levels and work well together to serve patients do a terrific job of exactly that.
  6. by   CrazyPremed
    Quote from StikyNoteRightr
    Does idealistic translate into nieve? Its ok if it does, I'm here to learn. I know that I don't have alot of experience in the field or anything but from the few nurse practitioners I've met they have said that they haven't had that many problems while working with physicians. I'm sure what I said was idealistic but I don't think it was too far fetched, of course there will be problems and some tension but I think that physicians and nurse practitioners can be grown up enough to that aside to best serve their patients.
    Your post represents the relationship that quite a few mid levels have with their physicians. As you read many of the posts, though, you will find that there can be a sort of 'turf war' between the two. For example, some NP's here work in clinics where their pt's don't ever see the collaborating physician. The docs just sign off on their charts, and make themselves available when needed. The NP's handle seeing pt's, diagnosing, ordering labs and consults - pretty much everything.

    I can understand where the tension comes from. When an NP is (in various situations) doing the many of the same things as a physician, but making $40,000-100,000 + less, or needs a physician to sign off on pt's that s/he never saw, tension is created. I think this is where most of it stems from. Is it justified? I'm still working on that answer. As you read the posts, and go through your training, you will have to make your own judgments.

    CrazyPremed
  7. by   gauge14iv
    Quote from CrazyPremed
    I can understand where the tension comes from. When an NP is (in various situations) doing the many of the same things as a physician, but making $40,000-100,000 + less, or needs a physician to sign off on pt's that s/he never saw, tension is created. I think this is where most of it stems from. Is it justified? I'm still working on that answer. As you read the posts, and go through your training, you will have to make your own judgments.

    CrazyPremed
    I'd say that tension is alleviated quite well by the additional money made by the physcian! Several scenarios - The NP services are billed by the MD and the MD pays the NP salary, percentage or some combination but he gets the rest; OR the NP hires and pays the MD to be the medical director or collaborator. It isn't a losing situation for physicians at all - a business savvy NP & MD can both profit from the addition of an NP to a practice. And an MD who want's to move away from practice can profit from the services he or she provides as medical director. There is very very good money in it for the doc.

    ETA: Some NP's resent the fact that they need a physician at all. Well in Texas, there are ways to not have one - open a rural health clinic in an underserved area.

    I see what you are saying about the tension, however, I think a lot of that is lack of knowledge and understanding of business tactics - not practice issues.
    Last edit by gauge14iv on Dec 2, '06
  8. by   bosch
    Hello group.
    As a PNP with 18 years experience I find the Minute Clinic and such centers an outrage to our profession. Both NPs and PAs. Look into the history. The current president was the CEO of Arby's.
    I just recently found out about these shops "cropping up" at the Walmart near you.
    I am a legal nurse consultant and would not be found treating patients in this arena.
    I just finished a busy day at the office--35 patients or more. The great thing is I had their medical records.
    We are kidding ourselves if we think that CEO's can run a clinic and understand the ins and outs of practice.
    It is not just colds that will be seen. And why don't they man them with interns or residents? HMMMM.
    Case in point--my fellow pediatrician saw a child for bug bites. Found enlarged liver and child had ALL. Now, if we need to see patients as fast as possible (why not do drive through strep tests) do you think things will be missed? Absolutley. We are not in the Starbucks or Walmart business.
    I feel we should stand up and refuse to be used by these corporations making money on our profession--and where will they be when that lawsuit arises??
    I am a busy and happy NP--glad for my education--and will NOT be bought out by Minute Clinics. And guess what, you can invest in their business. Anyone out there work for one?
    Just some of my thoughts. I welcome yours.

    Joanne
  9. by   mvanz9999
    Quote from MS, APRN, BC, FNP
    It would be nice if we could determine the quality of the healthcare we're getting just by looking at the credentials after the name but it's just not possible from my experience. It's better just to look at the providers name and then ask around.

    You sound like idealistic premed student. Don't worry, you'll learn.
    Indeed. The absolute hands down worst two doctors I ever had were both from Harvard Medical school. What I want in a doctor is someone who will LISTEN to my concerns, and not make judgements based on their training or assumptions about my apparent age or general health.
  10. by   gth
    After having so much trouble with my legs. A np is the only person who was able to realize my polio was comming back. She takes the extra time with patients. Being male but it does not bother me at all.
  11. by   General E. Speaking, RN
    I always book my gyn appts with the NP. As a matter of fact, I followed her to her new office... absolutely love her! Would like to see a NP in family practice but have yet to find one in the area.

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