Physician Hostility - page 5

Why are so many physicians threatened and hostile toward NPs? What are the strategies in dealing with these types of professionals,and in what ways can we make it easier to practice together?... Read More

  1. by   gwenith
    please once again a reminder to debate the topic not the person. focus on the issues and not your fellow members. please also remember this is a public access board and information posted here is available to a wide range of people. please, please be very careful when posting names.


    now i have to second fergus's point we have a terrible time trying to get medical personnel out to rural and remote areas despite big incentives from the goverment which is one reason why we are going to np's here. we do not have pa's at all. if a patient comes in with something beyond the scope of the rn/np we ship them out either by flying doctor or medivac.
  2. by   zenman
    Aloha gwenith! Fair-go, mate! She'll be apples! Don't send the divvy van after us! Well, got to go walkabout to Border's Books.
  3. by   Hellllllo Nurse
    Quote from MD Terminator
    You're my HERO!
    I hunted an hour for that article. Googling isn't my strong strength, ya know

    :kiss YOU ROCK!

    -Dave
    Right back at ya', Dave! :kiss

    Another point I'd like to make is that physician's assistants are just what the title indicates: assistants to physicians.

    Nurse Practitioners are Nurses who "practice a learned profession."*

    Nursing is a very seperate profession from medicine. Of course, Nursing and medicine do overlap in some areas. However, an NP is a practitioner:. A PA is an assistant.







    *The noun "practitioner" has 1 sense in WordNet.

    1. practitioner, practician -- (someone who practices a learned profession)
  4. by   Tenesma
    isn't this debate getting old for you guys??? PA vs NP... yawn...

    what blows me away is this striving for complete autonomy!!! do i believe that most PAs/NPs can take care of most basic issues? SURE!!! and they are fantastic at it!!! and the patients love them... but when there is a problem who do they turn to?

    I ran into such a situation tonight... There are several PAs/NPs, who are pushing for more autonomy, who got a patient in the cardiac step down unit with a dysfunctional LVAD --- the pts Systolic BP=55 and he was cold, clammy, diaphoretic. They were trying to tell me what to do (i was on card. anesth. call) and in the end they were just hoping I could fix everything for them, because that was the extent of their training. How can you ask for autonomy in the field you are specializing in, when you can't manage things that deviate from "norm"???

    it still boggles my mind... i felt like saying: here is your opportunity to be autonomous!!! but i just did what i always end up doing... I took over the care...
  5. by   PA-C, DO
    We agree Tenesma
  6. by   fergus51
    Well, congrats for you. I guess that one story shows that NPs should not be autonomous. Of course, when those stories come out about other docs, they're just individual stories right?
  7. by   Roland
    Were either of the NP's Acute care certified and had they had recent ACLS training?, Had they been trained with ventricular assist devices? In addition, you should consider that most of the arguments for greater autonomy are in the context of primary, ambulatory NOT acute care settings. I think it is also true that NP's would consider well meaning criticisms for increasing the length, and or nature of their training in order to facilitate a level of education that would make doctors more secure. However, short of medical school I don't think that most M.D.'s will have much advice to offer in this area. Finally, keep in mind my argument which argued that significant cost savings can in certain cases justify a lower level of competence (and greater morbidity and mortality rates as a result of that situation, not that I actually concede that this situation exists, rather I'm arguing that EVEN if it did there are circumstances where NP's would be the logical choice)

    Another compromise might consist of "limited oversight and review" of NP's that practiced independently. Under this scenario NP's would be responsible to an organization made up of NP's and MD's who would "evaluate" their patient care on a quarterly or even annual basis. NP's would be responsible for defending the care that they provided, and their rates of success and failure to provide good care would be compared with other NP's and M.D.'s in their area (and who treated similar types of clinical presentations).
  8. by   Dave ARNP
    You bring up a very good point about extending NP training.
    I think it merits another thread.

    I'll be making it, stat!

    -Dave

    Quote from Roland
    Were either of the NP's Acute care certified and had they had recent ACLS training?, Had they been trained with ventricular assist devices? In addition, you should consider that most of the arguments for greater autonomy are in the context of primary, ambulatory NOT acute care settings. I think it is also true that NP's would consider well meaning criticisms for increasing the length, and or nature of their training in order to facilitate a level of education that would make doctors more secure. However, short of medical school I don't think that most M.D.'s will have much advice to offer in this area. Finally, keep in mind my argument which argued that significant cost savings can in certain cases justify a lower level of competence (and greater morbidity and mortality rates as a result of that situation, not that I actually concede that this situation exists, rather I'm arguing that EVEN if it did there are circumstances where NP's would be the logical choice)

    Another compromise might consist of "limited oversight and review" of NP's that practiced independently. Under this scenario NP's would be responsible to an organization made up of NP's and MD's who would "evaluate" their patient care on a quarterly or even annual basis. NP's would be responsible for defending the care that they provided, and their rates of success and failure to provide good care would be compared with other NP's and M.D.'s in their area (and who treated similar types of clinical presentations).
  9. by   Tenesma
    i have no issue with autonomy (well - i don't have a say in it) but I truly feel that in an ambulatory setting NPs and PAs excel!!!! i agree that autonomy in the hospital/acute/critical setting is still not an option... but you would be surprised how many NPs and PAs (who i have very close friendships with) in those acute/critical settings still moan and argue for autonomy. that is what boggles my mind.
  10. by   EastCoast
    This is an interesting thread. However, what bothers me just a little is how we tend to classify everyone's potential and capabilty by what our personal feelings are or what we have 'seen' in practice and then generalize. I don't know how to explain what i truly want to say. In short I guess just because you are an NP doesn't mean you should or shouldn't seek autonomy. I also think it is awful when people who aren't NP's or for that matter even in nursing pass that judgement. On the other hand it goes without saying that your level of intelligence and ability to care for humans is what guides outstanding practice. Whether you are a MD or a DO...I don't really care. I hope you have the sense to know what you are doing. Whether you are an NP in a hospital or a private setting or both...the word NP signifies your licensure. Your practice and performance signify your ability.
    Thanks for letting me vent.
  11. by   LolaRN
    I just was at a site called studentdoctor network and there is a guy called macyver who is ranting about NP taking over the role of family practice and internal medicine doctors. He is something else and I don't think that I can stand to read his opinions anymore.Blah Blah blah
  12. by   LolaRN
    it is studentdoctor.net under family practice board
  13. by   Dave ARNP
    I know, it's a dark place isn't it.

    That thread was mentioned to me and I went over and looked at it.
    Seems that they're so scared of NP's at the moment, they need to come see where we hang out.

    They're really not worth our time.

    -Dave

    Quote from tjjs
    I just was at a site called studentdoctor network and there is a guy called macyver who is ranting about NP taking over the role of family practice and internal medicine doctors. He is something else and I don't think that I can stand to read his opinions anymore.Blah Blah blah

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