Which Level? Extending What?

Specialties NP

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Specializes in Neurology, Psychiatry.

Numerous positions posted in Michigan (and elsewhere) titled "Mid Level provider" and "physician extender." First of all, who would actually be confident and proud to post a position looking for a mid level provider? After earning a DNP and gaining experience in various areas, of you would like an advanced practitioner, then yes I would consider it. Advertising that you need and employ mid level providers sounds to consumers as if they're "going to get what's provided and from this clinician that's only MID level care." Who's considered the low level providers? Second, I'm not a physician extender, I'm a nurse. I'm not extending any physician practices. I practice nursing and I'm extending my skills and knowledge to treat you. Now I'm assuming that phrase may be commonly applied to physician assistants, which still delineates the knowledge and skills they're applying to treat patients because they are extending their attending's practices. Any thoughts??

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Specializes in Outpatient Psychiatry.

Idk. I think it's semantics. We have midlevel training. I'd say a nurse is low level and a boarded physician is high level. The DNP has no nexus with clinical training so that's an irrelevant resume addition.

I see the physician extender problem. One, it makes me think of erections. Two, I don't have a physician in my region so I'm not doing anything with a physician. Basically, if a job will leave me completely alone and pay me over 150,000 I'm in.

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Specializes in Neurology, Psychiatry.

I think it's ridiculous. I'm curious to find out where it even originated. Once again physicians want to emphasize the fact they are "supervising" when really in the majority of my experiences they were barely collaborating. When I think back to working neuroICU during the dreaded month of July and having my 3 years of experience, I innocently taught new residents simple hands on patient care techniques. And the nerve to call us midlevel. But in all honesty in the psych world I've never had any issues with psychiatrists we've worked very well together. My FNP and ACNP friends have differing views.

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Specializes in Internal Medicine, Geriatric Medicine.

I dislike the terms mid-level provider and physician extender for advance practice nurses. My practice is my own. I am independently licensed as an RN and as an NP. I am also Dr. K. In NYS, I do not need a collaboration agreement because I am post the 3600 hour collaborative requirement.

Physician assistants were designed just for that, so arguably they could be "mid-level" providers and "physician extenders". They are strictly medicine, whereas advance practice nurses are nursing who in many cases straddle the line into medicine. I always tell people my grounding is as a nurse, which forms the foundation for how I practice medicine.

I don't claim to know everything. I also don't think an MD or DO (or PA) can claim to know everything. Healthcare is too diverse. I appreciate and love good collaboration. I don't collaborate well with anyone who assumes that I need my hand held because I don't have MD or DO after my name.

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I never hear physician extender ever. Midlevel is used in my setting only to describe a group but not an individual. The medical Director may say we expect to hire 4 mid-levels. However, I have never been referred to a patient or other provider as a mid-level, they will introduce me as NP or simply provider. I think of it more as a category and not a slight.

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Specializes in acute care, critical care, surgery.

I work in a hospital where we have NPs and PAs on the same team/ service. When we are referred to as a group, we are called midlevels. As in, "we will be hiring a surgery midlevel" or "please call the midlevel on call". Individually, we are introduced as Diane Doe, NP or Jim Jones, PA. Its just used as a collective term here. I realize that may always be the case.

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Specializes in Family Nurse Practitioner.

I could care less what anyone calls me. There are far more important things to attempt to change especially with the current climate where anyone who pays the tuition can start calling themselves "Dr." without any actual nursing experience.

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Specializes in Outpatient Psychiatry.
I dislike the terms mid-level provider and physician extender for advance practice nurses. My practice is my own. I am independently licensed as an RN and as an NP. I am also Dr. K. In NYS, I do not need a collaboration agreement because I am post the 3600 hour collaborative requirement.

Physician assistants were designed just for that, so arguably they could be "mid-level" providers and "physician extenders". They are strictly medicine, whereas advance practice nurses are nursing who in many cases straddle the line into medicine. I always tell people my grounding is as a nurse, which forms the foundation for how I practice medicine.

I don't claim to know everything. I also don't think an MD or DO (or PA) can claim to know everything. Healthcare is too diverse. I appreciate and love good collaboration. I don't collaborate well with anyone who assumes that I need my hand held because I don't have MD or DO after my name.

Now, now. Let's not go throwing the PAs under the bus.

I'm not sure anything about what I get paid to has any connection to nursing outside of words printed on miscellaneous certificates.

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Specializes in Neurology, Psychiatry.

Most programs allow this to happen to show their large cohorts and acceptance/graduation from the program to boost their recognition and reputation. As far as those who wish to use 'Dr.' in all actuality they have earned it. I don't prefer to use it because it does not determine my ability to provide care. But realistically if someone were to obtain a DMA (doctor of musical arts) then he can use Dr. as well to exhibit is expertise in that area. It is what it is.

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Specializes in Outpatient Psychiatry.
Most programs allow this to happen to show their large cohorts and acceptance/graduation from the program to boost their recognition and reputation. As far as those who wish to use 'Dr.' in all actuality they have earned it. I don't prefer to use it because it does not determine my ability to provide care. But realistically if someone were to obtain a DMA (doctor of musical arts) then he can use Dr. as well to exhibit is expertise in that area. It is what it is.

I agree. Anyone with earned doctorate is Dr if they do choose. If I were a general, you bet I'd introduce myself as General Guy.

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Specializes in Family Nurse Practitioner.
I agree. Anyone with earned doctorate is Dr if they do choose. If I were a general, you bet I'd introduce myself as General Guy.

Maybe kind of sort of. In the hospital where I work it is frowned upon for anyone other than a real doctor, my words, MD to introduce as Dr. So and So. My guess is at some point there will be a policy on it but for now there are just random eyerolls.

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Specializes in Outpatient Psychiatry.
Maybe kind of sort of. In the hospital where I work it is frowned upon for anyone other than a real doctor, my words, MD to introduce as Dr. So and So. My guess is at some point there will be a policy on it but for now there are just random eyerolls.

Do you ever work with FMGs who go by Dr but have never earned a doctorate? A lot of these foreign guys still have bachelors in medicine and surgery. I think calling them Dr is retarded.

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