Why are MD's preceptors?

mom2cka · Apr 14, 2013

I learned in a different way from each of my preceptors; I was with a pediatrician for my peds rotation, and an internal medicine physician for another rotation, and am with 2 NPs now. Sometimes, it's what's available and what you can find, and other times, it's purposeful. I wouldn't discount any opportunity you might have to learn.

TennesseeNP123 · Apr 14, 2013

I agree that I think if a physician has offered to precept, that's who you get....I had a majority of NPs as preceptors, and in my final clinical rotation, I was placed with an attending physician at the largest teaching hospital in my area...it was an incredible experience, and very interesting to see the differences in the nursing model and medical model....I also spent a lot of time working with residents and med students, which was really neat to see how they learn and do rotations, etc....

AlphaPig · Apr 14, 2013

I'm not discounting the learning opportunities - I guess I am seriously just wondering "why"? NP's never precept MDs, nurses don't precept RTs or pharmacists, NP's don't precept PA's. . .there is usually not crossover that is why I was curious why crossover was accepted for MD's precepting NP's especially since the medical model is different than nursing. Is it because there are not enough NP's to precept?

NJprisonrn · Apr 14, 2013

In my program we are allowed to be precepted by NPs and doctors, but not PAs (not sure why). It's usually based on who is available in your area. My current preceptor is an NP, but I also work with her collaborating MD sometimes. They basically do the same job, except the doc has more authority. It works out well for me, as I get the best of both worlds.

Sha-Sha RN · Apr 14, 2013

In my program they told us we can't be precepted by PAs because their role is different from NPs in that they are practitioners who are supervised by MDs vs NP who are independent practitioners. To me it makes sense to be precepted by an MD because as NPs we are learning the medical model and using it with a nursing model. Plus most doc function the same vs NPs have varying levels of autonomy, function & involvement. So some NPs in my experience work collaboratively with MDs and make decisions based on their knowledge and practice. However, there are other NPs who's practice hinges on the decisions made by docs, write orders and prescribe treatment based on what the doc. says. I've seen the latter more inpatient.

Trauma Columnist · Apr 14, 2013

Many NPs don't or cant precept due to job situation.

enoRN · Apr 17, 2013

Many NPs don't or cant precept due to job situation.

What do you mean by "job situation"????

BlueDevil,DNP, DNP, RN · Apr 18, 2013

I'm not trauma, but I wouldn't precept unless my practice could get paid for all the time it takes. I couldn't see as many patients and that is lost revenue. I have a responsibility to my partners and cannot unilaterally decide to cut my RVUs by 1/3 for 4 months while I precept a student.

I had MD and NP preceptors in school. I did work with a few PAs on the sly as well, lol. Say what you will about the whole "medical vs. nursing model" thing, but the MDs taught me something none of the NPs seemed to be very good at, and that is how to command control the visit. Many of the NPs that precepted me seemed to have a problem wrestling control of the visit away from patients, but I watched and learned how to do it without making patients feel disrespected. It may also have something to do with gender, but only to a small degree. Docs simply put up with less caca than NPs, which is probably why NPs are better liked by patients, we are 100x more likely to listen to them whine. I think I read someplace that the average MD will let a patient speak for 15 seconds before interrupting them, while the average NP will let a patient speak a full 2 minutes without interrupting. I have a clock, and when I get a rambler, I watch the second hand tick just like I did when I was a kid in elementary school. I give them 30-40 seconds, and then wrap it up. Hybrid training is advantageous.

The PAs taught me how to aspirate and inject joints like nobody's business, and I make mad bank with that little skill. It takes 5 minutes, tops, and pays out like you won the powerball compared to most of the other stuff we do in primary care, lol. I silently thank them from the bottom of my heart several times a week!