Nurses Masquerading As Doctors (INSULTING)

[djaychris]

The growing shortage of medical doctors, which will be made much worse by health care reform, will mean more and more patients are cared for entirely by "nurse specialists" and nurse practitioners, instead of physicians. Nurses are lobbying for increased prescribing privileges and for the right to be addressed as "doctor" in health care settings.

(link removed - the page is no longer available)

What do you guys think about this idiot, and the ignorant nonsense he is blabbering over on fox news? Kind of insulting to those of us who have spent years pursuing advanced degrees such as CNP, and often save lives and clean up messes made by arrogant, egotistical physicians...

[Susie2310]

I am not trolling, I am legitimately asking these questions, here is the reason why.

I recently volunteered to be part of a Community Outreach and Streamline Committee. Figured I could get some extra pay and a little glimpse on how business is conducted. I was present in a presentation in regards to the Hospitals Finances and where most of the expenditures and productivity are coming from. The biggest "waste" of resources (money) comes from the ER. The majority of pts we serve are in the lower end of the socioeconomic spectrum. Our state's reimbursement of procedures and services for these pts always ends up less than the actual cost, therefore for every pt that comes in with state coverage, we lose money. It is always a net loss, so now we are figuring out ways to mitigate hospital loss.

Now a few changes were implemented recently to decrease the amount of people using ER "resources". One of them was "Call ahead waiting", where the pt can reserve a spot in ER by calling ahead of time. Yes, I understand that if you can wait to be seated in ER then how sick are you really. Now the problem is many of our community use the ER as their primary care facility. So how do we "re-allocate" expenditures so as to increase productivity.

The Urgent Care Clinic we have can handle most of these pts. The problem is a lack of awareness and education coupled with long standing cultural belief. We do not have enough physicians to man the clinic and hospital. The reason behind this is that our hospital terminated a contract with a medical group covering the clinic mainly due to retainer fees and a few other things. Now we started staffing the clinic with NPs, most of them are masters prepared. I know them personally since they were coworkers in ICU that transitioned.

In theory the problem should have been solved. The problem now is that there has been an extreme decline of visits by these types of pts to the clinic. One reason is that the word has spread that the MDs servicing the clinic are gone. The pt population lost confidence in the kind of care they would receive and started going to the ER en-mass. The reason why they chose the ER is because they know there is always atleast 1 physician on duty.

So how do we fix this problem? One idea was re-branding. There is precedence for non-PhD staff to be called "Doctor". This precedence is set in Academia, where lecture instructors can have a MAsters Degree and still be referred to as "Doctor" due to their position. In short we apply a two prong approach.

The first proposal is The facility writes policy authorizing calling NPs?PAs with Masters Degrees "Doctor" in the Urgent Care setting or facility wide. The idea is word gets out that "Doctors" are now back in the urgent care clinic. Use of guerrilla marketing was mentioned at this point. Apparently if the people feel that the word came from witin their community they are more apt to believe the news. In theory pts would return back to the clinic instead of the ER. This is the short term fix.

The second proposal is to begin an aggressive community outreach education program to educate the targeted pt demographics in regards to what an NP can do. Educating the pt population in regards to their care not changing much now that NPs/PAs are the PCPs. This is the long term fix.

The reason why being called "Doctor" is important to the hospitals targeted pt demographics is a matter of culture. People grew up in the old country seeing a "Doctor", pts feel more comfortable with a "Doctor" in charge of their care. We sent out surveys in regards to pt satisfaction, and results were that people did not like having a "Nurse" in charge of their care. Compiled data from mail in surveys, in person polling and pt complaint records have shown a lack of confidence.

Now I log onto AN and see this article. I was wondering if anyone else has seen this implemented and how is it panning out. The proposed measures would also save the hospital money because instead of paying a medical group to cover services, you can now pay NPs instead. Since the NPs will be employees of the hospital, the hospital will also save money again by not having to pay retainer fees.

Every time the hospital can make or save money on something, they tend to try annd implement it even if on a trial basis.

Part of the plan feels like a lie, to change policy to call someone something they are not feels wrong to me. Re-Branding a title to make it sound more pleasing to target demographics, it makes me feel uneasy about it. It kind of makes me feel a little slimy.

But I guess this is how the Business of Healthcare is done. It has been an eye opening experience.

The general public are not stupid. Once you lose trust, you lose confidence, and then what's left? Trust and confidence are earned, take a long time to build, are easily lost, and are very hard, if not impossible, to regain.

[BeachsideRN, ASN]

A masters degree teacher I academia is typically referred to as "professor" I have never seen a non-PhD instructor call themselves or ask to be called Dr. I've been to many schools and have worked in academia myself.

[BostonFNP, APRN]

Seems to me that podiatrists, psychologists, opticians, and chiropractors (who are doctorate-prepared) use the title in clinical practice without too much patient confusion.

[OCNRN63, RN]

It seems to me that your facility could get into trouble for presenting these individuals as "Drs." when they do not have a doctoral degree or a degree that confers the title "Dr." This sort of dissimulation is unethical.

[PMFB-RN, RN]

Part of the plan feels like a lie, to change policy to call someone something they are not feels wrong to me. Re-Branding a title to make it sound more pleasing to target demographics, it makes me feel uneasy about it. It kind of makes me feel a little slimy.

But I guess this is how the Business of Healthcare is done. It has been an eye opening experience.

Wow, you work for a terrible facility! We very seldom read of something so obviously unethical talked about so openly.

BTW there is no precedent for teaching staff who do not hold doctorates to be called "Doctor" in academia.

[toomuchbaloney]

So let me get this straight; the community doesn't trust the facility, so the well paid executives of the facility have decided that in order to regain the trust of the community they will lie to them.

right

I wonder how big that person's bonus will be this year?

[AOx1]

A masters degree teacher I academia is typically referred to as "professor" I have never seen a non-PhD instructor call themselves or ask to be called Dr. I've been to many schools and have worked in academia myself.

This is the case at every school I have attended or taught for.

[kalevra, BSN, RN]

I wonder how big that person's bonus will be this year?

If this gamble works, I imagine a director will be getting a sizeable bonus. However, I don't think their bonus will even come close to what the CEO makes.

For now it is a wait and see.

[kalevra, BSN, RN]

The general public are not stupid. Once you lose trust, you lose confidence, and then what's left? Trust and confidence are earned, take a long time to build, are easily lost, and are very hard, if not impossible, to regain.

My facility is not the only one in town. However, it is the only one that the target demographics able to "afford". The state reimbursement program many are enrolled in are not accepted by the other facilities.

My understanding is, we are literally the only game in town for these demographics. It is also my understanding that based on convenience, we are located in the heart of the "Iron Triangle" so we get many homeless etc coming in. The other facilities are in the outskirts of town or in suburban like neighborhoods.

Aggressive marketing campaigns can really sway public opinion. I would not be surprised if this works. Just going to wait and see, Ill try and keep this updated.

[kalevra, BSN, RN]

Wow, you work for a terrible facility! We very seldom read of something so obviously unethical talked about so openly.

BTW there is no precedent for teaching staff who do not hold doctorates to be called "Doctor" in academia.

Lol, yeah its not the greatest place to work. The pay is high but at a very high cost in terms of staff satisfaction. That is why I am exploring other avenues. This is a segway into the business side of things.

The more I look at the trends, the more I see the bedside staff getting the short end of the stick. I don't want to be on the losing side of the war. I have to do what I feel is best for me and my family. Coming home after a 12 hour shift, back hurting, and tired is not how I want to spend the rest of my 20 years.

As for ethics, read/watch enough news and I have some to the conclusion that business wins almost all the time. The

[PMFB-RN, RN]

Lol, yeah its not the greatest place to work. The pay is high but at a very high cost in terms of staff satisfaction. That is why I am exploring other avenues. This is a segway into the business side of things.

The more I look at the trends, the more I see the bedside staff getting the short end of the stick. I don't want to be on the losing side of the war. I have to do what I feel is best for me and my family. Coming home after a 12 hour shift, back hurting, and tired is not how I want to spend the rest of my 20 years.

As for ethics, read/watch enough news and I have some to the conclusion that business wins almost all the time. The

Ya you are right. However there are some checks and balances. In most cases the little guy gets screwed. However with such a blatantly unethical strategy the hospital is really hanging it's butt on the line. One news reporter is all it would take to create a huge scandal.