Consumer Reports Article - What Do You Think?

[Dodongo, APRN, NP]

Will You See an Actual Doctor the Next Time You Go to the Doctor?

It used to be so simple: You made an appointment with a doctor and would almost certainly see an M.D., someone who spent four years in medical school and then had at least three years of additional training, usually in a hospital.

But today you're likely to encounter a veritable alphabet soup of healthcare degrees: D.O., P.A., N.P., R.N., and N.D., to name a few. Who are all these people? What training do they have? Which one is best for you? And where's your good old M.D., anyway? (See our guide to healthcare providers, below.)

The truth is, you may not always need a traditional physician-and may have a difficult time finding one. The U.S. is short on doctors, especially those practicing primary care, who typically earn less than specialists. We now have fewer primary care physicians per person than many other developed nations. Canada, for example, has 1.2 per 1,000 people; the U.S., just 0.3.

[Oldmahubbard]

The article, overall, is OK, but it does perpetuate the myth that NPs only should handle the simple and non complicated cases.

As an experienced Psych NP, I can assure you that it isn't the case in my field. Not even close.

Thankfully I have had several decent MDs who have mentored me over the years.

However, most of the very few psychiatrists in my area are foreign.

We have had a cohort of old foreign male psychiatrists, who are slowly dying off.

They have universally had real deficits, either in their demeanor, work ethic, knowledge of English or overall medical competence. Or all of the above.

Having interacted with some of them, they seem to have little interest in psychiatry, and some have had very little knowledge.

I know people that prescribe risperdal no matter what the problem.

To be fair, the pay level for this area of medicine, 200k or a bit more, is not suited to people who have 3k student loan payments.

Still, it is hard to grasp that some psychiatrists go through residency and don't learn anything.

They can't diagnose the simplest thing and can't tell when they are being manipulated by malingerers who are trying to get SSDI.

They hear the pt say " I hear voices" and out comes the prescription pad for the risperdal and the SSDI paperwork. No questions asked.

You suck.

[LibraSunCNM, BSN, MSN, CNM]

I thought some info was a little strange---to me, mentioning DOs in the same paragraph as NDs makes DOs seem a lot more "alternative" than they really are, I personally view them as interchangeable with MDs. And as the above poster mentioned, it does imply that NPs only work in primary care with common health problems. But overall, any article that mentions advanced practice nurses in a generally positive light is cool with me.

[GoodNP]

An oversimplification, but not bad on the whole.

[umbdude, MSN, APRN]

I thought it was strange to include RNs. RNs do not operate anywhere near the scope of NPs and PAs.

[BostonFNP, APRN]

Great post thanks for sharing.

I actually thought the article was a pretty good one. Some things are oversimplified but in general I agreed with everything that was said.

We have some posters here who would cringe to read "But is seeing one of them as good as seeing a medical doctor? In most cases, yes, says Ateev Mehrotra, M.D., an associate professor of healthcare policy at Harvard Medical School."!

[Dodongo, APRN, NP]

I agree with the majority of the points made in the article. I just have an issue with how they try and present common vs complicated health problems. An unexplained fever that has lasted for a few weeks. That's a problem that can absolutely be handled by an NP. Or multiple complex diagnosis. How many NPs, both inpatient and out, manage patients with multiple comorbidities on multiple medications. It's just not that simple. Expect a physician if you think you have a complicated problem - an NP is fine if you think your problem isn't a big deal. Patients don't know.

And the comments section kills me. Haha.

[BostonFNP, APRN]

I agree with the majority of the points made in the article. I just have an issue with how they try and present common vs complicated health problems. An unexplained fever that has lasted for a few weeks. That's a problem that can absolutely be handled by an NP. Or multiple complex diagnosis. How many NPs, both inpatient and out, manage patients with multiple comorbidities on multiple medications. It's just not that simple. Expect a physician if you think you have a complicated problem - an NP is fine if you think your problem isn't a big deal. Patients don't know.

And the comments section kills me. Haha.

The sentiment to the layperson is the same though, they neglect to mention if you have any unexplained/complex problem you would be referred to a specialist physician whether or not your PCP is a NPP or physician.

Comment sections are always the dregs of the Earth.