discussion regarding education of NP (DNP) and PA compared to MD/DO

physasst · Feb 9, 2009

I think that the DNP degree will decrease enrollment. By increasing academic standards, making the program longer, and therefore MORE expensive, you may dissuade many RN's from making the jump.

This, at a time, when a recent survey indicates that only 2% of current medical students plan on entering primary care. And I think that BOTH the PA and NP professions need to be looking at ways to INCREASE enrollment, and encourage practice in primary care.

I think that any nurses addressing themselves as doctor in the clinical setting is not only dangerous, but downright fraudulent. I have several friends who are PA's that have PhD degrees, not a SINGLE one of them would dare to entertain the thought of using that title on their name tags, or in the clinical setting. I will follow their example when I complete my degree.

I am a PA, and I am pursuing a doctoral degree in Health Policy, as I am also a fledgling policy wonk.

Dr. Tammy, FNP/GNP-C · Feb 10, 2009

I have several friends who are PA's that have PhD degrees, not a SINGLE one of them would dare to entertain the thought of using that title on their name tags, or in the clinical setting. .

Rightfully so as the PhD credential is not a clinical-based doctorate like the DNP or MD degree. Holding oneself out as a clinical doctor in a clinical setting with a research-based credential would be misleading, fraudulent and dangerous.

physasst · Feb 10, 2009

Rightfully so as the PhD credential is not a clinical-based doctorate like the DNP or MD degree. Holding oneself out as a clinical doctor in a clinical setting with a research-based credential would be misleading, fraudulent and dangerous.

Are you honestly trying to compare a DNP degree to an MD degree? Really?

That is the height of blatant arrogance. A DNP is NOT a clinical doctor, despite their feelings to the contrary.

I'll tell you what, if you are willing to take the physician board exams for whichever specialty you choose to practice in, and are willing to complete a 3-5 year residency, than perhaps I will change my mind. If you are willing to RE-board in those specialties, and are willing to be licensed by the state medical board, perhaps I will change my mind.

Until then, you have taken a very vaulable asset, the rural NP, and taken the profession down a VERY dangerous road.

Mike

PA-C, MPAS

Dr. Tammy, FNP/GNP-C · Feb 10, 2009

Are you honestly trying to compare a DNP degree to an MD degree? Really?
That is the height of blatant arrogance. A DNP is NOT a clinical doctor, despite their feelings to the contrary.
I'll tell you what, if you are willing to take the physician board exams for whichever specialty you choose to practice in, and are willing to complete a 3-5 year residency, than perhaps I will change my mind. If you are willing to RE-board in those specialties, and are willing to be licensed by the state medical board, perhaps I will change my mind.
Until then, you have taken a very vaulable asset, the rural NP, and taken the profession down a VERY dangerous road.
Mike
PA-C, MPAS

I know you are new here and have taken the initiative to make this a personal attack.

I will be as gentle as I can be in helping you understand reality. A doctor of nursing practice is a practice or clinical based degree just as a MD degree is a clinical or practice-based degree, just as a DDS is a practice or clinical-based degree, just as a OD is a clinical or practice-based degree, just as a DMD is a clinical or practice-based degree, just as a PharmD is a clinical or practice-based degree. A PhD, however, is a research based degree.

I have not compared the DNP to the MD degree anymore than I have compared the MD degree to the PharmD or OD to the DNP in that they are both clinical doctorate degrees.

Welcome to allnurses.

physasst · Feb 10, 2009

I know you are new here and have taken the initiative to make this a personal attack.
I will be as gentle as I can be in helping you understand reality. A doctor of nursing practice is a practice or clinical based degree just as a MD degree is a clinical or practice-based degree, just as a DDS is a practice or clinical-based degree, just as a OD is a clinical or practice-based degree, just as a DMD is a clinical or practice-based degree, just as a PharmD is a clinical or practice-based degree. A PhD, however, is a research based degree.
I have not compared the DNP to the MD degree anymore than I have compared the MD degree to the PharmD or OD to the DNP in that they are both clinical doctorate degrees.
Welcome to allnurses.

It was not a personal attack in the least. Your words compared a DNP to an MD. Not mine. PharmD is a doctorate, as is PT....none of them refer to themselves as doctor. Because of the practice similarities between an MD and NP, it will blur the line even further, which creates an additional unnecessary liability. Believe me, I have discussed this with the NP leadership ad nauseum, but as usual, reason escapes them. I understand that PhD is a research degree, completely understand that, and I also understand that many of my colleagues with MD and PhD degrees will tell you that the PhD was more difficult to complete.

I am a supervisor of the midlevel providers in my department, and our institution based on recommendations partly from me, have initiated a policy making it so that DNP's cannot use the title doctor at our institution. And I can assure you, that it will be a cold day in hell before I ever refer to an NP as a doctor.

You don't have to like my post, but nothing in it consists of a personal attack....an attack on the DNP, SURE, but not you personally. I don't even know you.

Dr. Tammy, FNP/GNP-C · Feb 10, 2009

Your words compared a DNP to an MD. Not mine.

Again, reread. . The MD and DNP degree are both clinical based doctorates.

PharmD is a doctorate, as is PT....none of them refer to themselves as doctor.

So does that mean they are not worthy of using the title doctor, or is the title of doctor only reserved for physicians, or perhaps those who physicians indicate they may use the title doctor, such as dentists and podiatrists?

Because of the practice similarities between an MD and NP, it will blur the line even further, which creates an additional unnecessary liability. Believe me, I have discussed this with the NP leadership ad nauseum, but as usual, reason escapes them. I understand that PhD is a research degree, completely understand that, and I also understand that many of my colleagues with MD and PhD degrees will tell you that the PhD was more difficult to complete.

Good work on comparing apples to Buicks. It's not about what is better, what is harder, what is easier or what is more difficult. The basis of your argument against the utility of the title by DNP's, does nothing more than underscore the medical establishments rhetoric for increasing barriers for nurses and their professional development. Fortunately, the rhetoric is falling on deaf ears which is why the terminal degree for NP's for 2015 is the clinical doctorate.

I am a supervisor of the midlevel providers in my department, and our institution based on recommendations partly from me, have initiated a policy making it so that DNP's cannot use the title doctor at our institution. And I can assure you, that it will be a cold day in hell before I ever refer to an NP as a doctor.

With the DNP being the new terminal degree, you will soon discover that NP's will no longer be referred to as midlevel care providers. Not so much because they are no longer in between a basic nurse and a physician, which they never were in the first place, but because like the physician and unlike the PA, they have a clinical-based doctor in their own discipline and own profession.

Also, if you would prefer not to refer to DNP's as doctors in the clinical setting, I'd suggest booking tickets to hell now, while gas is still cheap. Your lack of respect for earned credentials by advanced practice nurses, however is appreciated.

Editorial Team / Admin · Feb 10, 2009

Guys......??

Asking that you please debate the topic without making personalizations. This just derails the thread and at the same time, makes my head hurt.

Thanks.

Dr. Tammy, FNP/GNP-C · Feb 10, 2009

Guys......??
Asking that you please debate the topic without making personalizations. This just derails the thread and at the same time, makes my head hurt.
Thanks.

My bad. I should have just ignored.

Editorial Team / Admin · Feb 10, 2009

I am a supervisor of the midlevel providers in my department, and our institution based on recommendations partly from me, have initiated a policy making it so that DNP's cannot use the title doctor at our institution.

From '07:

Current Law
According to the 2007 Pearson Report, only 7 states (Georgia, Illinois, Maine, Missouri, Ohio, Oklahoma, and Oregon) have statutes or regulations prohibiting a nurse practitioner (NP) or other doctorally prepared health professional from using the title "Doctor.[3]" Several other states have provisions in law allowing nonphysician healthcare professionals to use the title "Doctor" as long as they also include their title of licensure or specialty (NP, physical therapist, etc) in patient communication. The American Medical Association (AMA) has identified use of the professional title of "Doctor" as a topic for legislative initiative on behalf of its membership. Resolution 211, passed by the AMA House of Delegates, accused nurses and other "nonphysicians" with doctoral degrees of misleading patients "to believe that they are receiving care from a doctor.[4]" The resolution states further that the AMA resolves to work with individual states to "identify and prosecute those individuals who misrepresent themselves as physicians to their patients.[4]"
Although the AMA resolution has no binding effect on individual state law, it does indicate intent to mount a campaign that challenges the abilities of nurses and other health professionals to claim the title "Doctor," even if a degree is earned and recognized by the public.
http://www.medscape.com/viewarticle/563176

Pearson Report 2008

physasst · Feb 11, 2009

From '07:
Pearson Report 2008

I agree with that, and I've noted that the current "Truth and Transparency" legislation before congress currently, is likely to pass, and would make those rules and regulations a NATIONAL law. Which is something that I support, and have already called my Sen and Reps offices in DC to let them know that....actually talked to their policy advisors, but those are the people that make things happen anyway.

I certainly did not mean to be acrimonious. As one of my friends, Bob Blumm, often says, we need to work TOGETHER.

PA's and NP's together can accomplish so much. I just would prefer a more subtle approach, then simply thumbing our noses at the medical establishment.

Oh well, I've had long day. Had to sedate a patient twice (thanks ortho:uhoh3:), perform 2 LP's, run the airway and intubate a level one trauma patient, and run a rescucitation (failed, but he was dead before he even hit our doors), and manage an inferolateral STEMI. Not to mention the work I have piled here at my desk......4 abstracts to review, a book chapter to finish, an article on TIA management, and the new ABCD2 guidelines, and about 60 emails......(***????) So, back to work. Thanks for the pleasant debate.

inthesky · Feb 12, 2009

I would not be so upset about the switch to dnp programs if it included more in depth specialty education. I would happily spend those two extra years studying psychopharmacology and etc advanced coursework than drowning in nursing leadership theory drivel. Nursing is a different profession than medicine and does follow a different model, however, nurse practicioners working for doctors get pretty close to the medical model. more science less philosophy please! I'm getting worked up =P

menetopali · Feb 23, 2009

I agree with that, and I've noted that the current "Truth and Transparency" legislation before congress currently, is likely to pass, and would make those rules and regulations a NATIONAL law. Which is something that I support, and have already called my Sen and Reps offices in DC to let them know that....actually talked to their policy advisors, but those are the people that make things happen anyway.
I certainly did not mean to be acrimonious. As one of my friends, Bob Blumm, often says, we need to work TOGETHER.
PA's and NP's together can accomplish so much. I just would prefer a more subtle approach, then simply thumbing our noses at the medical establishment.
Oh well, I've had long day. Had to sedate a patient twice (thanks ortho:uhoh3:), perform 2 LP's, run the airway and intubate a level one trauma patient, and run a rescucitation (failed, but he was dead before he even hit our doors), and manage an inferolateral STEMI. Not to mention the work I have piled here at my desk......4 abstracts to review, a book chapter to finish, an article on TIA management, and the new ABCD2 guidelines, and about 60 emails......(***????) So, back to work. Thanks for the pleasant debate.

Truth and Transparency? will physicians finally identify themselves by profession instead of the academic title they usurped so very long ago (Doctor)?