Doctors blackballing NPs/DNPs

Trauma Columnist · Dec 5, 2007

Everyone is entitled to their opinion. I don't purport to, as a mid-level provider, be a physician. No contest there - lol. However, there is a definite need for us in the world of US healthcare. I provide a service that is reimbursable by Medicare/Medicaid and am very lucrative for our practice. Our physicians in the practice where I work have mutual respect for our abilities and assessment skills. I would not personally work with physicians where this did not exist. I think its time to wake up and smell the coffee for students who can't keep up with progress.

It should be noted that the other website is for student doctors. So...I would say they are feeling out their career goals, defining their roles in our healthcare system and some of them, probably need to mature a bit.

I would always consider the source and the motive behind the statements.

Editorial Team / Admin · Dec 5, 2007

Agree with traumaRUs. That other site is for physicians and med-students. You will always have biased responses there. Just like here at allnurses.com, nurses and nursing students come to vent/discuss about everything nursing including venting about physicians.

Will NPs attempt to expand their scope of practice beyond what is safe for patients?

I cannot imagine for one second an APN participating in unsafe practices. I would hope the NP, CNS, CRNA, CNM practices within evidenced-based guidelines and within their own state NPA and certification guidelines.

As traumaRUs states, the role of APN is here to stay. The DNP is certain to come about as well. Physicians will have to adjust to this. DNP does not equal MD and we as APNs make no pretense that the two are synonymous.

mslinzyann · Dec 5, 2007

Here is the article that really threw me for a loop.

http://www.forbes.com/2007/11/27/nur...partner=alerts

PediASL · Dec 5, 2007

See the recent thread that introduced the article...

DNP Article ( 1 2 3)

by prairienp

there are also responses to this article at Forbes' website.

core0 · Dec 5, 2007

Lately I've been on a particular board dedicated to doctors and student doctors and there has been a lot of talk about/ a lot of fear about DNPs and NPs in general. Many of the doctors and pre-med students on the board have even discussed the idea that doctors should band together to not hire NPs, and hire PAs again.
I find this to be dismaying for me personally, as the fields I am interested in are all primarily geared towards NP rather than PA- peds, nurse midwife, neonatal, ect. However, I want to know what the nurses take to this is- are nurses going to be so aggressive that they turn the 'big dogs' of medicine against them? Will NPs attempt to expand their scope of practice beyond what is safe for patients?
I feel there is a place in medicine for midlevels, but midlevels aren't doctors, either.

I wouldn't worry about postings on SDN. There are some malignant personalities over there who have started at least four threads on this so they can expound on their personal biases. One of them was banned here and has been banned on the PA forum at least twice for trolling.

I think that the article does pose a problem for NPs however. While I would agree that it does represent NPs in practice, the author is a prominent member of the nursing community. The article is also being discussed on the MGMA mailing list with similar negative comments. That is a much more real danger.

David Carpenter, PA-C

ukstudent · Dec 5, 2007

I went to a meeting at John Hopkins School of Nursing last spring. They had someone talking about their DNP program. The emphasis of the talk was about getting young nurses that had gone straight into nursing (BSN) from high school and getting them to go straight into the DNP. Special scholarships are being created just for them (there was an age limit, I think you had to be less than 25 when starting the DNP to get it).

The possibility then becomes that someone could become an RN with only clinical experience. Go into the DNP program and graduate again with only clinical experience as no work experience is needed and there is no residency. To me this idea is scary. As a new grad I am truly learning just how much school cannot teach.

mslinzyann · Dec 5, 2007

Truthfully, I think that the PAs have a better educational model for existing in the medical world, but I do think that the holistic nature of nurse training is useful. My main reasoning for wanting to be an NP rather than a PA was because my interest is primarily in peds, neonatal, and ob stuff- which are pretty dominated by NPs rather than PAs. And I wanted to be a nurse first in order to get experience in the medical world before becoming a midlevel. I'm a slow learner, but a detailed and thorough learner, so I want to have my time to get it all figured out.

I went to a meeting at John Hopkins School of Nursing last spring. They had someone talking about their DNP program. The emphasis of the talk was about getting young nurses that had gone straight into nursing (BSN) from high school and getting them to go straight into the DNP. Special scholarships are being created just for them (there was an age limit, I think you had to be less than 25 when starting the DNP to get it).
The possibility then becomes that someone could become an RN with only clinical experience. Go into the DNP program and graduate again with only clinical experience as no work experience is needed and there is no residency. To me this idea is scary. As a new grad I am truly learning just how much school cannot teach.

prairienp · Dec 5, 2007

I wouldn't worry about postings on SDN. There are some malignant personalities over there who have started at least four threads on this so they can expound on their personal biases. One of them was banned here and has been banned on the PA forum at least twice for trolling.
I think that the article does pose a problem for NPs however. While I would agree that it does represent NPs in practice, the author is a prominent member of the nursing community. The article is also being discussed on the MGMA mailing list with similar negative comments. That is a much more real danger.
David Carpenter, PA-C

As usual David has a good perspective on SDN. The most recent thread on SDN started by "mr malignant" actually has some good and positive responses about NPs. Don't get me wrong, the majority are negative, yet I found some of the responses heart warming in that when people are rationale the most important thing is the healthcare patients receive.

caliotter3 · Dec 5, 2007

I wouldn't take anything said on the other website to heart, consider the source. How you progress and maintain yourself as an ANP is entirely up to you. If you find yourself in a toxic work environment that belittles your abilities, then move on. There are many places out there that will willingly accept your help and not treat you like you're worthless.

platon20 · Dec 5, 2007

NPs can already run their own clinics and work 100% independent of any MD, so I dont know that they can really hurt us that much.

core0 · Dec 6, 2007

NPs can already run their own clinics and work 100% independent of any MD, so I dont know that they can really hurt us that much.

Well 98% of NPs do not run their own clinics or work independently. Most work for physician practice groups or hospitals and can definitely be hurt. While Physicians have to a large extent allowed NPPs to have as much primary care as they want, the claim that DNPs are better at specialty practice will not sit well with physician groups (in my opinion).

David Carpenter, PA-C