Eliminating Physicians/Medical Schools

[AAC.271]

Serious Question. Should US Medical schools and physicians be phased out in favor of an NP driven and lead healthcare system? Some of my NP Peers assert that a 2 year Master degree NP program provides the equivalent education and yield superior outcomes than a 7 year medical school+ residency education trained Family Medicine Doctor. This saves students so much money and can easily fill the market with tons of trained healthcare providers. Plus, there are many online NP programs which opens the doors for many aspiring healthcare providers to study at their own pace and at home, without the burden and expense of having to attend a brick and mortar school.

NP's can easily transition into all the major sub specialities like dermatology, GI, psychiatry, surgery, Peds etc.. without all the red tape and regulations physicians need to go through.

With so many states gaining full NP autonomy and equal pay, with the argument that the nursing model is equal, if not better, than the physician model, do you think it is time for physicians to get the boot since they are too overtrained and a waste of limited resources when a cheaper NP can replace them?

[RiskManager]

If the OP was concerned over overtrained healthcare professionals representing a waste of resources, then he should look into the how the US military does it. Some valid arguments based upon decades of experience can be made that a US Navy Independent Duty Corpsman, US Air Force Independent Medical Technician or US Army Special Forces Medic can autonomously provide a great deal of primary care at a considerably lower cost than a physician, nurse practitioner or physician assistant. Our current licensure and credentialing systems do not provide for this in the civilian marketplace, but the military need not abide by this.

[Graduatenurse14]

Doctors are necessary! An above poster mentioned neurosurgeons who are so intelligent and go to school the longest to do brain surgery!!

I work in neurosurgery/neuroscience and see first hand really only a small part of what the Residents go through and I think they are insane but at the same time we NEED them!! I am so grateful that we have people who are willing to put the time in to be able to remove a glioblastoma, stop a subdural hematoma and prevent someone from losing bladder and bowel function or becoming completely immobile.

[AAC.271]

Perhaps I am too progressive thinking, but look at where we are now! 10 years ago who would have even contemplated the np profession equalizing with primary care doctors. Now there is a general consensus that primary care docs can be replaced by NPs.

Look ok what i am saying is that in every profession, there are steps that people take to rise higher in the chain. The nursing model provides those gradual steps for a person to move up to greater responsibilities and scope of practice. The medical model churns out doctors without any prior healthcare experience. Is an np driven healthcare model so radically different? Not necessarily. I would argue it is even more meritocratic because providers must slowly gain that experience to move up the chain.

[RegularNurse]

The premise is moronic. There is a vast difference, and I mean vast, between an NP and MD in both knowledge base and training. There seems to be this militant arm of the ANA or some other organizations trying to reach clinical parity with physicians. This will never happen, despite any billing or operational changes in healthcare.

I have peers who literally went to school 100% online and did 16 hours of clinical weekly for only one of their two year program. Any one who thinks that is the same as medical school and residency is drinking the kool aid. This is the problem with nursing collectively. We want our cake and we want to eat it too- all without logging the training hours.

Here is how you end the debate once and for all. Have all NPs take the the medical boards for whatever specialty they want to practice in. I doubt the NPs would be willing to be held to the same standard as medical training because their education is not of the quality.

Imagine the uproar from nurses if they allowed paramedics and EMTs to work in hospitals at full-RN wages without going to nursing school.

[MomAndSonInMD]

Physicians are important and should definitely not be phased out.

NPs do some stuff better though. I think the training and philosophy in nursing makes most psych NPs preferable to most psychiatrists. I also personally prefer NP for gynecology. Not because they tend to be female. I prefer them to the female gynecologists.

I think NPs might be able to replace physicians in primary care too. But I don't think NPs are generally better here, like they are in psychiatry. Probably about the same.

We need physicians as specialists for sure and of course we need surgeons.

NPs can not replace doctor gyns, especially for those of us with a history of cancer and surgical procedures.

[sirI, MSN, APRN, NP]

Note removal of other discussion(s).

Please just stick to the topic and not bring up other topics such as ADN vs BSN, etc.

Thank you ...

[JustKeepDriving]

The medical model churns out doctors without any prior healthcare experience. Is an np driven healthcare model so radically different? Not necessarily. I would argue it is even more meritocratic because providers must slowly gain that experience to move up the chain.

That's incorrect. To get accepted to medical school most program require extracurricular activities including Physician shadowing, volunteering, hospital experience (a lot of the students take scribe positions) and undergraduate research. The first 1-2 years of schools are sciences. The last 2 consist of full time rotations doing clerkships and sub-intern years. You pass the steps and require certain scores to be competitive for your desired specialty. Then there is 3 - 7 years of residency that is completed before you're able to be a full fledged physician that practices without oversight. The medical model trickles out providers that have >40,000 hours (estimated) medical experience.

The PA model requires 2,000 hours prior practice, a year of theory followed by a year of full time clinical hours that is equal to another 2,000 hours. So all together your PA has about 4,000 hours of experience.

The NP? You've got people that have 15 years RN experience, that go to a competitive on campus program and graduate after completing 1200 hours of clinical. Then you have the "I just completed my RN and don't want to practice as a nurse, apply to walden with a 2.5 gpa and pay someone to shadow for 4 hours a week for a total of 700 hours of watching someone else practice". The NP model is not going to replace MD's anytime soon outside of *maybe* rural primary care. Definitely not in the big cities or desirable areas and until the NP model can figure itself out and standardize entry requirements, get rid of for profit online schools and have solid clinical hours it's just not going to happen.

[bgxyrnf, MSN, RN]

Letting NPs act as physicians makes just about as much sense as letting chiropractors or homeopathic practitioners act as physicians.

[RNperdiem, RN]

Maybe the MAs will replace the nurses and we can make healthcare a low-wage field for everyone.

[RNdynamic]

No, this is ridiculous.

[sailornurse]

If the OP was concerned over overtrained healthcare professionals representing a waste of resources, then he should look into the how the US military does it. Some valid arguments based upon decades of experience can be made that a US Navy Independent Duty Corpsman, US Air Force Independent Medical Technician or US Army Special Forces Medic can autonomously provide a great deal of primary care at a considerably lower cost than a physician, nurse practitioner or physician assistant.

This is true however consider that IDC, independent duty corspman mostly are dealing with a very healthy population that's extremely physically fit. People develop many conditions medically boarded out of the military.

[allennp]

We need MD's we need NP's, we need RN's we are all spokes on the wheel, different overlapping supporting roles.