Eliminating Physicians/Medical Schools

Specialties NP

Published

  1. Should physicians/Med Schools be phased out

    • Yes! NP's should replace physicians!
    • No! Physicians and Nurses serve important, and distinct roles
    • Maybe

105 members have participated

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?

Specializes in Reproductive & Public Health.
From a primary care perspective, exactly right on. But what is increasingly happening is that many NP's are entering specialties as well and gaining experience in these fields. I am friends with a GI NP and cardiology NP. I know a classmate of mine who is going into INTERVENTIONAL RADIOLOGY NP position!!

NPs can become competent in pretty much any specialty I can think of. But I agree that going straight from NP school into a narrow specialty absolutely REQUIRES extended and close preceptorship. That should be a GIVEN.

Specializes in Outpatient Psychiatry.
If you look at this form the primary care perspective, it's already happening. Primary care is increasingly falling into the hands of NPs and PAs (and FWIW they do a pretty good job at it, look at the numerous studies). There is currently a shortage and the projection for the next decade is is a deficit of 50-100,000 PCPs depending on the source. At the same time fewer physicians are entering primary care. If the populaiton projections are correct it also leaves a deficit in specialist physicians, so there may be a reasonable argument to move more physicians towards specialty to fill that void and increase the number on non-physician primaries to fill that void.

Physicians will never be replaced, at least in our lifetime in the United States. We need more of all types of providers, physicians included, for both primary and specialty care.

I do disagree with a previous poster than states NPs are valid only in a "supporting" role. The truth is, any provider should practice in a collaborative manner, regardless of education model or degree.

Can you point me to some of the studies you mention? People sling them here, but I've not found them in any database.

Please and thanks.

Specializes in Adult Internal Medicine.
Can you point me to some of the studies you mention? People sling them here, but I've not found them in any database.

Please and thanks.

Mundinger, M. O., Kane, R. L., Lenz, E. R., Totten, A. M., Tsai, W. Y., Cleary, P. D., ... & Shelanski, M. L. (2000). Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial.Jama, 283(1), 59-68.

Lenz, E. R., Mundinger, M. O. N., Kane, R. L., Hopkins, S. C., & Lin, S. X. (2004). Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Medical Care Research and Review, 61(3), 332-351.

Hoffman, L. A., Tasota, F. J., Zullo, T. G., Scharfenberg, C., & Donahoe, M. P. (2005). Outcomes of care managed by an acute care nurse practitioner/attending physician team in a subacute medical intensive care unit. American Journal of Critical Care, 14(2), 121-130.

Horrocks, S., Anderson, E., & Salisbury, C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. Bmj, 324(7341), 819-823.

Newhouse, R. P., Stanik-Hutt, J., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., ... & Weiner, J. P. (2011). Advanced practice nurse outcomes 1990-2008: a systematic review. Nursing Economics, 29(5), 230.

Litaker, D., MION, L. C., Planavsky, L., Kippes, C., Mehta, N., & Frolkis, J. (2003). Physician–nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care.Journal of interprofessional care, 17(3), 223-237.

Sackett, D. L., Spitzer, W. O., Gent, M., Roberts, R. S., HAY, W. I., LEFROY, G. M., ... & GOLDSMITH, C. H. (1974). The Burlington randomized trial of the nurse practitioner: health outcomes of patients.Annals of Internal Medicine, 80(2), 137-142.

Mundinger, M. O., Kane, R. L., Lenz, E. R., Totten, A. M., Tsai, W. Y., Cleary, P. D., ... & Shelanski, M. L. (2000). Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial.Jama, 283(1), 59-68.

Lenz, E. R., Mundinger, M. O. N., Kane, R. L., Hopkins, S. C., & Lin, S. X. (2004). Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Medical Care Research and Review, 61(3), 332-351.

Hoffman, L. A., Tasota, F. J., Zullo, T. G., Scharfenberg, C., & Donahoe, M. P. (2005). Outcomes of care managed by an acute care nurse practitioner/attending physician team in a subacute medical intensive care unit. American Journal of Critical Care, 14(2), 121-130.

Horrocks, S., Anderson, E., & Salisbury, C. (2002). Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. Bmj, 324(7341), 819-823.

Newhouse, R. P., Stanik-Hutt, J., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., ... & Weiner, J. P. (2011). Advanced practice nurse outcomes 1990-2008: a systematic review. Nursing Economics, 29(5), 230.

Litaker, D., MION, L. C., Planavsky, L., Kippes, C., Mehta, N., & Frolkis, J. (2003). Physician–nurse practitioner teams in chronic disease management: the impact on costs, clinical effectiveness, and patients' perception of care.Journal of interprofessional care, 17(3), 223-237.

Sackett, D. L., Spitzer, W. O., Gent, M., Roberts, R. S., HAY, W. I., LEFROY, G. M., ... & GOLDSMITH, C. H. (1974). The Burlington randomized trial of the nurse practitioner: health outcomes of patients.Annals of Internal Medicine, 80(2), 137-142.

Nice!!!! We do it better!!! Though to be fair the lead authors like m. O. Mundinger are NPs, but data is data!

Specializes in Family Nurse Practitioner.
Nice!!!! We do it better!!! Though to be fair the lead authors like m. O. Mundinger are NPs, but data is data!

Meh. Some decent articles but they are all too old to be considered relevant now especially with the large numbers of NPs with minimal nursing experience being cranked out each year by all schools, not just the for profits with bad reputations. My fear is the outcomes won't be this rosy going forward.

Anecdotally speaking from the medication regimens I see on the acute psych unit as well as repeated hospitalizations of certain prescribers patients the quality of new grad NPs is declining each year. Multiple antipsychotics which is not supported by any evidence I've ever seen. Benzos and stimulants galore for patients with suicidal gesture history and active substance abuse its both ametuer and dangerous. The physicians are starting to comment on it and its embarrassing.

Aren't these studies like focused on simple algorithm type disease like HTN and DM2? Most of these are old. Anybody in their right mind would know that nurse practitioners cannot handle everything that a physician can. And the ones that can are usually the ones that are extensively trained by physicians.... especially in specialty areas.

If we did not have medicine, APRNs would not exist. Why do nurses seek so strongly to unplant those who provide us with most of our education basis? Has anyone ever read the reference section of their FNP textbooks? Sources and studies conducted by physicians are usually the primary sources and without those we would have NO basis for practice.

Stop trying to flaunt that nurses can do the same as the docs can, its such a foolish endeavor that is simply there to feed one's ego.

Without the PHD chemists, biologists, etc and physicians we would have nearly no medical knowledge, and APRN practice would not exist. But i do not seen PHDs trying to oust doctors or vice versa. What is it with nursing that sets us apart in trying to show that we are better than others when we most obviously are not.

It does a disservice to everybody....

Specializes in Adult Internal Medicine.
Meh. Some decent articles but they are all too old to be considered relevant now

Some more recent articles from 2015 on a number of different roles:

Kuo, Y. F., Chen, N. W., Baillargeon, J., Raji, M. A., & Goodwin, J. S. (2015). Potentially Preventable Hospitalizations in Medicare Patients With Diabetes. Medical care, 53(9), 776-783.

Kuo, Y. F., Goodwin, J. S., Chen, N. W., Lwin, K. K., Baillargeon, J., & Raji, M. A. (2015). Diabetes Mellitus Care Provided by Nurse Practitioners vs Primary Care Physicians. Journal of the American Geriatrics Society, 63(10), 1980-1988.

Landsperger, J. S., Semler, M. W., Wang, L., Byrne, D. W., & Wheeler, A. P. (2015). Outcomes of Nurse Practitioner-Delivered Critical Care: A Prospective Cohort Study. CHEST Journal.

Jennings, N., Clifford, S., Fox, A. R., O'Connell, J., & Gardner, G. (2015). The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. International journal of nursing studies, 52(1), 421-435.

Anecdotally speaking from the medication regimens I see on the acute psych unit as well as repeated hospitalizations of certain prescribers patients the quality of new grad NPs is declining each year.

Inappropriate medication regimens are certainly not limited to NPs. I see them all the time and the vast majority are physician prescribed.

dont patients with residents and ACNP still have to have attendings round on the patients on a daily basis.

I think at most hospitals this is required, at least for billing purposes, so the care isn't solely provided only by ACNP or residents.

I could only view the abstract though.

Specializes in Adult Internal Medicine.

If we did not have medicine, APRNs would not exist.

Do you think without nursing, medicine would exist?

No one here is (seriously) seeking to "unplant" physicians or "show they are better than others".

I really love when people talk about "simple algorithim type disease". Anyone that has spent even the slightest amount of time treating them knows it is rarely ever simple. If NPs did nothing but perfectly manage hypertension, diabetes, and hyperlipdemia it would be the largest reduction in morbidity and mortality in the history of medicine.

Do you think without nursing, medicine would exist?

No one here is (seriously) seeking to "unplant" physicians or "show they are better than others".

I really love when people talk about "simple algorithim type disease". Anyone that has spent even the slightest amount of time treating them knows it is rarely ever simple. If NPs did nothing but perfectly manage hypertension, diabetes, and hyperlipdemia it would be the largest reduction in morbidity and mortality in the history of medicine.

The op and his classmates probably are.

It it usually is simple. Eat healthy and exercise. Lol hard to convince people to do that. We prolly need to have a staff of car salesmen in our offices pushing patients to have better lifestyle

Specializes in Adult Internal Medicine.
The op and his classmates probably are.

It it usually is simple. Eat healthy and exercise. Lol hard to convince people to do that. We prolly need to have a staff of car salesmen in our offices pushing patients to have better lifestyle

Then they will get humbled pretty quick when they get to practice.

Why eat healthy and exercise when there is just a pill I can take?

Then they will get humbled pretty quick when they get to practice.

Why eat healthy and exercise when there is just a pill I can take?

5 pounds of kale compacted into a capsule������������������������������������������������������

Might be be a lethal dose of it though haha

+ Add a Comment