Eliminating Physicians/Medical Schools

Specialties NP

Published

  1. Should physicians/Med Schools be phased out

    • 3
      Yes! NP's should replace physicians!
    • 100
      No! Physicians and Nurses serve important, and distinct roles
    • 2
      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 Peds OR as RN, Peds ENT as NP.

We always will need physicians, they should never be eliminated.

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Specializes in Registered Nurse.
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.

I totally agree with some of these sketchy for profit schools somehow getting accredited and churning out new NPs that have no business practicing. It infuriates me to see these

programs take students with extremely low GPAs, no healthcare experience all because they are willing to pay exorbitant amounts on tuition. Then they come out, go into practice without knowing their ass from their elbow. It reflects poorly on all of us. I know the AMA keeps a tight leash on med schools- with the idea that not everyone is cut out to be a physician. I simply cannot understand what our game plan is.

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Specializes in Registered Nurse.
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.

No not necessarily. We have an entirely run NP service for inpatients- some of those we will not round with the attending. That said, if a patient is more complicated or there's outstanding issues we will seek them out to round with us.

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There is another way to look at this, rather than it being NPs v Physicians. I would question whether technology is making physicians, if not obsolete, definitely required less than in the past. Is the system stuck in the 19th century and not taking account of standard medical protocols that people with pretty basic training can follow rather than needing specialists. All the information needed is right there at a click of a button. I see people saying nurses can't be surgeons but right now there are robots capable of performing surgery independently, yes they're new and can only do limited things, but it's just the beginning. I can foresee a time when we only have a fraction of the doctors we have now and more specialist mid level practitioners providing a limited range of medical care following country or at least state wide protocols written by the physicians. Robotic Surgery Just Got More Autonomous | AAAS - The World's Largest General Scientific Society

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no...

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The context of the poll is silly, but it does raise interesting questions about the future of a health care system that is rapidly becoming too complex for clinicians to keep up with and unaffordable for most consumers of health care. It makes no sense at all to compare NPs to physicians. None! Our training is nowhere near the amount of training that physicians receive. Some of us excel in our fields as NPs because we have many years of clinical experience and we study well beyond the basic stuff that is traditionally taught in NP school. But, what is taught in NP school is hardly enough to qualify NPs to completely replace physicians. Medical school is a much longer (and much more expensive) path for one simple reason: the volume and depth of the material that medical students study is so much more than what we get in NP school that it would be ridiculous to compare the two. There is no such thing as "over-training". Training never stops. Its the reason why even licensed clinicians have to do continuing medical education credits every year. Students need to be exposed to a broad range of patient presentations and appropriate treatment modalities---including those that don't fit the traditional textbook models. How else would the clinician know what to do when one of the outliers show up in front of him/her? Do you really believe that the 60 hours of clinical time that NPs get per rotation compares to the rotations that medical students go through? I don't think so.

But, you are on to something here. We are a broke nation, and the profiteering health insurance companies cannot go on indefinitely gouging people with ever-increasing costs of premiums while declining more and more service coverage. We are getting close to the point where more people simply choose to not pay anymore and just go without insurance---notwithstanding the tax penalties associated with Obamacare. I had a patient who told me that she was paying almost $1000 a month to one of the exchanges for coverage for her family. Seriously, how many people can afford to spend that much of their income on health insurance? And, on top of that, the insurance sucked. She had to pay a huge deductible and they declined to cover most of the medications that she needed anyway.

The latest thing now is these mini clinics that offer deeply discounted primary care, labs, and other diagnostic services for cash-paying clients---many of which are being staffed with NPs. The same companies that provide contract services for things like MRIs, CT scans, and labs are now offering backdoor discounted services to the mini clincs for cash. Now this is where the physicians will take a hit as people start looking for more affordable ways to get basic health care. After the current president leaves the White House, the next one (no matter who it is) will dismantle the Affordable Care Act---which really isn't all that affordable anyway, and the rules will change to reduce costs.

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So are you saying there will. Be a fragmented healthcare. System? The rich get the doctors and the poor get. The nurse practitioners?

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Not really. That NPs are mostly staffing these mini clinics is probably nothing more than a coincidence. But its not exactly a secret that fewer and fewer medical students are choosing to go into primary care now; meanwhile, there is such a glut of FNPs in so many areas out there now that many graduates have difficulty finding a job.

Once the politics changes, so do the rules---then the players all line up to goose-step in unison to the beat. As the money dries up over the next several years, the Affordable Care Act will simply become an unfunded mandate that will eventually disappear along with many of the currently existing programs (i.e. the ones that allow federal monies to be used to provide free medical services for "undocumenteds" via the community outreach and faith-based health programs that were mostly created under the Bush 43 regime), and many people will find themselves being purged from the Medicaid rolls as the states step up their cost-cutting to match with the loss of federal dollars. And, health care will once again become about providing care that people need rather than the way it is now---which is about choice, culture-PC care, customer service, redundancy, and bureaucracy. Of course, those who have the cash to pay can continue to access concierge medicine---whether the provider is an MD or an NP. And, those who are poor will get a doctor or an NP but they're likely going to find that they no longer have many of the choices they now do.

To see where health care in the USA is going, look to the positions of the two likely presidential candidates who will be headed to the general elections in November. Both of them are promising to change the current system with dramatic cost-cutting. My feeling is that the health care system will get worse for a while, then better. And I believe that NPs will be playing a much greater role in primary care than we now do for two reasons: 1. there are more of us; and, 2. its cheaper for them to use us than to use physicians.

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its not really physician specific being replaced by robots. much of what nurses can do can be replicated even more easily than what surgeons do.

I would say it would take many more lines of code to produce a surgery robot in comparison to one that hands out medicine, gives bed baths, titrates drips, and stuff like that.

The future should be interesting. I know if whatever I do ever becomes obsolete I'm going into robotics though lol.

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Don't ever see this happening.

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Specializes in Forensic Psychiatry.
its not really physician specific being replaced by robots. much of what nurses can do can be replicated even more easily than what surgeons do.

I'd love to see psych - any area of psych replaced by robotics. Que *robot voice*

Welcome to [inpatient Psychiatry] you have been placed on a [51/50] hold for [Danger to others] after [Chasing neighbors down the street yelling "Die Xenomorphs!" with a Katana]. I am you Automated-Nursing User-Centered Service, you can call me Nurse A.N.U.S. Our treatment algorithm shows you meet the Axis I criteria for [schizophrenia] due to your symptoms of [auditory hallucinations, visual hallucinations, delusions, anhedonia and anergia]. According to treatment algorithm [schizophrenia] automated program Specialty Healthcare Interventions and Treatment [Psychiatry] Dr. S.H.I.T has prescribed [Olanzapine Zydis] [Three times daily]. Dispensing pills. Please take your [Olanzapine zydis] from the pill dispenser. If you feel like you require continued assistance return to the Automated Nursing User-Centered Service and pick up connected telephone to contact our Central Representative All-Department Personnel. The C.R.A.P system is located in [india] and your wait time is [234,000,000,000 Minutes]. If you feel like your at an imminent risk of harming yourself or others please expose buttocks and back into the A.N.U.S system to receive IM medication.

Failure to comply will result in requests to apply [twice as tough Posy Restraints] to [upper and lower extremities]. If you require further assistance of education on treatment care plan please return to the Nurse A.N.U.S system. [Olanzapine Zydis] administered. Please remove the [Olanzapine zydis] from administration chamber. View above screen and enter [Hourly] pain score. If [Hourly] pain score is > 3 please contact the Central Representative All-Department Personnel [Wait time is now 234,000,000,005 Minutes] for further assistance. Please enter satisfaction score for above services, if patient satisfaction score is [below 3 out of 5] Turkey Sandwich, Xanax and Taxi Voucher will be administered for a rating above [3] upon discharge.

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I'd love to see psych - any area of psych replaced by robotics. Que *robot voice*

Welcome to [inpatient Psychiatry] you have been placed on a [51/50] hold for [Danger to others] after [Chasing neighbors down the street yelling "Die Xenomorphs!" with a Katana]. I am you Automated-Nursing User-Centered Service, you can call me Nurse A.N.U.S. Our treatment algorithm shows you meet the Axis I criteria for [schizophrenia] due to your symptoms of [auditory hallucinations, visual hallucinations, delusions, anhedonia and anergia]. According to treatment algorithm [schizophrenia] automated program Specialty Healthcare Interventions and Treatment [Psychiatry] Dr. S.H.I.T has prescribed [Olanzapine Zydis] [Three times daily]. Dispensing pills. Please take your [Olanzapine zydis] from the pill dispenser. If you feel like you require continued assistance return to the Automated Nursing User-Centered Service and pick up connected telephone to contact our Central Representative All-Department Personnel. The C.R.A.P system is located in [india] and your wait time is [234,000,000,000 Minutes]. If you feel like your at an imminent risk of harming yourself or others please expose buttocks and back into the A.N.U.S system to receive IM medication.

Failure to comply will result in requests to apply [twice as tough Posy Restraints] to [upper and lower extremities]. If you require further assistance of education on treatment care plan please return to the Nurse A.N.U.S system. [Olanzapine Zydis] administered. Please remove the [Olanzapine zydis] from administration chamber. View above screen and enter [Hourly] pain score. If [Hourly] pain score is > 3 please contact the Central Representative All-Department Personnel [Wait time is now 234,000,000,005 Minutes] for further assistance. Please enter satisfaction score for above services, if patient satisfaction score is [below 3 out of 5] Turkey Sandwich, Xanax and Taxi Voucher will be administered for a rating above [3] upon discharge.

Don't give the powers-that-be any ideas. We might all be surprised at the lengths to which they might go to avoid spending a buck. Then again, maybe we won't be all that surprised. The scene is changing. Money is tight. And the bean counters have decided that they want more. The few remaining ACA exchanges will collapse in 2017 unless Congress bails them out. They would need to add more billions to the current federal budget to make that happen, and it's not going to happen.

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