Equal work for Equal Pay

[AAC.271]

What are your thoughts folks? As an sNP, I think if we do the exact same work we absolutely deserve the same high salary that physicians get.

Some of my peers in medical school say that education and qualifications deserve higher pay i.e. A college PH.D professor gets paid more than a masters trained high school teacher, even if they are both teaching AP biology/Intro to Biology 101.

I understand their Point of View, but I think it's unfair that just because we aren't learning as much material, but going to be dealing with many of the same cases and patients, that we do not deserve a physician's salary. Studies again and again show that NP's do an equal job if not better job than physicians at correctly diagnosing problems and treating patients. Some would argue that in a quality outcome based system, Nurse Practitioner's deserve even more pay because our results are better!!

[traumaRUs, MSN, APRN]

Of course we should be paid the same for the same work. Reimbursement used to be based on CPT, not license. General physicians used to argue that they should be paid the same for the same work as their specialist counterparts, and eventually won that argument. This argument is exactly the same. If pay was based on degrees, DOs would be paid different than MDs and perhaps CNS different than NPs. 40 years of research shows NPs provide the same or better high level care that a physician provides. The only reason most states have not embraced equal pay for equal work (although Oregon has!) is for two reasons.

The first reason is insurance companies like to make money, so they will cut corners wherever they can. The second reason is not economics, but political - the AMA is very powerful and they have crafted a careful, almost price fixing environment where they artificially inflate how difficult it is to get into medical school so that the supply of physicians remains small, demand remains high, and therefore reimbursement is high.

With NPs, however, that demand is no longer as high, state by state, as NPs are recognized as independent. It is only a matter of time before NPs are paid equitably as physicians.

You don't see physicians trying to prove their worth - sorry but a DNP is NOT equal to a physician.

And....you know what? That's okay. I don't want to be a physician. If I did, I would have gone to school for that. APRNs have worth and provide excellent care - no argument there. However, nursing education is not the same as physician education.

[Libby1987]

If the argument for equal work should equal pay based on the premise that NP skill is commensurate with MD counterpart, why aren't you arguing for reducing MD education instead of raising your pay?

If you're just as qualified as you claim, let's just change up our PCPs and hosptialist's education (and eliminate those resisdencies while were at it since NPs are managing patients better without it) to that of our NPs.

NOW you're even and can be paid the same.

And NP should be the track for specialities as well, just add on some classes and voila you have a cardiologist, surgeon, researcher.. if NPs have the same knowledge and skill base, specialities can just build on your education base with no need to reinvent the wheel, yes?

I mean, god help us but just following the OP's logic.

[TuxnadoDO]

Two people can paint the same picture, it doesn't mean it's the SAME picture.

People complain about getting billed X dollars in the ER for a diagnosis of sprained ankle or concussion "because we didn't do anything." You didn't come for a "thing," you came for my expertise as a board-certified physician and my ability to handle any emergent medical situation - and that's what you got, even if you can't see it. Much of the work we do is medical decision making, it's an internal process, not just following a flowchart of guidelines. A board certified physician has many more hours/years of clinical training, exams and maintenance of certification requirements. That's not nothing, just because you don't SEE it.

Show me a study of independent NPs, with no physician oversight, handling a similar percentage of medically complex patients compared to their physician counterparts, funded and executed by a joint effort between physicians and nurses, and we would have a much better picture of how outcomes compare.

[traumaRUs, MSN, APRN]

Two people can paint the same picture, it doesn't mean it's the SAME picture.

People complain about getting billed X dollars in the ER for a diagnosis of sprained ankle or concussion "because we didn't do anything." You didn't come for a "thing," you came for my expertise as a board-certified physician and my ability to handle any emergent medical situation - and that's what you got, even if you can't see it. Much of the work we do is medical decision making, it's an internal process, not just following a flowchart of guidelines. A board certified physician has many more hours/years of clinical training, exams and maintenance of certification requirements. That's not nothing, just because you don't SEE it.

Show me a study of independent NPs, with no physician oversight, handling a similar percentage of medically complex patients compared to their physician counterparts, funded and executed by a joint effort between physicians and nurses, and we would have a much better picture of how outcomes compare.

For those of us that are experienced APRNs you won't get any argument with this post. I've been a APP (there are so many acronyms for us) for 12+ years now. My relationship with physicians is top notch. They look to me to handle dialysis patients because for the non-nephrologist I can help them to manage this aspect of their very complicated care. I did work in the ED for 10 years prior to this and again had a very collegial relationship with the doctors.

I sincerely appreciate the differences and similarities that we bring to pt care. I do think that NPs and APRNs bring something extra that a physician might not have the time to do - explain the plan of care in simpler terminology, answer questions, help to drive a pt in a certain direction, etc.

So....if all we work as a team, we all benefit the pt. There's room for all of us.

[TuxnadoDO]

For those of us that are experienced APRNs you won't get any argument with this post. I've been a APP (there are so many acronyms for us) for 12+ years now. My relationship with physicians is top notch. They look to me to handle dialysis patients because for the non-nephrologist I can help them to manage this aspect of their very complicated care. I did work in the ED for 10 years prior to this and again had a very collegial relationship with the doctors.

I sincerely appreciate the differences and similarities that we bring to pt care. I do think that NPs and APRNs bring something extra that a physician might not have the time to do - explain the plan of care in simpler terminology, answer questions, help to drive a pt in a certain direction, etc.

So....if all we work as a team, we all benefit the pt. There's room for all of us.

Absolutely. Bravo.

[TuxnadoDO]

Exactly! Thank you for your comments. This is exactly why I also believe physicians and physician education is outdated. They belong to an antiquated system built for the 20th century. This is the 21st century where we have education and knowledge right at our finger tips. The Data clearly shows that NP's are superior to MD's in diagnosing and treating problems. Clearly, the NP model of Education is superior in yielding efficient and good outcomes. NP's are the new face of healthcare and as we expand into more physician territory, we will become stronger, better, and more experienced. This is why the concept of physicians and MDs will become outdated as hospitals look for NP's as better practitioners.

Aside from being incorrect, that's a very dangerous and ignorant attitude. I'm sorry, but you don't know what you don't know.

[traumaRUs, MSN, APRN]

Aside from being incorrect, that's a very dangerous and ignorant attitude. I'm sorry, but you don't know what you don't know.

Sometimes you have to consider the source and realize (as I'm sure you are already aware) some people are less then experienced providers. I do appreciate a physician's insight here on AN. While I agree we are colleagues and each can provide excellent patient care, there are always going to be naysayers both in the NP community as well as the physician community.

[BostonFNP, APRN]

Sometimes you have to consider the source and realize (as I'm sure you are already aware) some people are less then experienced providers. I do appreciate a physician's insight here on AN. While I agree we are colleagues and each can provide excellent patient care, there are always going to be naysayers both in the NP community as well as the physician community.

I would venture a guess that some of the provocateur posters aren't actually nurses at all, let alone NP/APNs.

[traumaRUs, MSN, APRN]

And I would venture BostonFNP that you might be correct - lol