I've always wanted to know what the difference is

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between an NP and a general practice/family practice MD?

I always got the impression that they're very similar.

Or maybe it's just my continuing confusion about what the NP role is.

I'd rather have a broader, more holistic focus, something I think you see more with nursing.

Nursing IDEALS encompass holistic care. Generally, in nursing education, there's explicit emphasis on this - so for that reason, nursing education might appeal to you more. The REALITY is that many nursing roles demand prioritization of patient needs and often the less immediately life-threatening needs don't get addressed as thoroughly as one would hope. For example, traditionally NPs had more time to spend with patients and could use their added awareness of holistic care (and relatively cheaper billing time) to address patient needs that the physician was less likely to address. But as NPs are pushed to see more patients in less time, they may end up being pressured to just treat immediate concerns and rush on to the next patient. Meanwhile, there's no reason physicians can't choose to take a more holistic view of their patients (given the time and resources available).

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Specializes in Acute Care - Cardiology.

joe,

forgive my bluntness, but i think you have the wrong idea. there are tons of postings on this site about np vs md vs pa and the philosophical backgrounds.

bottom line: mds can act holistically and some do. but... generally speaking, nps are generally more focused on the holistic side of things. being an np is an expansion of being a "nurse." you still have the same background and what i say all the time is, "i am a nurse first." i'm still transitioning into a successful np, but ultimately... i value my nursing instinct and approach to healthcare.

example from today: there was an 84 year old lady, very sweet with an extensive problem list. came in for angina last week. she has charcot-marie tooth syndrome and horrible tardive dyskinesia. last week, she had to use sublingual ntg. because of my nursing background, i'm keen on thinking of "are they tolerating this medication, can they take it without difficulty, do they understand how to take it, can they afford it, what questions do they have about the medications, do they know the side effects, what as an np can i do to make sure they are getting the most of their medical treatment?" well... guess what, she couldnt hold the ntg under her tongue very easily so i changed her to the spray. the doc (who is generally very good about thinking of "special needs") didn't even think about it... he was just more worried about the medical process itself, as he should be. but as an np, i have to be able to incorporate knowledge about the medical process while thinking of those "extra" things.

i think that nurses just go an extra step which makes them valuable in a mlp position. i have been told by the same doc that he appreciates my ability to teach little things to patients that he doesn't think about. it's not a "one is better than the other" situation... but a complementary relationship with nps and mds. they each bring value to the patient care table.

i would suggest you explore some of the other threads comparing the varying roles... you might be pleasantly surprised. :)

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Specializes in Med surg, cardiac, case management.

example from today: there was an 84 year old lady, very sweet with an extensive problem list. came in for angina last week. she has charcot-marie ii syndrome and horrible tardive dyskinesia. last week, she had to use sublingual ntg. because of my nursing background, i'm keen on thinking of "are they tolerating this medication, can they take it without difficulty, do they understand how to take it, can they afford it, what questions do they have about the medications, do they know the side effects, what as an np can i do to make sure they are getting the most of their medical treatment?" well... guess what, she couldnt hold the ntg under her tongue very easily so i changed her to the spray. the doc (who is generally very good about thinking of "special needs") didn't even think about it... he was just more worried about the medical process itself, as he should be. but as an np, i have to be able to incorporate knowledge about the medical process while thinking of those "extra" things.

that's a good example.

but i don't have any interest in seeing patients, making diagnosis, and writing prescriptions. nor in having to learn what things like charcot-marie ii syndrome are. ;)

my interest is more in research, administration, and possibly education. and fairly abstract/philosophical research at that...i'm presently investigating the process of meaning-making in chronic illness.

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Specializes in Acute Care - Cardiology.

"i'd rather have a broader, more holistic focus, something i think you see more with nursing."

ahh... well when you said you wanted a "holistic" focus, that through me off.

best of luck to you...

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My interest is more in research, administration, and possibly education. And fairly abstract/philosophical research at that...I'm presently investigating the process of meaning-making in chronic illness.

It sounds like then you might want to approach your education that way... you could focus on something like chronic illness from a liberal arts or social sciences perspective. There are those who study the philosophy of medical care, the sociology of illness, the psychology of chronic disease. If you're not interested in clinical practice at all, it doesn't seem like a good investment of your energies to become a nurse or doctor. But there are ways you can still be involved with health issues in the way you mention.

To find out more, you might want to go to medical library and ask a librarian to show you where you could find information about what interests you. They could point you to journals that focus specifically on issues like you mentioned.

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Specializes in Med surg, cardiac, case management.
If you're not interested in clinical practice at all, it doesn't seem like a good investment of your energies to become a nurse or doctor. But there are ways you can still be involved with health issues in the way you mention.

May have given you the wrong impression...it's not that I'm not interested in the clinical side of things, it's just that I don't want to be a clinician in that way.

Perhaps describing my research as "abstract/philosophical" was exaggerated...I meant "philosophical" in comparison to something like "The Effects of Caffeine on the Half-Life of Prolixin Decanoate"

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If you want to practice either nursing or medicine with a strong holistic bent, you can do either. However, neither course of training would be sufficient in and of itself. Similar to alternative health practictioners. An MD or RN can supplement their practice with training and competency in alternative methods of health care (eg acupuncture) but general MD or RN training will not train a clinician in specific alternative health practices. They'd have to get that training elsewhere and then they'd have that knowledge that they could apply *in addition to* their other skills and knowledge.

Are you thinking of a something of a "boutique" or "niche" health practice where clients who aren't satisfied by the less than holistic approach of the average practitioner can go to find a health practitioner who will specifically and routinely address patients in a very holistic manner? Is so, that would be a great, ambitious idea. It would involve more than just getting a degree and finding a job. One would need to market themselves and develop a client base in order to make a living at it. Or maybe you're thinking of something else entirely.

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Specializes in Med surg, cardiac, case management.

Most people use the term "holistic" when referring to complementary and alternative medicine. I'm a little different in that I use "holistic" to refer to palliative measures, patient/family coping, and care management.

And that's what I plan to focus on as a nurse, primarily by conducting research in order to change policies and procedures.

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Well it definitely sounds like NP is not the role for you. Is your MSN program for FNP, then? Do you think you'd like to go straight to research? Are you considering working as a bedside nurse for awhile to see how it works in the trenches and develop your research interests?

Having first-hand experience as a practicing nurse could only enhance your future research efforts. On the other hand, I do think that policy research can also be effective if done those familiar with the field and who are able to really see the nursing angle but who don't have a great deal of hands-on experience in that specific area. Either way, it's a not a career goal with a clear cut career path. That kind of research is usually done by academic faculty so that may be a direction for you to look into. Further studies in health policy might be useful as well, both for the content as well as for the professional contacts (ie future potential employment opportunities) it could provide.

I'd be curious to see where you go from here! Keep us informed!

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Specializes in Accepted...Master's Entry Program, 2008!.

I use the term holistic in the same manner that you do.

I'm not sure where this is going from the original question....

Sounds to me like what you are looking for is a PhD. I know a lot of people that do research as nurses, and they hold PhD's. They do exactly what you are talking about....research in pain, asthma, oncology and on and on and on. They generally focus on both treatments and holistic practices (in the way you use the term).

While it is true that all of these people are also university faculty, many of them teach very part time (around 25%). Perhaps that would suit you.

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Specializes in Med surg, cardiac, case management.

My MSN is a generalist degree, most of my classmates go on to get NP certification.

I do plan to work at the bedside for a while and then see what happens. A PhD is definitely a possibility, though some have said a DNP might be better.

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Specializes in ED, Cardiac-step down, tele, med surg.
between an NP and a general practice/family practice MD?

I always got the impression that they're very similar.

Or maybe it's just my continuing confusion about what the NP role is.

Very good question. I'm presuming that the MD may know more about complex diseases, in depth understanding of biological science and pharmacology, and more clinical experience. MDs obviously have a more lengthly program. But I don't know if that matters much in general/family practice b/c the patient could be referred to a specialist to deal with complex issues.

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