as i understand the debate rages on over the equivalency between physicians and np's, especially in the sense that soon we will all possess clinical doctorates-physician and apn alike. many have stated that physicians and np's are not "equivalent." although i believe that most are stating this in the context of comparing medical school training and np training, i am starting to get a sense, however, that this is transcending into a different area--that is from a training point of view to a product/professional standpoint. this concerns me.
to that end, i think we can all agree that medical school is not the same as np school, just like md school is not the same as podiatry or optometry school. from a license structure, md's and anp's are quite different. apn's are no more licensed to practice medicine than physicians are licensed to practice nursing. the danger lies, i feel, when we start on a path describing discrepancies and disparities in the form of inequalities in the form of equivalencies between the two separate disciplines from a training and licensure standpoint to that of a profession and product.
the oxford english dictionary, the gold standard for defining and initiating concept analysis provides the following definition for "equivalent":
1. of persons or things: equal in power, rank, authority, or excellence.
with the contemporary power structure there is much evidence to support the notion that physicians have superior power, rank and authority in comparison to np's (for now) in the health care industry. this is evidenced by the medical communities power in attempting to suppress nursings utility of clinical doctorate titles in the health care setting, while at the same time, supporting the use of other clinical-based" doctor" titles for other disciplines, such as dentistry and podiatry. this clearly sets the tone, as just one example, especially if supported by apn's that physicians truly do have more power, or i should say the power apn's allow them to have.
i'm curious, though with regards to "excellence" in the definition. how many np's out there feel that the excellence they demonstrate through caring, practice and leadership are less than that of a physician?
2. equal in value, significance, or meaning.
how many np's out there feel that their value, significance or meaning to themselves, clients, the profession or intuitions are less than the physician?
3. that is virtually the same thing; having the same effect.
for those np's who consider themselves as practicing medicine: is the medicine you practice of any lesser quality than the medicine practiced by the physician? if not, does adhering to the same standard of care yield the same results--that is provide the same effect? for those who consider their apn practice as nursing and only nursing--that is functions of advanced nursing overlap with other disciplines (e.g. medicine) are the outcomes of your clients inferior to that of the outcomes effected by the physician?
4. having the same relative position or function
think about the term, concept and practice of "primary health care." how many np's feel they cannot perform primary care functions to the same standard and yield equivalent outcomes for their clients as the physician? do you take care of clients knowing they would have received better care and consequently a better outcome if they would have been seen by the physician?
5. something equal in value or worth.
how many np's out there feel they have less value or worth than that of a physician?
to sum it up, when apn's state that md's and np's are "not equivalent" i am hopeful this is only in the context of training and licensure and not practice, outcome or product-based.
in this context for anyone to claim that apn's and md's are not equivalent, they would have to subscribe to the following system of beliefs:
1) apn's do not demonstrate the same excellence in care and practice as the physician,
2) apn's are insignificant; of lesser value and ultimately mean less to themselves, their clients, their profession and the institutions in which they are employed.
3) clients have less than a positive outcome when treated by apn's as compared to those who are treated by physicians.
4) apn's provide primary health care services to clients in an inferior manner as compared to the physician.
5) apn's have lesser of a value than physicians.
i hope, in this context, that i will not be the only one on this board who believes apn's are equivalent to physicians.
HeartsOpenWide, RN
1 Article; 2,889 Posts
Do DNPs even want to be considered "equivalent" to MDs? I know when I become a CNM (although I am told I would be grandfathered if I get my CNM before the doctorate requirement kicks in) I do not want to be compared to an ObGyn on any level. When I tell people how long it is going to take me to become a CNM they always ask; "why don't you just become a doctor then?"...because I do not want to practice medicine, because I like the nursing philosophy on childbirth, and unless I wanted to perform C-sections I would never go to med school to help women birth their babies. I worked for one of the best FNPs out there who only has an ASN (got his FNP in 1980) and I would go to him for many of things before I would go to an MD...and in the office setting there really isn't much an MD can do than an FNP can't.