The title says it all. Have you faced hates or disrespect from physicians (either attending or training) just because you are a NP? Because I did. Online.
As a RN and a NP student, I have seen many great attending physicians who work collaboratively and respectively with NPs. That rosy perception completely changed once I joined Reddit medical communities. There are massive posts showing hates against NP. The two main areas of criticism come down to: 1. Taking NP's malpractice cases or individual's anecdotal examples to basically question competency of all NPs in the states (although I am curious as to malpractice cases in comparison with MDs), 2. misunderstand and derogate the implication DNP (though it's an academic degree, not a clinical degree as MD, the physicians and trainee there seem to take it as NPs just trying to put a doctor title and lobbying to obtain an independent practice despite NP's allegedly inadequate competency.
I am not here to say NPs are equally trained as MDs because they are certainly not. Also, I also feel NP education has definitely rooms for improvement (another area of discussion).
Also, I acknowledge these people don't represent the majority medical societies so should take these views with a grain of salt. Nonetheless, I am unsure what to make out of the hates from these physicians (primarily in training) who will be our future coworkers other than trying to continuously learn and improve my competency and hopefully avoiding these toxic people in my future career if I have a choice.
I would appreciate any insightful advice from current NPs in the field. Thank you!
I was going to comment here with a thoughtful response about the current climate and physician groups who oppose independent practice. I read your post about “hate on NPs,” and then read a whole bunch of insults aimed at physicians, with a hefty serving of misinformation to boot.
I was going to comment here with a thoughtful response about the current climate and physician groups who oppose independent practice. I read your post about “hate on NPs,” and then read a whole bunch of insults aimed at physicians, with a hefty serving of misinformation to boot.
nice.
Realistically it comes from all sides. MD forums voice their concerns on the regular. Independent practice is a hot button issue across the board. While I’m an advocate for more independence, I don’t discount the value of my physician colleagues.
The problem is some people here advocate for extreme change to a degree that isn’t plausible en masse. They take their limited experience and limited clinical scope and presume it’s something applicable across the board for all specialties and all personal situations when they’ve 1. Never worked in those specialties and 2. Don’t understand that not everyone has the same financial or living situation to go that route. Some clinicians prefer to have the safety net of a lower straight forward salary in exchange for benefits and flexibility of schedule. They have a very skewed view of what it takes to run a clinic because theirs specifically has little overhead.
I also don’t agree a ton with the telehealth argument, especially in most our primary care. Tools like telehealth may help some populations in some specialties, but they aren’t plausible in all. It furthers the divide of hands on treatment/diagnosis and pushes to more diagnosis based on labs and imaging over clinical assessment, which further drives up broader healthcare costs. Covid for instance is my biggest issue with a range of problems I could be missing. I have infants put on my schedule for telehealth visits for a fever because *gasp* fever is a Covid symptom and anyone with a Covid symptom gets a telehealth visit period. I need to do a Covid swab on that patient before I can even see that child for the range of things that could be causing the fever and then I have to wait at least two days just for the green light to bring them in. Influenza diagnoses are down this year, not because it’s gone but because nobody is getting in to get it diagnosed or treated. Chronic conditions are just getting blanket refills without in office evaluations of the changes that we might pick up when we look at the skin, eyes, mouth, heart, lungs, or even the patients in person demeanor and gait. All because we want to increase access.
the issue IMO is the persistent us vs them mentality and the presumption that NPs are somehow “better”. Some old “studies” sponsored by those who would benefit suggest we can deliver similar outcomes, but most will agree our education standards can improve and perhaps our bar of entry is a tad low in comparison. Maybe the physician bar is too high as well. Independent practice is fine and all. Just be realistic about your individual needs and don’t preach about what all NPs should strive for. Many are perfectly content working in a supervised role. Much like many physicians don’t want to own their own practice.
Realistically it comes from all sides. MD forums voice their concerns on the regular. Independent practice is a hot button issue across the board. While I’m an advocate for more independence, I don’t discount the value of my physician colleagues.
The problem is some people here advocate for extreme change to a degree that isn’t plausible en masse. They take their limited experience and limited clinical scope and presume it’s something applicable across the board for all specialties and all personal situations when they’ve 1. Never worked in those specialties and 2. Don’t understand that not everyone has the same financial or living situation to go that route. Some clinicians prefer to have the safety net of a lower straight forward salary in exchange for benefits and flexibility of schedule. They have a very skewed view of what it takes to run a clinic because theirs specifically has little overhead.
I also don’t agree a ton with the telehealth argument, especially in most our primary care. Tools like telehealth may help some populations in some specialties, but they aren’t plausible in all. It furthers the divide of hands on treatment/diagnosis and pushes to more diagnosis based on labs and imaging over clinical assessment, which further drives up broader healthcare costs. Covid for instance is my biggest issue with a range of problems I could be missing. I have infants put on my schedule for telehealth visits for a fever because *gasp* fever is a Covid symptom and anyone with a Covid symptom gets a telehealth visit period. I need to do a Covid swab on that patient before I can even see that child for the range of things that could be causing the fever and then I have to wait at least two days just for the green light to bring them in. Influenza diagnoses are down this year, not because it’s gone but because nobody is getting in to get it diagnosed or treated. Chronic conditions are just getting blanket refills without in office evaluations of the changes that we might pick up when we look at the skin, eyes, mouth, heart, lungs, or even the patients in person demeanor and gait. All because we want to increase access.
the issue IMO is the persistent us vs them mentality and the presumption that NPs are somehow “better”. Some old “studies” sponsored by those who would benefit suggest we can deliver similar outcomes, but most will agree our education standards can improve and perhaps our bar of entry is a tad low in comparison. Maybe the physician bar is too high as well. Independent practice is fine and all. Just be realistic about your individual needs and don’t preach about what all NPs should strive for. Many are perfectly content working in a supervised role. Much like many physicians don’t want to own their own practice.
There are nurses that hate doctors and there are doctors that hate NPs, that’s a tiny minority that more serious people don’t care about or listen to.
But being concerned with the current standards and nurse practitioner education, and advocating against independent practice is not “hate.”
Voicing one’s disagreement with independent practice because of startling deficiencies in many NP educational programs is not hate. Advocating for one’s profession with many years dedicated to education and training in order to enter that profession is not hate. If someone calls that hate, it’s because they lack the capacity to understand the conversation on a professional level.
You know what hate looks like? Insulting the personalities, intentions, and motivations of an entire profession of people. And that’s what I saw plenty of here.
I have great respect and even love for MD's. However, in my experience pay and working conditions for NP's have been vastly superior in groups owned by NP's or by therapists. That is not a love or hate perspective, but one rooted in the best interests of my fellow RN's/NP's. Usually, the pay differences have been dramatic on the order of 50%. Also, given that this is an RN/NP board is is reasonable to expect a bias towards NP's in the same manner that I would expect a bias (and indeed find) a bias towards MD's on sites like StudentDoctor.net.
There are nurses that hate doctors and there are doctors that hate NPs, that’s a tiny minority that more serious people don’t care about or listen to.
I think you are correct. It is a small minority. I don't think any of the MDs/PAs I hung out with the other night at a pharma "free education" dinner (shame on me d/t covid) hated each other. You mostly encounter this online no IRL... which is why I am reading less and less here and other places. If you think it's bad here, go read reddit. There is far more brigading against NP and seeming "hatred" by the medical community there if you think this site is bad. Go look into r/noctor, r/residency, etc... I don't go in there anymore. I got harassed by a medical student for offering advice to people in r/askpsychiatry... there are too many threads there and not enough people replying (just like real life)
Specializes in Psychiatric and Mental Health NP (PMHNP).
20 hours ago, TuxnadoDO said:
You know what hate looks like? Insulting the personalities, intentions, and motivations of an entire profession of people. And that’s what I saw plenty of here.
Given the vast amount of nasty and belittling online comments leveled by MDs and med students against NP, it is hardly surprising that the NP community has some resentment. Frankly, MDs are far too thin-skinned. I don't care if you were upset. Far more online hate is directed against NPs by MDs and med students than vice versa. If you want to build a bridge, great, but don't come here in high dudgeon and think you are going to do so.
One thing that really irks me is that the MD community does a terrible job of policing its own ranks. There are incompetent MDs out there and I have had to clean up multiple "messes" produced by them. I'd suggest you focus on cleaning up the MD profession before coming over here to discuss the shortcomings of the NP profession.
Who cares what anonymous people say on social media? You don't even know if those people are really doctors.
MDs have more education and training than NPs. However, does that make them far superior providers? Evidently not, based on the evidence. Granted, NPs are not going to be neurosurgeons, but for basic care, NPs do a fine job. It's the old 80/20 rule, people. Honestly, I think RNs could do a significant portion of primary care, like treating the common cold, draining abscesses, sports and employment physicals, etc. It's just that in healthcare, unlike a lot of other professions, there is such incredible insecurity and jealousy over education and "turf."
Now that I have a few years of NP experience, preceded by 20 years of business executive experience, I'm going to make some anecdotal observations:
1. Most MDs are weird. They are not people I would want to socialize with. Most RNs and NPs are "normal" and fun to hang out with. I think this is because MDs are generally super nerds, and had to study so hard for so long, that they didn't develop great social skills. I'm a nerd, too (HS valedictorian, Captain of the Debate Team, Yale undergrad initially, blah, blah). Out of my Yale friends, I never kept in touch with the pre-meds, but pretty much every other major, I remained friends with. And for patients, that does make a difference. Over and over again, my patients tell me, "You really listen to me and make me feel like you care."
2. MDs vary widely in quality from outstanding to crap. It's a bell curve, like any other profession.
3. MDs have no clue about NP education. They do not understand that NPs must specialize on entering school. Most of them think 18 months to 2 years of NP schools is some kind of med school "lite" that covers everything med school does, very lightly.
4. Nursing is holistic. That is often dismissed, but I am now appreciating the difference. I have switched from primary care to mental health. I have patients that are switching from MDs to me. Why? Because I actually care about them as humans, and ask about their families, jobs, etc. I don't view them as nothing more than chemical factories that consume pills. I give them practical advice and guidance beyond just what medication to take. I also help them with things like GoodRx, etc. I understand that things like their home environment, lack of a car, etc., impacts their ability to care for themselves.
5. Unfortunately, at least in the US, MDs are taught to be arrogant a**holes who think they know everything about everything and don't want to admit when they don't know something. That can cause real harm to patients. Once, while in primary care, I was filling in for a doctor on vacation. One of their patients had been seeing the MD for almost a year about an issue, which clearly the MD did not know how to treat. I didn't either, and said so, then sent the patient to a specialist. I saw that patient again and he was extremely grateful, saying the specialist knew immediately what was wrong and provided the correct treatment! This type of thing has happened to me multiple times.
6. Many patients complain that the MD just types on their computer and never even looks at them! At least I look at my patients!
Medicine is not "magic" and most of it is not rocket science. In addition, good patient care is not purely mechanistic and requires a good provider-patient relationship, something many MDs fail to understand. I think most MDs are very insecure people with poor social skills and over-inflated egos and a huge sense of entitlement.
Honestly, in what other field would someone make 2x as much for doing the exact same thing? If patients had to actually pay cash based on hourly rates, which normally are based on compensation, who would pay 2 or 3x as much for the exact same thing? If I could buy a Starbucks coffee for $2.50 at store A or $5 at store B, where do you think I would go? I think this is fueling all this MD hate of NPs and independent practice. They are angry and resentful that people with less education and training are doing the same thing, and equally as well. Since many MDs' entire personal identity is based on their perceived superiority over the rest of us mere mortals, it is easy to see why they get angry.
Glad to get that off my chest!
I don't think I've ever read anything as true as this post. It made me laugh a little and think a lot. Well put on all fronts.
TuxnadoDO
72 Posts
I was going to comment here with a thoughtful response about the current climate and physician groups who oppose independent practice. I read your post about “hate on NPs,” and then read a whole bunch of insults aimed at physicians, with a hefty serving of misinformation to boot.
nice.