Has anyone taken a gander at this recently? Looks like someone with a pro-physician lobby has gotten ahold of the page and it really casts NPs in a very negative light.
Some of the statements like contact hours and education aren’t inaccurate, but they definately go out of their way to make us look bad and it’s very one sided. Many of the “articles” cited are actually just surveys conducted by physicians. Kind of funny.
Theres a whole section on “quality of care” that is basically bogus and doesn’t care to reference or mention any articles that are based on systemic reviews that say we actually have better ourcomes than physicians in many regards.
Oh by the way, I reported this to the AANP a while ago (even though I hate NPs, and myself...). Here is the response:
"On behalf of AANP president, Dr. Joyce Knestrick, we’d like to thank you for responding to our request for updates on media messaging. We are aware of the misinformation in Wikipedia and are in the process of revising the language to accurately reflect the nurse practitioner role. We appreciate your efforts to help us stay informed of any negative or misleading statements made about nurse practitioners and we urge you to continue to be vigilant about the way NPs are referenced in the media. Please keep this link handy and let us know about any future comments made in a public space that inaccurately define NPs. Patients need to have all the most relevant information when choosing their health care provider and with your help, we can make sure that information provided to the general public is an unbiased and accurate picture of the exceptional care that NPs provide. Please note that anyone can make changes to Wikipedia at any time. So, we need to be prepared to see constant revisions. We will try to update it as often as possible."
Point two...a physician is a physician after four years of medical school whether they go for an additional 3 years for residency or not. They can in theory work as one whether they go through residency and board certify or not. It is certainly limiting career wise, but doesn't make them any less awarded that title.
Point three...a few schools have 100% acceptance and their graduation rates don't typically equal the total who start their programs. Suggesting that "many" clinical experiences are limited to a shadowing experience is likely a gross mischaracterization and can't be truly measured unless you can say you honestly personally account for this experience (which means you either benefited from this or contributed to it). It sure as eff wasn't my clinical experience.
I honestly have never met an np with more professional self loathing in my life. How you remain in this field or don't exercise your Superior opinion of yourself and your education to get your MD is beyond me.
Of all provider types it’s the nps who are the most resistant to understanding their short comings. Hence why very rarely will I supervise one
Most surgeons are at least adequate. 3-4K hours training times 5 years after medical school makes the most mundane person into someone who can at least perform mediocre. The same cannot be said of 500 hours of an NP. But I always found it funny that nurses critique surgeons the most when there probably are less than a handful that could point on any more than 10 anatomical structures in an open colectomy
Most surgeons are at least adequate. 3-4K hours training times 5 years after medical school makes the most mundane person into someone who can at least perform mediocre. The same cannot be said of 500 hours of an NP. But I always found it funny that nurses critique surgeons the most when there probably are less than a handful that could point on any more than 10 anatomical structures in an open colectomy
luckily we have scrub techs
I agree most surgeons are adequate. Most I’ve met are fantastic.
When you took a generalized shot at the NP profession and our personality not understanding shortcomings (which had you actually ever been on this site would know there’s literally hundreds of pages worth of NPs discussing the profession and our shortcomings), I decided to make a joke about surgeons.
Surgeons are experts at deflecting their own mistakes and shortcomings onto others. Clearly not all of them are, but there’s a reason for the profession being associated with the term “God Complex”.
At the end end of the day, comparing education has done nothing to enhance the physician lobby, and more and more states are granting NPs their independence, not the other way around.
When I sat in a recent hearing where the government of New Mexico passed a law allowing all APRNs the ability to admit their own patients in a hospital without a physician, the senators asked point blank, if the physicians there fighting the bill had any proof that nurse practitioners, particularly in independent states like New Mexico, provided inferior care or their patients suffered worse outcomes, and they straight up said no proof exists, and spouted on again about education. They were promptly silenced. The bill passed easily and was signed by the governor just this month.
I agree most surgeons are adequate. Most I’ve met are fantastic.
When you took a generalized shot at the NP profession and our personality not understanding shortcomings (which had you actually ever been on this site would know there’s literally hundreds of pages worth of NPs discussing the profession and our shortcomings), I decided to make a joke about surgeons.
Surgeons are experts at deflecting their own mistakes and shortcomings onto others. Clearly not all of them are, but there’s a reason for the profession being associated with the term “God Complex”.
At the end end of the day, comparing education has done nothing to enhance the physician lobby, and more and more states are granting NPs their independence, not the other way around.
When I sat in a recent hearing where the government of New Mexico passed a law allowing all APRNs the ability to admit their own patients in a hospital without a physician, the senators asked point blank, if the physicians there fighting the bill had any proof that nurse practitioners, particularly in independent states like New Mexico, provided inferior care or their patients suffered worse outcomes, and they straight up said no proof exists, and spouted on again about education. They were promptly silenced. The bill passed easily and was signed by the governor just this month.
lack of proof does not mean it does not exist. only studies i’ve ever seen inpatient are mid levels vs residents or fellows and the best part was all were supervised by attending.
Never understood why nps on inpatient wards need to compare themselves to those still in training especially when both had attending physicians managing their care plans.
as as we all know the government always signs into affect ludacris laws but the dominos will soon fall my friend. i think an rn could manage a patient if an attending was hovering over their every move as in the inpatient studies midlevels often quote
here is the study i see most often quoted. it states acnp and residents all share supervision by fellows and attending. this is the type of garbage that gets thrown out there. literally everything gets the final day through attending physicians yet midleveld act as if they did all this on their own. in addition they compare medical residents on icu rotation. why is it acnp vs residents? they aren’t even fully trained yet
lack of proof does not mean it does not exist. only studies i’ve ever seen inpatient are mid levels vs residents or fellows and the best part was all were supervised by attending.
Never understood why nps on inpatient wards need to compare themselves to those still in training especially when both had attending physicians managing their care plans.
as as we all know the government always signs into affect ludacris laws but the dominos will soon fall my friend. i think an rn could manage a patient if an attending was hovering over their every move as in the inpatient studies midlevels often quote
Possibly compared because they are the comparable part of the profession that is actually seen at the bed side regularly Who are actually writing the notes and developing plans. Not just tagging a smart phrase stating "I have read the plan and independently assessed the patient (yeah ok) and agree with what's started here".
lack of proof does not mean it does not exist. only studies i’ve ever seen inpatient are mid levels vs residents or fellows and the best part was all were supervised by attending.
Never understood why nps on inpatient wards need to compare themselves to those still in training especially when both had attending physicians managing their care plans.
as as we all know the government always signs into affect ludacris laws but the dominos will soon fall my friend. i think an rn could manage a patient if an attending was hovering over their every move as in the inpatient studies midlevels often quote
So because those are the only studies you’ve seen makes it definitive I guess?
Many states have had independent practice for over 20 years. You’d think it would be all fire and brimstone there with how terrible NPs are.
Look at a map of states that have independent practice, and they coincide with some of the healthiest states in the country. Look at the most restrictive practice states ( the south), and you have some of the most unhealthy states in the country. I’m not saying NPs are the cause of that either way, but it’s clearly not a detriment, and just perhaps patients that have greater access to more providers is a good thing, and a net positive.
Lets not beat around the bush. Physicians against independent practice are worried about their bottom line. Plain and simple.
So because those are the only studies you’ve seen makes it definitive I guess?
Many states have had independent practice for over 20 years. You’d think it would be all fire and brimstone there with how terrible NPs are.
Look at a map of states that have independent practice, and they coincide with some of the healthiest states in the country. Look at the most restrictive practice states ( the south), and you have some of the most unhealthy states in the country. I’m not saying NPs are the cause of that either way, but it’s clearly not a detriment, and just perhaps patients that have greater access to more providers is a good thing, and a net positive.
Lets not beat around the bush. Physicians against independent practice are worried about their bottom line. Plain and simple.
No I would agree having nps around is great but the major np groups are not welcome to the limitations that need to be in place. We couldn’t function without mlps since there are too many patients and not enough of us to go around. But we can’t forget that nps only make up a tiny amount of pcps even and in most places they are managed by attendings.
When it comes to primary care it’s a moot topic often. It’s hard to really do a terrible deed to a patient and monitor outcomes in those studies. Too much moving of patients around to different providers , referrals, non compliance etc. I think most people could manage htn and dm adequately which is what most studies monitor. Since that makes up most mortality. But the things missed by mlps are missed very often and those aren’t really monitors by studies since the disease occurances are so infrequent the missing of RVHtn in a younger person barely shakes the statistics. Hence why I am for mlps but they should not be given equal rights nor work alone. But again physicians are part to blame because they love the cities and the coast and most sadly it’s our fault the interior is left to MLPs often
i think we all know a burger in hand daily means more than your pcp
here is the study i see most often quoted. it states acnp and residents all share supervision by fellows and attending. this is the type of garbage that gets thrown out there. literally everything gets the final day through attending physicians yet midleveld act as if they did all this on their own. in addition they compare medical residents on icu rotation. why is it acnp vs residents? they aren’t even fully trained yet
”Sharing of fellows and attending physicians was equal’’
honestly can’t wait for the day an np run hospital emerges and the crap hits the fan when no consults are available
It’s sort of funny you mention “an NP run hospital”.
I work as a hospitalist in a group that is 50/50 physician and NP hospitalists. We are part of a pilot program by our company to determine if a larger pool of NPs in a group is effective and safe. Effectively our company wants to know if they can get away with this model because we are paid a lot less than the physicians, so it’s a big cost saver.
We split the assignments, admissions, acuity, hours worked, committee memberships, and everything else evenly. It’s an independent practice state so there’s no co-signing.
After two years, the NPs as a whole have a better satisfaction rating, lower readmission rate, equal length of stay, equal consultation frequency, fewer adverse outcomes, and fewer core metric fallouts.
As a result, several of our sister hospitals are eliminating physician positions in favor of more NPs in the practice group.
Since our group started this we surprisingly have more consultants that have moved to the area. No one has fled!
Dodongo, APRN, NP
793 Posts
Oh by the way, I reported this to the AANP a while ago (even though I hate NPs, and myself...). Here is the response:
"On behalf of AANP president, Dr. Joyce Knestrick, we’d like to thank you for responding to our request for updates on media messaging. We are aware of the misinformation in Wikipedia and are in the process of revising the language to accurately reflect the nurse practitioner role. We appreciate your efforts to help us stay informed of any negative or misleading statements made about nurse practitioners and we urge you to continue to be vigilant about the way NPs are referenced in the media. Please keep this link handy and let us know about any future comments made in a public space that inaccurately define NPs. Patients need to have all the most relevant information when choosing their health care provider and with your help, we can make sure that information provided to the general public is an unbiased and accurate picture of the exceptional care that NPs provide. Please note that anyone can make changes to Wikipedia at any time. So, we need to be prepared to see constant revisions. We will try to update it as often as possible."