Nurses are Not Doctors

[PMFB-RN, RN]

(yawn) So NY is finally catching up to more progressive states and eliminate NP's requirement to colaborate with physicians. This is risk free, unless the case is to be made that the NPs of NY are some how less competent than NPs across state lines.

The physican's arguments aginst it are easily shot down by looking at NP practice history in the more modern states that already have independant NP practice.

[IrishIzCPNP, MSN, RN, APRN, NP]

I agree that the clinical importance of the physician's expertise is being underestimated. I am sure too that the cost-effectiveness of nurse practitioners is being over-estimated.

Nurse practitioner training at the master's level involves around 600 hours of clinical training or less according to the web sites of prominent universities I checked. This is but a fraction of the number of clinical hours of training a physician receives. A physician generally has a bachelor's degree in a science, attends medical school for four years, and spends several more years doing residencies, internships and fellowships. To train as a Nurse Practitioner one is required to be an RN, with a BSN, and NP schooling is generally three years.

Most people would agree that a physician undergoes a far more rigorous and extensive training. Because of physicians extensive training in medicine, my family and I choose to receive our medical care from physicians. If someone is standing in front of myself or my family, and is presuming to diagnose and treat us, they are presenting themself as a medical authority, and we are only willing to accept physicians as medical authorities.

A key difference is we are trained very specifically from the beginning. For example...a PNP may spend 600-700 hours of clinicals but they are 100% pediatric. Med students go through everything before they specialize. NP students specialize from the start.

[PMFB-RN, RN]

Nurse practitioner training at the master's level involves around 600 hours of clinical training

At any level really. The DNP programs have not added clinical hours.

A physician generally has a bachelor's degree in a science, attends medical school for four years, and spends several more years doing residencies, internships and fellowships.

Maybe, maybe not. Lot's of physicans without bachelors degrees practicing in the USA. Lots more who hold bachelors degrees but do NOT hold doctorates. I work with a number of physicians to do not have MD or DO degrees and only have bachelors degrees.

To train as a Nurse Practitioner one is required to be an RN, with a BSN, and NP schooling is generally three years.

Since when is a BSN required for NP? Is this something brand new or are you misinformed? I have seen very reputable adult NP programs that were 15 months.

[IrishIzCPNP, MSN, RN, APRN, NP]

At any level really. The DNP programs have not added clinical hours.

Maybe, maybe not. Lot's of physicans without bachelors degrees practicing in the USA. Lots more who hold bachelors degrees but do NOT hold doctorates. I work with a number of physicians to do not have MD or DO degrees and only have bachelors degrees.

Since when is a BSN required for NP? Is this something brand new or are you misinformed? I have seen very reputable adult NP programs that were 15 months.

There are some RN to MSN programs. You know of an RN to MSN/NP program?

[klone, MSN, RN]

Lots more who hold bachelors degrees but do NOT hold doctorates. I work with a number of physicians to do not have MD or DO degrees and only have bachelors degrees.

What physicians are you referring to who are not MDs or DOs?

[ceebeejay]

That's why doctors are called "doctors" and nurse practitioners are called "nurse practitioners" and they have different and separate licensing requirements. I don't know a NP that, when faced with a patient that is out of their frame of reference, would not refer or confer with a doctor. The whole argument is just moot.

[PMFB-RN, RN]

What physicians are you referring to who are not MDs or DOs?

Regular physicians you probably work with every day. I work with dozens of phsyicans who do not hold a doctorate in anything. You probably do to. I many countries the Bachelor of Medicine, bachelor of Surgery is the professional degree for physicians. If you work with any doctors who trained in China, pakistan, the UK, India and dozens of other countries they may not have an MD or DO. Despite this, and to avoid confision most of the them will have white coats that say "Dr. John Smith MD", even though they do not have an MD.

If you want to know more read this:

Bachelor of Medicine, Bachelor of Surgery - Wikipedia, the free encyclopedia

[PMFB-RN, RN]

There are some RN to MSN programs. You know of an RN to MSN/NP program?

Sure, there are a number of them. In addition many schools will admit RNs who have a bachelors degree in another field other than nursing. I know that many of the schools who state "BSN required" will admit nurses with other bachelors degree on a case by case basis. In particular CRNA (I know we are talking about NPs) schools seem to not care about a BSN.

Here is one such program:

ADN to MSN+DNP (Bridge) Entry Option | Frontier Nursing University

[traumaRUs, MSN, APRN]

I'm an APN. I'm not an MD or a plumber. 'Nuff said

[OCNRN63, RN]

Was I randomly bashing? I don't believe I was, but sorry if you read it that way OCRN. I think physicians are well aware of the expense of their career path before they even go to medical school. Plenty of nurses come from tough financial backgrounds too (not just from the student loan debt category) and our career outlook isn't nearly as lucrative as MDs and DOs, so if you're implying that physicians don't want to specialize in family practice because it isn't consistent with their financial goals (as opposed to, I don't know, providing medical care to and developing therapeutic relationships with families in a community) then my point stands. They must not truly want it.

Would you choose a career path if you knew you were going to be deep in debt and have difficulty managing after graduation?

I think you need to learn more about the issues going on in primary care for physicians before you continue to cast stones.

And, FYI, it's "OCNRN," as in "Oncology Certified Registered Nurse."

[OCNRN63, RN]

If nurse practitioners want total independence, then their malpractice policies should reflect that; their fees for insurance should be on par with physicians. Perhaps this is the case now, but in the past, they paid less for malpractice insurance.

I'm not an NP basher, but I do think a patient is served better when there is collaboration. NPs tout the time they spend with patients as something that makes them superior to physicians, but if they work independently, there is no way they'll be able to sustain longer patient visits and survive financially. Before long it will be the same as a doctor's office: "Move 'em in, roll 'em out..."

[IrishIzCPNP, MSN, RN, APRN, NP]

If nurse practitioners want total independence, then their malpractice policies should reflect that; their fees for insurance should be on par with physicians. Perhaps this is the case now, but in the past, they paid less for malpractice insurance.

I'm not an NP basher, but I do think a patient is served better when there is collaboration. NPs tout the time they spend with patients as something that makes them superior to physicians, but if they work independently, there is no way they'll be able to sustain longer patient visits and survive financially. Before long it will be the same as a doctor's office: "Move 'em in, roll 'em out..."

Independent practice doesn't make them an MD not does it mean they practice just like one. So their malpractice shouldn't always be equal. My malpractice costs change based on what I'm doing (I am a provider already...just not as an NP right now). My insurance is based on what I'm doing and how I'm "employed" (private practice versus employed by a group or hospital).