An article appeared today in the New York Times as a followup to a bill passed in New York granting nurse practitioners the right to provide primary care without the oversight of a physician. The authors of the bill state "mandatory collaboration with a physician no longer serves a clinical purpose and reduces much-needed access to primary care". The need for more primary care providers is due to the shortage of primary-care physicians, the aging boomer population, and the Affordable Care Act.
Although the president of the American Association of Nurse Practitioners feels that the current "hierarchical, physician-centric structure" is not necessary, many physicians disagree citing that the clinical importance of the physician's expertise is being underestimated and that the cost-effectiveness of nurse practitioners is being over-estimated.
Many physicians also feel that "nurse practitioners are worthy professionals and are absolutely essential to patient care. But they are not doctors."
What are your thoughts on this? Where do nurse practitioners fit into the healthcare hierarchy?
You assume that NPs would be "crushed" by the USLME, but where is your proof? A one-time sample of nurses taking a knock off exam of the USLME that you have already discounted.
Nurses never have been equivalent to TA's but lets just put that aside and focus on the analogy.
Should TA's prove to be just as good at teaching as the "real" teachers over 50 years and hundreds of studies (produced by other teachers, TAs, and education administrators) but cost less why not give them a shot?
Though it wouldn't ever get to that point had TA's been required to step up or allow countless kids to go without education... Likely after 40-50 years teachers would have proven they deliver a superior product through undeniable evidence.
I have no problem calling anyone with a doctorate "Dr So and so." I get no ego boost by being called doctor, in fact I introduce myself as "Dr. MD2B but you can call me FirstName, but I'm laid back. I think it's just confusing for a patient since doctor has become synonymous with physician, especially in the clinical setting.
If you walk up to someone and say I'm a doctor, they don't assume PhD (unless you are in a college/academic setting).
Again that isn't true because you have dentists, psychologists, chiropractors, and podiatrists that have all been using the title doctor without this much negative feedback in clinics and hospitals for decades and none of those professions are physicians.
Anyone that introduces them self to a patient for the first time and as needed afterwards should introduce their self by their full title not just academic degree and last name i.e. Hi I am Dr. X your Certified Registered Nurse Anesthetist or Dr. X I am 2nd year physician resident of family practice.
Yeah, studies funded by nursing lobbying groups who have a vested interest in the result. Yeah, no conflict of interest there.
I want to see the proof that all these studies were funded by nursing groups which is outright lie by the way.
The simple come back to this then why can't the medical societies provide any scientific proof then that these studies are pertinent or fund their own studies. It certainly isn't from their lack of funding.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
You can make the same argument for nursing. There are significantly more nurses/APNs in metro areas. People tend to work/live 1) where they are from 2) where they have the most opportunities. There are significantly more nurses than doctors, especially since it takes so long to produce a doctor.
No, no way. There is no shortage of nurses. Nobody is saying we need to grant more independence to LPNs because of a shortage of RNs. There are no nursing organization fighting aginst greater independence of LPNs by claiming that the nice areas are full of RNs and the less desirable areas can't hire RNs. It's not the same at all.
There is an easy fix to the problem. A solution that is already in use in Australia. Give med students the option of a full ride through college and med school plus pay them enough of a stipend so that they can support themselves and don't have to barrow a lot of money while in training. In return they spend X number of years serving an underserved population, while being paid well, at least as much as they would expect to make in a more desirable area.
There is an easy fix to the problem. A solution that is already in use in Australia. Give med students the option of a full ride through college and med school plus pay them enough of a stipend so that they can support themselves and don't have to barrow a lot of money while in training. In return they spend X number of years serving an underserved population, while being paid well, at least as much as they would expect to make in a more desirable area.
As an aside, Indiana has a program where you can get your med school (and maybe undergrad) paid for if you agree to work in a rural area.
You have a sample size of approximately 120 people taking this exam over a 5 year period and this is a sample size out of 106K nurse practitioners in the U.S. That is 1/10 of a percent of the NP population in 2010. That isn't adequate sample size even for the smallest NP populated state not to mention trying to make a comparison of the entire U.S. NP population.
ScienceWiz
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Yeah, they just get crush every year, see here: American Board of Comprehensive Care - Exam Pass Rates & Practice Analysis