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?
A tad off the OT but I had an experience yesterday with one of my adult patients with a history of poly sub abuse and coronary spasm who saw a clinical psychologist for ADD. The clinical psychologist sent a letter recommending the patient be started on 160mg Ritalin a day in divided doses.
I refused to prescribe that as a starting dose. The clinical psychologist called me quite upset stating "I'm the doctor".
A tad off the OT but I had an experience yesterday with one of my adult patients with a history of poly sub abuse and coronary spasm who saw a clinical psychologist for ADD. The clinical psychologist sent a letter recommending the patient be started on 160mg Ritalin a day in divided doses.
I refused to prescribe that as a starting dose. The clinical psychologist called me quite upset stating "I'm the doctor".
I prefer seeing the NP at my doctor's office and amy children always see the NP at the peds. The only time a MD has ever seen them was when my oldest daughter had a cyst under her arm and I suspected MRSA. The NP thought so too but wanted the MD to look at it for a second opinion. He came in, looked at it and agreed.
I find NP's to give a more thorough exam and are very up to date on current medications and treatments.
I know when i work sub school nursing some teachers are referred to as "Dr. Adams".
I do not want to be negative,but i do not understand why a nurse would want to be called "Dr".
I guess this is what happens when some wants really to be a nurse anymore.
If someone earns a PhD, they have the right to be called Dr. The term Dr. is not exclusive to medicine. In the university setting, it is rude to call a doctorally prepared professor anything but Dr.
May I just remind everyone that, boys and girls, anecdotes are not DATA!
Yes, and data is mostly meaningless turns out, as the militant nurses have apparently been secretly funding all the outcomes studies. Don't be distracted by the financial disclosures of who funded them. The militant nurses associations had those statements "fixed". I figure with all their vast membership and dues income they paid off JAMA to falsify the disclosures.
Since I know how difficult it is to communicate tone in this forum, let me be clear; sarcasm is dripping off every word above.
BostonFNP, APRN
2 Articles; 5,584 Posts
A tad off the OT but I had an experience yesterday with one of my adult patients with a history of poly sub abuse and coronary spasm who saw a clinical psychologist for ADD. The clinical psychologist sent a letter recommending the patient be started on 160mg Ritalin a day in divided doses.
I refused to prescribe that as a starting dose. The clinical psychologist called me quite upset stating "I'm the doctor".