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 implied that without a study proving otherwise NP =MD/DO, which is a conclusion based on interpreting the data. If you're memory is very short, I'll quote for good measure.
it's even more worrisome that some of the views expressed here seem to be NP/DNP=MD.
So in the qualification of providing effective primary care, show me a study that demonstrates NP does not equal MD/DO.
Great, thank you for answering the question.
I am not sure what your point is here: there is substantial data supporting that there are equivalent outcomes for physicians and NPs in a variety of outcomes measures. The data overtly supports one side.
I want to be very clear: this does not support that in general NP=MD. The education and training is significantly different and there are many area of medicine and surgery without any data on the outcomes. There is significant primary care data.
You have been asked, at least a half dozen times, to provide evidence that the extant studies in outcomes are biased, flawed, or inaccurate.
You seem more interested in debating personal opinion.
So again, you are being challenged, provide some data that outcomes are not equivalent in primary care.
I'm not sure if it's the inattention to detail, lack of reading comprehension skills, or just general conniving tactics but you should have noticed that not once have I claimed NPs were not equivalent to MDs in primary care. I've made no claims on the issue either way. In effect, I have no case to prove as I have made no claims on that issue.
This seems to be yet another evade and redirect post by you and your ilk.
Can you please quote where I have stated that nurses are misrepresenting themselves?
I'll save you some time, you can not, because I have not stated that.
The rest of your argument is a red herring, and appears to be yet another misguided attempt to evade and redirect.
Back to the issue, shall we?
Can you please produce scientific evidence for your position of, "That is incorrect. Both of the terms are used simultaneously i.e. Hi I am Dr. Smith nurse practitioner.-wtbcrna"
Post #346.
The whole thread is about NPs being independent providers and you or anyone else have yet to provide any evidence to support a reason that NPs should not be independent providers. Everything else on here is a "red herring" based purely on opinions.
I'm not sure if it's the inattention to detail, lack of reading comprehension skills, or just general conniving tactics but you should have noticed that not once have I claimed NPs were not equivalent to MDs in primary care. I've made no claims on the issue either way. In effect, I have no case to prove as I have made no claims on that issue.
This seems to be yet another evade and redirect post by you and your ilk.
So we agree NP and MD primary care is equivalent. Pleas read original post. End of discussion.
You have been asked, at least a half dozen times, to provide evidence that the extant studies in outcomes are biased, flawed, or inaccurate.
You seem more interested in debating personal opinion.
So again, you are being challenged, provide some data that outcomes are not equivalent in primary care.
Also, it would take very little stretch of imagination to conclude that you would reject out of hand any real critical examination of the literature on the subject. You seem to be under the quite naive impression that studies are objective and the data they produce stands on its own without a subjective analysis, interpretation, and conclusion.
So we agree NP and MD primary care is equivalent. Pleas read original post. End of discussion.
Thank you for making it clear that it's indeed your reading comprehension that is lacking. If someone has not taken a position on the issue does that make them:
Also, it would take very little stretch of imagination to conclude that you would reject out of hand any real critical examination of the literature on the subject. You seem to be under the quite naive impression that studies are objective and the data they produce stands on its own without a subjective analysis, interpretation, and conclusion.
Quite the contrary. I would be more than happy to consider any major (or minor) study that refuted the dozen studies that have reported consistent results. Please, cite a link to any such critical examination.
There is no naivety here. There is, however, a substantial body of supporting literature published in a myriad if countries and peer-reviewed journals. Unless you honestly think we are taking about an international and multidisciplinary conspiracy....
You may not have been serious about wanting to see those studies but you were serious in thinking you had made a reasonable response to my demands for evidence. However you unfortunately do not understand the difference between the two requests for evidence, namely one is demanding proof for the position taken by the poster I quoted, the same kind of proof he insists on demanding from others, the other is the logical fallacy of asking someone to prove a negative.
I was serious. The poster needs to be consistent and provide the same level of evidence for his claims as he demands of everyone else. If he can't do that, then he's being a hypocrite.
I'm struggling to even follow your criticism as I don't know of too many claims that I've made here that require or for which scientific evidence is even relevant. It's as though most of you here don't understand what you are asking for or why, you're merely trying to play a trump card or sorts, albeit poorly played and nonsensical.
You have been constantly stating your opinions as facts through every post you have made, and you get upset when someone asks you to prove those opinions/myths. That is far cry from someone being a hypocrite when making a statement that is clearly an opinion based on personal experience.
You didn't see me asking someone for scientific evidence, because they choose to see a physician versus an NP.
What you lack is the ability to win this argument through any kind of sound references so you revert to distractions and stating opinions as facts, and then get upset when someone asks for proof.
Thank you for making it clear that it's indeed your reading comprehension that is lacking. If someone has not taken a position on the issue does that make them:
a) for the position
b) against the position
c) neutral on the position
I'll give you a hint, it's not a.
Despite the evidence you are against the position (even though you just stated that you have never stated such) or you are undecided. May I inquire what your position is based on?
The whole thread is about NPs being independent providers and you or anyone else have yet to provide any evidence to support a reason that NPs should not be independent providers. Everything else on here is a "red herring" based purely on opinions.
I see you've yet again, evaded and redirected to a different issue. I'll take it that your final position is one of admitting you do not have any evidence, what so ever, to back your claim that I've quoted and been referring to over the span of several posts. In effect, you are hypocritically placing demands on others that you are not willing to fulfill yourself, as I suspected all along. For the sake of the audience, I think I've exposed you for the phony that you are and will drop this particular issue with you.
Despite the evidence you are against the position (even though you just stated that you have never stated such) or you are undecided. May I inquire what your position is based on?
BostonFNP, APRN
2 Articles; 5,584 Posts
I am not sure what your point is here: there is substantial data supporting that there are equivalent outcomes for physicians and NPs in a variety of outcomes measures. The data overtly supports one side.
I want to be very clear: this does not support that in general NP=MD. The education and training is significantly different and there are many area of medicine and surgery without any data on the outcomes. There is significant primary care data.