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?
I hope other states copy a page from Missouri... I want to see who these physicians (mostly Foreign Medical Graduates and some International Medical Graduates i.e US citizens) will be competing with...since after all they are better suited to practice medicine than NPs.
I hope other states copy a page from Missouri... I want to see who these physicians (mostly Foreign Medical Graduates and some International Medical Graduates i.e US citizens) will be competing with...since after all they are better suited to practice medicine than NPs.
Competition for jobs isn't a bad thing.
Even if every state in the country passed this, how many current medical students are going to opt into becoming an "assistant physician" and be handcuffed after 200k in debt to working under direct supervision in rural primary care? It think it would be great if they did. I doubt many will.
I hope other states copy a page from Missouri... I want to see who these physicians (mostly Foreign Medical Graduates and some International Medical Graduates i.e US citizens) will be competing with...since after all they are better suited to practice medicine than NPs.
And again where is your proof that untrained medical school graduates would do a better job as primary care providers than NPs. You spout a lot of nonsense, but you fail to provide any evidence to back up your opinions.
And again where is your proof that untrained medical school graduates would do a better job as primary care providers than NPs. You spout a lot of nonsense, but you fail to provide any evidence to back up your opinions.
Untrained med graduates? They have more clinical hours than NPs in 3rd and 4th year of med school and yet they don't let them practice medicine. On the other hand, they let the militant NP practice medicine in some states w/out supervision. I think it's only fair to let them practice to the fullest extent of their knowledge, which is not remotely comparable to NPs whose didactic knowledge is laughable....
Untrained med graduates? They have more clinical hours than NPs in 3rd and 4th year of med school and yet they don't let them practice medicine. On the other hand, they let the militant NP practice medicine in some states w/out supervision. I think it's only fair to let them practice to the fullest extent of their knowledge, which is not remotely comparable to NPs whose didactic knowledge is laughable....
Again. You have no idea what an NPs didactic or clinical knowledge is. You are a student.
You are advocating for autonomous practice for "assistant physicians" without any evidence they can practice safely all out of arrogance that because they went to medical school they must be better than everyone. I am sure patients will appreciate that.
Untrained med graduates? They have more clinical hours than NPs in 3rd and 4th year of med school and yet they don't let them practice medicine. On the other hand, they let the militant NP practice medicine in some states w/out supervision. I think it's only fair to let them practice to the fullest extent of their knowledge, which is not remotely comparable to NPs whose didactic knowledge is laughable....
Yes untrained. I have been with and served as the preceptor in the OR for medical students. These rotations do not give medical students the ability to practice medicine. It is meant as a bridge to internships and residencies while reinforcing some of the didactic education.
I have seen medical students spend their entire clinical rotation in a break room, so comparing that to NP clinicals doesn't add up.
And as always do you have any research to support that medical school graduates make competent providers without internships and residencies.
Y'all realize you're wasting time arguing with a studentdoctor dot net troll right? I mean, Gluteus had no interest in this forum back when obtaining his/her "BSN" (and there's not a nursing student in the country that hasn't posted a thread to ask if the PVT really works) and only shows up on this thread and one other to talk about how inferior NPs are.
Y'all realize you're wasting time arguing with a studentdoctor dot net troll right? I mean, Gluteus had no interest in this forum back when obtaining his/her "BSN" (and there's not a nursing student in the country that hasn't posted a thread to ask if the PVT really works) and only shows up on this thread and one other to talk about how inferior NPs are.
I am NOT trolling... Most med students and physicians are concerned about the trajectory medicine is taking with wanna-be physicians that want to practice medicine with no supervision...
I am NOT trolling... Most med students and physicians are concerned about the trajectory medicine is taking with wanna-be physicians that want to practice medicine with no supervision...
See, talking about wanna-be physicians is something you actually have some experience with.
Physicians are concerned about the trajectory of medicine away from their control. And their wallet.
That trajectory is based on hard evidence of equal care. Show us some data that demonstrates physician oversight is required. Seriously. Cite some data and save the drivel.
It must be real hard to have such a superiority complex but be unable to demonstrate any superiority.
Specializes in OR SCRUBULATOR, Nurse Practitioner.
I often find that the re-occurring point of debate between an MD and an NP is the amount of time dedicated to study.
As someone who wanted to be a doctor but started as a nurse and is now considering becoming a Nurse Practioner, I would be excited to see NP programs begin to incorporate residencies similar to medical residencies after graduation from NP school. Just as it is for medical school. I think this would not only be beneficial for NPs, especially those who went "straight" to NP school after nursing school, but it would be beneficial to patients who would now have the luxury of a practitioner with years of experience.
Personally I don't see an issue with expanding the time it takes for us to go out on our own and practice (similar to how a medical residency is done), and I can't see why it would be an issue, especially if said residency is paid (just like medical residencies are paid)
Afterall, its the safety and health of the patient that matters most, isn't it?
wtbcrna, MSN, DNP, CRNA
5,128 Posts
Actually, this medical student can call me Doctor or Major or even better not call me at all when it is time to save their butt.