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 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?
I guess there is one that they have not indoctrinated yet... Do yourself a favor--look at the curriculum of the school you plan to go to and use your common sense to see if it will make you competent to practice medicine without supervision... In post #438 there is a NP curriculum (online degree) and a PA one, compare them and you will understand where I am coming from... I am not even comparing NP to MD/DO...
Since you were interested in med school, you will be shocked to see who will be your NP classmates... Boy! I did my BSN with some of these folks who later became NP... and when I think about them practicing medicine.. All I can say is wow! I guess it is a race to the bottom...
Anyway, I have some comfort knowing there are some physicians like my cousin and some of his colleagues (yes, they talk about you) who don't take these people seriously...
How on Earth can you argue that a PA's education is "rigorous" compared to an NP? That's just silly. PAs get 2 years post bachelor's degree. An NP, by contrast has a nursing degree and at least a masters in nursing (but the push now is to have a doctorate). I work with PAs at my hospital. They do not get the kind of holistic training that nurses do. They are trained to be basically a doctor's assistant, occupying a narrow scope of practice with close oversight by a physician. An NP's training, by contrast, prepares them to be autonomous providers, which is presumably why states are increasingly giving them the power to practice solo.
Anyway, I have some comfort knowing there are some physicians like my cousin and some of his colleagues (yes, they talk about you) who don't take these people seriously...
Remember that I have a BSN so I know about the nursing education... When NP schools require basic science like Organic chem, Genetics, Biochem, etc..., I will consider them legit. Many of my former classmates became NPs with no knowledge in basic science... Heck... I guess the watered down anatomy we took at that community college was good enough to become a NP...
And yet, you seem very comfortable with becoming a doctor and not understanding the first thing about statistics and evidentiary research. There are already too many doctors who practice based on their arrogance and personal opinions, rather than in an evidence-based way. If you're preparing to be another one, do us all a favor and just stop now.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
I don't know one single competent MD who would spend their precious time on this earth working out their anger issues on a nursing forum instead of simply living their life as a not-nurse. If venting helps you get through whatever you're going through, we'd like to help but the endless rumination on the topic is for sure going to have diminishing returns.
Some NP programs really ARE a joke... This has been discussed several times in this forum recently by fellow nurses.
It is frightening to know that graduates of these silly expensive programs are fully licensed to practice medicine without supervision
I went one Sunday (when my pcp office was closed) to get a strep test at a clinic at target with an NP. After I told her my symptoms guess what she did?! She GOOGLED the diagnoses
I wish I could say I was joking, believe me...
I was rather appalled and frankly Embarassed for the profession
I am an aspiring nurse (eventually hope to become a FNP) and hope that the schooling to become an NP becomes more thorough- before our whole profession becomes one big joke. And as one poster suggested, I hope they incorporate residencies in which a nurse can choose a field and learn it INSIDE OUT until her knowledge base is comparable to that of an MD. Or at least close to it
And yet, you seem very comfortable with becoming a doctor and not understanding the first thing about statistics and evidentiary research. There are already too many doctors who practice based on their arrogance and personal opinions, rather than in an evidence-based way. If you're preparing to be another one, do us all a favor and just stop now.
Calm down... Evidence-based nursing... Lol. Guys/gals you know what I am saying is true. If you really think that someone can practice medicine by taking a few classes online (post #438) with 600 hours at a doctor's office, something must be wrong here... It is not about you/me... It is about the patients... Don't try to follow blindly your leaders and look at the direction your profession is taking...
Some NP programs really ARE a joke... This has been discussed several times in this forum recently by fellow nurses.
It is frightening to know that graduates of these silly expensive programs are fully licensed to practice medicine without supervision
I went one Sunday (when my pcp office was closed) to get a strep test at a clinic at target with an NP. After I told her my symptoms guess what she did?! She GOOGLED the diagnoses
I wish I could say I was joking, believe me...
I was rather appalled and frankly Embarassed for the profession
I am an aspiring nurse (eventually hope to become a FNP) and hope that the schooling to become an NP becomes more thorough- before our whole profession becomes one big joke. And as one poster suggested, I hope they incorporate residencies in which a nurse can choose a field and learn it INSIDE OUT until her knowledge base is comparable to that of an MD. Or at least close to it
A one-to-two year residency would be a good start, but they need to do more than that... I would be the first one to admit a couple of the med school prereqs are not needed to practice medicine, but a lot of it are important. The human body is very complex and one need to understand it at a cellular level to be an effective clinician... I know a lot stuff in medicine can be pattern recognition, that is why a formal residency is important; however, pattern recognition won't take you that far.
I think nursing needs people like you.. people who don't drink the cool aid and can look at stuff in a very objective way... I understand everyone want to defend their profession, but people should speak up when your leaders are doing egregious stuff... Look at what has happened to law school... NP education needs a MAJOR overhaul...
Calm down... Evidence-based nursing... Lol. Guys/gals you know what I am saying is true. If you really think that someone can practice medicine by taking a few classes online (post #438) with 600 hours at a doctor's office, something must be wrong here... It is not about you/me... It is about the patients... Don't try to follow blindly your leaders and look at the direction your profession is taking...
You have been called out dozens of times to provide some data or evidence to support your arrogant and ignorant statements and all you have been able to muster is and anecdotal story about an "OR doc" that preferred MDAs, a link to an editorial that you assumed was published research, and a link to the SDN.
Isn't medicine based on the scientific process? Perhaps you haven't gotten to that class yet.
A one-to-two year residency would be a good start, but they need to do more than that... I would be the first one to admit a couple of the med school prereqs are not needed to practice medicine, but a lot of it are important. The human body is very complex and one need to understand it at a cellular level to be an effective clinician... I know a lot stuff in medicine can be pattern recognition, that is why a formal residency is important; however, pattern recognition won't take you that far.
How do you know what it takes to be an effective clinician? You have never been a clinician. You "know" that because you were spoon fed that. The data tells a much different story.
You have been called out dozens of times to provide some data or evidence to support your arrogant and ignorant statements and all you have been able to muster is and anecdotal story about an "OR doc" that preferred MDAs, a link to an editorial that you assumed was published research, and a link to the SDN.
Isn't medicine based on the scientific process? Perhaps you haven't gotten to that class yet.
I really need an NP to school me on scientific process...
:eek:
47yomalestudent
21 Posts
C'mon folks, his (or her) screen name is Gluteus... So it should be of no shock value to learn that even they consider themselves to be an ***.