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?
When are DNP going to demand to be called doctors in healthcare settings? When are they going to demand to have hospital privilege?
Well since this has been happening for quite a while now and the world did not stop turning I think the healthcare system and the public will survive, and be the better off for it.
NP's are now suppose to have their Doctrate, the ACA endorsed more independent practice of NPs to address the shortage of the PCP's. This was endorsed by the federal government, so the states have to address the issue. I have mostly worked with NPs who were under a MD, but would certainly welcome the NPs who practiced independently. It is the choice of the NP. Of course, MDs would not like this because it interferes with their reimbursement. Unlike most nurses they are able to charge for their care. Remember before we had nurse assts??? Nurses were questioning if nurse assistants would be able to provide care to patients without the education levels that nurses had. That has been addressed and yes they can. Most NP programs are better than the PA programs that are out there. Yes, midwives have been doing this since at least the 70's, let nurses who chose to be NPs practice independently---its about time.
I agree with you, but the DNP and the PhD are two different types degrees.
Right; the point is you could have a degree in plants and be called doctor...it's the right of doing the dissertation (joke for those who have been there). Doc is doc, what you put after is what counts and tells the world who you are. They can't take the degree away so you always put your degree (BSN) and than comma...whatever, RN, MD ...etc... My mistake, I thought the DNP had their doctorate.
If you don't have the doctorate you can't be addressed as doctor, and why would you?
Right; the point is you could have a degree in plants and be called doctor...it's the right of doing the dissertation (joke for those who have been there). Doc is doc, what you put after is what counts and tells the world who you are. They can't take the degree away so you always put your degree (BSN) and than comma...whatever, RN, MD ...etc... My mistake, I thought the DNP had their doctorate.
If you don't have the doctorate you can't be addressed as doctor, and why would you?
A DNP is a clinical doctorate the PhD is a research doctorate. A DNP does not require a dissertation. There is a general confusion about the degrees. That is why I pointed it out.
Can you tell me what are the states that NP have the right to admit their own patients in a hospital? That is why I like my state--we are still very conservative here....
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Can you tell me what are the states that NP have the right to admit their own patients in a hospital? That is why I like my state--we are still very conservative here....
I don't know all the states that allow that. I do know at least two. Wisconsin and Oregon. Our little town's sole heath care provider is an NP who has admitting privalges in the local critical acess hospital (local in this case is the nearest hospital and is over 20 miles away). She rounds on her patients most mornings, writes all their orders, consults other services, and takes call on her patients. This is exactly the way local family practice docs do it and from my perspective there is no difference between the NPs patients and the FP doc's patients.
She is highly respected and has many patients who refuse to see any other provider. I have noticed that her patients are exceptionaly well managed. Her diabetic patient's come in with lower HA1-c's, her warfarin patients never come in with crazy INRs like some of the other providers. Her CHF patients are seldome seen in the ER with exacerbation.
One thing that is HUGE in a very rural area like this. She is one of the few providers who will write for all forms of birth control. We have a couple FP physicians who will only prescribe to married women, and a couple more who won't prescribe them at all. The rest will only write for certain ones. She is the sole provider of Plan B in the area as well, though since the only local pharmacy refuses to dispence it, she dispenses it from her office.
A DNP is a clinical doctorate the PhD is a research doctorate. A DNP does not require a dissertation. There is a general confusion about the degrees. That is why I pointed it out.
I had never heard of a DNP until I read these posts. I read up on it and it looks like they have a long ways to go to be called doctor. They do not bear the required body of work that gives them that right. Why in the world do "they" want to be called doctor: I couldn't find anything on that except this thread on this site...do you have a DNP and think you should be called doctor?
I had never heard of a DNP until I read these posts. I read up on it and it looks like they have a long ways to go to be called doctor. They do not bear the required body of work that gives them that right. Why in the world do "they" want to be called doctor: I couldn't find anything on that except this thread on this site...do you have a DNP and think you should be called doctor?
That would be incorrect anyone that receives a Doctorate can be called doctor it doesn't matter if it is in fine arts, calligraphy, an MD, DO, PT, Pharm D, or a DNP.
Physicians do not own the title of doctor.
Why would anyone that has earned a doctorate want to use the title Doctor?.
I have a Doctorate of Nurse Anesthesia Practice (DNAP), and I am a PhD nursing student. I am also in the USAF so it is more common for me to use my rank and last name than academic title, but I think it is important for anyone that wants to use the title doctor that has earned it to be allowed to utilize it in a clear manner.
In other words I do not see a problem with someone introducing themselves as Dr. X your nurse or Dr. Z your pharmacists etc.
Physicians, and ONLY Physicians have earned the right to call themselves Physicians. That is the title that they can legally lay claim to. Anyone who earns a Doctorate, be in PharmD, DNP, DNSc, PhD, etc, can call themselves a Doctor.
That would be incorrect anyone that receives a Doctorate can be called doctor it doesn't matter if it is in fine arts, calligraphy, an MD, DO, PT, Pharm D, or a DNP.
Physicians do not own the title of doctor.
Why would anyone that has earned a doctorate want to use the title Doctor?.
I have a Doctorate of Nurse Anesthesia Practice (DNAP), and I am a PhD nursing student. I am also in the USAF so it is more common for me to use my rank and last name than academic title, but I think it is important for anyone that wants to use the title doctor that has earned it to be allowed to utilize it in a clear manner.
In other words I do not see a problem with someone introducing themselves as Dr. X your nurse or Dr. Z your pharmacists etc.
I have not seen anyone call a DNP 'doctor' in a healthcare setting... Have you?
wtbcrna, MSN, DNP, CRNA
5,128 Posts
Well since this has been happening for quite a while now and the world did not stop turning I think the healthcare system and the public will survive, and be the better off for it.