Jstand

Maybe instead of taking the approach that you are a nagging mother, you should try giving some professional advice and leave it up to your patient to take it or leave it. People might respect your advice more if given in that fashion. Don't think that nagging someone by repeatedly using terror tactics is going to advance your point with them.

Nobody said that independent practice makes a nurse practitioner a physician.

I agree completely. There is simply no need for supervising or collaborating physicians. The scope of practice is what sets them limit. Physicians are only necessary when there needs to be a referral for specialty care for a patient.

Nobody ever said this was limited to doctors. This is aimed at unethical behavior, regardless of what the profession.

You really have to be kidding, I am going to assume that you are. This is the same sort of stuff that doctors do when they disclose at the end of a study which drug company they took money from and expect us to believe that they are independent and unbiased. It can't happen! There is no way that they remain independent. They must really not teach these people any ethics.

http://projects.propublica.org/docdollars/

What are you talking about? You don't think you are competent?

Personal attacks are not appreciated and from what I understand are not tolerated. There is no reason for you to question Ann's competency here. Let's just get down to business here and answer the question. Doctors are hostile towards the DNP and towards NPs in general becuase they have the a huge chip on their shoulder. They have enjoyed an unwarranted monopoly for WAY too long and they are about to lose it. I guess if I were them I would be upset about it too, but that is still no reason to deprive the public of access to care from autonomous NPs.

This is where it comes down to personal freedom. The fact that NPs are not allowed to practice autonomously is unconstitutional. You choose to have whoever you want to treat you and keep your beliefs to yourself. Stop trying to push your silly reservations about NPs on everyone else in society. Nobody really asked for your opinion. Physicians have basically hijacked medicine and healthcare alike and taken it as their own. They have made the costs balloon in the last 40 years and are ruining the system. If you want a physician's hand in the matter, why don't you go pay for it and let the rest of us get what we want.

Why are they not interchangeable? 1. The prevention, treatment, and management of illness and the preservation of mental and physical well-being. 2. The science of diagnosing, treating, or preventing disease and other damage to the body or mind. Hmmm, why don't you tell me which is which?

Physicians are far from the gold standard in patient treatment. They are not well trained in a number of fields. Physicians know extremely little about a number of things. Despite all of their training, they know very little about nutrition. They aren't well versed in physical therapy. Physicians are not superior to other health care providers, they are simply different. I don't want a physician when I need a dental hygenist. I don't want a physician when I need a social worker. You need to take off those blinders and realize that healthcare is much larger than physicians. They are know longer the king of the hill and never will be again.

The top of the food chain? What exactly do you mean by that? And how do you figure that physicians will always be there. Please explain yourself and add some citations here. Don't you have to prove it if you make the claim? Isn't that the hallmark of statistics and research?

Who is it that considers it to be so? Don't you need to have a citation for that? We certainly can't just take your word for it.

Are you joking? Show us the citation for where you came up with this garbage on the "hallmark of statistics and experimental design".

Where exactly did you learn to do your math anyway? Since when did 4 years equal three times 2-3 years? The other thing that is amazing is that you can't understand what a subset is. Have you ever heard of one? Physicians never should have been in control of medicine either. That is the leading problem we have in healthcare today. They have WAY too much control and far more than was ever warranted or deserved.

I don't consider them to be all that different. You are saying that they don't know enough, don't have enough intelligence, aren't smart enough. So I guess in the words of your friend wowza "no argument, argue semantics", right?

Sorry, I didn't mean to be insulting. My point is this, an NP does have enough training to be an autonomous generalist. You certainly do not have enough training to do your job autonomously. You need to clarify what you are talking about and don't GENERALIZE and I suppose I need to do the same. Also, I suppose I didn't mean to same NPs were meant to be generalists, but they are better off being generalists and can do so autonomously. Your opinion and your position and experience have little bearing on whether an NP should be able to practice independently in a primary care setting. The reason I said you aren't smart enough to do your job independently is because you imply that NPs aren't smart enough to do their jobs autonomously.

Why don't you explain that process to us all in detail?

If you are bowing out, that wasn't very graceful. The field lends itself to general practice much better than it does to specialty practice. Specializing was a CLM. Most NPs are FNPs, so most of them are NOT specialty focused. I'm not mudslinging, just calling a spade a spade.

Physicians are only trying to protect their gravy train at the expense of patients. They could care less about the well being of patients. Spare me the crap about life and death. Don't try to tell me that everything encountered in healthcare is a matter of life and death. Pimples and head colds don't typically kill people, do they? Give me a break. You really do have trouble doing your job, don't you?

I think we have identified your first problem, NPs were meant to be generalist, not specialists. You are trying to function as a specialist, in which case, you do need supervision. You are trying to function outside of your scope of practice to begin with. So you basically are not smart enough to do your job autonomously. I agree with you. On the other hand, if you were in a primary care office, the story is entirely different.

The truth about NPs is that they can and do practice autonomously and they DON'T endanger their patients. Physicians are the ones who endanger patients by blocking their access to care from NPs. Nobody has threatened anyone. You are the one who is becoming angry and hostile because you can't win the argument. In fact, you have no argument. Who ever decided that you have to be a physician to practice autonomously. Most professions do practice autonomously within their defined scope. This is the only one I have ever heard of that has a "supervision" requirement. That kind of shows you how stupid it is as well as how it was cooked up by physicians to artificially restrict competition since they know they would lose out to it.

So you are telling me that I have no idea and that NPs don't want to practice autonomously, but that NPs on this forum like to base their arguments on flawed studies? Which is it? Do they want to practice autonomously or not? You sound like you are angry by the way. Are you? You claim to know it all, so tell me something. If think you are too stupid to practice, why don't you just quit?

If I am a practitioner or not has no bearing on whether or not I know if all practitioners want independence. Neither does your profession. Basically your opinion is flawed because there was no reason for you to become a professional if you didn't want autonomy. Why do you assume that someone thinks they "know as much as a doctor" if they want autonomy? All that means is that they don't want to work with a doctor. WHO CARES ABOUT THE STUDIES? NOBODY CARES ABOUT THE STUDIES! Where you have it screwed up in your head is that you think that someone NEEDS to know as much as a doctor to be an independently practicing provider. Where exactly did that rule come from? And I will tell you now that you are very wrong about whether NPs have intentions of autonomous practice.

viral2010 should have remained an RN if she had no desire for professional autonomy. The problem here is not with NPs, but with physicians. They would like to think that their education makes them the RIGHT provider for every situation simply because they go to school longer. They certainly aren't more efficient simply by virtue of the fact that they study longer. In case you haven't noticed, it isn't just NP's, or DNP's for that matter who are interested in independent practice. Their patients are asking for it too. That should tell you something. What it tells you is that all of those senior residents and young attendings, the future generation of doctors should be angry at themselves and their own profession for not doing a better job of being the professionals that they claim to be. In regards to the rural matters, it simply doesn't matter. Why would NPs be licensed to practice independently "but only in rural areas"? That would be ridiculous. No state that has authorized independent practice has restricted it to low population density areas to my knowledge. I'm not sure why they would want to cut the urban citizens out of the benefit of having an independent nurse practitioner at their disposal either. I do continually find it comical when you medical students get on this board and run down any study that might make a nurse practitioner sound competent and then fail to ever produce a shred of evidence proving otherwise. You say "the verdict is still out" while ignoring the fact that there are several hundred thousand NPs out there providing care everyday and doing so successfully. Your arguments against this are so ridiculous that I don't believe that they come from the mouth of someone who has any education at all. You really expect someone to believe that you have a superior education when you make arguments like this?