I also 100% agree that, for the already practicing Advanced Practice Nurse, there needs to be a doctoral option that is truly clinically focused in the way the a medical doctorate is. The post-master's DNP, although an alternative to the post-masters PhD, is primarily policy and leadership focused. If an NP wants to practice in clinic as a primary care provider for 100% of their time for the rest of their career, let's say, in family medicine, for example, the DNP is simply not needed to advance their knowledge base or clinical proficiency. If a DNP truly produced better clinicians than an MSN degree it would be required for Full Practice Authority (FPA) and we have not seen that be the case. MSN NPs are truly good providers, safe and proficient in their fields and that is why we have been given FPA in many states.
If we truly want to elevate our Clinical Professionals (and especially if there is a push to make a Doctorate of Nursing the exit degree for NPs) we truly need to have an option among the doctoral degrees of a truly clinically focused terminal degree. I mean, yes, we (of the "clinical bent") could just go to medical school for a terminal degree if we are so determined to have a clinically focused doctorate... but many of us want to remain in the nursing field.
We need to show that our programs can produce consistently clinically proficient medical providers. Like it or not, NPs are working within and pushing for independence among what has been defined for centuries as medicine (not nursing). If we want to be able to practice at the highest level of clinical practice and colleague supported independence, it would be appropriate to have a Doctorate of Nursing program that mirrors the model of medical schools which has shown a consistent output of great clinical providers. This is done through extensive and rigorous didactic and supervised clinical learning experiences.
I personally would love to have the option of just being in primary care for the rest of my career AND have a terminal degree that supports my clinical pursuits as a primary care provider, not as a future policy maker or clinic manager, etc. That's not to say classes with policy or leadership focus should not be included in the "clinical doctorate" for NPs but I would much rather spend the additional 500+ clinical practice hours on a deeper dive into clinical specifics, in a fellowship, and/or in an ambulatory care specialty and not just a quasi-PhD research project.
It would be great to have a program that went into greater depth on all areas related to primary care (or acute care respectively for ACNPs) such as biochem, advanced kinetics and physiology, endocrine, cardiology, neurobiology, advanced application of differential dx's (the horses AND the zebras), advanced clinical nutrition & even maybe some alternative modalities like chiropractic (osteopathic) procedures, clinical herbalism and clinical acupuncture.
We COULD be so well-rounded as Doctoral Nurses with such potential to truly lead our field into peer-supported and colleague supportive professional advances within our passions toward primary care. Medical doctors typically spend so much money on medical school it is not always in their best interests to pursue Primary Care and get paid so much less than if they specialize. On the other hand, Advanced Practice Nurses (specifically in Primary Care) could, like another peer said in their post, really take the lead in the area of Primary Care. Primary Care Clinical Specialization could easily be where we could go with a clinically focused nursing doctorate for NPs. The PhD and the DNP are truly great options for so many NPs. They have their purposes and real strengths. And on the other hand, in my opinion, a Doctorate of Clinical Nursing Practice could elevate our terminal degree options as Nurse Practitioners who have a deep passion for primary care and/or primarily clinically-focused practice (acute/specialty). It could dramatically change the landscape of our future independence, satisfaction in our careers as PCPs and improve cohesiveness with clinical colleagues and our "non-NP" counterparts (physicians).