What is the difference between NP and DNP?

[ajhill00]

I was looking into future possibilities through Arizona State University and noticed that all their NP programs are "DNP". Does this mean you get the title of Dr. once you get this degree vs the NP degrees?

I have a long ways to go, but I can't find the answer to this anywhere and it's confusing.

Thanks,

Amber

[Disinherited]

Psychonaut - do you really think patients don't have any 'skin' in the game? I would suggest we patients have more skin in the game than anyone....

BTW - Not a Doc, not a med student, not a med student wannabe. Just a patient who used to think that PA/NPs were highly trained, experienced people who worked with physician oversight to take care of my family and I. My first run-in with a DNP was about a year ago and that got me curious. Looking into this training and education - - - I am stunned at what I found.

And you can dismiss my concerns if you want. After all, I am but one patient (well....I pretty much represent 8 patients with my family). But you might want to consider me a "consumer" of what you provide. And trust me, woe comes to businesses who dismiss what their consumers want/need.

[dgenthusiast]

Does anybody know the answer to this question? Are there a bunch of nurses who go to medical forums and harass them? Is that what draws med students over here to heckle nurses? I mean it's not like we practicing nurses don't have a lot of "dirt" on shoddy medical practice that we could throw back at them.

Haha, pointing out the flaws in your "doctorate" is harassing you guys now? Btw, I'm not a med student. I'm just smart enough to know when someone is trying to BS me. It's extremely, extremely unlikely for a midlevel to have anywhere near the same level of knowledge as a full-fledged attending in the same field. Don't tell me you've "streamlined" 7+ years of intense medical training into 3 years of fluffy courses and then tell me you can provide equal care as physicians. And then, don't cite horribly flawed studies to support your statements. I mean, really. You guys take so many stats courses in your NP/DNP curriculum (and I have no clue why...) and yet, fail to notice these huge flaws? Or do you just blindly support any study that puts you in a good light with complete disregard to its validity?

Oh, and a reason why nurses don't go on medical forums to "harass" physicians is because when they try to, the physicians just rip them apart (usually because the nurse used terrible logic to reach his/her conclusion). However, there are also many well-versed nurses who are very valuable and post on some medical forums. The difference though is that when these nurses criticize something about medicine, the physicans don't go crying about it. I know that's anecdotal, but you guys here don't seem to believe in actual statistics and place more weight on personal experience anyways.

[psychonaut]

Psychonaut - do you really think patients don't have any 'skin' in the game? I would suggest we patients have more skin in the game than anyone....

BTW - Not a Doc, not a med student, not a med student wannabe. Just a patient who used to think that PA/NPs were highly trained, experienced people who worked with physician oversight to take care of my family and I. My first run-in with a DNP was about a year ago and that got me curious. Looking into this training and education - - - I am stunned at what I found.

And you can dismiss my concerns if you want. After all, I am but one patient (well....I pretty much represent 8 patients with my family). But you might want to consider me a "consumer" of what you provide. And trust me, woe comes to businesses who dismiss what their consumers want/need.

Fair enough, but I was specifically referring to the post I was answering, regarding the people who come to this forum and essentially hit on the same few points repeatedly ("fluffy courses", "essentially MPH degree", use of titles in clinical setting, hours of clinical study as student, etc.).

These concerns are also shared by many in the nursing/APN community. We debate them amongst ourselves here regularly. NP education is a personal bugaboo of mine, as is the issue that initiated this thread.

However, for the most part, the nature of our debates is (for the most part) focused upon refinement on an idea that we take as successful, that is, the concept of advanced practice nursing. Non-nurses posting here tend to start from a viewpoint of limiting the APN concept, or at the very least preventing expansion of that concept.

Thus, I am not dismissive of patient concerns in general. I am dismissive of postings that repeat the same points here over and over.

For you personally, I of course support your right to choose your provider, and to know the education and experience of that provider. I won't even debate you regarding your single poor experience with an APN, or try to change your mind.

I am all for market forces determining the success/failure of a profession. I am of the impression that these forces have been a large part of the success of the APN concept. Whether this success extends to the DNP will have to wait and be seen.

[llg, PhD, RN]

Great post, psychonaut. You have helped me to further develop my thinking on the topic. That's why I come here.

I am neither an NP or an DNP. I am a PhD who is has been involved in education and advanced role clarification for many years. I come here to discuss these issues with other interested people and enjoy finding people who can discuss them without taking the conversation on a downward spiral of insults. Thank you.

[Dr. Tammy, FNP/GNP-C]

There are a number of med students and phsycians posing as NPs on this board. Interesting they have so much time to come NP bashing instead of studying for their degree.

I am not a med-level provider. And I do not need a collaborating physician. Deal with it med students.

No particular comment. Just thought this needed to be reposted.

[Dr. Tammy, FNP/GNP-C]

No (and I know I won't be telling you anything that you don't already know). What draws them here is this strange phenomenon of converging themes, arising from:

-a few medicos who are passionately disturbed by the entire concept of independent advanced practice nursing

-a larger cadre of (mostly) pre-meds and med students, insecure about their futures, and eager to parrot the themes of the above group

-both the above groups mimicking the style and substance of the very ugly CRNA vs MDA debates

-throw in a few self-loathing nurses, and some "patients" with no skin in this game who just like to pile on; most of this latter group essentially copy-and-pasting the same themes from those "medical forums" you reference above

-mix it all in a pot, with a generous dose of internet anonymity/expertise/hostility, and voila!

As a former poster to a medical wannabe network who 86'd me for presenting truthful comments regarding APN literature in response to nurse bashing that is almost as prevalent here, I can only add that this forum is a good medium for nurse bashing as evidenced by many of these postings that are permitted to remain. Many of which underscores an intent to decrease our patients access to safe, effective and affordable care.

It is important for us to remember, that although these individuals might be categorized as trolls here, they represent a certain segment of the future medical establishment that is based on physician-centered paradigms of the last century when nursing was considered an owned profession by medicine; during a time when nurses were considered hand-maidens, incapable of making decisions without a physician and during a time when nurses were seen only as a servants in the servant-master relationship with the physician.

Although times have changed, old world thinking dies hard.

[efy2178]

The difference might be that they are referring to themselves as being a nurse--NPs are stating they have a doctorate--they are not calling themselves a "physician" so this is not the same thing..

You seem to think that NPs will intentionally mislead patients. I have not seen that happen.

[efy2178]

I am finding this thread very unproductive. This debate has become NPs vs Physicians.

I work closely with physicians and will continue to do so. If in primary care I decide when I need to collaborate with a physician and I often do. I very much appreciate their input. BUT I GET TO DECIDE!!! and sometimes I am right and the physician is wrong. Stating that NPs are incapable of deciding if they need to collaborate on a particular case is insulting to our abilities as practitioners.

I wonder, do you med students ever ask nurses for their input when you are on the floor? If you consider them so beneath you then you are missing our on a valuable resource. That kind of arrogance will get you into trouble in life.

[Dr. Tammy, FNP/GNP-C]

This debate has become NPs vs Physicians.

Actually, the real issue is patient's access to safe and affordable care versus physician profits. On one side, you have patients who need access to health care with over 100+ research products supporting that NP's provide safe and effective care.

On the other side, you have physician wannabe's who are, rightly so, very nervous seeing their protected and historically monopolized turf slowly erode as 23 states now (and growing) provide for independent NP practice--and the NP profession is only 45 years old. 25 years ago, NP's did not have independent practice rights in any state. It cuts deep and strikes a raw nerve with many of these individuals when all advanced practice nurses will soon be addressed as "doctor" --the same title their physician forefathers swiped from academics a bit more than a century ago. To these individuals, it makes little difference if their actions serve as an antecedent to impede patient's access to safe care or if their verbiage is not supported by any form of evidence.

If I was one of these pre med students or medical students I too would be nervous. They have no understanding of nursing, the nursing process, nursing framework nor have they gone through an MSN program or DNP program yet are quick to cast aspersions on the DNP related to the "fluff" nature of these programs. They only see an increase in nurse practitioner autonomy across the country. If their rhetoric didn't pose such a threat to patient's access to quality care that physicians are failing to provide to our society, they would be little more than a nuisance.

Fortunately, in dnp programs across the country, barriers in the form of such physician and medical association rhetoric are being addressed and critically appraised. Game plans are being devised and action is being taken. At Duke, we just finished a DNP intensive in the legislative process, including the intricacies of lobbying organizations and how to address issues at the legislative level. We were provided an opportunity to advocate issues central to APN independent practice in front of lobbyist and power players who are key players in the political community. The feedback and knowledge gained was breathtaking. Within 10 years there will be an army of DNP's armed with information to effect positive change for our patients through the legislative process. Physicians advocating NP supervision will soon become little more than bumps in the road to complete and total NP independent practice ultimately yielding a substantial improvement to patients access to safe and more affordable care.

I strongly feel what we are experiencing now, is the beginning of the end of the physician-based medical monopoly strangle hold the medical community has held over the entire spectrum of any field related to health for more than a century. With nursing continuing to fight for patients access to safe and affordable care, the anti-nursing rhetoric spewed on this site and many others will finally be reduced to what it truly is - patients access to safe and affordable care versus physician profits.

[wowza]

Actually, the real issue is patient's access to safe and affordable care versus physician profits. On one side, you have patients who need access to health care with over 100+ research products supporting that NP's provide safe and effective care.

Haven't we been over this in about a million other threads. There are currently no publications with solid methods, done on complex patients and that are not produced by people with obvious conflicts of interest. So there are no adequate articles.

On the other side, you have physician wannabe's who are, rightly so, very nervous seeing their protected and historically monopolized turf slowly erode as 23 states now (and growing) provide for independent NP practice--and the NP profession is only 45 years old. 25 years ago, NP's did not have independent practice rights in any state. It cuts deep and strikes a raw nerve with many of these individuals when all advanced practice nurses will soon be addressed as "doctor" --the same title their physician forefathers swiped from academics a bit more than a century ago. To these individuals, it makes little difference if their actions serve as an antecedent to impede patient's access to safe care or if their verbiage is not supported by any form of evidence.

And again, it is not fear about NPs taking over our jobs. MDs will always have jobs. I personally will be in a field where NPs will never compete with me. What the med students worry about is that we are dumbing down our primary care providers when clinical hours and courses that teach someone how to take care of people are replaced.

I agree with you, as incentives to go into primary care decrease, fewer medical students will go into primary care. It will be taken over by NPs. Doctors will almost all specialize. I still don't understand how you think that could possibly be a good thing. As it stands now, we need as many people to go into primary care.

I also don't think any medical students would have issues with NPs in primary care if the education was stronger.

Fortunately, in DNP programs across the country, barriers in the form of such physician and medical association rhetoric are being addressed and critically appraised. Game plans are being devised and action is being taken. At Duke, we just finished a DNP intensive in the legislative process, including the intricacies of lobbying organizations and how to address issues at the legislative level. We were provided an opportunity to advocate issues central to APN independent practice in front of lobbyist and power players who are key players in the political community. The feedback and knowledge gained was breathtaking. Within 10 years there will be an army of DNP's armed with information to effect positive change for our patients through the legislative process. Physicians advocating NP supervision will soon become little more than bumps in the road to complete and total NP independent practice ultimately yielding a substantial improvement to patients access to safe and more affordable care.

Oh that's great. So instead of first addressing educational deficiencies, Duke has added lobbying so that they can push for more rights . I have to hand it to the nursing lobby, they are good at what they do.

[efy2178]

Actually, the real issue is patient's access to safe and affordable care versus physician profits. On one side, you have patients who need access to health care with over 100+ research products supporting that NP's provide safe and effective care.

On the other side, you have physician wannabe's who are, rightly so, very nervous seeing their protected and historically monopolized turf slowly erode as 23 states now (and growing) provide for independent NP practice--and the NP profession is only 45 years old. 25 years ago, NP's did not have independent practice rights in any state. It cuts deep and strikes a raw nerve with many of these individuals when all advanced practice nurses will soon be addressed as "doctor" --the same title their physician forefathers swiped from academics a bit more than a century ago. To these individuals, it makes little difference if their actions serve as an antecedent to impede patient's access to safe care or if their verbiage is not supported by any form of evidence.

If I was one of these pre med students or medical students I too would be nervous. They have no understanding of nursing, the nursing process, nursing framework nor have they gone through an MSN program or DNP program yet are quick to cast aspersions on the DNP related to the "fluff" nature of these programs. They only see an increase in nurse practitioner autonomy across the country. If their rhetoric didn't pose such a threat to patient's access to quality care that physicians are failing to provide to our society, they would be little more than a nuisance.

Fortunately, in DNP programs across the country, barriers in the form of such physician and medical association rhetoric are being addressed and critically appraised. Game plans are being devised and action is being taken. At Duke, we just finished a DNP intensive in the legislative process, including the intricacies of lobbying organizations and how to address issues at the legislative level. We were provided an opportunity to advocate issues central to APN independent practice in front of lobbyist and power players who are key players in the political community. The feedback and knowledge gained was breathtaking. Within 10 years there will be an army of DNP's armed with information to effect positive change for our patients through the legislative process. Physicians advocating NP supervision will soon become little more than bumps in the road to complete and total NP independent practice ultimately yielding a substantial improvement to patients access to safe and more affordable care.

I strongly feel what we are experiencing now, is the beginning of the end of the physician-based medical monopoly strangle hold the medical community has held over the entire spectrum of any field related to health for more than a century. With nursing continuing to fight for patients access to safe and affordable care, the anti-nursing rhetoric spewed on this site and many others will finally be reduced to what it truly is - patients access to safe and affordable care versus physician profits.

Very well said!

[Jstand]

Haven't we been over this in about a million other threads. There are currently no publications with solid methods, done on complex patients and that are not produced by people with obvious conflicts of interest. So there are no adequate articles.

There are plenty of publications with very solid methods that prove the point that NP's have similar outcomes to physicians in the primary care arena. Why do you insist on throwing in something about "complex" patients? You talk about conflicts of interest? I suppose you would like to see a study designed by physicians and administered by physicians and you would try to tell us that it had no conflicts? I guess that shouldn't be a surprise as physicians have been used to pulling this type of trickery on the public for years. They try to claim that unless a physician leads medical research, it has no validity. They even lead and do research that they have inherent conflicts of interest with and then think that they can disclaim their own conflicts by disclosing them. If you really think that studies showing NP's have similar outcomes are flawed because NP's designed the study, then you are basically saying that there are no valid physician studies either and they should all be thrown out the window.

"And again, it is not fear about NPs taking over our jobs. MDs will always have jobs. I personally will be in a field where NPs will never compete with me. What the med students worry about is that we are dumbing down our primary care providers when clinical hours and courses that teach someone how to take care of people are replaced.

I agree with you, as incentives to go into primary care decrease, fewer medical students will go into primary care. It will be taken over by NPs. Doctors will almost all specialize. I still don't understand how you think that could possibly be a good thing. As it stands now, we need as many people to go into primary care.

That is a wonderful thing. That means that patients can get greater access to more affordable care without a massive side of arrogance.

I also don't think any medical students would have issues with NPs in primary care if the education was stronger.

I'm not sure why anyone would really care a bit what medical students think about the issue. They are completely irrelevant in fact.

Oh that's great. So instead of first addressing educational deficiencies, Duke has added lobbying so that they can push for more rights . I have to hand it to the nursing lobby, they are good at what they do.

They obviously must teach some strange brand of lobbying or rhetoric in the medical schools. Sounds like when you become a part of the fraternity they teach you to cry about student loans, whine about how low your pay is, and then beg society to give you more money.