Why your local physician group is wary of hiring a new graduate nurse practitioner

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Why your local physician group is wary of hiring a new nurse practitioner

Many physicians are wary about hiring new graduate nurse practitioners into their practice, and I believe they have every right to think this way. The standards required of becoming a nurse practitioner are significantly lower than that required of a physician. This is not to stay that having the title MD or DO behind your name automatically constitutes a person being an intellectual genius, but overall physicians are much more thoroughly educated than nurse practitioners.

Topics to be discussed here will include; entry into programs, difficulty of curricula, length of program, and type of people who go into the programs.

Entry into the program

Medical school requires a much stricter set of standards than most nurse practitioner schools. Medical school has its own standardized test (MCAT) required for entry. Nurse practitioner programs simply require the GRE in most cases. Nearly all medical schools require a competitive MCAT score for entry also, unlike many NP programs which will literally take any GRE score above what seems the 25th percentile.

Difficulty of programs

Contrary to popular belief in the nurse community, medical school is much more difficult than nursing school. It may seem that nursing and medical students study about the same amount of time, but other variables must be considered. Medical students are often much more efficient than nursing students at retaining information. They often have more years of school under their belts, are more well versed in memorizing college material, and have better study habits. This is not always true, but I would bet a high dollar on this assumption. The same is also true of nurse practitioner programs. While some will debate this, the honest fact is that a completely online program with no set of written tests will not be as difficult as a completely brick and mortar medical program. Lack of written tests equates to lack of knowledge..... directly. Writing papers on nursing policy does not constitute difficulty and does not translate into better practice outcomes and clinical decision making.

Length of program

This cannot be debated. A minimum of 7 years of training vs 12-36 months (many of the programs being part time)? Who is going to be better trained? If you answer anything besides the MD, you are just plain wrong and need to reevaluate your math skills. The first debate somebody will throw at this argument is "I have been a top- level, elite trauma nurse for 20 years and know everything there is." Your right, you do know everything, ABOUT NURSING, NOT MEDICINE. I am not stating that all nursing experience is worthless, but 20 years of nursing does not equate to 20 years of practicing medicine or as a nurse practitioner. Being in the same environment doesn't count. That's like saying being a custodian wiping up the mess after a trauma scene is the same thing as performing a thoracotomy on an acutely unstable patient.

Different type of student

This one will be difficult to explain, since there are people from many walks of life that go into both professions. But in an overwhelming majority of cases, these facts and figures stand true. Medical students are often much more dedicated to the sciences than the average nursing student. Many nursing students are reaching for a secondary career and have a less than steady academic background than the average medical student. There are some second career physicians out there, but overall, not the same amount as in the nursing field. The trend does seem to be changing though with more young nurses entering the field at a younger age, thus making nursing their primary career at an early age. Quite frankly the single mom who has worked at the grocery store for 10 years and who decides to go back to be a nurse is often in a different situation than the 23 year old who has been taking 12 credit hours of science classes for the past 4 years of college.

Disclaimer

If the most you get out of this article is that medical students are geniuses and that nurses and nursing students are dumb, you have greatly missed the point. This being my disclaimer, not all of these figures stated above will be correct 100% of the time. Simple observation regarding the differences between nurses/nursing students and physicians/medical students should be enough to understand these differences though. Much of the blame is to be put on the accrediting agencies, who as I have stated in a previous post basically throw licenses in crackerjack boxes, to be earned without significant effort, testing, or any check regarding ability of the individual. Sadly, it is the same group of so-called elitist nurses who continually debate for unrestricted practice for all APRNs. No wonder nursing has a poor reputation in light of medicine. Until the standards are raised and equality (or at least near-equality) is promoted across all programs, the average APRN will not be equal to the average physician.

They often have more years of school under their belts, are more well versed in memorizing college material, and have better study habits.

Taking what amounts to 30-35 credits semester. You better be good at memorizing.

Iof nurse practitioner programs. While some will debate this, the honest fact is that a completely online program with no set of written tests will not be as difficult as a completely brick and mortar medical program.

This is false. The platform the instruction is delivered is irrelevant. The effectiveness of instruction is based on curriculum design & development.

Lack of written tests equates to lack of knowledge….. directly. Writing papers on nursing policy does not constitute difficulty and does not translate into better practice outcomes and clinical decision making.

I was wondering if your bold statements can be backed up with evidence. What constitutes difficulty? Does that mean more years of schooling mean better nurse practitioners? Or does it just mean more papers about the nursing model? Again, where is the evidence and data?

Why is there even a comparison with MDs and NPs? Isn't that like comparing apples to oranges? There is a study that was mentioned about the relationship with nurse practitioners and patient outcomes, and as far as I know, it seemed pretty positive and equal to a primary care physicians level of care, is not better! How would you interpret results of that?

Sent from my HTC One using allnurses.com

Specializes in Internal medicine/critical care/FP.

Thank you all so much for these great responses. There are large amounts of wisdom in each and every one of them, and I love the depth to which this post was taken into discussion. Again, thank you all so much for the great posts.

For starters, I would greatly like to pass the sign of relief around the room, that as an NP myself, I do not agree with much of what was stated in my original post.

"WHY IN THE WORLD WOULD YOU POST SUCH RUBBISH IF YOU KNEW IT NOT TO BE TRUE?"

Since when am I the one doing the hiring at the physician offices? Absolutely never! At least not at this point.

"I am still lost, many physicians prefer to hire NPs due to their ability to save the practice money!"

But I am strictly speaking in regards to the practices that DO NOT hire many new graduates and post the ONLY EXPERIENCED nurse practitioner positions.

"I am still confused....."

My original post can be described as coming from the perspective of 1. an MD/DO elitist, 2. one of the said practices which has attendings or supervising physicians who think this way, 3. a medical student or resident who was bred to dispose midlevels (to whom we are referred to by many). Or in other words, THE ABSOLUTE WORST CASE SCENARIO TRAIN OF THOUGHT... toward an NP.

"But I am still lost, please explain more thoroughly."

We all agree that there is a problem, at least in many areas, of new graduates having difficulty finding positions as nurse practitioners, correct? We also can agree than many practices do not like these for profit, no name, online programs, correct? I do believe myself that nurse practitioner programs need to be regulated more thoroughly, with much stricter standards than they do at this time (being one of the things i agree with from my main post).

But if the evidence (which it does) points towards equal outcomes, then why are many places wary of hiring these new graduate nurse practitioners? Now don't get me wrong, there are programs I would never hire a new graduate from, but in many (if not most) cases, I would be perfectly fine with it. BUT STILL...... again, what about the clinics and hospitals that do not prefer new graduates??????? I never see any physician jobs (I am sure there are a few but i have yet to see!) that state "must have 5 years post-residency experience." WHY IS THIS???? I do not know this answer myself, but if I had to guesstimate, it would be along the lines of those who think as my original post speaks...

"But why even post something like that, again, if you do not agree with it yourself completely?"

First of all, who would read a post named, "Hey this is my little estimate of why new graduate nurse practitioners in many areas are having trouble getting hired."

BORING

And who would much less respond with the elaborate and greatly thought out responses which I have seen since my original post?

NADA.

Now for the great question, if I, myself, was going to hire a nurse practitioner, WOULD I BE WARY?

YES, I would be at least a little bit more wary than if hiring a physician straight out of residency.

"Why?"

Even thought all of the evidence points toward equal outcomes, who would not be at least a little bit more wary of throwing a new grad NP with much less experience than a family practice physician into the fray? In my humble opinion, I would (for at least a new graduate, since I know they have not been exposed to everything they need to be exposed to in the amount of time they were in training). But, I also do agree that the INDIVIDUAL is the most important factor in the success rate of a practicing NP or MD/DO PA, etc, etc, etc.

Thank you all!

And I do apologize for the harsh tone of my original post, but there are those out there who think along these lines, and the AMA is feeding them very well.

Specializes in Emergency, Family Practice, Occ. Health.
Why your local physician group is wary of hiring a new nurse practitioner Many physicians are wary about hiring new graduate nurse practitioners into their practice and I believe they have every right to think this way. The standards required of becoming a nurse practitioner are significantly lower than that required of a physician. This is not to stay that having the title MD or DO behind your name automatically constitutes a person being an intellectual genius, but overall physicians are much more thoroughly educated than nurse practitioners. Topics to be discussed here will include; entry into programs, difficulty of curricula, length of program, and type of people who go into the programs. Entry into the program Medical school requires a much stricter set of standards than most nurse practitioner schools. Medical school has its own standardized test (MCAT) required for entry. Nurse practitioner programs simply require the GRE in most cases. Nearly all medical schools require a competitive MCAT score for entry also, unlike many NP programs which will literally take any GRE score above what seems the 25[sUP']th[/sUP] percentile. Difficulty of programs Contrary to popular belief in the nurse community, medical school is much more difficult than nursing school. It may seem that nursing and medical students study about the same amount of time, but other variables must be considered. Medical students are often much more efficient than nursing students at retaining information. They often have more years of school under their belts, are more well versed in memorizing college material, and have better study habits. This is not always true, but I would bet a high dollar on this assumption. The same is also true of nurse practitioner programs. While some will debate this, the honest fact is that a completely online program with no set of written tests will not be as difficult as a completely brick and mortar medical program. Lack of written tests equates to lack of knowledge….. directly. Writing papers on nursing policy does not constitute difficulty and does not translate into better practice outcomes and clinical decision making. Length of program This cannot be debated. A minimum of 7 years of training vs 12-36 months (many of the programs being part time)? Who is going to be better trained? If you answer anything besides the MD, you are just plain wrong and need to reevaluate your math skills. The first debate somebody will throw at this argument is “I have been a top- level, elite trauma nurse for 20 years and know everything there is.” Your right, you do know everything, ABOUT NURSING, NOT MEDICINE. I am not stating that all nursing experience is worthless, but 20 years of nursing does not equate to 20 years of practicing medicine or as a nurse practitioner. Being in the same environment doesn’t count. That’s like saying being a custodian wiping up the mess after a trauma scene is the same thing as performing a thoracotomy on an acutely unstable patient. Different type of student This one will be difficult to explain, since there are people from many walks of life that go into both professions. But in an overwhelming majority of cases, these facts and figures stand true. Medical students are often much more dedicated to the sciences than the average nursing student. Many nursing students are reaching for a secondary career and have a less than steady academic background than the average medical student. There are some second career physicians out there, but overall, not the same amount as in the nursing field. The trend does seem to be changing though with more young nurses entering the field at a younger age, thus making nursing their primary career at an early age. Quite frankly the single mom who has worked at the grocery store for 10 years and who decides to go back to be a nurse is often in a different situation than the 23 year old who has been taking 12 credit hours of science classes for the past 4 years of college. Disclaimer If the most you get out of this article is that medical students are geniuses and that nurses and nursing students are dumb, you have greatly missed the point. This being my disclaimer, not all of these figures stated above will be correct 100% of the time. Simple observation regarding the differences between nurses/nursing students and physicians/medical students should be enough to understand these differences though. Much of the blame is to be put on the accrediting agencies, who as I have stated in a previous post basically throw licenses in crackerjack boxes, to be earned without significant effort, testing, or any check regarding ability of the individual. Sadly, it is the same group of so-called elitist nurses who continually debate for unrestricted practice for all APRNs. No wonder nursing has a poor reputation in light of medicine. Until the standards are raised and equality (or at least near-equality) is promoted across all programs, the average APRN will not be equal to the average physician.

You are clearly misinformed.

Specializes in allergy and asthma, urgent care.

My experience has been the the exact opposite of the OPs harangue. I have yet to have a negative experience with an MD who thinks NPs are a less evolved and less intelligent species. Where do you get your information??

I agree with others who think we should be working together to promote and increase respect and knowledge of our profession and abilities. It makes no sense to continually snipe at our peers, spread false information, and bring each other down. I had hoped we left that behind in high school.

At this point it seems like you're trolling.

Specializes in Nephrology, Cardiology, ER, ICU.

Hmmm....so you come here, expound on a point of view that you knew would incite posters - hunh??? Why in the world would you do this?

YOU are the reason that any NP gets less then the respect they deserve. Enough!

Please do not feed the troll.

MD =/= NP. Comparing apples and oranges. Different profession. More efficient process; evidence shows equivalent if not better outcomes. NP's are the way to saving healthcare. MD's may be wary because they may feel threatened; but clearly don't understand what NP's are meant to do.

#trollhasbeenfed

Specializes in Emergency.
@zenman - too bad I can only push the "like" button once!!!

Ditto

Specializes in Internal medicine/critical care/FP.

But if you are not willing to look through the eyes of our opposers then we are already defeated. While the benefit of this post may not have dawned upon everybody yet, the day you are in need of formulating a rebuke against one of the minds alike the original post, your memory will now be primed for a great response. Roses and chocolate candy posts regarding the efficiency and effectiveness may warm the heart of many on this forum, but it will prove no benefit when in the midst of a debate regarding the autonomy of the APRN!

I am not stating that all nursing experience is worthless, but 20 years of nursing does not equate to 20 years of practicing medicine or as a nurse practitioner. Being in the same environment doesn’t count. That’s like saying being a custodian wiping up the mess after a trauma scene is the same thing as performing a thoracotomy on an acutely unstable patient.

Wow. Equating the nurse to the custodian? That pretty much says it all, OP.

Specializes in allergy and asthma, urgent care.

Really, Chillnurse??? Do you actually think deception and playing games is helpful? Do you think anyone will take you seriously now? Your little ploy was immature and insulting to our intelligence. We can defend ourselves against detractors just fine without your assistance. Come back and talk to us when you've grown up and have lost some of that sense of false superiority.

Specializes in Internal medicine/critical care/FP.

Ah but this is exactly why we cannot hold our ground to the AMA, too much internal dispute. I definitely apologize for rubbing some of you the wrong way. I don't think of myself as superior to anybody, I think i put in one of my last posts that I am just the average NP. We can't let our egos take ahold of us like this, to get angry at something posted in a forum is unhelpful in many ways!

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