Why are so many Doctors hostile towards the DNP?

allnurses Guide · Jun 27, 2010

I'm currently completing masters in NP - but I can't see the point of a DNP. It gives me no more practice ability than the masters degree. The classes aren't additional clinical classes to make me more of a clinical expert, but are mostly what *I* consider to be airy fairy ones. If I want an advanced degree, I'll do a PhD which is universally accepted.

MDs are concerned about people encroaching on their turf. Just listen to what they say about DOs. They are like little children having a tantrum and calling names... and like children having a tantrum, the best way to address it is to not give them the attention they want.

Meesterjojo · Jun 27, 2010

I'm currently completing masters in NP - but I can't see the point of a DNP. It gives me no more practice ability than the masters degree. The classes aren't additional clinical classes to make me more of a clinical expert, but are mostly what *I* consider to be airy fairy ones. If I want an advanced degree, I'll do a PhD which is universally accepted.
MDs are concerned about people encroaching on their turf. Just listen to what they say about DOs. They are like little children having a tantrum and calling names... and like children having a tantrum, the best way to address it is to not give them the attention they want.

True, but these groups also oppose ANPs also. Pretty much NPs, period.

But what concerns me is all these med students holding these beliefs, which will only grow deeper and stronger, then going into practice and having to interact with nurses.

Honestly, a lot of the things between the AMA and the ANA they cite seem highly political. That by 2015 to be an NP will require a DNP seems like nurses might be trying to push an agenda not related to patient care in the faces of the MDs. The MDs just seem ignorant of nursing.

Oh well. Should be an interesting future :)

Jules A, MSN · Jun 27, 2010

I'd be hesitant to make a blanket statement about this sort of like nurses eating their young which definitely is not the norm in my experience. I am yet a NP but the residents and physicians I have spoke with have been very positive and supportive. Our NPs seem to be happy with their positions and from what I can tell are respected by the rest of the team.

elkpark · Jun 27, 2010

In the first place, there is no "requirement" that advanced practice nurses be DNP-prepared starting in 2015. This is a proposal by a few of the academic nursing organizations, nothing more, so far. The only advanced practice group that has embraced the "mandatory-DNP" idea so far is the CRNAs, and I think their final date is 2025. The rest of the nursing community is not jumping on the bandwagon for this.

Second, I've not encountered hostility toward NPs and other advanced practice nurses in my career (I'm a psych CNS) from actual physicians -- it appears lots of people are hearing a lot of trash talk on SDN (I don't waste my time on SDN, so I don't know what actually gets said there). Keep in mind these are students, and their perspective is not necessarily a) realistic or b) representative of the larger physician community. Look at the attitudes of many of the student posters here (or even the wanna-be-students, with no real-life experience whatsoever) that are seriously incongruent with (and even offensive to!) many of the experienced nurses here. The practicing physicians I've known over the years have all embraced the idea of advanced practice nurses and been v. gracious and welcoming toward us (of course, I realize it may simply be that physicians who feel otherwise don't communicate that to me ... :)).

Third, I think much of the hostility toward the DNP is directly related to that kook Mundinger at NYU and her personal crusade to let the world know that she considers the graduates of NYU's DNP program to be at least the equal of primary care physicians, if not superior to them. IMHO, the articles she's written and interviews she's given on this have done a lot of harm, esp. since she's not been able to back up her talk with any hard evidence (the one effort to have NYU's DNP grads take a watered down version of the most basic step of the USMLE was an, ummm, disappointment, to say the least. :rolleyes: )

"Why do MDs feel they're being pushed away"??? How about, because they're being told that people with a fraction of their education can do their job as well as they can, and should get paid the same amount and get the same respect they do?? I know that it's only small percentage of people are making that claim (and many of them, here, seem to be students!) but they are the ones getting attention from the medical community. You know how we feel when CNAs or MAs say that they know as much as the nurses do and do almost the same job nurses do? I'm sure physicians feel the same way when they hear some people claiming that advanced practice nurses know as much and should be considered the equal of physicians.

There are a lot of us, not just physicians, who don't really see the point of or need for doctoral-level preparation for advanced practice nurses, and have issues with some of the hype being put out there.

Trauma Columnist · Jun 27, 2010

I've been an APN since 2006 and a nurse for almost 20 years now. People (in all walks of life) can look for the bad and find it.

However, if you choose the APN route, then stick with positive people. Physicians, nurses, students, etc who don't want to work with APNs are few and far between in my experience.

The few MD and student MD posters here notwithstanding, in the real world, this conflict just doesn't exist.

Why would an MD practice hire APNs if they didn't want to work with them? Why would a hospital hire APNs if they didn't feel there was a bonafide need?

You can always look for and find negative people. My take on this: if you are an educated person, then you work with other educated people.

As to the DNP requirrement? My prediction is that it will go the way of "BSN should be the entry level to nursing" and we are still in that battle and its been going on at least 30 years.

cruisin_woodward · Jun 27, 2010

There is one simple answer to this question F-E-A-R...

I am a student, getting my BSN-DNP. I have been hit with all sorts of negativity....not only from physicians, but also from nurses...MSNs especially. I think it is crazy. Why would more education be a bad thing? I don't get the hostility. Now, I'm going to guess that some DNPs get a God complex...but my guess is that they had this before....probably when they were a nurse's aide.

I want to scream when I hear "airy fairy", or "fluff" classes. Come sit in class with me...I GUARANTEE you will change your mind. The rigor is equivalent to the PhD program, and in fact some of the classes are the same.

Now, to address the "why"...people do not understand the DNP. This is not a program meant to create mini physicians. This is a program meant to create NURSING LEADERS, and bring the evidence that the PhD's obtain to the bedside, and identify new area that need to be examined. DNPs will partner with PhDs in doing research, each playing a different role in the process. The classes are not all clinical classes, because the program is not designed for that. I think the best way to describe it is to compare the BSN prgrams to the ADN...we all thought these "non clinical" classes were stupid. But they produced nurses that could critically think.

I don't know what all the hullabaloo is all about. More education = better nurse. Everyone freaked out when the NP program went from a certificate program to a masters, and said it would "never happen", and "no one would do it." etc. Well...guess what? It did happen, and nurses still went into the masters program.

I think physicians think that nurses just want to be called "Dr"...perhaps that may be some people's motiviation, but I don't go into a room as a staff nurse and introduce myself as "Amy, a bachelor's prepared nurse"....I introduce myself as "Amy, your nurse for the next 12 hours". ANY profession will have some "hot dog, know it all, deputy dog"...It's not fair to to assume that all DNPs will be that way.

Advanced Practice Columnist / Guide · Jun 27, 2010

In the first place, there is no "requirement" that advanced practice nurses be DNP-prepared starting in 2015. This is a proposal by a few of the academic nursing organizations, nothing more, so far. The only advanced practice group that has embraced the "mandatory-DNP" idea so far is the CRNAs, and I think their final date is 2025. The rest of the nursing community is not jumping on the bandwagon for this.
Second, I've not encountered hostility toward NPs and other advanced practice nurses in my career (I'm a psych CNS) from actual physicians -- it appears lots of people are hearing a lot of trash talk on SDN (I don't waste my time on SDN, so I don't know what actually gets said there). Keep in mind these are students, and their perspective is not necessarily a) realistic or b) representative of the larger physician community. Look at the attitudes of many of the student posters here (or even the wanna-be-students, with no real-life experience whatsoever) that are seriously incongruent with (and even offensive to!) many of the experienced nurses here. The practicing physicians I've known over the years have all embraced the idea of advanced practice nurses and been v. gracious and welcoming toward us (of course, I realize it may simply be that physicians who feel otherwise don't communicate that to me ... :)).
Third, I think much of the hostility toward the DNP is directly related to that kook Mundinger at NYU and her personal crusade to let the world know that she considers the graduates of NYU's DNP program to be at least the equal of primary care physicians, if not superior to them. IMHO, the articles she's written and interviews she's given on this have done a lot of harm, esp. since she's not been able to back up her talk with any hard evidence (the one effort to have NYU's DNP grads take a watered down version of the most basic step of the USMLE was an, ummm, disappointment, to say the least. )
"Why do MDs feel they're being pushed away"??? How about, because they're being told that people with a fraction of their education can do their job as well as they can, and should get paid the same amount and get the same respect they do?? I know that it's only small percentage of people are making that claim (and many of them, here, seem to be students!) but they are the ones getting attention from the medical community. You know how we feel when CNAs or MAs say that they know as much as the nurses do and do almost the same job nurses do? I'm sure physicians feel the same way when they hear some people claiming that advanced practice nurses know as much and should be considered the equal of physicians.
There are a lot of us, not just physicians, who don't really see the point of or need for doctoral-level preparation for advanced practice nurses, and have issues with some of the hype being put out there.

I agree with your post. However, Mundinger is a faculty member and current Dean at the School of Nursing at Columbia University.

elkpark · Jun 27, 2010

I agree with your post. However, Mundinger is a faculty member and current Dean at the School of Nursing at Columbia University.

Oooh, you're right -- my bad! Mundinger is at Columbia and not NYU. Got my NYC university nursing programs mixed up. Thanks for correcting me.

eternallearner · Jun 27, 2010

Alot of what I believe you are seeing is SDN and other such sites. You would do well to remember that these are students and they have no real concept of how it really operates in the real world. I have, over the last few weeks read all, and I mean all, of the posts on SDN about DNP and nurse practitioners. My take away from this experience is that they are mostly younger and insecure people who are being wound up by a vocal few with dis-information and then turned loose on the intarwebs.

In other words just like everything you read on a internet forum, it has little resemblance to the real world.

Meesterjojo · Jun 28, 2010

In the first place, there is no "requirement" that advanced practice nurses be DNP-prepared starting in 2015. This is a proposal by a few of the academic nursing organizations, nothing more, so far. The only advanced practice group that has embraced the "mandatory-DNP" idea so far is the CRNAs, and I think their final date is 2025. The rest of the nursing community is not jumping on the bandwagon for this.
Second, I've not encountered hostility toward NPs and other advanced practice nurses in my career (I'm a psych CNS) from actual physicians -- it appears lots of people are hearing a lot of trash talk on SDN (I don't waste my time on SDN, so I don't know what actually gets said there). Keep in mind these are students, and their perspective is not necessarily a) realistic or b) representative of the larger physician community. Look at the attitudes of many of the student posters here (or even the wanna-be-students, with no real-life experience whatsoever) that are seriously incongruent with (and even offensive to!) many of the experienced nurses here. The practicing physicians I've known over the years have all embraced the idea of advanced practice nurses and been v. gracious and welcoming toward us (of course, I realize it may simply be that physicians who feel otherwise don't communicate that to me ... :)).
Third, I think much of the hostility toward the DNP is directly related to that kook Mundinger at NYU and her personal crusade to let the world know that she considers the graduates of NYU's DNP program to be at least the equal of primary care physicians, if not superior to them. IMHO, the articles she's written and interviews she's given on this have done a lot of harm, esp. since she's not been able to back up her talk with any hard evidence (the one effort to have NYU's DNP grads take a watered down version of the most basic step of the USMLE was an, ummm, disappointment, to say the least. )
"Why do MDs feel they're being pushed away"??? How about, because they're being told that people with a fraction of their education can do their job as well as they can, and should get paid the same amount and get the same respect they do?? I know that it's only small percentage of people are making that claim (and many of them, here, seem to be students!) but they are the ones getting attention from the medical community. You know how we feel when CNAs or MAs say that they know as much as the nurses do and do almost the same job nurses do? I'm sure physicians feel the same way when they hear some people claiming that advanced practice nurses know as much and should be considered the equal of physicians.
There are a lot of us, not just physicians, who don't really see the point of or need for doctoral-level preparation for advanced practice nurses, and have issues with some of the hype being put out there.

You seem rather...heated. Sorry to encourage such on here I could be mistaken, and hope I am :)

As for the 'requirement'- again, my mistake. Looking at the AACN website http://www.aacn.nche.edu/dnp/pdf/faq.pdf , so accordingly it was my understanding that if the AACN is saying that their member schools have voted and to move the ANP to the doctoral level from the masters. This is not true? Or the AACN is powerless, and if so why is anyone concerned? The nursing schools I'm interested in are all AACN member schools.

Just curious- I am getting a lot of conflicting information now

Unfortunately there are physicians who are very vocal on SDN, and yes I'm pretty much avoiding the site- it's such a drag to think that a future generation of physicians are going to be hostile towards ones profession.

Do you think that these students on SDN and other sites will 'grow up', or rather, come to see that NP's aren't trying to take their livelihoods away (as they seem to believe)?

I found another site, a blog, written by a nurse who is in med school now and trying to become a physician. She, of course, is excessively hostile to anyone making comments, and usually responds to nurses with "why not just go to med school? It's a waste!" and the like.

So much hostility, just a heated topic, fascinating, and it is very interesting how lines are being drawn, and the opinions on the DNP everyone has. I'm fairly enthralled with the responses here thus far :)

DNPStudent: I agree based on the reactions I've seen all over the net- fear. Why would the MSN's fear the DNP except for possibly a fear of being pushed out? And since you're earning your DNP now, these are actual physicians who are giving you grief, or students? Can you give any examples? Curious! It's like a healthcare battle, with a vast gulf of ignorance between the 2 groups. I'll say some of the groups pushing the DNP, and some of the articles I've read (like this one I need to find/repost from the NYTimes) is pretty much a slap in the face of physicians, and I could see why they'd get upset. Interesting stuff.

traumaRUs: True, but I think the problem, or as I see it with my, granted, limited insight, is that future physicians might be...strongly biased against the DNP. Professionalism in any profession is usually learned by our peers- if a culture of hostility exists, but is encouraged by their peers through their residencies, well...

eternallearner: You're probably right :)

OH- also sorry for posting a link to SDN- I didn't realize that was a no-no! Thanks for the responses!

Trauma Columnist · Jun 28, 2010

I just don't see this hostility towards DNPs - where do you all practice?

Personally, I am treated as I act: as a professional. If a physician doesn't want to work with me, fine and dandy.

However, the practice where I work makes it very clear that their mid-levels (NPs, PAs, CNS's) are to be treated respectfully.

I just don't have any firsthand knowledge (and I discount the wannabe docs on SDN), of this hostility.