Study says NPs provide better care than MDs

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Status
Not open for further replies.
futuredoc15

futuredoc15

Membership Revoked
Removed
10+ Year Member
Joined
Feb 13, 2011
Messages
110
Reaction score
1
Patients of advanced practice registered nurses have similar or better results in many outcome measurements compared with physicians and other healthcare teams without APRNs, according to a new study.Published in Nursing Economics,
the report reinforces that APRNs provide effective, high-quality patient care and play an important role in improving the quality of care in the United States according to a news release.,
Robin P. Newhouse, RN, PhD, NEA-BC, associate professor at the University of Maryland School of Nursing and assistant dean for the Doctor of Nursing Practice Program, and co-authors conducted a systematic review comparing APRN processes and outcomes to those of physician providers. They analyzed 69 studies published between 1990 and 2008 and summarized 28 outcomes for nurses in APRN roles.,
The authors described patient outcomes for each of three patient groups — nurse practitioners, certified nurse-midwives and clinical nurse specialists. ,
Outcomes with similar or better grades than those of physician comparison groups included:,
• Nurse practitioners: glucose control, lipid control, patient satisfaction, functional status, mortality.,
• Certified nurse-midwives: cesarean, low APGAR score, episiotomy, labor analgesia, perineal lacerations.,

• Clinical nurse specialists: Satisfaction, length of stay, cost.,,The authors wrote that the results could help address concerns about whether care provided by APRNs can safely augment the physician supply to support reform efforts aimed at expanding access to care.The complete article is available as a PDF at http://bit.ly/oeFILW.</p>
Members don't see this ad.
 
A report written by nurses praising nurses.

tumblr_lheh3dUeed1qae5vp.gif
 
They couldn't get into MD/DO school so they decided to do something else and then try to elevate it to the status of MD/DO. I'm sorry but you have to put in the work to have the autonomy, specialized knowledge, and yes...lifestyle/income.
 
  • Like
Reactions: 2 users
Members don't see this ad :)
pointless thread. everyone knows that nursing assistants provide the best care :rolleyes:
 
A meta-analysis (which is what I'm guessing this is) is only as good as the studies it reviews. And there aren't any well-done studies suggesting that care provided by independently practicing APNs is equivalent/superior to that of physicians. A lot of those flawed studies look at silly metrics like patient satisfaction and equate it to quality of care provided.

Unfortunately, the public and politicians eat this crap up...
 
gettheleadout said:
Yeah, I stopped reading at "Published in Nursing Economics..."

Also, misleading title is misleading.
Click to expand...
You beat me to it :(.

Biased report is biased. And don't forget stupid. It is also stupid.
 
AntiHouseMD said:
A report written by nurses praising nurses.

tumblr_lheh3dUeed1qae5vp.gif
Click to expand...

Hahahaha

gettheleadout said:
Yeah, I stopped reading at "Published in Nursing Economics..."

Also, misleading title is misleading.
Click to expand...

Yes

Kaushik said:
A meta-analysis (which is what I'm guessing this is) is only as good as the studies it reviews. And there aren't any well-done studies suggesting that care provided by independently practicing APNs is equivalent/superior to that of physicians. A lot of those flawed studies look at silly metrics like patient satisfaction and equate it to quality of care provided.

Unfortunately, the public and politicians eat this crap up...
Click to expand...

Misinformed... meta analyses SUCK!
 
The public and politicians are idiots

Kaushik said:
A meta-analysis (which is what I'm guessing this is) is only as good as the studies it reviews. And there aren't any well-done studies suggesting that care provided by independently practicing APNs is equivalent/superior to that of physicians. A lot of those flawed studies look at silly metrics like patient satisfaction and equate it to quality of care provided.

Unfortunately, the public and politicians eat this crap up...
Click to expand...
 
First thing I want to know is whether this journal with a $ in its name is peer reviewed. Anyone know?
 
Members don't see this ad :)
Tired said:
We ignore the underlying issues here at our own peril:

(1) The NPs actively seek to compare themselves favorably to us. We, in turn, pretend like everything is okay. You can argue all you want about the validity of their conclusions, but anyone want to show me the legions of studies from our community arguing otherwise?

(2) The NPs don't get clinical time unless we supervise them. They don't get jobs unless we let them in. In our clinics, we allow patients to view them as physician-equivalents, even as we privately refer to them as physician-extenders. So how exactly is this all the fault of the NPs? Face it, it's our own damn fault, and especially the AAFP who let all this crap get started in the first place.

(3) For all the garbage that gets spouted around here about NP "independent practice", the reality most places is that NPs work under physicians. They are only as "independent" as their clinical supervisors allow, and unfortunately at many places it is far too independent. How can you blame them for expecting equivalency to all MDs, when their own MD supervisors treat them as such?

Get educated about what constitutes an NP education. Then when you are in practice, and you have the choice to hire a PA or an NP, do the smart thing and go with the PA. It's the right thing to do, both politically and for the good of your patients.
Click to expand...
I agree with you 100%, especially the bolded. :thumbup:
 
CodeBlu said:
I have a question... why a PA?
Click to expand...
Far superior training in the basic sciences. And several times as many clinical hours of training compared to an NP/DNP.

The avg. NP/DNP has 500-1000 hours of clinical training. PAs get more than twice that, if not more. There's also very little basic science emphasis in many (most?) NP/DNP programs (they tend to focus on health policy, business, etc, types of courses rather than those that pertain to clinical practice).
 
Kaushik said:
Far superior training in the basic sciences. And several times as many clinical hours of training compared to an NP/DNP.
Click to expand...

Oh, I see! I think I know what you mean now... there's the basic nursing pharmacology textbook used by nurses, and then there's Katzung and Lippincott for pharm texts in medicine.

I took an undergrad intro pharm course, it was the same course that the nursing students took, and it's scary to think that is there only pharm training. I'm sure NP/DNP do a bit more... but I can see the argument for PA having better training now.
 
It's simple...PAs take the same biology/chem classes we do in pre-med....nurses take well...nursing chemistry

Kaushik said:
Far superior training in the basic sciences. And several times as many clinical hours of training compared to an NP/DNP.

The avg. NP/DNP has 500-1000 hours of clinical training. PAs get more than twice that, if not more. There's also very little basic science emphasis in many (most?) NP/DNP programs (they tend to focus on health policy, business, etc, types of courses rather than those that pertain to clinical practice).
Click to expand...
 
I'm speaking strictly of what we take to get into our respective professional/graduate schools. PAs/Pre-Meds take more advanced science classes <----my point

CodeBlu said:
The bio/chem we learned in ugrad.... does NOT compare with what we learn in med school, apparently.
Click to expand...
 
Tired said:
My undergrad biochem was substantially more difficult than in med school. Med school had less chemistry and more clinical correlation.
Click to expand...

I was referring to the intro biology and chem classes. But, yes I can imagine there is no need for a medical student to learn the ins and outs of edman degradation.
 
BSN nurses at most schools are required to take the same biology, chemistry etc as pre-meds, plus many are required to take microbiology, anatomy/physiology before starting their nursing curriculum. This is not "nursing chemistry", this is the same exact class any undergrad would take (this is bachelor level nursing, not associate level).

And as for the number of clinical hours for a DNP, they might only get 1000 in grad school, but what about the hours they got in undergrad and the 1500-2000hrs per year they got working as an RN before going to DNP school? Many of these places require 2 years of clinical experience before you can start - that is 3000-4000 of pure clinical hours before even beginning school.

And in case you were wondering, not all nurses chose their path because they could not get into med school. That is an unbelievable statement. I went to nursing school because I had bad experiences with physicians and I wanted a healthcare profession that emphasized holistic and empathetic care. Now that I have been a nurse for a while I realized that I can still do this as a physician, but I am looking for more autonomy and a bigger scope of practice (thus applying to med school).

That being said...DNP does not equal MD/DO. They are different jobs with different philosophies and responsibilities. DNP has some of the same scope of practice as a physician, but not nearly as much. But they each have the same ultimate goal which is a positive patient outcome. I do agree, however, that believing this "study" at face value is like listening to the cigarette companies tell you that smoking is not bad for you.
 
postbacpremed87 said:
It's simple...PAs take the same biology/chem classes we do in pre-med....nurses take well...nursing chemistry
Click to expand...

Who cares what they took in undergrad? 90% of the pre-med material has 0 relevance to clinical practice.

The PA's and NP's do what you teach them. Once you're out in practice and you're looking for someone to cover some of your rounds for you, you will most likely just go with someone that's (a) easy to work with, (b) trustworthy, and (c) teachable and whether they have DNP or PA-C after their name probably won't matter at all to you.
 
There is some correlation between taking more advanced pre-requisites and mental capacity/ability......the difference in undergrad courses is night and day...PAs have a higher mental capacity/learning ability, on average.

Point being, PA's will make better associates than NPs....this is a circular argument here...we agree.

bucks2010 said:
Who cares what they took in undergrad? 90% of the pre-med material has 0 relevance to clinical practice.

The PA's and NP's do what you teach them. Once you're out in practice and you're looking for someone to cover some of your rounds for you, you will most likely just go with someone that's (a) easy to work with, (b) trustworthy, and (c) teachable and whether they have DNP or PA-C after their name probably won't matter at all to you.
Click to expand...
 
postbacpremed87 said:
There is some correlation between taking more advanced pre-requisites and mental capacity/ability......the difference in undergrad courses is night and day...PAs have a higher mental capacity/learning ability, on average.

Point being, PA's will make better associates than NPs....this is a circular argument here...we agree.
Click to expand...

lol wut

You're not gonna be looking for Einstein PA-C. Chances are you'll just want someone to round on your uncomplicated patients, do H&P's, hold the retractor, etc. and an individuals fitness for doing these things for you is going to have more to do with their attitude rather than any perceived mental capacity as judged by their educational background.
 
Dude all of what I said is relative to the NP.....the best model is MD/DO...and PA mid-levels

bucks2010 said:
lol wut

You're not gonna be looking for Einstein PA-C. Chances are you'll just want someone to round on your uncomplicated patients, do H&P's, hold the retractor, etc. and an individuals fitness for doing these things for you is going to have more to do with their attitude rather than any perceived mental capacity as judged by their educational background.
Click to expand...
 
Tired said:
Pretty much what I thought when I read your post.



Wow, you really have zero concept of what PAs do.
Click to expand...

Not going to justify myself to you but suffice to say I hold PA's in very high regard.

That said, when hiring an extender I still maintain that the attitude of the candidate and your overall impression of their capabilities (regardless of how they got them) are going to matter more than the initials behind their name.
 
Ya I meant Intro level courses. But what about the people who only take the pre-reqs and then get a degree in English? If med schools cared about the clinically relevant courses in undergrad they would make these types of classes required. The fact is, undergrad prereq science course are to show that you can grasp science, but all the actual learning of clinical relevance takes place in med school.


Im pursuing med school over NP because I want deeper and more challenging training in healthcare. Honestly, I would be scared as a new grad NP to have that scope of practice without the in depth training that med school provides. So yes, I do agree with you.


Tired said:
Nobody "chooses" to see an NP because they have an issue "better suited" to their training. People go to see a doctor, and get stuck in an exam room with an NP instead. Lucky for the NPs the public doesn't understand their education and training, and half the time just assume the person in the white coat is a physician.

This is the only real disagreement I have with you. I know several people who have either their PCP or OB/GYN as a NP and they choose this because, quoting from what they told me, "The NP spends an hour in the room with me and treats me like I am more than just lab values written on a chart". People will probably say this is the "stupid public" not knowing about a NPs training, but at least two of these people work in a hospital (one being a nurse and one a DPT).

Anyways, not sure we have any real philosophical disagreement here. It just bugs me to read people posting things like "NPs are too dumb to get into med school".
Click to expand...
 
Also, on a completely unrelated note, how do you quote multiple parts of a post in your reply?
 
colberag said:
BSN nurses at most schools are required to take the same biology, chemistry etc as pre-meds, plus many are required to take microbiology, anatomy/physiology before starting their nursing curriculum. This is not "nursing chemistry", this is the same exact class any undergrad would take (this is bachelor level nursing, not associate level).

And as for the number of clinical hours for a DNP, they might only get 1000 in grad school, but what about the hours they got in undergrad and the 1500-2000hrs per year they got working as an RN before going to DNP school? Many of these places require 2 years of clinical experience before you can start - that is 3000-4000 of pure clinical hours before even beginning school.

And in case you were wondering, not all nurses chose their path because they could not get into med school. That is an unbelievable statement. I went to nursing school because I had bad experiences with physicians and I wanted a healthcare profession that emphasized holistic and empathetic care. Now that I have been a nurse for a while I realized that I can still do this as a physician, but I am looking for more autonomy and a bigger scope of practice (thus applying to med school).

That being said...DNP does not equal MD/DO. They are different jobs with different philosophies and responsibilities. DNP has some of the same scope of practice as a physician, but not nearly as much. But they each have the same ultimate goal which is a positive patient outcome. I do agree, however, that believing this "study" at face value is like listening to the cigarette companies tell you that smoking is not bad for you.
Click to expand...



I am really getting sick of this example. Who gives a **** if the DNP worked as an RN for X number of hours. They had DIFFERENT LEVELS OF RESPONSIBILITY as an RN compared to being independent as a DNP! That would be like me saying my 10,000 hours as an ED tech, somehow counts as experience towards being a physician. Ummmmm no, not even remotely close to being on the same level, and I would never claim this "experience" counts. Yet, somehow this is one of the most commonly cited examples of "clinical experience" that DNPs and NPs seem to spout?

Next we are going to have flight attendants saying they can fly the plane because the flew on X number of flights.
 
i dont get why you guys are so pissed off about this report. Judging by your comments any physicans journal that said physicans provide better care than NP's would be total BS. Remember that while med school may teach you more and may give you more clinical practice, all health care pro's sing and dance to the same tune. The tune of their patients. The best provider actually listens to the patients needs, and I think however biased the journal is, NP's might spend more time actually talking to the patients and so the patients feel that their care is more personalized. I think that your utter disrespect for NP's, and other nurses are the reason why the public despises physicians as cocky, unreasonable, elitists that earn too much money. Learn some respect, without nurses or NP's a physicians life would be a million times more miserable. I am a pre-med applying to only MD schools, and I have my reasons for doing so, but that does not give me or another MD the right to think they are a better "provider" than NP's PA's or DO's just because they had more training. I know more NP's that actually care about their patients than MD/DO's. ask any nurse, they think physicians are ***holes. Did it ever occur to you that nurses chose their profession for other reasons than "they were too stupid for med school"? The simple reality is that nurses spend more time with patients, physicians just sneak a peek and manage care.

BTW, if you think you'll be making big bucks and have all the prestige doing primary care as an MD in the next 20 years, think again. PA's and NP's will take over all primary care for the sole reason of cheap labor (look at china), anything else will be refereed to specialists. so you better learn to respect everyone in the healthcare field. I was pretty disappointed reading some of your comments.


oh and just a little tidbit for all those elitist DO's out there. Patients dont think your an equivalent to an MD so try to wrap that around your egos. Go outside the Americas and see how well received your DO is then youll know what its like to be an NP and get no respect.
 
Last edited:
sylvanthus said:
I am really getting sick of this example. Who gives a **** if the DNP worked as an RN for X number of hours. They had DIFFERENT LEVELS OF RESPONSIBILITY as an RN compared to being independent as a DNP! That would be like me saying my 10,000 hours as an ED tech, somehow counts as experience towards being a physician. Ummmmm no, not even remotely close to being on the same level, and I would never claim this "experience" counts. Yet, somehow this is one of the most commonly cited examples of "clinical experience" that DNPs and NPs seem to spout?

Next we are going to have flight attendants saying they can fly the plane because the flew on X number of flights.
Click to expand...

Ya, I agree with you. I did not mean clinical training hours. Obviously, an NP only has the training to be an NP during those specific hours. I misread another comment that just said clinical hours, and I thought they were referring to all clinical hours, not just NP training. Anyways, like I said a few posts ago, I would be scared silly as a newly graduated NP to have that scope of practice without having gone to medical school or a much longer and more in depth training.
 
banner18 said:
i dont get why you guys are so pissed off about this report. Judging by your comments any physicans journal that said physicans provide better care than NP's would be total BS. Remember that while med school may teach you more and may give you more clinical practice, all health care pro's sing and dance to the same tune. The tune of their patients. The best provider actually listens to the patients needs, and I think however biased the journal is, NP's might spend more time actually talking to the patients and so the patients feel that their care is more personalized. I think that your utter disrespect for NP's, and other nurses are the reason why the public despises physicians as cocky, unreasonable, elitists that earn too much money. Learn some respect, without nurses or NP's a physicians life would be a million times more miserable. I am a pre-med applying to only MD schools, and I have my reasons for doing so, but that does not give me or another MD the right to think they are a better "provider" than NP's PA's or DO's just because they had more training. I know more NP's that actually care about their patients than MD/DO's. ask any nurse, they think physicians are ***holes. Did it ever occur to you that nurses chose their profession for other reasons than "they were too stupid for med school"? The simple reality is that nurses spend more time with patients, physicians just sneak a peek and manage care.

BTW, if you think you'll be making big bucks and have all the prestige doing primary care as an MD in the next 20 years, think again. PA's and NP's will take over all primary care for the sole reason of cheap labor (look at china), anything else will be refereed to specialists. so you better learn to respect everyone in the healthcare field. I was pretty disappointed reading some of your comments.


oh and just a little tidbit for all those elitist DO's out there. Patients dont think your an equivalent to an MD so try to wrap that around your egos. Go outside the Americas and see how well received your DO is then youll know what its like to be an NP and get no respect.
Click to expand...

You, my friend, have definately drank the koolaid. "NPs care more about their patients than MDs/DOs" really? Yup and "physicians just sneak a peek" Wow, just wow.

You claim to want people to be more respectful, by completely being disrespectful. Yaaaaa that makes a lot of fukin sense.
 
i happen to like my koolaid, its the newest flavor! you should try it. tastes like reality and it bites!
 
sylvanthus said:
You, my friend, have definately drank the koolaid. "NPs care more about their patients than MDs/DOs" really? Yup and "physicians just sneak a peek" Wow, just wow.

You claim to want people to be more respectful, by completely being disrespectful. Yaaaaa that makes a lot of fukin sense.
Click to expand...


you should work for FOX news. no where in my statement do i say that ALL np's care more about their patients than MDs. I said "I KNOW" more that do; like a patient i will judge by personal experience and this is what I and probably most of the people that were interviewed for the study felt. I want to be an MD at all costs because its the only title that gives me the authority to manage ones care. As a primary care doc, I know that i will have very little time to actually spend more than 5-10 mins with a patient per day (I'm forced to see as many pts as possible due to the perils of the healthcare system), this is why i will specialize or work in a private practice so i have the chance to actually get to know my patients AND manage their care. primary care can be done at a low cost with NP's and PA's. you get your med school education's worth by specializing and that is the trend that has continued for decades causing the primary care physician shortage.

you like this koolaid?
 
colberag said:
BSN nurses at most schools are required to take the same biology, chemistry etc as pre-meds, plus many are required to take microbiology, anatomy/physiology before starting their nursing curriculum. This is not "nursing chemistry", this is the same exact class any undergrad would take (this is bachelor level nursing, not associate level).
Click to expand...
Yeah, no, not usually. It was not the case at my school, and it wasn't the case where my wife went to school either (to get her BSN).

And as for the number of clinical hours for a DNP, they might only get 1000 in grad school, but what about the hours they got in undergrad and the 1500-2000hrs per year they got working as an RN before going to DNP school? Many of these places require 2 years of clinical experience before you can start - that is 3000-4000 of pure clinical hours before even beginning school.
Click to expand...
1. That's work, not school or residency.
2. They're working as nurses, doing nursing stuff.

The PA students who rotate with us on surgery do what the med students do. We don't get NP students.
 
banner18 said:
i dont get why you guys are so pissed off about this report. Judging by your comments any physicans journal that said physicans provide better care than NP's would be total BS. Remember that while med school may teach you more and may give you more clinical practice, all health care pro's sing and dance to the same tune. The tune of their patients. The best provider actually listens to the patients needs, and I think however biased the journal is, NP's might spend more time actually talking to the patients and so the patients feel that their care is more personalized. I think that your utter disrespect for NP's, and other nurses are the reason why the public despises physicians as cocky, unreasonable, elitists that earn too much money. Learn some respect, without nurses or NP's a physicians life would be a million times more miserable. I am a pre-med applying to only MD schools, and I have my reasons for doing so, but that does not give me or another MD the right to think they are a better "provider" than NP's PA's or DO's just because they had more training. I know more NP's that actually care about their patients than MD/DO's. ask any nurse, they think physicians are ***holes. Did it ever occur to you that nurses chose their profession for other reasons than "they were too stupid for med school"? The simple reality is that nurses spend more time with patients, physicians just sneak a peek and manage care.

BTW, if you think you'll be making big bucks and have all the prestige doing primary care as an MD in the next 20 years, think again. PA's and NP's will take over all primary care for the sole reason of cheap labor (look at china), anything else will be refereed to specialists. so you better learn to respect everyone in the healthcare field. I was pretty disappointed reading some of your comments.


oh and just a little tidbit for all those elitist DO's out there. Patients dont think your an equivalent to an MD so try to wrap that around your egos. Go outside the Americas and see how well received your DO is then youll know what its like to be an NP and get no respect.
Click to expand...

how_smart_i_am_today.jpg
 
banner18 said:
any physicans journal that said physicans provide better care than NP's would be total BS
NP's might spend more time actually talking to the patients and so the patients feel that their care is more personalized.
I think that your utter disrespect for NP's, and other nurses are the reason why the public despises physicians as cocky, unreasonable, elitists that earn too much money.

without nurses or NP's a physicians life would be a million times more miserable.
I am a pre-med applying to only MD schools, and I have my reasons for doing so
that does not give me or another MD the right to think they are a better "provider" than NP's PA's or DO's just because they had more training.

I know more NP's that actually care about their patients than MD/DO's.
ask any nurse, they think physicians are ***holes. Did it ever occur to you that nurses chose their profession for other reasons than "they were too stupid for med school"?
The simple reality is that nurses spend more time with patients, physicians just sneak a peek and manage care.
BTW, if you think you'll be making big bucks and have all the prestige doing primary care as an MD in the next 20 years, think again. PA's and NP's will take over all primary care for the sole reason of cheap labor (look at china), anything else will be refereed to specialists.
oh and just a little tidbit for all those elitist DO's out there. Patients dont think your an equivalent to an MD so try to wrap that around your egos. Go outside the Americas and see how well received your DO is then youll know what its like to be an NP and get no respect.
Click to expand...
In order of the bits of your post I chopped and colored.
-Yes, it would be BS. That said, I would be very surprised to see physicians feeling the need to tell the public what they already know.
-This is probably true
-The only people I have met that dislike physicians are poor people who think the doctors are lazy, greedy, people because when they went to the EMERGENCY department for a non emergency, they had to wait. Most people I know think being a doctor would be cool. That said, my sample size is too small to matter.

-Without the 16 year olds making fries and flipping burgers, the CEO of McDonald's life would be miserable too.
-HAHAHAHAHAHAHAHAHA no need to really go off about this one as it speaks for itself
-MD's/DO's ARE better care providers. They diagnose the problem and save the life. The nurses just carry out their orders.
-Similar to myself, your sample size is too small for this statement to matter.
-Some people lack confidence in their ability to get through medical school. Others go into nursing since the pay is good especially considering it is much easier to get into and much faster to get into than medicine. These two points go into why physicians have earned the right to feel superior.
-The fry cook makes more fries. The CEO of McDonald's just manages the company.
-I would never have a nurse as my PCP. Nurses are not doctors.
-I wonder how many people know what MD or DO even mean. Until I decided to pursue medicine, I did not know what either were. I just knew there were doctors that you went to see. I would have had no idea that a resident was not at the same level as an attending either. People just want to see a doctor. I doubt many people aside from pre-meds even care about this.
 
Last edited:
banner18 said:
you should work for FOX news. no where in my statement do i say that ALL np's care more about their patients than MDs. I said "I KNOW" more that do; like a patient i will judge by personal experience and this is what I and probably most of the people that were interviewed for the study felt. I want to be an MD at all costs because its the only title that gives me the authority to manage ones care. As a primary care doc, I know that i will have very little time to actually spend more than 5-10 mins with a patient per day (I'm forced to see as many pts as possible due to the perils of the healthcare system), this is why i will specialize or work in a private practice so i have the chance to actually get to know my patients AND manage their care. primary care can be done at a low cost with NP's and PA's. you get your med school education's worth by specializing and that is the trend that has continued for decades causing the primary care physician shortage.

you like this koolaid?
Click to expand...


Did you make a specific point in this rambling drivel or just spew a bunch of random nonsense?

I'll address one point. "primary care can be done at a low cost with NP's and PA's." Have you really thought about this or are you spouting some nonsense from allnurses.com? Salary is not the main factor in healthcare costs. How many referrals do you think NPs make in comparison to MD's/DO's? How about shotgun ordering of tests? Who is more likely to order more unnecessary testing? Do you think this may actually drive up healthcare costs in the end?

Having a bunch of subpar trained practitioners as the gatekeepers is not the answer. It may sound like a smart move because the salaries of PAs and NPs are less, but salary is obviously not the main factor.

With this, I am done with your nonsensical posts.
 
banner18 said:
i dont get why you guys are so pissed off about this report. Judging by your comments any physicans journal that said physicans provide better care than NP's would be total BS. Remember that while med school may teach you more and may give you more clinical practice, all health care pro's sing and dance to the same tune. The tune of their patients. The best provider actually listens to the patients needs, and I think however biased the journal is, NP's might spend more time actually talking to the patients and so the patients feel that their care is more personalized. I think that your utter disrespect for NP's, and other nurses are the reason why the public despises physicians as cocky, unreasonable, elitists that earn too much money. Learn some respect, without nurses or NP's a physicians life would be a million times more miserable. I am a pre-med applying to only MD schools, and I have my reasons for doing so, but that does not give me or another MD the right to think they are a better "provider" than NP's PA's or DO's just because they had more training. I know more NP's that actually care about their patients than MD/DO's. ask any nurse, they think physicians are ***holes. Did it ever occur to you that nurses chose their profession for other reasons than "they were too stupid for med school"? The simple reality is that nurses spend more time with patients, physicians just sneak a peek and manage care.

BTW, if you think you'll be making big bucks and have all the prestige doing primary care as an MD in the next 20 years, think again. PA's and NP's will take over all primary care for the sole reason of cheap labor (look at china), anything else will be refereed to specialists. so you better learn to respect everyone in the healthcare field. I was pretty disappointed reading some of your comments.


oh and just a little tidbit for all those elitist DO's out there. Patients dont think your an equivalent to an MD so try to wrap that around your egos. Go outside the Americas and see how well received your DO is then youll know what its like to be an NP and get no respect.
Click to expand...
Which sounds more arrogant/disrespectful to you:

1) Physicians saying that NPs/DNPs and their 500-1000 clinical hours of training are not good enough for independent practice. Especially when there isn't a single well-done study comparing NPs/DNPs with attendings (even the JAMA article that nurses often cite is riddled with huge methodological flaws...I was honestly surprised it got accepted).

OR

2) NPs/DNPs (and the nursing leadership) insisting that, even though they receive a tenth of the training a physician receives, they're equal/superior to physicians.

Patient satisfaction =/= quality medical care. Keep that in mind. In this era of PC-ness, it seems we've decided to throw away common sense and critical thinking because you might offend someone otherwise.
 
I'm not sure I understand why this whole NP thing is a big deal. I see an NP for most of my primary care needs and I think she does a good job. I'm sure if I presented with anything really complex she wouldn't try to overreach the scope of her training. For patients with typical illnesses and few comorbidities research does indicate that NPs do a good job. The only thing I do worry about is that an increase in the number of NPs will spell the end for primary care physicians (especially if more states allow independent billing). But as things stand right now with the lack of primary care physciains these NPs seem to be helping people gain access to some form of care that perhaps they may not have been able to get otherwise.
 
dude you analogy about mcdonalds just proves my point. how often do you get satisfaction from the ceo of mcdonalds? never. how often do you at the very least get a pleasant response from the cashier or the take out person? probably more than the ceo that your rarely meet.

i didnt mean to turn this into a np vs md/do battle. I'm pointing out that when it comes to PRIMARY CARE, the role of physician can be completed by NP's and PA's. i think that the med school education we get is indeed FAR superior to what NP's or PA's get, but i believe that education is wasted by going into primary care (unless you find a sub-speciality within internal med). btw you are misinformed about what an NP can do:

  • Diagnosing, treating, evaluating and managing acute and chronic illness and disease (e.g. diabetes, high blood pressure)
  • Obtaining medical histories and conducting physical examinations
  • Ordering, performing, and interpreting diagnostic studies (e.g., routine lab tests, bone x-rays, EKGs)
  • Prescribing physical therapy and other rehabilitation treatments
  • Prescribing drugs for acute and chronic illness (extent of prescriptive authority varies by state regulations)
  • Providing prenatal care and family planning services
  • Providing well-child care, including screening and immunizations
  • Providing primary and specialty care services, health-maintenance care for adults, including annual physicals
  • Providing care for patients in acute and critical care settings
  • Performing or assisting in minor surgeries and procedures (with additional training and/or under physician supervision in states where mandated; e.g. dermatological biopsies, suturing, casting)
  • Counseling and educating patients on health behaviors, self-care skills, and treatment options
hmmmm sounds like the same things a primary care physician does, wow!


oh, if you think your patients are going to be that ignorant that they wont look you up online to learn about you, you are totally misinformed yet again. personal story: my friends mom is a DO. old pt comes in with severe chronic pain, hes been coming back many times and his condition isnt improving. He REFUSES to see my friends mom after looking at the DO on her badge. He simply yelled "i want a real doctor" over and over again without letting her speak, my friends mom was in tears when she came back home to see me and my friend. She is currently going after an MD.

please dont think your patients are ignorant about who you are, they know a lot more than you think and sometimes they are misinformed because of what they read. this isnt the 1900's with no internet.
 
banner18 said:
oh, if you think your patients are going to be that ignorant that they wont look you up online to learn about you, you are totally misinformed yet again. personal story: my friends mom is a DO. old pt comes in with severe chronic pain, hes been coming back many times and his condition isnt improving. He REFUSES to see my friends mom after looking at the DO on her badge. He simply yelled "i want a real doctor" over and over again without letting her speak, my friends mom was in tears when she came back home to see me and my friend. She is currently going after an MD.
Click to expand...
Dear god.

:troll:
 
Contrary to popular belief, primary care is one of the most difficult medical specialties, IMO. I think people equate non-competitive to easy and I think that that's an unfair association. The breadth of knowledge you need to have as a PCP is absolutely enormous. As an attending once told me, "it's very easy to be a mediocre PCP but it's very difficult to be a good one."
 
banner18 said:
oh, if you think your patients are going to be that ignorant that they wont look you up online to learn about you, you are totally misinformed yet again. personal story: my friends mom is a DO. old pt comes in with severe chronic pain, hes been coming back many times and his condition isnt improving. He REFUSES to see my friends mom after looking at the DO on her badge. He simply yelled "i want a real doctor" over and over again without letting her speak, my friends mom was in tears when she came back home to see me and my friend. She is currently going after an MD.
Click to expand...

Thank you for saying something so unrealistic that I know you are a troll.
 
arfc6 said:
I'm not sure I understand why this whole NP thing is a big deal. I see an NP for most of my primary care needs and I think she does a good job. I'm sure if I presented with anything really complex she wouldn't try to overreach the scope of her training. For patients with typical illnesses and few comorbidities research does indicate that NPs do a good job. The only thing I do worry about is that an increase in the number of NPs will spell the end for primary care physicians (especially if more states allow independent billing). But as things stand right now with the lack of primary care physciains these NPs seem to be helping people gain access to some form of care that perhaps they may not have been able to get otherwise.
Click to expand...

Thank you. a voice of reason. mds are freaking out that their roles as pcp's is vanishing. welcome to the 21st century, you are replaceable when it comes to basic primary care.
 
Kaushik said:
Contrary to popular belief, primary care is one of the most difficult medical specialties, IMO. I think people equate non-competitive to easy and I think that that's an unfair association. The breadth of knowledge you need to have as a PCP is absolutely enormous. As an attending once told me, "it's very easy to be a mediocre PCP but it's very difficult to be a good one."
Click to expand...


This!
 
banner18 said:
oh and just a little tidbit for all those elitist DO's out there. Patients dont think your an equivalent to an MD so try to wrap that around your egos. Go outside the Americas and see how well received your DO is then youll know what its like to be an NP and get no respect.
Click to expand...

Are you joking me? I know plenty of DOs, all of them are equally as awesome. When it comes to billing... DO's of the same specialty don't bill for LESS than their MD counterparts... they bill the same. DO schools are easier to get into because the competition isn't as fierce. MD/DO... no real difference anymore.. AT Still's vision was great but it didn't survive the turn of the century.

banner18 said:
oh, if you think your patients are going to be that ignorant that they wont look you up online to learn about you, you are totally misinformed yet again. personal story: my friends mom is a DO. old pt comes in with severe chronic pain, hes been coming back many times and his condition isnt improving. He REFUSES to see my friends mom after looking at the DO on her badge. He simply yelled "i want a real doctor" over and over again without letting her speak, my friends mom was in tears when she came back home to see me and my friend. She is currently going after an MD.

please dont think your patients are ignorant about who you are, they know a lot more than you think and sometimes they are misinformed because of what they read. this isnt the 1900's with no internet.
Click to expand...

:laugh: Your mom's friend? Is your mom's friend secretly you?
 
Status
Not open for further replies.
Next unread thread

Similar threads

Mr.Smile12
NYT: $1 Billion Donation Will Provide Free Tuition at a Bronx Medical School
Replies
21
Views
3K
zakimran23
Z
P
Research assistant no publications after 2 years; PI says managing the lab has more weight than first authorships, publications
Replies
17
Views
2K
pauliyah
P
M
Better state to be resident for application? NC or SC
Replies
6
Views
478
chssoccer7
C
Jacob Saadoun
Taking care of special needs sister
Replies
8
Views
540
Goro
Goro
Ilikespidey
Is GPA more “emphasized” at Texas MDs?
Replies
20
Views
3K
sugasathya
S
Top