SP and Idio, I'm sure your fellowship was great. I understand you saying NPs are necessary to 'get the work done' in your ICUs. That doesn't mean you start a 'fellowship' for them, to empower the movement, to bring them one step closer to claiming equivalence to YOU. Big difference between hiring NPs for daily function, and creating a fellowship.
Fair enough, we can all agree that this is not a great thing for ICU physicians in general. I dont think any of the fellows at Vanderbilt are excited about this progression. With that said, the development of DNP programs is going to stimulate this kind of subspecialized training (and there will be other fellowships).
Vanderbilt is a medical center that trains medical students, residents, fellows, post-docs, nurses, nurse practitioners, SRNAs, LPNs, care partners, janitorial staff, administrators - basically anything that is needed to run a hospital in the 21st century. Your opinion of the value of such training is really immaterial, as is mine, but I also dont think its an indictment of the anesthesia CCM fellowship that there happens to be someone doing clinical rotations with you and presenting patients to you on rounds (at least for three shifts a week on a few rotations a year).
In my opinion, this fellowship is something that was going to happen here, as an extension of the various nursing training programs, and as a member of the CCM department, Id rather be involved in the development and implementation of it than have it happen anyway without any input from our department. Ill admit to not knowing a ton about the 'fellowship' aspect of the program, as most of my experience with it comes from the same article posted above. Im sure over time we will see a more concrete presentation.
For those of you rigidly opposed to these developments, I salute you. There are numerous programs around the country that do not employ physician extenders, I am sure, and I encourage you to seek out those places to hone your skills. I happen to think the ICU of the future is very similar to the OR of the future, which will have physicians directing care and multiple tiered providers delivering the care, based on the acuity of the situation. Even with the inevitable repeal/dilution of the affordable care act, midlevel practitioners are going to remain part of the workforce.