Okay, Kaushik, here's your chance.
Mary Mundinger has a letter in today's Wall Street Journal you might enjoy. Start crafting your reply.
Isn't the study she cited HER study? Just curious.
Oldiebutgoodie
I will write something up, but it's extremely unlikely that the WSJ will put up something I write. The best I can probably do is to write in the comments section.
Don't encourage him. He probably barely has time for his homework as it is!
Yea, because spending a couple of minutes discussing a topic of interest means that my entire life revolves around only this issue and that I have no time for anything else. Right?
What a lot of posters seem to not understand is that health care is in a time of tremendous flux right now.
Residency is creating a bottleneck in physician training right now, and is severely limiting the number of trained caregivers with M.D. after their name.
So what's happening? PAs, & NPs are filling that void. Along with all kinds of emerging technical staff like AAs.
The solution is not to fill in the void of highly-trained physicians with nursing midlevels, who have a fraction of the training that a physician receives. Especially in a field like primary care, which demands that you have an extensive medical knowledge base.
We also need more dermatologists, cardiologists, lucrative-specialty-ologists right? Because I see NP "residencies" opening up in these lucrative fields. Guess they don't care that much about primary care after all...
Also, most health care institutions, read hospitals, are run not by physicians, but business people.
So when you have a CRNA who costs you $120,000 a year to employ or an Anesthesiologist who costs you $350,000+ (and that's low) what do you think makes more sense to a business mind? That's right hire 1 Anesthesiologist and have them work with 1-4 CRNAs rather than hire that many Anesthesiologists....profit!
I would be more likely to believe this argument if the nursing midlevels who want independence weren't also pushing for equal reimbursement as physicians. If they want to get paid at the same level as physicians, why would you hire them? You're getting someone who costs the same as a physician but with significantly less training. It's a lose-lose (for both the businessman and the patient).
Just something to keep in mind; the paradigm of Physician with nurses scuttling around beneath them is going the way of house calls. I know there is the chest-thumping-arrogance associated with the 8-ish years of education that goes into an M.D. (I'm currently on several wait-lists to get those initials after my name), but seriously it's not doing anything to advance the debate of how to provide enough care for those being left in the 150,000-200,000 physician void that's looming over the next 20 years or so.
Actually, I haven't seen that on these forums or in actual clinical settings (at least where I volunteered and shadowed).
Kaushik, it may feel great to troll on the internet about contacting media sources about the evils of nursing, but seriously if you're going to be a physician with that mentality I feel bad for anyone who has to work with you. I've met several physicians/residents/fellows with that mentality while working as a NA, and the only person who suffers when you snub the nursing staff is the patient. Grow up, and get over yourself. You're part of a team whether you like it or not, and there will be nurses who are better than you at delivering care, deal with it, and move on. There's nothing wrong with it, and if you can use those people effectively you'll make your care all the more effective; if not you'll have a dysfunctional care-team and your patients will be the only ones suffering.
It's pretty clear that you haven't read anything I've written (beyond a sentence or two). Don't put words in my mouth; it makes
your arguments seem weaker when you make stuff up. Go back and reread what I wrote. Nowhere did I say that nursing is evil. Nowhere did I say that I had anything against nursing or midlevels in general (in fact, I'm very supportive of PAs and most NPs). Heck, the ED where I used to volunteer had several NPs that I got along extremely well with.
The group that I am against is the one filled with NPs/DNPs/CRNAs who are continually pushing to have an equivalent scope of practice as physicians. Especially when there isn't any convincing evidence to suggest that this is a good idea (as I previously mentioned, the best NP/DNP study is the Mundinger one, and that is not only heavily flawed in design but also barely has any follow-up looking at long-term outcomes). Do you really think that 2-3 yrs of online school = rigorous MD/DO school + residency? That is the
only group I'm against. Like I said, go back and reread my posts before responding.
It's funny that you're telling me to grow up and to get over myself. Let me ask you a question though: which of these comes off as more arrogant?
1) Me claiming that an NP/DNP who has between 500-1000 clinical hours of training is nowhere close to being equal to a physician who has more than 10000 hours of clinical training (and this isn't even taking into account that physicians receive a significantly greater basic science foundation than nursing midlevels).
Or,
2) NPs/DNPs claiming that they're equal/superior to physicians (has been stated many times in media articles...Mundinger herself has been quoted saying that DNPs are superior to physicians) and demanding that they have an equivalent scope of practice and equal reimbursements. Don't mind the fact that they receive only a fraction of the training that an attending receives.
I'm curious to see if you think choice 1 is more arrogant and to hear your reasons as to why.
Also, nice job invoking Burnett's Law: "if you believe [insert random opinion], you'll be a terrible doctor and I am scared for your future patients!" Come on...come up with a better "argument" than that.
Anyway, it's some interesting stuff here in this thread (that WSJ article was a good read). I know I am looking at PA and ACNP as options if I don't get off of these wait-lists.
If you're referring to the Mundinger letter as being a good read, it unfortunately was not. Her study has been debunked many times in the past, not only on SDN but also in the allnurses forums. I'm not sure why she keeps on referencing it. Not only that, her DNPs at Columbia (supposedly the "cream of the crop") had a 50% fail rate on a watered-down version of the easiest Step exam. This exam was specially catered to the DNPs, the questions were made easier, and the passing score was also lowered. Yet, there was a 50% fail rate. That tells you quite a bit about the rigor of their training. As a note, from what I've been told by residents, most interns take the real Step 3 (you know, not the watered-down one) with barely any studying and have a nearly-100% pass rate.
Good luck with the waitlists. Letters of interest/intent have worked for others and might help you out as well.
Edit: Looks like Dr. Oops beat me to it.