NYT article on Doctor Nurses

[btbam]

Interesting article...

http://www.nytimes.com/2011/10/02/health/policy/02docs.html?_r=1&hp

---

Members don't see this ad.

 

[BLADEMDA]

Who Gets to Be Called a Doctor?

By TARA PARKER-POPE

Josh Anderson for The New York TimesPatti McCarver, a nurse who recently earned a Doctor of Nursing Practice degree, calls herself a doctor when she introduces herself to her patients.
Many nurses are going back to school to earn doctorate degrees, but does that give them the right to call themselves doctor?

 

[Lubeckd]

In Chinese Doctorates are Bu si Shen.
In Chinese Doctors/M.D are called Yi Shen.
There used to be 20 DNP programs, now there is 120 (Some of online colleges) I think it's to fill in primary care physicians shoes right?

 

[Nooblet]

.

 

[Bertelman]

.

 

[cfdavid]

Still wanna be an internist?

Seriously though, this is going to be a unifying factor for organized medicine like we haven't seen in quite some time. Every MD/DO who reads that article will run to the bathroom like I almost just did (just dry heaved since I haven't had breakfast).

The RATE of enchroachment of CRNA's in our profession is nothing like what primary care (but not only primary care since I personally know of DNP-to-be's in cardiology and peds endo to name just two which I am sure of) and other specialties are going to see.

This will bring thousands of physicians from other fields to the greater battle which will help us in a big way. That's the only silver lining I see, but I think, for us, this will be significant. In the past other specialties have been somewhat apathetic w/r/t mid-levels in anesthesia and their power grabs, but that apathy is going to go away very quickly.

You know, why don't PA's go for THEIR doctorates!? Oh yeah, that would mean medical school.....

 

[BLADEMDA]

I have spent countless hours, nay, days on SDN since I became a member 5 years ago.

I have never seen an avatar that big.

IMHO, it takes away from whatever message happens to be placed alongside.

Any advice on how I can shrink it down? I'll PM Arch for help.

 

[carml]

My reply to the article:
http://community.nytimes.com/comment...308#comment308

I stole it right out of someone's signature on here - sorry, but I thought it was very pertinent. If you guys agree with the reply, please click on "recommend" on there so it makes it to the top of the reply chain and most lay folks can see the difference in training.

 

[nycitygas]

Barbara
New York
October 2nd, 2011
12:14 pm

Nurses need to stop thinking they know more than Drs., nurses are NOT doctors.
And it's a very dangerous game to think they know more than - they actually know.
Same holds true for pharamacists, but it really raises my blood pressure when nurses
act like they know more. I have seen this time and time again. I don't want to see a
"nurse practioner" - I want to see a doctor with M.D. after his or her name.

Maybe people are beginning to wake up...

 

[cfdavid]

Barbara
New York
October 2nd, 2011
12:14 pm

Nurses need to stop thinking they know more than Drs., nurses are NOT doctors.
And it's a very dangerous game to think they know more than - they actually know.
Same holds true for pharamacists, but it really raises my blood pressure when nurses
act like they know more. I have seen this time and time again. I don't want to see a
"nurse practioner" - I want to see a doctor with M.D. after his or her name.

Maybe people are beginning to wake up...

Indeed. People are tiring of the watering down of the things they value in their lives. There are trends in society in general which are making the "average joe" more skeptical of such "initiatives".

 

[Bertelman]

Any advice on how I can shrink it down? I'll PM Arch for help.

Think you just have to resize the photo. Don't know what your source was, just look for a different source with a smaller pic.

 

[Taurus]

This is one of the best articles about the DNP, DPT, pharmd, etc. It is not so one-sided and pro-DNP that I so often read in the mainstream media. Instead, it did a good job of describing the training of DNP's and mentioning how DNP's are no better than master's level NP's. The authors did their research. I wonder if they spent a lot of time on SDN.

 

[VA Hopeful Dr]

Indeed. People are tiring of the watering down of the things they value in their lives. There are trends in society in general which are making the "average joe" more skeptical of such "initiatives".

In the end, that won't matter. Let's say your average joe has insurance that has a $30 co-pay to see his PCP. Let's say that the same insurance only requires he pay $5 to see an NP. Americans will drive across town to save $0.05 per gallon on gas, I know how this will play out.

That's my fear.

 

[BLADEMDA]

In the end, that won't matter. Let's say your average joe has insurance that has a $30 co-pay to see his PCP. Let's say that the same insurance only requires he pay $5 to see an NP. Americans will drive across town to save $0.05 per gallon on gas, I know how this will play out.

That's my fear.

You are correct. At least the patient gets a choice whether to see his/her F.P. MD vs. NP. I'm not so sure that will occur in anesthesia.

Even today if you walk into certain outpatient centers or GI centers the Anesthesia provider is chosen for you. I expect that provider will be a CRNA as more centers suck the profit from anesthesia reimbursements and pay the Advanced Anesthesia Nurse $100 per hour flat fee.

 

[BF2BC EMT]

Hopefully theyll allow CNA's with one year of ICU experience to enter a direct RN/BSN program. That would only be fair

 

[RxBoy]

One of the comments talks about how at Mayo Clinic, no doctor wears a white coat which exposes all the doctor wannabees. Doctors wear either standard issue scrubs or a suit. I love that, I wish that became the new norm everywhere.

I refuse to wear my white coat, it just collects dust.

I spent 2 grueling years wearing that ridiculous short white coat to get the upgrade. Meanwhile social workers/NPs/PAs/CRNAs/Administrative staff/PT/OT all starting wearing them. I was a little pissed but was like fine at least mine says MD. I then moved downstairs to OR land to begin my anesthesia residency and realized that circulators/anesthesia techs/PACU/preop nurses/billing staff all wear them. Not very happy but I still wore mine proud to be an MD. The last straw was when I went to the floor to do a preop and noticed a nursing assistant (while cleaning a patients poop) was wearing one. At that moment I promised myself to never wear it again.

The funny thing is the other day I overheard a NP talking about how ridiculous it was that the hospital allows "regular" nurses to wear white coats. It was quite amusing.

 

[powermd]

I was quite happy to ditch the white coat. To me it's a symbol of training. "I wear this because they make me wear this." Or, considerably lamer "I wear this because I want everyone to know I'm a doctor". I think wearing whatever you damn well please is a much more powerful symbol of "having arrived". That's something I can take pride in.

One of the comments talks about how at Mayo Clinic, no doctor wears a white coat which exposes all the doctor wannabees. Doctors wear either standard issue scrubs or a suit. I love that, I wish that became the new norm everywhere.

I refuse to wear my white coat, it just collects dust.

I spent 2 grueling years wearing that ridiculous short white coat to get the upgrade. Meanwhile social workers/NPs/PAs/CRNAs/Administrative staff/PT/OT all starting wearing them. I was a little pissed but was like fine at least mine says MD. I then moved downstairs to OR land to begin my anesthesia residency and realized that circulators/anesthesia techs/PACU/preop nurses/billing staff all wear them. Not very happy but I still wore mine proud to be an MD. The last straw was when I went to the floor to do a preop and noticed a nursing assistant (while cleaning a patients poop) was wearing one. At that moment I promised myself to never wear it again.

The funny thing is the other day I overheard a NP talking about how ridiculous it was that the hospital allows "regular" nurses to wear white coats. It was quite amusing.

 

[cincincyreds]

This just makes me want to vomit. These people are disgusting. They lie to other people about what they are. If they want to be called doctor, they should take the mcat, get above a 30 and go to medical school.

 

[BLADEMDA]

This just makes me want to vomit. These people are disgusting. They lie to other people about what they are. If they want to be called doctor, they should take the mcat, get above a 30 and go to medical school.

Now why would they want to do that?

 

[jwk]

It's no different than nurse anesthesia students wanting to be referred to as "residents".

They can squawk all they want about not wanting to be called "doctor" - the simple fact is they lie through their teeth.

Support the ASA and AAAA and all 50 state medical associations in speaking up for and supporting H.R. 451, the Health Care Truth and Transparency Act of 2011


****************************************

H.R. 451, the Health Care Truth and Transparency Act:
Frequently Asked Questions
ISSUE
Consumers want and need more information about their health care provider.
QUESTIONS
What is the purpose of this legislation?
This legislation would improve consumer access to accurate information about health care providers.
Why is the legislation necessary?
As the health care marketplace has evolved in recent decades, consumer access to accurate information about their health care provider has not kept pace with the changes. Today, there is significant consumer confusion in the new health care marketplace concerning the licensing, education, training and skills of different health care providers.
Common terms once reserved exclusively for specific health care providers are now used by other health care providers. A health care provider who identified himself or herself as a "doctor" has long been assumed to be a medically trained physician. Similarly, a health care provider in training who identified himself or herself as a "resident" was long assumed to be physician completing a physician residency program. However, in recent years, the meanings of these and other titles have been blurred. Many different types of health care providers including nurses now identify themselves as "doctors." Additionally, nursing programs have begun to shift their students' titles from "student nurses" to "residents" – a term typically reserved for physicians undergoing advance training in a medical specialty.
Moreover, provisions included in the Patient Protection and Affordable Care Act (PPACA) will further blur differences among health care providers and accelerate confusion. The so-called "Non-Discrimination in Health Care," (sec. 1201) provision includes a prohibition against health plans "discriminating" against health care providers for purposes of participation or coverage. This broad and unprecedented prohibition effectively limits the ability of health plans to properly distinguish among varying health care providers and will exacerbate confusion over providers' education, training and skills.
Consumers need access to accurate information about health care providers. And while the FTC is unlikely to halt recipients of "Doctors of Nurse Practice" degrees and other non-medical degrees from calling themselves "Doctors," the commission can enhance transparency by addressing misrepresentation and working to ensure that patients and consumers have more information about the actual license under which their "Doctor" practices.
What does this legislation do?
The legislation applies longstanding Federal Trade Commission (FTC) Act consumer protections to the new health care marketplace. Specifically, the bill would 1) make it unlawful to misrepresent a health care provider's licensure, education, training, degree or clinical expertise and 2) require the disclosure of the license under which the provider practices - physician, nurse, technician, etc. – in any advertisement.
Doesn't the Federal Trade Commission already have jurisdiction over this issue?
Section 5 of the FTC Act declares unfair or deceptive acts or practices unlawful. However, it is not clear that Section 5 is being applied to avert this type of confusion in the new health care marketplace concerning the licensing, education, training and skills of health care providers. Indeed, the FTC has undertaken little if any enforcement of unfair or deceptive acts in the health care marketplace as they apply to how health care providers represent their licensing, education, training and skills to patients when they are providing care or in advertisements. This legislation would bring such enforcement about.
Does this legislation change the scope-of-practice of any providers?
No. The legislation explicitly provides that "Nothing in this Act shall be construed or have the effect of changing State scope of practice for any health care professional."
Who supports this legislation?
The legislation is supported by 18 national medical specialty and 50 state medical organizations and the American Academy of Anesthesiologist Assistants (AAAA).
Who opposes this legislation?
The legislation is opposed by a coalition of 10 national allied health care provider organizations.
Why is this legislation important?
In other areas of commerce, Congress has worked to empower FTC to take action to ensure consumers have accurate information about the products and services being purchased. Whether it is "The Fur Products Labeling Act," that gives consumers information about fur garments, or the "Dolphin Protection Consumer Information Act", that ensures consumer access to accurate information about the harvesting of tuna, Congress has empowered the FTC to enhance transparency and provide consumers more information where there is a need. There is an urgent need in the health care marketplace, and the FTC should be directed to provide consumers of health care services more transparency and information regarding health care providers and health care provider advertisements.

 

[Paseo Del Norte]

Frankly, I'm embarrassed.

 

[W222]

"It's not like a group of us woke up one day to create a degree as a way to compete with another profession," she said. Nurses are very proud of the fact that they're nurses, and if nurses had wanted to be doctors, they would have gone to medical school."

This is the biggest lie ever told. I am calling BS on this NURSE.

 

[W222]

On a similar note: Has anyone here witnessed some absolutely horrific care provided by independent practice midlevels or CRNAs?

I can attest that I have seen several instances where people were lucky to have survived and the only reason their lives were threatened was midlevel care.

 

[ctsicu]

i also found this article totally disgusting. like they don't want to compete!! what a f-ing joke! why ELSE would they want to be called doctor? only to misrepresent what they know!!
and yes, i have most certainly seen midlevels provide horrific care. numerous misdiagnoses like you wouldn't believe. in fact, one of them used to bring me ekgs (which they would frequently get on healthy 30 year olds by the way) because they couldn't read them. i used to be a subspec surgeon, and when i took er consults, the ones from the midlevel side were so stupid and pathetic that it made me want to scream. any half competent er doctor could have handled all of those calls and then some in a fraction of the time and tests. its just ridiculous.
i actually wrote an email to the guy who wrote the article. here it is:

Dear Mr. Harris,
As a practicing physician, I read your article with dismay and disgust. I find the idea that nurses trying to equal themselves to physicians preposterous. What was worse was that I felt your article was biased and inaccurate. The so called "studies" which claim equivalency of care, had you bothered to check, were funded by nurses and their associations themselves. Moreover, how were these "studies" conducted? The data is unsound and appallingly lacking in science. I'm not even sure something like that can be measured. What is the outcome parameter they are using?
There is no other reason for a nurse to call themselves "doctor" unless they want to compte. Would lawyers ever allow paralegals to call themselves esquire or something equivalent? I don't think so. If you think I am taking this personally, I AM. I didn't slave through college, study day in and day out in medical school, and do five years of residency, often working 24 hour shifts, in order for someone who has less than half my education to use the same title. And I think that even you would find it offensive if a high school English student said he could do your job as a reporter just as well you despite the fact that you have attended an Ivy League and written for the Wall Street Journal. Because that's about what you're saying.
As a physician who has worked with countless "advanced practice" nurses, I can guarantee that they have nowhere near the knowledge base as a physician. It is not possible to cram 8 years of medical school and residency into 16 months of "clinicals" which are completely non standardized, particularly when you are talking about people with lower intellectual capacity. Ask one of these nurses to answer even 40% of the exam questions we have to take correctly, and I would be shocked.
In essence, they will actually drive the cost of health care UP. Let me give you an example: any internal medicine physician will manage a person's diabetes, heart disease, and let's say, depression at the same time. A nurse practitioner will consult the cardiologist, endocrinologist, and psychiatrist because they lack the knowledge base necessary to treat more than one thing. As a former specialist consultant who has worked in emergency rooms, I recieved calls from both ER physicians and midlevel providers. Most, if not all of the calls from the midlevel providers would have been easily handled by the ER physician, but way out of the capabilities of a midlevel provider. Adding a consultant fee to hospital visit occurs at a cost to the patient, their insurance company, and the health care system. Where is the savings in that?

 

[BF2BC EMT]

I know this is about Dr. Nurses but are you guys/gals obligated to teach SRNAs/CRNAs or can you say no? I've seen no from MD and yes from CRNA.

One more thing about the Dr. debate and this has happened to me twice in my EMS days and I think it is kind of related to who calls themselves a Dr. while trying to render medical aid/advice. Both times people who identified themselves as doctors came on scene offering assistance/asserting themselves and when people hear Dr, you, me and everyone assumes MD/DO. Well these "Dr's" turned out to be a chiropractor and a podiatrist

Anyways what I'm trying to say is yes, these people were "Dr's" and yes they were kind of knowledgeable about the human body but that's it, "kind of". They knew nothing about EMS yet tried to assert themselves. Dr. Nurses know some things and "kind of" know how to diganose and treat, but there is plenty more they don't know which an MD/DO does

If people understood a lot of these programs can be done online they might not think so highly about going to Dr. Nurses(especially when they think it's a serious issue) maybe ITT Tech will open a program up? I hope so....

 

[Paseo Del Norte]

i also found this article totally disgusting. like they don't want to compete!! what a f-ing joke! why ELSE would they want to be called doctor? only to misrepresent what they know!!
and yes, i have most certainly seen midlevels provide horrific care. numerous misdiagnoses like you wouldn't believe. in fact, one of them used to bring me ekgs (which they would frequently get on healthy 30 year olds by the way) because they couldn't read them. i used to be a subspec surgeon, and when i took er consults, the ones from the midlevel side were so stupid and pathetic that it made me want to scream. any half competent er doctor could have handled all of those calls and then some in a fraction of the time and tests. its just ridiculous.
i actually wrote an email to the guy who wrote the article. here it is:

Dear Mr. Harris,
As a practicing physician, I read your article with dismay and disgust. I find the idea that nurses trying to equal themselves to physicians preposterous. What was worse was that I felt your article was biased and inaccurate. The so called "studies" which claim equivalency of care, had you bothered to check, were funded by nurses and their associations themselves. Moreover, how were these "studies" conducted? The data is unsound and appallingly lacking in science. I'm not even sure something like that can be measured. What is the outcome parameter they are using?
There is no other reason for a nurse to call themselves "doctor" unless they want to compte. Would lawyers ever allow paralegals to call themselves esquire or something equivalent? I don't think so. If you think I am taking this personally, I AM. I didn't slave through college, study day in and day out in medical school, and do five years of residency, often working 24 hour shifts, in order for someone who has less than half my education to use the same title. And I think that even you would find it offensive if a high school English student said he could do your job as a reporter just as well you despite the fact that you have attended an Ivy League and written for the Wall Street Journal. Because that's about what you're saying.
As a physician who has worked with countless "advanced practice" nurses, I can guarantee that they have nowhere near the knowledge base as a physician. It is not possible to cram 8 years of medical school and residency into 16 months of "clinicals" which are completely non standardized, particularly when you are talking about people with lower intellectual capacity. Ask one of these nurses to answer even 40% of the exam questions we have to take correctly, and I would be shocked.
In essence, they will actually drive the cost of health care UP. Let me give you an example: any internal medicine physician will manage a person's diabetes, heart disease, and let's say, depression at the same time. A nurse practitioner will consult the cardiologist, endocrinologist, and psychiatrist because they lack the knowledge base necessary to treat more than one thing. As a former specialist consultant who has worked in emergency rooms, I recieved calls from both ER physicians and midlevel providers. Most, if not all of the calls from the midlevel providers would have been easily handled by the ER physician, but way out of the capabilities of a midlevel provider. Adding a consultant fee to hospital visit occurs at a cost to the patient, their insurance company, and the health care system. Where is the savings in that?

I disagree. The article is far from disgusting. It's much less pro nurses gone wild than other the kool aid drinker articles and even describes the profound differences between the education of physicians and noctors.

 

[epidural man]

On a similar note: Has anyone here witnessed some absolutely horrific care provided by independent practice midlevels or CRNAs?

I can attest that I have seen several instances where people were lucky to have survived and the only reason their lives were threatened was midlevel care.

Umm....

We have also all seen where horrific care was provided by a highly trained MD/DO with their glorious 17,000+ hours of training.

I don't think that makes a good argument, that is all I am saying.

By the way, attached is the PDF article referenced by the OP.

View attachment ND degree - NYT.pdf

 

[rka]

So, let's have the CRNAs with doctorates take the USMLE Steps 1, 2 CK, 2 CS and 3. If they pass all of those, fine, let them call themselves doctors. They would never pass.

 

[pgg]

So, let's have the CRNAs with doctorates take the USMLE Steps 1, 2 CK, 2 CS and 3. If they pass all of those, fine, let them call themselves doctors. They would never pass.

No.

Simply permitting them to take the exams lends their ridiculous equality argument more credibility than it deserves.

If they want to take the USMLEs, they can go to medical school. Short of that, they are unqualified and undeserving of even the opportunity to sit down for one of our exams.

 

[rka]

Very very true, but it is so annoying to listen to them talk about their "boards!" I just wish they could see ours- they would run away crying! One would absolutely have to go to medical school to pass them.

 

[BLADEMDA]

"The title 'Doctor' is one which is earned by virtue of a doctorate program. There is no other definition for the title. The title "physician" is reserve for the MD DO clinical doctorate. They own that title and no one else should use it. By this very nature anyone who earns it is entitled to use it anytime they so choose in any position they so choose. That is simply the right conferred along with the degree. Neither the ASA, the AMA or any legislator should have any purview over this.

This is entirely about money to the ASA and the AMA, nothing else. Their arguments about transparency and 'confusion' for patients in this regard are as baseless as their arguments about patient safety when APNs & CRNAs take care of patients without an MD/DO. There is no evidence for any such argument nor will there ever be, in fact there is significant evidence to the contrary when it comes to patient outcomes and satisfaction.

So lets not bull**** that this has anything to do with anyone pretending their are something they are not. Lets not forget that both OTs, Pharms, Podiatrists, Optometrists and many others have long since used the term "doctor" on their name badges and with patients and yet this was not an issue. The only reason that it is with APNs is because physicians are worried that attaining an equal level terminal degree will cost them MONEY.

If the ASA and the AMA want to know why they are consistently losing ground to APNs & CRNAs they have but to spend a few minutes looking in the mirror to understand why we seek separation from working with them. While there are MANY MDAs who are AMAZING teachers and I count as personal friends and mentors, there are many more who propagate the baseless fear mongering and evidence free tactics consistently seen in every ASA and AMA press release. The most recent examples are the "doctor on your side" bull**** backed by the ASA and the check MD crap happening in KY. This sortof nasty and low brow style attack just serves to push more CRNAs and APNs to stop working with physicians. It really is that simple."

Leader of the Militant Band of CRNAs at Nurse Web site

 

[BLADEMDA]

"The title 'Doctor' is one which is earned by virtue of a doctorate program. There is no other definition for the title. The title "physician" is reserve for the MD DO clinical doctorate. They own that title and no one else should use it. By this very nature anyone who earns it is entitled to use it anytime they so choose in any position they so choose. That is simply the right conferred along with the degree. Neither the ASA, the AMA or any legislator should have any purview over this.

This is entirely about money to the ASA and the AMA, nothing else. Their arguments about transparency and 'confusion' for patients in this regard are as baseless as their arguments about patient safety when APNs & CRNAs take care of patients without an MD/DO. There is no evidence for any such argument nor will there ever be, in fact there is significant evidence to the contrary when it comes to patient outcomes and satisfaction.

So lets not bull**** that this has anything to do with anyone pretending their are something they are not. Lets not forget that both OTs, Pharms, Podiatrists, Optometrists and many others have long since used the term "doctor" on their name badges and with patients and yet this was not an issue. The only reason that it is with APNs is because physicians are worried that attaining an equal level terminal degree will cost them MONEY.

If the ASA and the AMA want to know why they are consistently losing ground to APNs & CRNAs they have but to spend a few minutes looking in the mirror to understand why we seek separation from working with them. While there are MANY MDAs who are AMAZING teachers and I count as personal friends and mentors, there are many more who propagate the baseless fear mongering and evidence free tactics consistently seen in every ASA and AMA press release. The most recent examples are the "doctor on your side" bull**** backed by the ASA and the check MD crap happening in KY. This sortof nasty and low brow style attack just serves to push more CRNAs and APNs to stop working with physicians. It really is that simple."

Leader of the Militant Band of CRNAs at Nurse Web site

I completely disagree with the above statements. In our society the term Doctor and Physician are used interchangeably in our hospitals. Thus, patients think Doctors are Physicians when they are in a clinical setting. I support the proposed legislation outlawing the use of the term "doctor" by a Nurse in a health care clinical setting.

If they want to be called Doctor in a hospital or surgicenter then please go to Medical School.

 

[BLADEMDA]

Things may seem pretty good right now to many of you. And it is. But, how many more laws must be passed for the AANA goal of MD anesthesia (pictured below) to become a reality for many Anesthesiologists:

 

[doctron]

I feel that the author of this article minimizes the fact that althought these nurses are receiving a doctorate level degree they are not receiving doctorate level training in pharmacology, pathophysiology, procedural skills, etc. They are receiving advanced training in things like organizing nursing schedules, medication administration schedules, public relations, etc. It would be the equivalent of comparing a medical degree to a doctorate of healthcare administration for example. This needs to be communicated more emphatically to the public.

 

[Arch Guillotti]

no.

Simply permitting them to take the exams lends their ridiculous equality argument more credibility than it deserves.

If they want to take the usmles, they can go to medical school. Short of that, they are unqualified and undeserving of even the opportunity to sit down for one of our exams.

+1

 

[SouthSideSteve]

You know, why don't PA's go for THEIR doctorates!? Oh yeah, that would mean medical school.....

As a PA student, this might not be too far off. I know the Army has a doctorate program, but I pray this foolishness doesn't catch on like with the RNs.

I'm also a RN and this makes me sick. Part of the reason I went to PA school and not NP, I actually wanted learn medicine not nursing.

 

[24858]

It's no different than nurse anesthesia students wanting to be referred to as "residents".

They can squawk all they want about not wanting to be called "doctor" - the simple fact is they lie through their teeth.

Support the ASA and AAAA and all 50 state medical associations in speaking up for and supporting H.R. 451, the Health Care Truth and Transparency Act of 2011


****************************************

H.R. 451, the Health Care Truth and Transparency Act:
Frequently Asked Questions
ISSUE
Consumers want and need more information about their health care provider.
QUESTIONS
What is the purpose of this legislation?
This legislation would improve consumer access to accurate information about health care providers.
Why is the legislation necessary?
As the health care marketplace has evolved in recent decades, consumer access to accurate information about their health care provider has not kept pace with the changes. Today, there is significant consumer confusion in the new health care marketplace concerning the licensing, education, training and skills of different health care providers.
Common terms once reserved exclusively for specific health care providers are now used by other health care providers. A health care provider who identified himself or herself as a “doctor” has long been assumed to be a medically trained physician. Similarly, a health care provider in training who identified himself or herself as a “resident” was long assumed to be physician completing a physician residency program. However, in recent years, the meanings of these and other titles have been blurred. Many different types of health care providers including nurses now identify themselves as “doctors.” Additionally, nursing programs have begun to shift their students’ titles from “student nurses” to “residents” – a term typically reserved for physicians undergoing advance training in a medical specialty.
Moreover, provisions included in the Patient Protection and Affordable Care Act (PPACA) will further blur differences among health care providers and accelerate confusion. The so-called “Non-Discrimination in Health Care,” (sec. 1201) provision includes a prohibition against health plans “discriminating” against health care providers for purposes of participation or coverage. This broad and unprecedented prohibition effectively limits the ability of health plans to properly distinguish among varying health care providers and will exacerbate confusion over providers’ education, training and skills.
Consumers need access to accurate information about health care providers. And while the FTC is unlikely to halt recipients of “Doctors of Nurse Practice” degrees and other non-medical degrees from calling themselves “Doctors,” the commission can enhance transparency by addressing misrepresentation and working to ensure that patients and consumers have more information about the actual license under which their “Doctor” practices.
What does this legislation do?
The legislation applies longstanding Federal Trade Commission (FTC) Act consumer protections to the new health care marketplace. Specifically, the bill would 1) make it unlawful to misrepresent a health care provider’s licensure, education, training, degree or clinical expertise and 2) require the disclosure of the license under which the provider practices - physician, nurse, technician, etc. – in any advertisement.
Doesn’t the Federal Trade Commission already have jurisdiction over this issue?
Section 5 of the FTC Act declares unfair or deceptive acts or practices unlawful. However, it is not clear that Section 5 is being applied to avert this type of confusion in the new health care marketplace concerning the licensing, education, training and skills of health care providers. Indeed, the FTC has undertaken little if any enforcement of unfair or deceptive acts in the health care marketplace as they apply to how health care providers represent their licensing, education, training and skills to patients when they are providing care or in advertisements. This legislation would bring such enforcement about.
Does this legislation change the scope-of-practice of any providers?
No. The legislation explicitly provides that “Nothing in this Act shall be construed or have the effect of changing State scope of practice for any health care professional.”
Who supports this legislation?
The legislation is supported by 18 national medical specialty and 50 state medical organizations and the American Academy of Anesthesiologist Assistants (AAAA).
Who opposes this legislation?
The legislation is opposed by a coalition of 10 national allied health care provider organizations.
Why is this legislation important?
In other areas of commerce, Congress has worked to empower FTC to take action to ensure consumers have accurate information about the products and services being purchased. Whether it is “The Fur Products Labeling Act,” that gives consumers information about fur garments, or the “Dolphin Protection Consumer Information Act”, that ensures consumer access to accurate information about the harvesting of tuna, Congress has empowered the FTC to enhance transparency and provide consumers more information where there is a need. There is an urgent need in the health care marketplace, and the FTC should be directed to provide consumers of health care services more transparency and information regarding health care providers and health care provider advertisements.

Thanks JWK, you are right on here. Hey guys this gentleman is offering a viable solution, lets STOP griping and START doing!!! Hello! Any ideas on how to support this? Should I call the Mass Medical Society and talk to the president and tell him/her to support HR 451? We all need to become political beasts, that is the ONLY way to WIN!! Bitching and moaning aint gonna solve shiq..

 

[elderjack21]

As a PA student, this might not be too far off. I know the Army has a doctorate program, but I pray this foolishness doesn't catch on like with the RNs.

I was talking to an SRNA set to graduate this winter from one of the army programs. He was explaining to me how soon they will all be getting "doctorates" of nurse anesthesia. I asked him if this was an acknowledgment of the inadequacy of their training, "no." "Then why do you need it?" "because it is designed to teach us how to be more research based."

So as part of their 1yr in duration "doctorate" training they have to write some 30 page book report summarizing some other person's research. Big deal.

 

[anynoise]

I was talking to an SRNA set to graduate this winter from one of the army programs. He was explaining to me how soon they will all be getting "doctorates" of nurse anesthesia. I asked him if this was an acknowledgment of the inadequacy of their training, "no." "Then why do you need it?" "because it is designed to teach us how to be more research based."

So as part of their 1yr in duration "doctorate" training they have to write some 30 page book report summarizing some other person's research. Big deal.

your first mistake was to engage them in conversation.

My opinion is, and always was, in order to be given the privelege ( and thats what it is. each and every time you treat and touch a patient) to treat a patient in a therapeutic relationship. you must sacrifice and train as long as we did. There are NO short cuts. You can make short cuts but quality will suffer. I dont care what any study you commission says. gosh darn it, the nurse practicioners havent even taken chemistry in their curriculum. I mean real chemistry. How can you be expected to make treatment decisions without basic knowledge

 

[jwk]

your first mistake was to engage them in conversation.

My opinion is, and always was, in order to be given the privelege ( and thats what it is. each and every time you treat and touch a patient) to treat a patient in a therapeutic relationship. you must sacrifice and train as long as we did. There are NO short cuts. You can make short cuts but quality will suffer. I dont care what any study you commission says. gosh darn it, the nurse practicioners havent even taken chemistry in their curriculum. I mean real chemistry. How can you be expected to make treatment decisions without basic knowledge

Keeping in mind that I'm on your side for the most part - When your arguments are emotional, arrogant, and only somewhat factual, it's hard to take you seriously. Healthcare providers of all sorts (whether CRNA, RN, RRT, PA, NP or phlebotomist) may not be physicians, but neither are they clueless and uneducated ditch-diggers. "Your first mistake was to engage them in conversation" pretty much screams that you're an arrogant a**. "Haven't even taken chemistry" means you haven't checked many curricula. Facts are your friend - learn them and use them to your advantage.

 

[anynoise]

Keeping in mind that I'm on your side for the most part - When your arguments are emotional, arrogant, and only somewhat factual, it's hard to take you seriously. Healthcare providers of all sorts (whether CRNA, RN, RRT, PA, NP or phlebotomist) may not be physicians, but neither are they clueless and uneducated ditch-diggers. "Your first mistake was to engage them in conversation" pretty much screams that you're an arrogant a**. "Haven't even taken chemistry" means you haven't checked many curricula. Facts are your friend - learn them and use them to your advantage.

my arguments are neither emotional nor arrogant. And aha, i have checked many curricula and they DO NOT include inorganic chemistry with a real lab, doing real experiments. I'm not talking surveyof chemistry or chemistry for nurses, I'm talking a real chemistry class that the chemistry majors take. How can you be in charge of patient care, making medical decisions when you havent even taken the basics? would you want a surgeon who has not taken an anatomy class? call me arrogant but whatever

 

[24858]

my arguments are neither emotional nor arrogant. And aha, i have checked many curricula and they DO NOT include inorganic chemistry with a real lab, doing real experiments. I'm not talking surveyof chemistry or chemistry for nurses, I'm talking a real chemistry class that the chemistry majors take. How can you be in charge of patient care, making medical decisions when you havent even taken the basics? would you want a surgeon who has not taken an anatomy class? call me arrogant but whatever

Use your talent and ambition to call your state medical society and state anesthesia society and the ASA in support of HR 451. Then ask them how you can further support this legislation. Write your state or national senators and fervently demand they back this legislation.

 

[24858]

Use your talent and ambition to call your state medical society and state anesthesia society and the ASA in support of HR 451. Then ask them how you can further support this legislation. Write your state or national senators and fervently demand they back this legislation.

Get a folding table and chair and sit outside the science building at your local university or medical school and advertise that you are having people sign a petition against people trying to subvert the education and position they are studying so damn hard to attain. I am sure that people that are pulling all nighters to get straight A's and >30 MCAT score in order to land a med school spot will be very sympathetic and at the same time very outraged by this subversion. Then once you get a petition signed send copies to you state and federal legislators demanding that the young future professionals are listened to and not dismissed.