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- Jan 3, 2010
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It's not up to physicians to show that NPs/DNPs provide inferior care. It's up to the NPs/DNPs to show that they provide equivalent care as the current gold standard (ie. physicians).
Think of it in terms of pharmaceuticals. When a new drug comes out, it's not up to the company producing the current gold standard to show that the new drug is inferior. It's up to the company producing the new drug to show that it's equivalent (or superior) to the standard.
Which of course will never happen because
A. NPs can't practice independently, making metrics very difficult to measure
B. The AMA will lobby heavily against any comprehensive study of this nature being done. (The ramifications of it not coming out in the favor of MDs would be enormous)
C. Any smaller scale studies, of which I have listed many below, will be construed as "poorly designed". Even if every single one of them shows that experienced NPs are fully capable of operating independently in a family practice environment.
I'm all for having a gold standard of clinical outcomes that all caregivers should meet, however I don't believe that any gold standard should be solely based on education
There are no well-done studies suggesting NPs/DNPs provide equivalent care as physicians. There are, however, lots of poorly done studies measuring useless outcomes (ie. patient satisfaction) and NPs/DNPs seem to think this proves that they're equivalent to physicians (I could make a very sarcastic comment here considering the NP/DNP curricula has so many stats/research courses in it).
http://www.bmj.com/cgi/content/full/324/7341/819
http://www.annals.org/content/143/10/729.full
Actually just go here
http://www.acnpweb.org/i4a/pages/index.cfm?pageid=3321
It is this sort of arrogant attitude that is so annoying in the context of this debate. I understand many people on this board believe that the increased education of an MD makes them a far better clinician (FP) then an NP. This could even be a very valid argument, however beyond the figerpointing and trashtalking there seems to be very little substance too it.
Patient satisfaction is useless? I guess the fact that satisfied patients are more likely to follow recommendations, take medical advice seriously, and make timely hospital visits is pretty irrelevant.