Debating between DO and DNP

[Duluth]

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Disclaimer:
I know this is a potential flame war in the making, so I would like to ask that responses are well thought out, rational advice. Yes I realize a DO and a DNP are different. I am an RN. I work with both NP's and DO's. This is not a debate about NP encoachment on family practice, or Obamacare or whatever you want to flame or troll about. I need mature advice from other sources than I have already sought.

About me:

I am a second career BSN, with a previous degree in Biology. I went into nursing with every intention of becoming a rural family practice NP. I believed this route to best suit my career goals. After talking with both NP's and DO's I'm having serious second thoughts and considering doing the DO route to practice rural family medicine.

What I want out of my career:

I want to work in rural family practice.
I want to develop relationships with patients birth to death.
I want to be free of of 4am calls from nurses.
I want to work 40-50 hours a week.
I want to be able to travel.
Money is NOT an issue for me, whatsoever. If I was paid 50k a year in either position I would be happy.
I want to be able to volunteer abroad for prolonged preiods of time (>1year).
I want autonomy.
I want to be skilled in what I do.
I do not want to be rushed with patient interaction.
I want to be in demand (Freedom to work where I want to).

I doubt that either option allows me to fufull all of my wants in a career, but which would fit best with what I want out of life?

The DO's I have talked to have been residents, anestesiologists, and hospitalists. I have not had the chance to work with a DO family practitioner. I have a shadowing opportunity with a family practice DO lined up, which should help answer my question, but I would love to hear from Osteopaths and pre-Osteopaths here.

I put it to you SDN, help me reconcile what direction to take! I realize that the mood in this forum is going to be DO>DNP. But does the DO fit well with my career goals?

 

[VassarLiberal]

You should also consider how much autonomy you want, if you want to be able to have said autonomy anywhere, and the time you're willing to commit to additional education.

If you're willing to spend 4 years in medical school, and at least 3 years in residency, and want to be able to practice in any state with medicolegal autonomy, go DO.
If you want to spend only two to three years, you can get your MSN and DNP (or you could do another year or two and get an MSN to be a masters-prepared NP, from which, at least in terms of practice restrictions, there aren't yet any differences from a DNP, IIRC).

Remember, though, NPs, whether masters or doctorally prepared, have some autonomy in some states and near total in others. However, their training is much less time consuming, but, naturally, less comprehensive.

 

[Postictal Raiden]

Disclaimer:
I know this is a potential flame war in the making, so I would like to ask that responses are well thought out, rational advice. Yes I realize a DO and a DNP are different. I am an RN. I work with both NP's and DO's. This is not a debate about NP encoachment on family practice, or Obamacare or whatever you want to flame or troll about. I need mature advice from other sources than I have already sought.

About me:

I am a second career BSN, with a previous degree in Biology. I went into nursing with every intention of becoming a rural family practice NP. I believed this route to best suit my career goals. After talking with both NP's and DO's I'm having serious second thoughts and considering doing the DO route to practice rural family medicine.

What I want out of my career:

I want to work in rural family practice.
I want to develop relationships with patients birth to death.
I want to be free of of 4am calls from nurses.
I want to work 40-50 hours a week.
I want to be able to travel.
Money is NOT an issue for me, whatsoever. If I was paid 50k a year in either position I would be happy.
I want to be able to volunteer abroad for prolonged preiods of time (>1year).
I want autonomy.
I want to be skilled in what I do.
I do not want to be rushed with patient interaction.
I want to be in demand (Freedom to work where I want to).

I doubt that either option allows me to fufull all of my wants in a career, but which would fit best with what I want out of life?

The DO's I have talked to have been residents, anestesiologists, and hospitalists. I have not had the chance to work with a DO family practitioner. I have a shadowing opportunity with a family practice DO lined up, which should help answer my question, but I would love to hear from Osteopaths and pre-Osteopaths here.

I put it to you SDN, help me reconcile what direction to take! I realize that the mood in this forum is going to be DO>DNP. But does the DO fit well with my career goals?

IMO, if you don't have a genuine desire to become a physician, I recommend you to save yourself 4 years of med school, @ least 3 years in residency, and all the financial burdens that you will carry upon graduation.

good luck

 

[lapelirroja]

Would you consider being a PA or is that not enough autonomy for you?

 

[Mike64119white]

I started out in a DO program and switched to a FNP program. In DO school I use the analogy that they write down a billion medical facts on a sheet of paper and the cut it into shreds, fill a trash can with it and dump it on your head. Your objective is to try to collect as many of those facts as you can, but you never really get to tie them together or make sense out of them until your residency. In FNP school they spoon feed you one fact at a time and show you how it is connected to the last fact so that you actually understand what you are learning as you go. As a FNP it is unlikely you will be awakened after hours. As a DO it is unlikely that you won't be awkened after hours. Hope this helps. DNPs are the underdogs, like DOs were years ago. DNPs have a huge battle to fight before full autonomy will be won.

 

[Duluth]

Thanks for the input so far everyone! Thanks for keeping this civil!

Would you consider being a PA or is that not enough autonomy for you?

I have not put much consideration into the PA route. Since I am a RN I have been looking at the NP route if I want to go mid level. I also have not worked with many PA's.

 

[group_theory]

One thing to consider is really your practice environment - as a DO, you can really set up your own practice environment. Do you want to work solo or as part of a group? Do you want to have some hospital priviledges or do you want the hospitalist to take over? Do you want to work outpatient as part of academia or do you want to be private practice? You get to decide what practice environment to practice in (and you can change later on).

If you want to work 40-50 hrs/week - you can do that (any specialist can do that) - you just have to find a practice that can accomodate that request (OR open your own practice and set your own schedule).

As for that 4AM calls - if you have hospital priviledges, you will get calls from nurses at 4AM for your patients. If you don't have hospital priviledges, the hospitalist will get the call. BUT if you want to be a rural family practice, someone has to be able to answer the calls from the patients (or parents) at 4AM - whether you're a DO (or a NP working independently). Many groups utilize a nurse triage system at night ... but the nurse needs someone to refer to if the call isn't simple or straightforward.

In regards to your needs

I want to work in rural family practice.

You can do that as a DO or as an FNP

I want to develop relationships with patients birth to death.

You can do that as a DO or as an FNP.

I want to be free of of 4am calls from nurses.

That depends on your practice environment and how you set up for night coverage. In a group practice, you share call responsibilities. As an FNP, if you are in solo practice practicing independently (if you live in the few states that allows independent practice), you need someone to cover those night calls. Some group practices may even require their FNP to take night calls as part of their employment. So it's not so clear cut just from "DO vs FNP" debate who gets the phone calls at night - it really depends on the practice environment and how you arrange for night time coverage.

I want to work 40-50 hours a week.

Again, as a DO you can arrange for your own schedule if you own your own practice. You can also be a part-time physician in a group practice. Or you can be a FNP working only days as part of a group practice. The downside to limiting your hours - you get less pay (you don't get paid by the hour in the medical field, you pay based on billing. If you work fewer hours, you get paid less than your colleagues who are putting in longer hours and generating more bills/income)

I want to be able to travel.

As part of employment or as vacation? Either way, you can do both as either DO or FNP. If you are in solo practice though, you have to find someone to provide coverage for your patients while you are on vacation or traveling.

I want to be able to volunteer abroad for prolonged preiods of time (>1year).

As an FNP, you are going to have a hard time finding an employer who will let you be MIA for > 1 year, unless you have worked there for years, are indispensible, and have developed a good relationship with the rest of the group. Otherwise, you are leaving a void where others must pick up the slack OR hire a temporary replacement (and locum tenens are expensive) while you are gone.

As a DO or FNP in solo practice, what will happen to your patients while you are gone? What about continuity of care? Who's gonna follow-up on your patients?

Now you can do medical missions for a few weeks or months - from a logistic standpoint, it's doable. But to do more than 1 year, you are basically going to abadon what you have and will need to start over once you return.

I want autonomy.

In what sense? As a DO or FNP, you will still battle the insurance and mountains of paperwork. If you are part of a group practice, are you a partner in the group or just an employee? The general trend is for physicians to be partners in the group and for NPs/PAs to be employees BUT there are groups where NPs/PAs are partners in the group (and a few cases where the PAs or NPs own and operate the business and they hire physicians as employees). As an FNP with a supervising (or collaborating physician), your physician will have final say. Why? Because in the event of a lawsuit, the physician will be held responsible as the supervising or collaborating physician.

In hospital settings, often the attending physicians will want to hear the final recommendation from another attending physician and not the PA/NP on service. In inpatient settings, the attending physicians will often have the final say on what happens to the patient (what drugs, what procedures, etc).

I want to be skilled in what I do.

No doubt, DO >>> FNP. You will be exposed to more pathology and more diseases in DO school than FNP school. You will see more during your clinical rotations in DO school than your clinical rotation in NP school. You will learn and see more in residency that you ever will learn in on-the-job training as an NP.

And if you want to be a rural practitioner, you are expected to know more and see more since there are fewer specialists available to you. Don't underestimate the vast knowledge that you must know as a PCP. As one attending in med school once told me - "the eyes do not see what the brain does not know"
If you don't know that this particular disease exist, how are you going to diagnose it? Patients do not come into the office with signs that says "I have a rare disease" or "I have atypical presentation of a common disease". How can you screen for potential complications if you are not aware of the potential complications. Would you know to ask the parents of an ex-NICU baby if the baby is seeing an eye doctor on a regular basis? When should you change from high caloric formula to regular formula? Why is the infant still on the high caloric formula even though he is gaining adequate weight? Your adult patient is thrombocytopenic - how are you going to do the workup?

I do not want to be rushed with patient interaction.

No one goes into medicine thinking they want to rush through patients. There is no course in med school or during residency where they teach you that rushing through patients is good for patient care. It's the practical reality that makes docs rush through patients. You bill based on patient encounters and procedures. The more patients you see, the more you bill. The more procedures you do, the more you bill. With overhead cost, employees to pay, insurance and school debt, and declining reimbursement, you have to see more patients. Don't kid yourself if you think you can spend more time with patients as a NP. If you work in a group practice, you were hired because you are expected to bring income into the group. Spend too much time with each patient, and there comes a point where your cost exceeds income generated.

In solo practice (as a DO or FNP), the fewer patients you see, the fewer items you can bill and you get less income. Now remember your overhead (rent, utilities, medical equipments, salaires and benefits of staff, insurances premiums) stays the same or goes up.

If you want to see fewer patients (and spend more time with each), there is no law against it - just realize your income will take a hit.

(concierge practice can spend more time with each patients because each patients pay more than what normal insurance would pay for each visits)

I want to be in demand (Freedom to work where I want to).

Both DO and FNP will be in demand. As a NP, you have the option of picking your field or changing field later on (at the cost of being an expert in that field). As a DO, once you finish residency and/or fellowship, you're fixed in that field unless you do another residency. But you will be the expert in the field that you choose to go into.


Hope this helps.

 

[VassarLiberal]

Speaking to the last point group_theory raises, being a PA might actually give you an advantage in regards to being able to change fields. PAs are trained as generalist providers of medical care, and don't have to do a residency. Usually, they acquire specific experience in a field as their training in that field (i.e. work with a dermatologist, become experienced in dermatology). Hence, they can switch specialties with much more ease than lots of other types of providers.

 

[Cp22kjer]

One path will be considerably tougher than the other. With the goals you've posted it may not be worth all the extra pain and heart ache to go down that road.

 

[atcpt1]

Disclaimer:
I know this is a potential flame war in the making, so I would like to ask that responses are well thought out, rational advice. Yes I realize a DO and a DNP are different. I am an RN. I work with both NP's and DO's. This is not a debate about NP encoachment on family practice, or Obamacare or whatever you want to flame or troll about. I need mature advice from other sources than I have already sought.

About me:

I am a second career BSN, with a previous degree in Biology. I went into nursing with every intention of becoming a rural family practice NP. I believed this route to best suit my career goals. After talking with both NP's and DO's I'm having serious second thoughts and considering doing the DO route to practice rural family medicine.

What I want out of my career:

I want to work in rural family practice.
I want to develop relationships with patients birth to death.
I want to be free of of 4am calls from nurses.
I want to work 40-50 hours a week.
I want to be able to travel.
Money is NOT an issue for me, whatsoever. If I was paid 50k a year in either position I would be happy.
I want to be able to volunteer abroad for prolonged preiods of time (>1year).
I want autonomy.
I want to be skilled in what I do.
I do not want to be rushed with patient interaction.
I want to be in demand (Freedom to work where I want to).

I doubt that either option allows me to fufull all of my wants in a career, but which would fit best with what I want out of life?

The DO's I have talked to have been residents, anestesiologists, and hospitalists. I have not had the chance to work with a DO family practitioner. I have a shadowing opportunity with a family practice DO lined up, which should help answer my question, but I would love to hear from Osteopaths and pre-Osteopaths here.

I put it to you SDN, help me reconcile what direction to take! I realize that the mood in this forum is going to be DO>DNP. But does the DO fit well with my career goals?

In my humble opinion.....NP and DO (physician) are difficult to compare. NP's are fine, but lack fundamental academic and clinical training. NP program require to you select a "specialty" or focus that you wish to practice.......all without generalist education that is required when being trained in the medical model (PA/MD/DO). I've never understood how you can specialize without generalist training first.

On the flip side NP practice is a real bargain for RN's. Politically, the nursing loby have been very effective and supportive of their members. NP is a good gig where you can recieve minimal training and practice in a role similar to the MD/DO/PA.

If you want autonomy, MD/DO is the only way to go, but in reality, nobody works alone autonomously. It should be a team approach regardless if your an RN, MD, DO, PA, or NP. It always concerns me when an NP with the least amount of training of all practitioners, is lobbying for "independent" practice. If you're concerned about patient care, my guess is that you wouldn't want that. Bedside nursing is still one of the most noble professions I know of. This is what nursing should stick to.....it's what their trained to do and what their good at. They spend lots more time with patients than probably any other healthcare provider (perhaps, dependent on the setting).

I'm rambling now, Best

 

[brucecanbeatyou]

If I were going to practice in a rural setting, I would want the most training I could get. Seriously, this isn't a flame, but I would be scared ****less to practice medicine in a rural setting as a DNP.

 

[atcpt1]

Disclaimer:
I know this is a potential flame war in the making, so I would like to ask that responses are well thought out, rational advice. Yes I realize a DO and a DNP are different. I am an RN. I work with both NP's and DO's. This is not a debate about NP encoachment on family practice, or Obamacare or whatever you want to flame or troll about. I need mature advice from other sources than I have already sought.

About me:

I am a second career BSN, with a previous degree in Biology. I went into nursing with every intention of becoming a rural family practice NP. I believed this route to best suit my career goals. After talking with both NP's and DO's I'm having serious second thoughts and considering doing the DO route to practice rural family medicine.

What I want out of my career:

I want to work in rural family practice.
I want to develop relationships with patients birth to death.
I want to be free of of 4am calls from nurses.
I want to work 40-50 hours a week.
I want to be able to travel.
Money is NOT an issue for me, whatsoever. If I was paid 50k a year in either position I would be happy.
I want to be able to volunteer abroad for prolonged preiods of time (>1year).
I want autonomy.
I want to be skilled in what I do.
I do not want to be rushed with patient interaction.
I want to be in demand (Freedom to work where I want to).

I doubt that either option allows me to fufull all of my wants in a career, but which would fit best with what I want out of life?

The DO's I have talked to have been residents, anestesiologists, and hospitalists. I have not had the chance to work with a DO family practitioner. I have a shadowing opportunity with a family practice DO lined up, which should help answer my question, but I would love to hear from Osteopaths and pre-Osteopaths here.

I put it to you SDN, help me reconcile what direction to take! I realize that the mood in this forum is going to be DO>DNP. But does the DO fit well with my career goals?

Don't want to dwell on the issue, but read the following passage from Johns Hopkins univ. DNP program FAQ page:

2) Why is the DNP degree necessary?
The changing demands of today's complex health care environment, outlined in recent reports from the Institute of Medicine, require that nurses serving in specialty positions have the highest level of scientific knowledge and practice expertise possible. Nurses are constantly working with individuals who have a high level of preparation in their respective fields - physicians, pharmacists, and other health providers. The effectiveness of nurses is directly related to the amount and type of education they receive, and recent research has established a clear link between higher levels of nursing education and better patient outcomes.

http://www.son.jhmi.edu/academics/academic_programs/doctoral/dnp/faq/

Is the nursing organization admitting that NP education is inadequete, that programs lack standardization, and NP outcomes aren't as good as those trained in the medical model. What's interesting is that the DNP education is still less academic and clinical training than a PA program at any level and that isn't taking into consideration all the time NP's spend on nursing theory.....What's even more concerning is that the DNP can be done once again online...and part-time.

At some level you have to admire the strength of the nursing organization and their lobbying efforts.
Unedited, ATCPT1

 

[pianoman511]

It's interesting that with the wording they choose it actually makes it seem like they are advocating not for an increase in autonomy/privileges for nurses (i.e. make them more like doctors), but actually mandating additional education for existing nursing. Basically, don't expand the scope of practice but maintain the existing scope and increase educational requirements for specialty nursing.

 

[VassarLiberal]

Basically, don't expand the scope of practice but maintain the existing scope and increase educational requirements for specialty nursing.

Good point. More money for the nursing schools? Could be a powerful motivator – especially considering how they're mandating it. The same thing happened, or so I've read, with the DPT. It's degree creep and makes money for the schools without helping the providers out.

 

[atcpt1]

It's interesting that with the wording they choose it actually makes it seem like they are advocating not for an increase in autonomy/privileges for nurses (i.e. make them more like doctors), but actually mandating additional education for existing nursing. Basically, don't expand the scope of practice but maintain the existing scope and increase educational requirements for specialty nursing.

5) If I am an NP now, will I have to return to school to get a DNP degree in order to practice?
No, advanced practice nurses with Master's degrees will be able to continue to practice in their current capacities.

I think it's clear.....the motivation of the nursing world is complete autonomy. They aren't happy as mid level providers. They see opportunity in the primary care specialties. It's a step by step process politically. It may work..... Can you blame them. The nursing organizations work for their people. They know that with time, the public will accept them as Dr's alongside DO's and MD's.

They also know that there is strength in numbers. They make their degrees accessible (online, distance learning, part-time, less rigorious training and education) affordable (Nurses have been very effective in employer paid education). Soon there will DNP's everywhere......All without generalist training academically or clinically. It's perfect timing with America on the cusp of healthcare reform.

they know what they're doing! They are experts at this game.

If they had high standards, long clinical training requirements, gernalist training/education, full-time resident classroom requirements....The DNP would fail. They would have to reform everything they do from clinical instructors and faculty to curiculum. Then it would simply be PA education.

They have a formula where they can compete with less and succeed.
It's a basic business model. They have a mission with goals. Their decisions are predicated on the mission. They no reason to readjust their mission.

The nursing mantra continues.

Who cares i guess. It only bothers me because the real nurses, bedside nurses, don't seem to be much of the focus for the nursing organization. They are what bring respect to the nursing profession. they are the bread and butter of healthcare. The RN is equally important as the MD. The NP is not, IMHO

 

[atcpt1]

DNP curriculum:
Course of Study
The 38-credit DNP program includes 18 credits of required DNP core, 12 credits of elective in the student's focus specialty area, and 8 credits for the required capstone project.
The DNP begins in the fall only.
First Semester
NR 210.803 Nursing Inquiry for Evidence Based Practice 3
NR 210.802 Advanced Nursing Health Policy 3
NR 210.801 Analytic Approaches for Outcomes Management: Individuals & Populations 3
NR 210.896 Capstone Project I 1
Second Semester
NR 210.804 Organizational and Systems Leadership for Quality Care 3
NR 210.805 Translating Evidence to Practice 3
NR 210.806 Health Economics and Finance 3
NR 210.897 Capstone Project II 1
Third Semester
NR 210.898 Capstone Project III 3
Electives 6 *

= Doctor
This looks more like a curiculum for social workers

 

[atcpt1]

Versus a PA curriculum

June - August (10 weeks)

​

PAC 500 - Anatomy

5​

PAC 503 - Clinical Assessment I

2​

PAC 506 - Integrating Seminar I

1​

PAC 509 - Clinical Medicine I

2​

PAC 511 - Health Promotion Disease Prevention 2 PAC 520 - Behavioral Science

1​

PAC 541 - Epidemiology

1​

Semester total

14​

​

Fall September - December (15 weeks) PAC 513 - Clinical Assessment II

2​

PAC 516 - Integrating Seminar II

1​

PAC 517 - Microbiology

3​

PAC 518 - Pharmacology I

3​

PAC 519 - Clinical Medicine II

7​

PAC 522 - Interprofessional Geriatric Education Program I

1​

Semester total

17​

Spring January - May (20 weeks) PAC 510 - Professional and Ethical Issues for Healthcare Providers

2​

PAC 533 - Clinical Assessment III

2​

PAC 536 - Integrating Seminar III

1​

PAC 537 - Emergency Medicine and Surgery

5​

PAC 538 - Pharmacology II

1​

PAC 539 - Clinical Medicine III

10​

PAC 540 - Interprofessional Geriatric Education Program II

1​

PAC 544 - Evidence Based Medicine I

3​

Semester total

25​

Spring II - Summer II June - June (12 months) Clinical Rotations PAC 600 - Internal Medicine (6 Weeks)

6​

PAC 601 - Internal Medicine (6 Weeks)

6​

PAC 602 - Emergency Medicine (6 Weeks)

6​

PAC 603 - Surgery (6 Weeks)

6​

PAC 607 - Family Medicine I (6 Weeks)

6​

PAC 608 - Family Medicine II (6 Weeks)

6​

PAC 612 - Primary Care Selective

6​

PAC 613 - Elective

6​

PAC 620 - Preparation for Clinical Practice

3​

PAC 624 - Evidence Based Medicine II

1​

Semester Total

52​

 

[n618ft]

Relationships birth to death? What are you, super-human? How long do you expect to live, Superman?

 

[Duluth]

Relationships birth to death? What are you, super-human? How long do you expect to live, Superman?

.Where I live, in jest, this is not a superhuman expectation. The children start chewing tobacco at age 10. They hit the Jack Daniels at 12.

All joking aside...

Thanks for the input. I have a DO shadowing set up and a meeting with a local NP to further discuss. Some of you have raised the legitimacy of NP education, and this is something that does concern me. If I do go the NP route I will be seeking the most clinically based program I can find. I have great concerns for the lack of uniformity of DNP programs. I also strongly dislike nonbrick and mortar ways of obtaining the degree. I do agree that the DNP is NOT a physician. They just might be the next best thing in my rural community though. Any physicians that want to move to my county and practice are welcome. You can expect the lowest pay in the nation. We are the size of the state of Connecticut with .4% of the population. We have two, count them, two stop lights in the entire county. This is not a sprawling metropolis. My county is nothing special. It is typical of (very) rural America. With a severe shortage of physicians in the area a NP is better than nothing. .

 

[atcpt1]

.Where I live, in jest, this is not a superhuman expectation. The children start chewing tobacco at age 10. They hit the Jack Daniels at 12.

All joking aside...

Thanks for the input. I have a DO shadowing set up and a meeting with a local NP to further discuss. Some of you have raised the legitimacy of NP education, and this is something that does concern me. If I do go the NP route I will be seeking the most clinically based program I can find. I have great concerns for the lack of uniformity of DNP programs. I also strongly dislike nonbrick and mortar ways of obtaining the degree. I do agree that the DNP is NOT a physician. They just might be the next best thing in my rural community though. Any physicians that want to move to my county and practice are welcome. You can expect the lowest pay in the nation. We are the size of the state of Connecticut with .4% of the population. We have two, count them, two stop lights in the entire county. This is not a sprawling metropolis. My county is nothing special. It is typical of (very) rural America. With a severe shortage of physicians in the area a NP is better than nothing. .

It's great your going to shadow.....but if you are considering midlevel practitioner positions, I would look much more closely at PA school. An RN who goes to PA school is better prepared to practice medicine than a RN who goes to DNP school. PA school is modeled after medical school, requires the similar pre-requisites, requires full-time study (can't work during school), and provides you with a generalist education. it's a harder route, but it's worth it! You'll be more versatile to help out your community.....
For instance, I also live in a rural community. A few of the local PA's practice in multple specialties. When they first game to the area they ran the ER. Now the ER is staffed by physicians. Now they practice doing multisurgical first assisting, work in the orthopedics, and run the fast track at the hospital. They do so much to help out the community that couldn't be filled by any other practitioner. If there were a shortage of FM docs, they could easily slide into that role. You can have several supervising physicians and practice in any specialty. That's the type of flexibility you need from a mid-level provider. NP's "specialize" and have a much more limited scope of practice as a result. Take the time to compare compare the studies of each profession.....you should see the differences.

If you want to practice medicine.....train yourself in the medical model
Make the sacrafice
Go to PA/MD/DO school.....
If you want to practice nursing....stick to RN.....DNP's don't practice nursing.

 

[JanikeyDoc]

They are two very different career paths. While it is true that these days Nurse Practitioners have the same duties as Family Practice physicians, many DOs these days are entering specialty fields. Its the IMGs, people who go outside the US that are more likely these days to become primary care physicians. I would say from what I know as a DO you will have a lot more professional autonomy. I know quite a few DOs, many are in their own solo practices in different specialties. Even with a DNP, you will not be a "Doctor" in the traditional sense of the word but as a DO you will be. I have even noticed in some residency programs DOs are actually listed as "MD" and have that designation on their lab coats and ID badges.

In the eyes of patients Doctors still are seen as the primary authority figure, as a Nurse Practitioner, your patients and colleagues perception of you will be different.

 

[RuralMEDPCP]

DNP curriculum:
Course of Study
The 38-credit DNP program includes 18 credits of required DNP core, 12 credits of elective in the student's focus specialty area, and 8 credits for the required capstone project.
The DNP begins in the fall only.
First Semester
NR 210.803 Nursing Inquiry for Evidence Based Practice 3
NR 210.802 Advanced Nursing Health Policy 3
NR 210.801 Analytic Approaches for Outcomes Management: Individuals & Populations 3
NR 210.896 Capstone Project I 1
Second Semester
NR 210.804 Organizational and Systems Leadership for Quality Care 3
NR 210.805 Translating Evidence to Practice 3
NR 210.806 Health Economics and Finance 3
NR 210.897 Capstone Project II 1
Third Semester
NR 210.898 Capstone Project III 3
Electives 6 *

= Doctor
This looks more like a curiculum for social workers

There is a lot of talk that DNPs have no "general" training. What do you call the whole first 5 years of education plus the 3 years(minimum) of required work experience? PA's do 52 credit hours post BS degree IN ANYTHING. I work with a PA who got his undergrad in History, minored in biology, and then went to PA school for 2years (4semesters) and then started practicing. The DNP program here:
The Primary Care Nurse Practitioner programs are 8 semesters in length, requiring 81-90 credit hours in didactic and clinical coursework. They are available only as full-time programs (9+ credit hours per semester) and are completed in three (3) years, including summer semesters.

Year 1 - Fall
NURS 6001: Professional Role & Collaboration (2)
NURS 6002: Health Care Delivery (2)
NURS 6007: Advanced Pathophysiology I (2)
NURS 6009: Intro to Clinical Epidemiology & Population Science (1)
NURS 7515: Issues in Health Care in Frontier, Rural &
Urban Underserved Populations (2)
Total Semester Credits: 9

Year 1 - Spring
NURS 6240: Clinical Genetics (2)
NURS 7007: Advanced Pathophysiology II (3)
NURS 7773: Leadership & Health Care Policy (3)
NURS 7505: Introduction to Biostatistics (3)
UUHSC 5500: Cultural Competency and Mutual Respect (1)
Total Semester Credits: 12

Year 1 - Summer
NURS 6000: Evidence Based Practice I (3)
NURS 6004: Intro to Information Technology (3)
NURS 6006: Advanced Principles of Pharmacotherapy (1)
NURS 6772: Quality Improvement & Clinical Data Analysis (3)
Approved Elective (2 or 3)
Total Semester Credits: 12 or 13

Year 2 - Fall
NURS 7020: Advanced Physical Assessment & Health
Promotion Across the Lifespan (2 Didactic/1 Clinical)
NURS 7021: Diagnostic Reasoning (2 Didactic/1 Clinical)
NURS 7022: Advanced Child Assessment & Health
Promotion (2 Didactic/1 Clinical)
NURS 7510: Social Context of Medicine & Public Health (3)
Total Semester Credits: 12

Year 2 - Spring
NURS 6041: Common Pedatric Problems (3)
NURS 6050: Advanced Pharmacology (2)
NURS 6601: Episodic Problems of Adults & Elders (3)
NURS 7601: DNP NP Practicum I (3)
GERON 6001: Introduction to Gerontology (3)
Total Semester Credits: 14

Year 2 - Summer
NURS 6100: Mgt Childbearing/GYN Problems (1)
NURS 6603: Chronic Problems of Adults & Elders (3)
NURS 7500: Evidence Based Practice II (3)
NURS 7602: DNP NP Practicum II (4)
Total Credits: 11

Year 3 - Fall
NURS 6042: Complex Pediatric Problems (3)
NURS 7603: DNP NP Practicum III (4)
NURS 7975: Capstone I (3)
Total Credits: 10

Year 3 - Spring
NURS 7604: DNP NP Clinical Residency (6)
NURS 7976: Capstone II (3)
Total Semester Credits: 9

Total Curriculum Credits: 89 or 90
Didactic Credits: 79 or 80
Clinical Credits: 20 (1,200 clock hours)

So please, don't go saying that the DNP doesn't have the training that a PA does.

 

[RuralMEDPCP]

Anyway, what I am getting at is this: If you already have your BSN, get some work experience (4-5 years preferably) and then go ahead and get your DNP. If you are wanting to work as a Primary care practitioner in a rural setting and money is not a huge issue, DNP is the way to go. You won't have the huge financial and time debt as compared to a MD/DO, you won't be as cemented into your specialty, and depending on what state you want to practice in, you may have almost complete autonomy. Our DNPs here can work completely independent from any supervising doc.

Long story short, for your goals and position, DNP. Hands down, no questions.

 

[rafman]

What's the point of bringing this back? Both DNP and PA's are excellent fields, and we're going to need quality people in both of these professions as we tackle the growing health care need in this country.

But, this is a DO forum, bring the DNP vs PA topic up somewhere else, most ppl here aren't interested. PS, sorry if I sounded like a jerk, I'm just voicing my opinon

 

[poopyhead]

holy necro thread, batman!

How come the DNP curriculum is so loaded with "soft" courses? First time seeing a nursing school curriculum, but I had assumed there would be a lot more hard science being taught. Yet, this seems more like a liberal arts curriculum 😕

If the OP is genuinely interested in the science behind patient care, then I hope (s)he took the DO route.

 

[DrCalculi]

wtf.

 

[WDeagle]

Is this a joke? Is that really the DNP curriculum? There is literally zero classes that have anything to do with medicine. Its more like a nursing liberal arts degree. Might as well take painting classes and ballet. You earn the right to care for patients with hard work. You don't earn it online.

 

[Drrrrrr. Celty]

So please, don't go saying that the DNP doesn't have the training that a PA does.

How many of those hours are online? In all honesty a PA has a significantly stronger understanding of the body and pathology than a nurse. A PA program is significantly more rigorous than this curriculum and in reality can be considered MD-lite in many regards. They also are more restricted so they filter for quality as opposed to DNP programs.

 

[Aislinn]

There is a lot of talk that DNPs have no "general" training. What do you call the whole first 5 years of education plus the 3 years(minimum) of required work experience? PA's do 52 credit hours post BS degree IN ANYTHING. I work with a PA who got his undergrad in History, minored in biology, and then went to PA school for 2years (4semesters) and then started practicing.

You're misinformed. While an aspiring PA can major in anything (just as a pre-med can major in anything), he/she must take pre-requisites before PA school (not to mention have real-life work experience in the hospital). The pre-reqs mirror the exact same courses that pre-meds take prior to the MCAT -- Gen Chem I and II, Organic Chem I and II, Biology I and II, Microbiology, Biochemistry, Anatomy & Physiology, Genetics (at some schools). The only difference between the pre-PA curriculum and the pre-med curriculum is Physics, so let's not make it sound like people with no science background whatsoever can suddenly get into PA school and be treating patients in two years.

 

[drgioiadds]

I started out in a DO program and switched to a FNP program. In DO school I use the analogy that they write down a billion medical facts on a sheet of paper and the cut it into shreds, fill a trash can with it and dump it on your head. Your objective is to try to collect as many of those facts as you can, but you never really get to tie them together or make sense out of them until your residency. In FNP school they spoon feed you one fact at a time and show you how it is connected to the last fact so that you actually understand what you are learning as you go. As a FNP it is unlikely you will be awakened after hours. As a DO it is unlikely that you won't be awkened after hours. Hope this helps. DNPs are the underdogs, like DOs were years ago. DNPs have a huge battle to fight before full autonomy will be won.

and now your doing an MD/PHD??

 

[DrMediterranean]

and now your doing an MD/PHD??

noticed the same thing

 

[drgioiadds]

I have a friend who graduated with a Bsc in Nursing and then went on to do a NP program online through Athabasca. The majority of the coursework was online, but I think he had to go to the campus for skills assessments or some sort of practical part to the program. Now he is doing DNP online again through Walden. Not sure how effective online training is, but I wouldn't want to train that way.

 

[Prncssbuttercup]

This has been hashed and rehashed. NPs/DNPs are not similar to DO in anyway other than being able to treat patients. If you want autonomy become a DO. Since an RN can become an NP without taking more than a CC level basic science course, I'm on the side of the PAs an DO/MDs having more science...

 

[Drrrrrr. Celty]

This has been hashed and rehashed. NPs/DNPs are not similar to DO in anyway other than being able to treat patients. If you want autonomy become a DO. Since an RN can become an NP without taking more than a CC level basic science course, I'm on the side of the PAs an DO/MDs having more science...

Even a good BSN program is pretty much biology-lite. If you've got a BS in biology you'll speed through the majority of the courses as they cover principles and facts which you've likely covered in more depth.

 

[Pisiform]

There is no point in reviving 2 year old threads ...

 

[DrMediterranean]

.