DNP versus MD?

[fab4fan]

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Thanks, horsenurse. Things haven't gotten better work wise, but next month I start classes, so it's the first step in reaching my goal. I'm really excited about being a student again!

 

[fab4fan]

horsenurse: Heh. Here's a test to see is your son is a "hardcore" fan. Ask him if he knows off the top of his head who played the piccolo trumpet solo in "Penny Lane." (No fair Googling the answer, 😉 )

 

[deleted87716]

I am working on my DNP. And when I get it, I will greet my clients as "Hello there, I am Dr. Sally, a Nurse Practitioner".

Even I don't introduce myself as "doctor." Sounds like a little humility might be in order for you.

Edit: Incidentally, I've always found the idea of calling yourself "Doctor (first name)" to be a ridiculous attempt at feigning some sort of folksy, homespun familiarity without conceding the fact that you consider yourself better than everyone else. Interestingly, this affectation is usually employed by people who aren't medical doctors (e.g., "Dr. Phil"), but hope that people will think they are. I strongly encourage you to reconsider.

Watch "Meet the Parents" for further examples of this phenomenon.

 

[Josh L.Ac.]

The "team" versus "hierarchy" concept was presented in my Professional Nursing class and I have to say I find it ridiculous. I'm not sure why nursing leaders have gotten it in their head that working as part of a team but with a definite hierarchy somehow devalues the role of the nurse. It doesn't. This idea runs parallel to the PC ideal that there is no way to determine which is better or higher-level between to different items, that different = equal.


In reality, there is a hierarchy (which is not a bad thing) and different roles or ideas can be quantitatively and/or qualitatively compared.

 

[Taurus]

There are lots of people in the health field that call themselves doctors... including psychologists, veterinarians, pharmacists etc. Are they more entitled to the word 'doctor' than a nurse who has gotten her doctorate degree? How about dentists? They 'only' go to school for about 8 years - about the same length of time it takes to get a DNP. Are they not qualified to use the term also?? How about doctor of physical therapy?

There is a criticial difference between DNP's and DPT's, DVM's, Pharm D.'s. DNP's practice medicine while these other professionals don't. If a Pharm D introduced herself as "Dr", it wouldn't take long for the patient to figure that person is not a physician. If a DNP introduced herself as "Dr", then the patient probably won't realize that person is not a physician because diagnosis/treatment techniques are similar.

I tell people now that you can't rely just on the provider saying that he/she is a "Dr". Look at the letters after the name. Everyone I tell is this is shocked because they didn't know that there are so many different types of "Dr"s now. They just assumed that someone who introduced themselves as "Dr" in a clinical setting such as a hospital is a physician. Unless there are laws against it, I fully expect DNP's to introduce themselves as "Dr"s. I think that physicians may need to start a public awareness campaign. Or, physicians maybe should introduce themselves as "Dr. __, a physician".

It is amusing to me that there are so many people both in and out of the health field that can use the sacred term, but not nurses. What are you guys afraid of?? Is the only thing separating you from nurses your beloved title?? If so, then maybe you need to look at that a little bit.

If the only thing separating a physician and a DNP is title, then this is the best evidence yet that DNP's are really practicing medicine and therefore should fall under the Board of Medicine. Does anyone know if there ever been a court case on this issue?

 

[deleted87716]

There is a criticial difference between DNP's and DPT's, DVM's, Pharm D.'s. DNP's practice medicine while these other professionals don't.

Context is everything.

If you're the guy behind the counter at Walgreen's, calling yourself "doctor" isn't likely to confuse anyone.

Same goes if you're fixing Fido at the local animal hospital, filling a cavity in your dental practice, or teaching a class in European history at the university. It's pretty obvious what kind of doctor you are in context.

Introduce yourself as "doctor" in a hospital or outpatient clinic, and everyone is going to assume you mean "medical doctor," whether you like it or not (and I strongly suspect that non-physicians who do this do like it, whether they admit it or not.)

 

[Noeljan]

The "team" versus "hierarchy" concept was presented in my Professional Nursing class and I have to say I find it ridiculous. I'm not sure why nursing leaders have gotten it in their head that working as part of a team but with a definite hierarchy somehow devalues the role of the nurse. It doesn't. This idea runs parallel to the PC ideal that there is no way to determine which is better or higher-level between to different items, that different = equal.


In reality, there is a hierarchy (which is not a bad thing) and different roles or ideas can be quantitatively and/or qualitatively compared.

👍 You said exactly what I was trying to say. And trust me, a lot of nurses don't have a problem with it. That is what I meant in my last post, not all nurses want to play doctor. Heck I have friends who tell me you couldn't pay them enough to do what a doctor does. They like their jobs in nursing (for the most part). I can't believe I would get attacked for giving examples of nurses sticking up for/respecting doctors, and not wanting their jobs.

Oh Fab4fan good luck to you. I think it's awesome to return to school. You can do it!!!

 

[ReblRose]

I just dont even know where to begin replying to these comments........😱

Im totally speechless.......

 

[fab4fan]

Oh, come on. Surely you can think of something.😉

 

[ReblRose]

LOL! Yeah I could think of something. Trying to put all of my thoughts into ummmmmmmm whats the word......... politically correct, non-condescending, non-argumentative..........lol

 

[caroladybelle]

Wow, so even you hate nurses who are master's prepared NPs? Sheesh, after reading that diatribe I put you right up there with the tantrum throwing baby docs I've been dealing with.

I happen to despise arrogant nurses who feel they have to put down their fellow nurses. I've seen some LPNs that could teach some ivory tower nurses a thing or two about patient care.

Face the facts Joy...at the end of the day, you are a NURSE! If you have some self-loathing issues regarding that (which come through loud and clear), get some therapy or go back to med school. I find it more than a little disturbing that you would say, "Pt's are confused anyway, so what if I add to the confusion by calling myself Dr." (to paraphrase) That's like saying since most of the public has the average of a 6th grade education, we shouldn't try too hard to do patient education, since they're all basically stupid.

Your post is a reminder of all that is offensive with the DNP scorched earth philosophy.

Yeah, That!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[Quine]

I won't comment on the quality of care as others have already. I assume that someone who has at least 7 years of training and passed umpteen tests can provide higher quality of care than someone with only 2 years.[/QUOTE]

To preface this post: I am a first year nursing student. Hate me if you must.

It seems to me that there is way too much fear about the changing job market and it's possible impact on salaries. If you took the time to think about the patients you see on a daily basis, there are no doubt some who do not require the skills and knowledge you possess to have good outcomes. Some people are just sicker than others. That is where advanced practice nursing comes in. It should take the burden of handling easy patients off the doctors so they can do what is most difficult<har har>. If there are not an unlimited number of doctors, and everyone only gets to see their doctor for five minutes, someone has to step up and get the job done regardless of who might get paid less. If I have a serious illness with an uncertain outcome, do I want an NP on the job? No. But if I have poison oak, do I care who gives me my prednisone? Of course not. The MD had no time to see me, and the NP did. I don't care if they have the same training as the doctor. I only care if they have training adequate to do the job they're doing. In some cases that is in question, but that is a matter for either a) requiring additional training or b) not allowing the NP to do that particular job.

I would also like to address some of the very negative attitudes toward nurses. It's more than understandable to be frustrated when someone with far less education than you questions what you are doing. They may seem like they think they know everything, but it is a nurses job to question what doctors do. Sometimes the questions are stupid, and sometimes they are a matter of life and death. My only suggestion is that if the nurse questions orders in a respectful manner, they should receive a courteous response. It would be extra nice if the doctor would even take a minute to share some of their fancy education, but I know you don't have a minute. There shouldn't be a foul attitude from either party despite their abundant justifications. I know this can be done because I hated nurses for years in my role as a nurses aid.

Besides, the real threat is the influx of foreign health professionals who will work for a nickel. And who doesn't hate foreigners?

I'm joking.

 

[ReblRose]

still working on my words........

 

[PainDr]

There is a criticial difference between DNP's and DPT's, DVM's, Pharm D.'s. DNP's practice medicine while these other professionals don't. If a Pharm D introduced herself as "Dr", it wouldn't take long for the patient to figure that person is not a physician. If a DNP introduced herself as "Dr", then the patient probably won't realize that person is not a physician because diagnosis/treatment techniques are similar.

I tell people now that you can't rely just on the provider saying that he/she is a "Dr". Look at the letters after the name. Everyone I tell is this is shocked because they didn't know that there are so many different types of "Dr"s now. They just assumed that someone who introduced themselves as "Dr" in a clinical setting such as a hospital is a physician. Unless there are laws against it, I fully expect DNP's to introduce themselves as "Dr"s. I think that physicians may need to start a public awareness campaign. Or, physicians maybe should introduce themselves as "Dr. __, a physician".

There IS a law...it's called IMPERSONATING A PHYSICIAN. During my residency, we had someone who got their DNP and started doing this. They weren't arrested, but were quietly reminded that they didn't have the credentials to call themselves Dr. in a clinical setting. It stopped pretty quickly.

 

[fab4fan]

Quine: You are right, it is absolutely appropriate for a nurse to question an order if it seems inappropriate. If you proceed with something that winds up being detrimental to a pt, you're just as culpable as the individual who wrote the order. I will caution you that you should know what you're talking about before you question an order, though. I've seen nurses question orders who really were pretty clueless--what happens next often isn't pretty.

And it's also totally appropriate to ask questions because you want to learn. Here's the problem: Not all docs are going to want to be teachers, so you're going to have to become very observant of who the docs are who seem approachable. Some really like to teach--you just have to make sure you're not asking questions at a bad time. But find the good teachers and pick their brains.

 

[Quine]

Quine: You are right, it is absolutely appropriate for a nurse to question an order if it seems inappropriate. If you proceed with something that winds up being detrimental to a pt, you're just as culpable as the individual who wrote the order. I will caution you that you should know what you're talking about before you question an order, though. I've seen nurses question orders who really were pretty clueless--what happens next often isn't pretty.

And it's also totally appropriate to ask questions because you want to learn. Here's the problem: Not all docs are going to want to be teachers, so you're going to have to become very observant of who the docs are who seem approachable. Some really like to teach--you just have to make sure you're not asking questions at a bad time. But find the good teachers and pick their brains.

Well said, and I thank you for the advice.

 

[zenman]

BTW, I'm a practicing physician (not a student) and if I EVER heard a NP being referred to as Dr., I'd raise hell. Am I territorial? Absolutely. I EARNED the right to be called Dr. and if someone else wants to pretend they have the same right, I'll be there to correct them.

As a male nurse, and not an NP, I've been called "Dr." so many times it hurts. You are going to spend a lot of time "correcting" patients and they still won't get it.

 

[zenman]

LOL! Yeah I could think of something. Trying to put all of my thoughts into ummmmmmmm whats the word......... politically correct, non-condescending, non-argumentative..........lol

You're not going to do very well here at SDN.....😀

 

[Josh L.Ac.]

LOL! Yeah I could think of something. Trying to put all of my thoughts into ummmmmmmm whats the word......... politically correct, non-condescending, non-argumentative..........lol

Actually being PC and trying not to disturb the auras of all those in a thread is hardly a requirement for posting on SDF. After all, this isn't allnurses.




Snap. Did I actually say that?



Yes, yes I did.

 

[deleted87716]

LOL! Yeah I could think of something. Trying to put all of my thoughts into ummmmmmmm whats the word......... politically correct, non-condescending, non-argumentative..........lol

It's perfectly fine to be politically incorrect, condescending, and argumentative. Just stick to the topic, and don't make it personal (e.g., no ad hominem attacks, name-calling, hitting below the belt, eye-gouging, etc.) 😉

 

[fab4fan]

No eye gouging? Well, then what's the fun of it? 😉

 

[PainDr]

As a male nurse, and not an NP, I've been called "Dr." so many times it hurts. You are going to spend a lot of time "correcting" patients and they still won't get it.

As a female resident I was called "nurse" so many times it hurt, so I completely understand what you're saying but I'm not talking about that type of situation. I'm talking about DNPs who are perpetuating the confusion and masquerading as physicians.

 

[ReblRose]

No eye gouging? Well, then what's the fun of it? 😉

Yeah that!!!

 

[ReblRose]

Actually being PC and trying not to disturb the auras of all those in a thread is hardly a requirement for posting on SDF. After all, this isn't allnurses.




Snap. Did I actually say that?



Yes, yes I did.

Oh you so went there!! lol

 

[ReblRose]

You're not going to do very well here at SDN.....😀

😆 well you know.... didnt want to wear out my welcome tooooo soon!

 

[fab4fan]

C'mon, now, let's not be a tease. Spill it, sister.

 

[horsenurse25]

All righty. I don’t have a lot of time here since I am running off to watch my kids soccer tournaments (my is a forward and my son is defence, 4 back to back games, so it is going to be a long day!!!). But here is a quick response as we mustn’t let this informative, well-intentioned thread die out…. 🙄🙄

Most Importantly… Fab4 – I asked my son that question…he is only 11.. and now he is obsessively going through his Beatle books looking for the answer since the computer is off limits. Thanks a lot. He might not even gear up for soccer… he is sitting on the floor of his room humming Penny Lane in the middle of a pile of Beatle cr*p. (Figuratively speaking).😛

KentW- as I mentioned in my earlier post, I always have my patients (or residents, depending upon where I am working) call me by my first name. I do not have any intention of changing that. However, once I get my doctorate I will most likely introduce myself as such. I worked for it. I earned it. I want people who come to me know exactly in what I am qualified. And yes, I will be proud. But no, I will not be running around telling people that I am a Doctor with a capital D. I never saw ‘Meet the Parents’, but I did see ‘Meet the Fokkers’. Love that Ben. DeNiro was a bit of a disappointment though. I like him better as a gansta. 👎

Josh – I am part of a team. Shoot, the housekeepers are part of the team. Yes, there are captains of the team. But basically we all pull together to get the best outcome we can. Obviously you have never worked at a remote rural hospital. I suggest you try it. It really drives home the concept of how important each person is and how to work together.

Taurus – You bleat on and on about medicine this and medicine that. Honestly. What exactly is your definition of medicine??? “ The practice of medicine is defined under the MPA as the "cure of diseases and the preservation of the health of man, including the practice of the healing arts with or without ..." The term "healing arts" is defined as "the science and skill of diagnosis and treatment in any manner whatsoever of disease or any ailment of the human body." “ [Taken from the Medical Professional Act - bolds were added by myself]
Hmmm. Sounds like something nurses (and many other health professionals) do every day. Medicine is not the exclusive domain of physicians. Sorry to tell you that. Let’s look at some examples…
Nurses give vaccinations, administer PRN medications (how do you think they determine when they are needed?), attend home palliative care. (You don’t think that the entire scene there is not heavy duty?? You don’t think there are lots of decisions made there?) Treat and dress wounds, are front line public health providers who are responsible for detecting potential problems and passing/referring them on to a physician. How about ECU (extended care units for those who might not know…) where a doctor rarely if ever shows their face? Those RNs are making critical medical decisions every day. Heck, even the decision to call in the physician is a medical decision. And then when the physician is called, they expect a complete synopsis of the condition and potential problem of said patient – the nurses must justify their reasons for calling. You don’t think the nurse is making medical assessments and diagnoses in their heads? They have to in order to tell the physician what is relevant or not.

Noeljan – You did not get ‘attacked’ for giving an example of nurses respecting doctors. You gave a pathetic, probably fictional anecdote of perceived fashion infringement. Refraining from badmouthing, gossiping or denigrating and conversing in an honest, attentive way with doctors as professionals are examples of respecting doctors.

And finally,

KentW – That is an interesting concept. Other people who get their doctorates; for example lawyers, academics, veterinarians, pharmacists, etc. can have their titles and use them proudly. But Nurses who work hard to attain this distinction must hide it and downplay their academic and professional achievements for fear of overstepping their boundaries. I see.

Further, I do not want to be mistaken for a physician. I am a nurse – with a Masters and hopefully to get my Doctorate. And I am proud of it. That does not mean I have to hide in corners because some people think the general public is too stupid to tell the difference between a medical doctor and a nurse with a doctorate. I have actually found people to be able to differentiate between the two once it is explained to them. But then again, I forget, some physicians are too busy practicing medicine to explain anything to anyone….

love the banana. Off to soccer on this brilliant May day.

 

[fab4fan]

horsenurse:

Tell your son the answer to the question can be found in THE BEATLES RECORDING SESSIONS: The Official Abbey Road Studio Session Notes 1962-1970 p. 93 (Or he can just Google it). Good taste for an 11y old!

You made some very good points. I'm still not quite there on nurses calling themselves "doctor," but I do agree that there is a problem with nurses devaluing or minimizing their work or acomplishments. I think part of the problem was the arrogant manner in the way the DNP was presented, kind of "We're just as good as doctors, so there!" That was bound to set up hostility from the get-go; it's not as if nursing and medicine have a great rapport to start with...now this.

It is a shame that there are some here that refuse to acknowledge that they need nurses for more than just the shovel and broom brigade. Kent has asked for no ad hominem attacks or name calling, so I'll respect that and just say, you know who I mean.

 

[Noeljan]

All righty. I don’t have a lot of time here since I am running off to watch my kids soccer tournaments (my is a forward and my son is defence, 4 back to back games, so it is going to be a long day!!!). But here is a quick response as we mustn’t let this informative, well-intentioned thread die out…. 🙄🙄

Most Importantly… Fab4 – I asked my son that question…he is only 11.. and now he is obsessively going through his Beatle books looking for the answer since the computer is off limits. Thanks a lot. He might not even gear up for soccer… he is sitting on the floor of his room humming Penny Lane in the middle of a pile of Beatle cr*p. (Figuratively speaking).😛

KentW- as I mentioned in my earlier post, I always have my patients (or residents, depending upon where I am working) call me by my first name. I do not have any intention of changing that. However, once I get my doctorate I will most likely introduce myself as such. I worked for it. I earned it. I want people who come to me know exactly in what I am qualified. And yes, I will be proud. But no, I will not be running around telling people that I am a Doctor with a capital D. I never saw ‘Meet the Parents’, but I did see ‘Meet the Fokkers’. Love that Ben. DeNiro was a bit of a disappointment though. I like him better as a gansta. 👎

Josh – I am part of a team. Shoot, the housekeepers are part of the team. Yes, there are captains of the team. But basically we all pull together to get the best outcome we can. Obviously you have never worked at a remote rural hospital. I suggest you try it. It really drives home the concept of how important each person is and how to work together.

Taurus – You bleat on and on about medicine this and medicine that. Honestly. What exactly is your definition of medicine??? “ The practice of medicine is defined under the MPA as the "cure of diseases and the preservation of the health of man, including the practice of the healing arts with or without ..." The term "healing arts" is defined as "the science and skill of diagnosis and treatment in any manner whatsoever of disease or any ailment of the human body." “ [Taken from the Medical Professional Act - bolds were added by myself]
Hmmm. Sounds like something nurses (and many other health professionals) do every day. Medicine is not the exclusive domain of physicians. Sorry to tell you that. Let’s look at some examples…
Nurses give vaccinations, administer PRN medications (how do you think they determine when they are needed?), attend home palliative care. (You don’t think that the entire scene there is not heavy duty?? You don’t think there are lots of decisions made there?) Treat and dress wounds, are front line public health providers who are responsible for detecting potential problems and passing/referring them on to a physician. How about ECU (extended care units for those who might not know…) where a doctor rarely if ever shows their face? Those RNs are making critical medical decisions every day. Heck, even the decision to call in the physician is a medical decision. And then when the physician is called, they expect a complete synopsis of the condition and potential problem of said patient – the nurses must justify their reasons for calling. You don’t think the nurse is making medical assessments and diagnoses in their heads? They have to in order to tell the physician what is relevant or not.

Noeljan – You did not get ‘attacked’ for giving an example of nurses respecting doctors. You gave a pathetic, probably fictional anecdote of perceived fashion infringement. Refraining from badmouthing, gossiping or denigrating and conversing in an honest, attentive way with doctors as professionals are examples of respecting doctors.

And finally,

KentW – That is an interesting concept. Other people who get their doctorates; for example lawyers, academics, veterinarians, pharmacists, etc. can have their titles and use them proudly. But Nurses who work hard to attain this distinction must hide it and downplay their academic and professional achievements for fear of overstepping their boundaries. I see.

Further, I do not want to be mistaken for a physician. I am a nurse – with a Masters and hopefully to get my Doctorate. And I am proud of it. That does not mean I have to hide in corners because some people think the general public is too stupid to tell the difference between a medical doctor and a nurse with a doctorate. I have actually found people to be able to differentiate between the two once it is explained to them. But then again, I forget, some physicians are too busy practicing medicine to explain anything to anyone….

love the banana. Off to soccer on this brilliant May day.

My example was neither fictional or pathetic. It was the truth. I don't appreciate being called a liar, when I was there and have NO reason to lie. I am also a nurse like you, with a masters like you (except mine is in Biochem) and I am beginning medical school in two months (unlike you). It is not a bad or good thing (nurse vs doctor). I never once attacked nursing or nurses. Why would I? I am one. But, a nurse is not a doctor and I stand by that. I also don't see what is wrong with specific roles and professional boundaries. Nurses do it to. We don't like when CNAs or med techs call themselves nurses. We earned that right. We did the schooling, the work, and the liability over them. Same with doctors. We shouldn't want to take away from that. The more education one gets, they should advance professionally. I am going to teach my kids that being in the NBA or acting is not the only way to make your way in this world. Education needs to be valued.
Please don't call me names again. As for the uniform, I stand by more structure. Doctors, RNs, CNAs, janitors, etc. It is tough figuring out who is who when everyone is wearing whatever they want.

oh and on another note,
when I am a physician I will welcome questions from nurses. I think that is awesome when people want to learn, or if we can help eachother out in any way. When I was a student I had several doctors that were eager to teach. My classmates and I used to joke about it on a specific hospital we rotated at, the docs were more eager to help us than the nurses.

 

[fab4fan]

I admit to feeling very conflicted over this. There's a part of me that thinks why shouldn't a nurse who has earned a doctoral degree in a clinical area be allowed to be called "Dr." when others e.g. psychologists, PTs, etc. do the same. I think some of it has to do with the proverbial tension between doctors and nurses. There's still very much a "handmaiden" attitude out there among doctors in the way they treat nurses.

OTOH, I find it more troublesome that some DNPs claim to be equal to MDs/DOs. To me, that's a bigger problem than having them use a degree title they've rightfully earned. Those individuals to me are the real troublemakers.

I think it's great, Noeljan, that you aspire to be one of those docs who will welcome questions. If only other docs would realize that doing something so simple not only fosters good relations among staff, it helps improve patient care in the long run. Believe it or not, there are nurses out there who want to know more than just the "how." We want to know "why."

Whatever. My goal is to just be a masters NP. I can't think of a reason to have a DNP at this stage of my life. I have no desire to practice independently. I just want to find a nice internal medicine group where I can spend the rest of my career, working in collaboration with a good group of docs.

 

[PainDr]

I have a question for anyone who would care to answer. What is the difference between a Masters' NP and a DNP? If one already has an NP, what are the additional training/educational requirements?

 

[kylek044]

There's a part of me that thinks why shouldn't a nurse who has earned a doctoral degree in a clinical area be allowed to be called "Dr." when others e.g. psychologists, PTs, etc. do the same.

I think the only issue is where the title is used. I remember a few years ago (more like 8) when I was hospitalized for foot surgery, I didn't know about any of this crap - but I was fully aware when I was seeing a Physical Therapist, the child psycologist to help me deal with the surgery, and the DPT. The grey area is when someone walks into the inpatient room - are they a doctor? a nurse? That was back in the day when part of me still believed that every male in the hospital was a doctor and every female was a nurse. For a nurse to go into a patient's room where the patient isn't really sure what to expect, and call him/herself "doctor", it is deceiving. I understand that NP's have a great deal of knowledge, but the truth is, they are not physicians. If it was you in the patient bed, how would you feel.
I know plenty of NPs who have introduced themselves as "Nurse Practitioner __." DNP's have earned a doctorate, but they should keep the title out of patients rooms. If I hear doctor, I think physician. If I were a nurse, at the nurses station or in nursing school and had someone introduce them self as "Dr. ___, but you can call me___", it would be understood. It's like Joe Schmo who earned his doctorate in Spanish Languange (yes, I know someone) - in the academic setting, the use of the title is appropriate. If he walked in to a hospital and introduced himself to a patient as Doctor, there would be an issue. I understand that is an exaggeration, but I really want people to understand the patient side of it (yes, sometimes it has to be about the patient, not just personal pride).

 

[deleted87716]

Other people who get their doctorates; for example lawyers, academics, veterinarians, pharmacists, etc. can have their titles and use them proudly. But Nurses who work hard to attain this distinction must hide it and downplay their academic and professional achievements for fear of overstepping their boundaries.

It has nothing to do with "boundaries." It has to do with perceptions. I assume you have reasons for becoming a DNP that go beyond calling yourself "doctor."

 

[fab4fan]

I have a question for anyone who would care to answer. What is the difference between a Masters' NP and a DNP? If one already has an NP, what are the additional training/educational requirements?

Because more knowledge, more training is never a bad thing. If someone wants to take it further to a higher degree level, good for them.

 

[fab4fan]

I think the only issue is where the title is used. I remember a few years ago (more like 8) when I was hospitalized for foot surgery, I didn't know about any of this crap - but I was fully aware when I was seeing a Physical Therapist, the child psycologist to help me deal with the surgery, and the DPT. The grey area is when someone walks into the inpatient room - are they a doctor? a nurse? That was back in the day when part of me still believed that every male in the hospital was a doctor and every female was a nurse. For a nurse to go into a patient's room where the patient isn't really sure what to expect, and call him/herself "doctor", it is deceiving. I understand that NP's have a great deal of knowledge, but the truth is, they are not physicians. If it was you in the patient bed, how would you feel.
I know plenty of NPs who have introduced themselves as "Nurse Practitioner __." DNP's have earned a doctorate, but they should keep the title out of patients rooms. If I hear doctor, I think physician. If I were a nurse, at the nurses station or in nursing school and had someone introduce them self as "Dr. ___, but you can call me___", it would be understood. It's like Joe Schmo who earned his doctorate in Spanish Languange (yes, I know someone) - in the academic setting, the use of the title is appropriate. If he walked in to a hospital and introduced himself to a patient as Doctor, there would be an issue. I understand that is an exaggeration, but I really want people to understand the patient side of it (yes, sometimes it has to be about the patient, not just personal pride).

So you would demand the same of a doctorally prepared psychologist?

 

[fab4fan]

It has nothing to do with "boundaries." It has to do with perceptions. I assume you have reasons for becoming a DNP that go beyond calling yourself "doctor."

I think this is boiling down to nurses needing to remember to "learn their place." This post is a telling example, even though it doesn't say it directly.

 

[DogFaceMedic]

We can argue endlessly about who should be called what. The bottom line is does the title of Dr have a specific meaning to patients? The answer is a definitive yes. Pts expect someone introducing themselves in a clinic/hospital as Doc to be fully licensed to recognize and treat all of their health concerns. DNPs, DPTs, PhDs, EDDs, JDs, etc do not fit this criteria no matter how good they are -- especally if they went through a correspondance program.

In academia, Dr is a title of expertise in their area and the general public knows this. In health, people want fully licensed MD/DOs. No one will hurt my feelings insisting on being called a Doc in a clinic (Psych, DPT, DNP), but their pts will. If pts feel mislead about their health, they will find a lawyer to accept a retainer fee and charge malpractice.

Call yourself a Doc only in the right context.

 

[horsenurse25]

Pts expect someone introducing themselves in a clinic/hospital as Doc to be fully licensed to recognize and treat all of their health concerns. .

That is a ridiculous comment. NO MD is qualified to recognize and treat all of anyone's health concerns. That is the entire purpose of referrals and specialists.

Basically you are saying that no one is as good at anything as much as MDs are good at everything. 🙄

 

[horsenurse25]

I think this is boiling down to nurses needing to remember to "learn their place." This post is a telling example, even though it doesn't say it directly.

You got it.

 

[fab4fan]

We can argue endlessly about who should be called what. The bottom line is does the title of Dr have a specific meaning to patients? The answer is a definitive yes. Pts expect someone introducing themselves in a clinic/hospital as Doc to be fully licensed to recognize and treat all of their health concerns. DNPs, DPTs, PhDs, EDDs, JDs, etc do not fit this criteria no matter how good they are -- especally if they went through a correspondance program.

In academia, Dr is a title of expertise in their area and the general public knows this. In health, people want fully licensed MD/DOs. No one will hurt my feelings insisting on being called a Doc in a clinic (Psych, DPT, DNP), but their pts will. If pts feel mislead about their health, they will find a lawyer to accept a retainer fee and charge malpractice.

Call yourself a Doc only in the right context.

So a PhD psychologist seeing pts in the hospital isn't allowed to be addressed as "Dr." according to your rule.

Okey dokey.

 

[deleted87716]

I think this is boiling down to nurses needing to remember to "learn their place." This post is a telling example, even though it doesn't say it directly.

Not really. I'm not in the habit of speaking in riddles. I don't think nurses should call themselves doctors in a setting where they could potentially be confused with physicians. You've pretty much said the same thing, more than once. I suspect we're in the majority.

 

[DogFaceMedic]

That is a ridiculous comment. NO MD is qualified to recognize and treat all of anyone's health concerns. That is the entire purpose of referrals and specialists.

Basically you are saying that no one is as good at anything as much as MDs are good at everything. 🙄

I Really shoud be out cleaning the BBQ and getting ready for the thick pork ribs with a cold adult beverage, but I couldn't resist.

Don't misunderstand me: know one knows everything but me (couldn't resist that either.) But, pts have expectations when someone calls themselves Dr and DNPs do not meet it. It is viewed as hubris at best, and viewed as dishonest at worst. Pts expect a Doc to have a certain amount of education and experieince -- i.e., specialized residency -- that DNPs do not have.

Go ahead and intro youself as Dr to students and pts, then judge the different reactions. Students will respect the education, pts will be suspicious because they know MDs/DOs have more experience. Again, do not misunderstand me: I did not say smarter or wiser, just more training and experience and are usually, not always, better diagnosticians/clinicians.

 

[horsenurse25]

It has nothing to do with "boundaries." It has to do with perceptions. I assume you have reasons for becoming a DNP that go beyond calling yourself "doctor."

Naturally.
And perceptions only change when people are willing to be educated or to educate. Bottom line is that SOME (and by no means the majority) of physicians (and wanna-be physicians) are trying desperately to cling to a tradition that does not have a foundation any longer...

 

[PainDr]

Because more knowledge, more training is never a bad thing. If someone wants to take it further to a higher degree level, good for them.

I never said more training was a bad thing, but you didn't answer my question. What additional training do DNPs have that NPs don't have.

 

[deleted87716]

And perceptions only change when people are willing to be educated or to educate

Well, good luck with that.

 

[Taurus]

Among my early posts (many, many pages back) on this thread, I predicted this:

http://www.latimes.com/business/la-fi-prices28may28,0,4102332.story?coll=la-home-center

California's largest private physician practice has become one of the first doctor groups in the nation, and almost certainly the largest, to make prices for its medical procedures widely available to consumers.

...

The move was motivated in part by the rapid advance of walk-in medical clinics at drugstore chains and discount retailers, such as CVS Caremark Corp. and Wal-Mart Stores Inc., where the prices of blood pressure checks and flu shots are as easy to spot as those for rubbing alcohol and cat food.

...

Now, employers are increasingly shifting costs onto employees through higher deductibles and co-payments and through so-called health savings accounts, said Chris Ohman, chief executive of the California Assn. of Health Plans, a trade group that represents insurers.

...

Clinics offer walk-in appointments, are open nights and weekends and typically provide a short menu of simple services, often employing nurse practitioners rather than physicians. They cater mostly to people with suspected ear infections, strep throat and urinary tract infections.

...

Although physicians may be reluctant to list prices, Scott said it could actually give their patients a greater appreciation of their value.

"It shows them, 'This is why I'm paying more,' " she said. "They are giving me more."

 

[deleted87716]

Although physicians may be reluctant to list prices, Scott said it could actually give their patients a greater appreciation of their value.

"It shows them, 'This is why I'm paying more,' " she said. "They are giving me more."

Actually, many of us have a publicly-available fee schedule for cash-paying patients. It's illegal for us to disclose the fee schedules that we've negotiated with third-party payors, however, as it's believed that this could lead to collusion or price-fixing. Plus, given the almost countless variations in individual coverage, it would be next to impossible for us to accurately predict a patient's out-of-pocket expense.

 

[PainDr]

Naturally.
And perceptions only change when people are willing to be educated or to educate. Bottom line is that SOME (and by no means the majority) of physicians (and wanna-be physicians) are trying desperately to cling to a tradition that does not have a foundation any longer...

"Trying desperately to cling to a tradition that does not have a foundation any longer"? Hmm...I suppose that's one way of spinning it. I'm still not sure what value a DNP adds? No one seems willing...or able...to answer this question.

 

[Taurus]

If the DNP's want to compete with physicians by offering similar services, I don't have a problem with that as long as physicians aren't hamstrung. Let the free market dictate salaries, insurance premiums, etc.

In the future, I think that the consumer will be in the driver's seat. They did it with 401(k)'s and they're trying to do it with healthcare. If there is harsh price war among physician groups and consumers can get the same services at the same price from physicians as the DNP's, the DNP's are gonna be hurting because given a choice most consumers would choose physicians. There are no guarantees of income or job and it is quite possible to saturate a market with providers.

 

[fab4fan]

Not really. I'm not in the habit of speaking in riddles. I don't think nurses should call themselves doctors in a setting where they could potentially be confused with physicians. You've pretty much said the same thing, more than once. I suspect we're in the majority.

Like I said, I have "issues" with it. But I also have a problem with nurses always being expected to devalue or hide their accomplishments. Doctors aren't gods. Why shouldn't a patient know the nurse taking care of him/her has a doctoral degree? But heaven forfend if the nurse puts that on her badge, because then you guys start mocking her for that ("Stupid nurses with all that alphabet soup behind their names..."). There have been threads devoted to that. Then you get threads devoted to stupid nurses who have nothing but two years of college who don't know how to perform a competent patient assessment.

See what I mean? We can't win for losing.