Do most NP's think they are better primary care?

[badasshairday]

It seems that on the internet you hear a lot of NPs claiming not only equivalence, but superiority at providing primary care compared to physicians? Do most NP's really have a chip on there shoulder?

I think NP's are great, they play an extremely important role, but to encroach on physicians and make claims like that are really uncalled for. Do they have any respect for the training an MD has, or do they just believe it is useless? I just want to get a true feel from NP's on this forum. It feels demoralizing to hear this as a medical student....

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[NarcolepticRN]

you hear a lot of NPs claiming not only equivalence, but superiority at providing primary care compared to physicians? Do most NP's really have a chip on there shoulder?

I'll admit, I have heard this too. Usually the sentiment is related to the popular theory that nurses have a better bedside manner than MDs. This seems a bit biased since most nurses have spent some time working "at the bedside". They physically spend more time with the average hospitalized patient, and the nurse-patient relationship is inherently more intimate.

I have heard from both lay people and nurses that NPs in primary care can do everything that an MD does and more. This is just patently false. However, I think many people who believe this are generally in good health and see their NPs for well-visits, routine screening, and relatively simple episodic complaints. NPs who believe this are not seeing the big picture (that is, their success in caring for a primarily well-population or stable chronic patients has inflated their sense of their capabilities and their training). For the record, I do not personally know any NPs that believe this, including my own NP.

I'm also not saying that NPs can't handle acute or complex situations. They can and often do. But having a person with medical training available to consult with is always necessary, since the NPs focus in primary care is in diagnosing and treating common diseases and patient education. They are great at that, but they do not have the extensive medical background that MDs have, and I think physician involvement in some capacity is critical for safe and effective patient care. For full disclosure, I am a new NP. I would not work without a physician on site at this point in my career, if ever.

Do they have any respect for the training an MD has, or do they just believe it is useless?

Yes, and oh my god no.

 

[badasshairday]

you hear a lot of NPs claiming not only equivalence, but superiority at providing primary care compared to physicians? Do most NP's really have a chip on there shoulder?

I'll admit, I have heard this too. Usually the sentiment is related to the popular theory that nurses have a better bedside manner than MDs. This seems a bit biased since most nurses have spent some time working "at the bedside". They physically spend more time with the average hospitalized patient, and the nurse-patient relationship is inherently more intimate.

I have heard from both lay people and nurses that NPs in primary care can do everything that an MD does and more. This is just patently false. However, I think many people who believe this are generally in good health and see their NPs for well-visits, routine screening, and relatively simple episodic complaints. NPs who believe this are not seeing the big picture (that is, their success in caring for a primarily well-population or stable chronic patients has inflated their sense of their capabilities and their training). For the record, I do not personally know any NPs that believe this, including my own NP.

I'm also not saying that NPs can't handle acute or complex situations. They can and often do. But having a person with medical training available to consult with is always necessary, since the NPs focus in primary care is in diagnosing and treating common diseases and patient education. They are great at that, but they do not have the extensive medical background that MDs have, and I think physician involvement in some capacity is critical for safe and effective patient care. For full disclosure, I am a new NP. I would not work without a physician on site at this point in my career, if ever.

Do they have any respect for the training an MD has, or do they just believe it is useless?

Yes, and oh my god no.

Thank you for the thoughtful response.

Like you said, I agree NP's are very good with their specific patient population. I'm just wondering more specifically if the majority of NP's are on the more extreme edge of full DNP=MD in every scope and practice setting. Or is this just a minority group of say 10%? Internet forums and comment sections on articles give no real meter to what beliefs are in actual day to day practice. Unfortunately the most vocal are the minority extremists on the internet.... at least I hope so. And this goes for both sides, MD and NP.

 

[Paseo Del Norte]

I think the answer is you have some that do, some that do not, and every type of sentiment in between. Clearly, this DNP concept and push for indi practice could potentially backfire on us.

The reality being, health care without physician involvement is potentially disastrous and may prove to be harmful. Ultimately, many patients are going to be fine in spite of what we do to them; however, this may not be the reality for all patients.

Solid evidence where complex clinical decisions in patients with medical problems requiring intervention beyond an algorithmic approach is lacking IMHO.