ducki303

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I may totally get slammed for this, but....

Nursing and Medicine are two different fields. If the Nurses wanted to do the work of the doctor, why don't they go to Medical school and become doctors? I would be in support of a track for nurses to go through Medical training to become a doctor, complete with USMLEs and Residency.
 
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I may totally get slammed for this, but....

Nursing and Medicine are two different fields. If the Nurses wanted to do the work of the doctor, why don't they go to Medical school and become doctors? I would be in support of a track for nurses to go through Medical training to become a doctor, complete with USMLEs and Residency.
+1:thumbup:
 

mfrizzo3

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My favorite comment..............

"One of my best doctors was a Nurse Practitioner - she is the one who originally diagnosed me correctly - my so called expert countered her diagnosis and managed to screw me up to the point that I am now disabled! Give me a RNP any day of the week!":thumbdown:
 

millepora

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Why in the world are they proposing to dump more medicare money into DNP training, when they can just use that money to expand PC residences!
 
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I don't know about anyone else, but I like spending LESS time with my PC. At the student health clinic, my doctor is a badass who spends like ten minutes and gets the diagnoses right every time. When I have to see the NP it's an ordeal. She takes my blood pressure, looks in my eyes, throat, and takes my temperature. Why should I have to get a full physical before she burns a wart off my foot?

My problem is that, in my experience (yay argument from personal experience) doctors are sharp, to the point, and get things right. Sure there are a few bad experiences here and there, but I've found that dealing with other health professionals are almost always a bad experience. Sure they're great for drawing blood, giving shots, and talking to, but otherwise they tend to be very mediocre in comparison to doctors. DNPs doing more can only mean one thing from my perspective: more miserable experiences for patients. More misdiagnoses and more money spent on unneeded tests.

I'm done ranting. Don't take anything I said too seriously because I don't.
 
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When you're on top, everyone below you wants to tear you down. Doctors are on top, what are they gonna do to protect their position? This is one case where I see a slippery slope.
 

MedcatHouse

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SoundofSilver

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Why in the world are they proposing to dump more medicare money into DNP training, when they can just use that money to expand PC residences!
From what I've heard, many PC residencies go unfilled.

Instead of pumping money into DNP training, they could use that money to create incentives (i.e. partial loan forgiveness) in order to make a career in primary care more economically feasible for those med school graduates with catastrophic debt.

Also, with the expansion of U.S. medical schools and the static number of residencies, it's likely that the competitive residencies will become even more competitive which will force more people into choosing primary care.
 

nburnett3

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I may totally get slammed for this, but....

Nursing and Medicine are two different fields. If the Nurses wanted to do the work of the doctor, why don't they go to Medical school and become doctors? I would be in support of a track for nurses to go through Medical training to become a doctor, complete with USMLEs and Residency.
I completely agree. Call me pretentious or whatever, but DNPs just seem to be trying to backdoor their way into being a real doctor. They didn't go to medical school or do a residency, ergo they aren't physicians. The idea that they want to be able to call themselves Dr. Suchandsuch is ridiculous to say the least.

"They say they're highly trained and as skilled as doctors at diagnosing illness during office visits."

Give me a break. I can probably diagnose a cold as well as the next doctor, but that doesn't mean I'm as highly trained and skilled as them. The only people as highly trained and skilled as doctors are, well, other doctors.

I think nurses and nurse practitioners are genuinely important to health care functioning, but they should play the role of the nurse, not try to play the role of the doctor. See Taurus' signature for how I feel about DNPs pushing to be equivalent to full-fledged doctors.
 

millepora

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It depends on what you mean by "expand"... from my understanding of it...hundreds of residency slots, under this category, go unfilled each year

http://blogs.wsj.com/health/2009/11/27/would-adding-residency-slots-solve-the-primary-care-shortage/tab/article/
I agree that AMG's do not fill the PC slots, but as the article states the IMG's usually fill the remaining slots. The caribbean IMG's may be less competent than the AMG's, but still far better than NP's.
 
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Here's an idea, why not expand their roles and have patients decide if they will accept a NP or if they prefer being treated by an MD? Want a lower cost NP? You can pocket half the difference, in cash, from your insurance company. Maybe if congress and the AMA didn't have centrally planned MD monopoly on medicine that also limits the number of spots available in medical school, we would, by now, have more advanced NPs to meet demand that could do much more for much less. Medical school tuition would fall dramatically due to this downward pressure on costs and we would all be much happier (except the doctors who just paid six figures for their degree).

Think outside the box guys. We don't have enough physicians to meet demand, and more people are going to become insured. How are we going to meet this demand and lower costs if we can only use a small supply of doctors with a $250,000 MD degree for routine care? People will just receive less, more expensive care.

If we are truly worried about costs, it's time to put our money where our mouths are.

My 2 cents.
 

elftown

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I recently had a student from a 2-year nursing program tell me that they learn everything a doctor does, but condensed into 2 years. It's no surprise to me these idiots want to take over the medical field.
 

Suenya

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Here's an idea, why not expand their roles and have patients decide if they will accept a NP or if they prefer being treated by an MD? Want a lower cost NP? You can pocket half the difference, in cash, from your insurance company. Maybe if congress and the AMA didn't have centrally planned MD monopoly on medicine that also limits the number of spots available in medical school, we would, by now, have more advanced NPs to meet demand that could do much more for much less. Medical school tuition would fall dramatically due to this downward pressure on costs and we would all be much happier (except the doctors who just paid six figures for their degree).

Think outside the box guys. We don't have enough physicians to meet demand, and more people are going to become insured. How are we going to meet this demand and lower costs if we can only use a small supply of doctors with a $250,000 MD degree for routine care? People will just receive less, more expensive care.

If we are truly worried about costs, it's time to put our money where our mouths are.

My 2 cents.
This. I'm totally okay with more of a market in terms of healthcare. But even if that weren't the case, most docs I know love their NPs... maybe that's because they work with NPs they like, but at least the psych and ED NPs I've worked with seem to be well liked and well appreciated.
 

Suenya

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I recently had a student from a 2-year nursing program tell me that they learn everything a doctor does, but condensed into 2 years. It's no surprise to me these idiots want to take over the medical field.
I had an EMT tell me the same thing, in regards to everything a nurse learns. It's pretty amazing when people don't know how limited they are.

One of the amazing thing about good midlevels is that most know their limits. I honestly think that DNPs and regular NPs should be able to practice independently. Much like a PCP has to know when to refer to a specialist, NPs should know when they have to refer to a PCP to handle more complex cases.
 

IndianVercetti

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This is pretty sad, I guess the moral of the story is that medical care is beginning to become diluted from the bottom up. I wouldn't be surprised if in the next 25 years MD/DOs start to become a field leading to solely medical specialization - and primary/family practice becoming a field dominated by NPs. Essentially, this would work out to be most cost efficient for governing agencies, but the end result is a lack of expertise in primary care.

There is no way a Nurse Practitioner has the same level of expertise as a well-trained primary care physician. Some of the comments on that page by readers are laughable.
 

IndianVercetti

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Here's an idea, why not expand their roles and have patients decide if they will accept a NP or if they prefer being treated by an MD? Want a lower cost NP? You can pocket half the difference, in cash, from your insurance company.
What the heck makes you think that insurance companies will be so benevolent that they start giving the difference back to physicians?? If anything, they will pocket this difference to reap a profit (especially since they are going to be forced to reduce insurance premiums for the uninsured by the new legislation).

Also, as sad as it is, I think MANY uneducated citizens would actually choose NPs over MD/DOs since it is cost-effective, and they really don't have the foresight to realize the difference in education. To many uneducated people, anyone with a degree is "really smart"
 

link2swim06

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Here's an idea, why not expand their roles and have patients decide if they will accept a NP or if they prefer being treated by an MD? Want a lower cost NP? You can pocket half the difference, in cash, from your insurance company. Maybe if congress and the AMA didn't have centrally planned MD monopoly on medicine that also limits the number of spots available in medical school, we would, by now, have more advanced NPs to meet demand that could do much more for much less. Medical school tuition would fall dramatically due to this downward pressure on costs and we would all be much happier (except the doctors who just paid six figures for their degree).

Think outside the box guys. We don't have enough physicians to meet demand, and more people are going to become insured. How are we going to meet this demand and lower costs if we can only use a small supply of doctors with a $250,000 MD degree for routine care? People will just receive less, more expensive care.

If we are truly worried about costs, it's time to put our money where our mouths are.

My 2 cents.
Not the problem....residencies make practicing docs not med schools.
 

Dr Oops

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Here's an idea, why not expand their roles and have patients decide if they will accept a NP or if they prefer being treated by an MD? Want a lower cost NP? You can pocket half the difference, in cash, from your insurance company. Maybe if congress and the AMA didn't have centrally planned MD monopoly on medicine that also limits the number of spots available in medical school, we would, by now, have more advanced NPs to meet demand that could do much more for much less. Medical school tuition would fall dramatically due to this downward pressure on costs and we would all be much happier (except the doctors who just paid six figures for their degree).

Think outside the box guys. We don't have enough physicians to meet demand, and more people are going to become insured. How are we going to meet this demand and lower costs if we can only use a small supply of doctors with a $250,000 MD degree for routine care? People will just receive less, more expensive care.

If we are truly worried about costs, it's time to put our money where our mouths are.

My 2 cents.
So why dont you go into nursing?

Start medical school, then see if you would want nurses independently in charge of your care.

I for one, certainly do not.
 

IndianVercetti

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What is scary is that these Nurse Practitioners are calling themselves doctors when they introduce themselves to patients - how is an uninformed patient supposed to tell the difference if they don't explicitly ask/look up credentials?
 

oaklandguy

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lmao @ NP's replacing doctors. of course NP's thinking that they go thru the training of doctors is like a pre-med student thinking they go thru the same training as PA's or something of that nature. I was tutoring some nursing students and it's unreal how much their material is watered down. The nursing organic chemistry was like the first 2 weeks of real orgo, and the nursing physiology is basically intro to bio level. I think it is safe to say that any med-student would be able to go thru nursing school in their sleep. No disrespect to nurses because I've seen them work and it's not easy by any means, but their schooling is easier than pre-med. So if their undergrad schooling is less meticulous than a physicians, how in the world is does their "grad schooling" even compare to that of a physicians? Just my $0.02.
 

elftown

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What is scary is that these Nurse Practitioners are calling themselves doctors when they introduce themselves to patients - how is an uninformed patient supposed to tell the difference if they don't explicitly ask/look up credentials?
"I don't think patients are ever confused. People are not stupid," said Linda Roemer, a nurse practitioner in Sedona, Ariz., who uses "Dr. Roemer" as part of her e-mail address.

Calling themselves doctors and wearing white coats... of course patients think it's a nurse seeing them. :rolleyes:
 

oaklandguy

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"I don't think patients are ever confused. People are not stupid," said Linda Roemer, a nurse practitioner in Sedona, Ariz., who uses "Dr. Roemer" as part of her e-mail address.

Calling themselves doctors and wearing white coats... of course patients think it's a nurse seeing them. :rolleyes:
If they are confused and think they are seeing a doctor that would mean that when they have the choice of primary care they would choose a doctor over a nurse practitioner right?

I think the regular "uneducated" person would choose a doctor over a nurse practitioner just due to the word nurse being in the name. I think nurses get a really bad rep.

I wonder whose better at primary care though, NP's or PA's.
 

oaklandguy

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There are more residency spots available than there are MDs each year.
Not for long. DO students are taking more MD residency spots every year, there are a handful of MD schools opening up and many MD schools are growing their class sizes every year. There may be unfilled spots in PCP and "unwanted" fields each year, but even that will become more competitive within the near future.
 

elftown

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If they are confused and think they are seeing a doctor that would mean that when they have the choice of primary care they would choose a doctor over a nurse practitioner right?

I think the regular "uneducated" person would choose a doctor over a nurse practitioner just due to the word nurse being in the name. I think nurses get a really bad rep.

I wonder whose better at primary care though, NP's or PA's.
Good point. :thumbup:
 

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"I don't think patients are ever confused. People are not stupid," said Linda Roemer, a nurse practitioner in Sedona, Ariz., who uses "Dr. Roemer" as part of her e-mail address.

Calling themselves doctors and wearing white coats... of course patients think it's a nurse seeing them. :rolleyes:

heck, most of the time anyone, phlebotmist, x-ray tech, etc. walk into a pts. room they think they're a doc. so yeah, pts. are not easily confused at all.:rolleyes:
 

oaklandguy

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heck, most of the time anyone, phlebotmist, x-ray tech, etc. walk into a pts. room they think they're a doc. so yeah, pts. are not easily confused at all.:rolleyes:
Haha this reminds me of when I had to do my EMT clinical rotations in the hospital setting. I was wearing EMT pants and a navy blue polo with the star of life on it and a few patients thought I was a medical student... Then again, there were patients that knew exactly what an EMT-Basic was etc.
 

Suenya

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On the other hand, while I'm all for independent NP practice, I always find it a bit annoying when a NP claims (and I haven't met one in real life that has, so I imagine it's just the ones that like getting into the articles) that NPs provide better, or more patient centered care or anything along those lines.

I think NP care is as good as doctor care (at least in the fields I've met met them both in) for many bread and butter things. Docs are overtrained for most of what they do. It's the other more complex things that the deeper training is needed for. I also think, at least at many programs, NPs are trained to know their limits and judge what they need to refer out more than adequately.

At the same time, I don't think the nurse to NP route provides much if any improvement in quality of any of the aspects of care (from having the nursing care experience), and I'm pretty damn sure the direct NP route is worse, just because of the fewer hours with patients.

I personally prefer my doctor for some things, but if I'm going for BP and cholesterol management, or some sort of infection, and an NP is available, I couldn't care less.
 

DrBowtie

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31 posts and no one has made fun of the OP for his title? SDN is slipping...
 

JaggerPlate

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Welcome to ****ing America ... everyone feels entitled to a piece of the pie without doing any of the work. This is super annoying in medicine, but it isn't limited to this field ... at all.

We should all just stop fighting it and take advantage of it ... open up a crap load of clinics, stuff 'em with these 'doctors,' and then just manage. Or better yet ... open up one of these DNP programs. I'm sure you don't have to screw with setting up rotations and such, so you could probably just open up shop, charge insane amounts for tuition and profit.
 

cliffhuxtableDO

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Welcome to ****ing America ... everyone feels entitled to a piece of the pie without doing any of the work. This is super annoying in medicine, but it isn't limited to this field ... at all.

We should all just stop fighting it and take advantage of it ... open up a crap load of clinics, stuff 'em with these 'doctors,' and then just manage. Or better yet ... open up one of these DNP programs. I'm sure you don't have to screw with setting up rotations and such, so you could probably just open up shop, charge insane amounts for tuition and profit.
Before we open up the DNP program, start a church first, that way its tax free!!!
 

Suenya

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31 posts and no one has made fun of the OP for his title? SDN is slipping...
That's what made posting in this one worthwhile, compared to the same threads every week. Something has to set it apart!
 

JaggerPlate

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Before we open up the DNP program, start a church first, that way its tax free!!!
Hmmm not a bad idea. Let's choose a fun religion though ... like bringing back the gods of Greek mythology. I think it would be way more badass all around.



'Oh you're Catholic. Me? Oh, well I worship Zeus ... sacrifice to Poseidon sometimes, etc.'
 

oaklandguy

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Hmmm not a bad idea. Let's choose a fun religion though ... like bringing back the gods of Greek mythology. I think it would be way more badass all around.



'Oh you're Catholic. Me? Oh, well I worship Zeus ... sacrifice to Poseidon sometimes, etc.'
I was gonna say Zoroastrianism would've been a cool one to do. But I'm down with the whole Zeus and Hercules thing.
 

cliffhuxtableDO

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Hmmm not a bad idea. Let's choose a fun religion though ... like bringing back the gods of Greek mythology. I think it would be way more badass all around.



'Oh you're Catholic. Me? Oh, well I worship Zeus ... sacrifice to Poseidon sometimes, etc.'
I was gonna say Zoroastrianism would've been a cool one to do. But I'm down with the whole Zeus and Hercules thing.
it's a done deal.
 

JaggerPlate

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I'm going to start drafting blueprints ...

The church is going to be a detailed replica of Mt Olympus.
 

mvenus929

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I recently had a student from a 2-year nursing program tell me that they learn everything a doctor does, but condensed into 2 years. It's no surprise to me these idiots want to take over the medical field.
Ha. Most nurses that I work with don't even know what the doctor is doing half the time, and they have pretty regular access to the chart. The ICU and Cardiology nurses are the ones most on top of it, but they're smart enough to know when they need to talk to the doctor.

lmao @ NP's replacing doctors. of course NP's thinking that they go thru the training of doctors is like a pre-med student thinking they go thru the same training as PA's or something of that nature. I was tutoring some nursing students and it's unreal how much their material is watered down. The nursing organic chemistry was like the first 2 weeks of real orgo, and the nursing physiology is basically intro to bio level. I think it is safe to say that any med-student would be able to go thru nursing school in their sleep. No disrespect to nurses because I've seen them work and it's not easy by any means, but their schooling is easier than pre-med. So if their undergrad schooling is less meticulous than a physicians, how in the world is does their "grad schooling" even compare to that of a physicians? Just my $0.02.
Indeed. We had a BSN program at my undergrad, and they had to take micro as one of their pre-reqs for the actual nursing classes. The professor watered down that class so much so that the nursing students could pass it, leaving those of us with a background in biology to bore holes into our skulls from the boredom of it. I don't think I learned a single thing in that class...

Makes me wonder about their A&P class... it was taught by a professor who was supposedly the pre-med advisor and told us that if we didn't take the MCAT after our sophomore year, we'd have to sit out a year before medical school.

heck, most of the time anyone, phlebotmist, x-ray tech, etc. walk into a pts. room they think they're a doc. so yeah, pts. are not easily confused at all.:rolleyes:
Actually, I've only had one person think I was the doctor, and that was a person on the psych unit who asked every person who walked into the room if he/she was the doc. Most of the time, they think I'm a nurse.
 

cliffhuxtableDO

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i'll start recruiting. let's make tidings 20%
 

oaklandguy

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it's a done deal.
Can we call it "Hercules' School for Doctors"? I think that would be awesome, seeing how they call themselves Dr. (insert last name here). We can even add in a Dental School and a Physical Therapy School as well. Maybe throw in a couple of PhD programs since they love being called Doctor as well. Too bad we won't get funded by the free masons because we are associated with polytheism. I wonder how hard it would be to get funding actually.
 

oaklandguy

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Indeed. We had a BSN program at my undergrad, and they had to take micro as one of their pre-reqs for the actual nursing classes. The professor watered down that class so much so that the nursing students could pass it, leaving those of us with a background in biology to bore holes into our skulls from the boredom of it. I don't think I learned a single thing in that class...

Makes me wonder about their A&P class... it was taught by a professor who was supposedly the pre-med advisor and told us that if we didn't take the MCAT after our sophomore year, we'd have to sit out a year before medical school.
My institution also has a BS program and a nurse anesthesist program. Most of the nursing courses are only for nursing students. Like the microbio you speak of is a separate class called Intro to Microbial Biology and it does not count as a biology class for bio majors but it's part of the nursing curriculum. In my intro to bio class there were nursing students and of course many of them were freshman and for them to be able to get a 2.0 the teacher ended up making a 90% a 4.0 a 75% a 3.0 and a 65% a 2.0... I haven't had nursing students in my classes since then, I believe their gen-chem is even separated from the norm, and I took calc based physics which didn't have any females in it let alone nursing students.
 
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What the heck makes you think that insurance companies will be so benevolent that they start giving the difference back to physicians?? If anything, they will pocket this difference to reap a profit (especially since they are going to be forced to reduce insurance premiums for the uninsured by the new legislation).

Also, as sad as it is, I think MANY uneducated citizens would actually choose NPs over MD/DOs since it is cost-effective, and they really don't have the foresight to realize the difference in education. To many uneducated people, anyone with a degree is "really smart"
I offer that as an example because it is assumed that if patients see a lower cost NP over an MD for, say, a sore throat, it costs the insurance company less. To incentivize this behavior, they can offer to share some of the savings with the policy holder. Keep in mind, if NPs weren't trained well enough to handle the situation (not implying they currently are), insurance wouldn't want to encourage this behavior because it would end up costing them more over time.

And yes, some patients are uneducated. However, I do not support forcing them to see an MD if they prefer to see a NP and they can pay for it either through insurance or their own money.

You may not like health insurance companies, but try paying for your own health care without one. They are doing you a favor. In addition, most are non-profit.

So why dont you go into nursing?

Start medical school, then see if you would want nurses independently in charge of your care.

I for one, certainly do not.
I'm not going into nursing because I want to be a physician and I am willing to take the financial risks associated with earning that title.

I do not want a nurse independently in charge of my care. However, my post was in regards to the future and it implies that NPs will receive greater training to meet an increase in demand for primary care. I am willing to pay more for an MD. However, I am not willing to deprive others of the option to pay less for NP's to treat specific issues that they are adequately trained to treat. Will they be MDs? No. But our current system is unsustainable and this is one way to meet increased demand while reducing cost.

Not the problem....residencies make practicing docs not med schools.
I agree, however, both are part of the same progression and both are controlled by the government. I just wanted to highlight a benefit of increased competition between health care providers.
 
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I love how terrible this argument is: "The AMA argues the title "Dr." creates confusion. Nurse practitioners say patients aren't confused by veterinarians calling themselves "Dr." Or chiropractors. Or dentists. So why, they ask, would patients be confused by a nurse using the title?"

Except it's context. When you're in a hospital someone called doctor is either a medical doctor or a doctor of osteopathy. Rarely do you get a visit from a dentist or a veterinarian in the hospital.

It's like saying that if people aren't confused about PHDs in theater being called doctor, then why would they be confused about nurses being called doctor? The title means different things in different contexts.

Also, chiropractors are not doctors. It annoys the crap out of me when people called them that. Many of them are quacks, and the rest are physical therapists with illusions of grandeur (I didn't come up with that).

The idea that they should be given more to do because they're doing a good job already is also fallacious. It's like saying a GP is well suited for minor surgery, so they should be allowed to do open heart surgery. Or in the non-medical field, a person who can drive a Toyota should automatically be licensed to drive a tractor trailer.

(like I said in my last post don't take anything I just said too seriously)
 

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As a PA student, and as a generalization....

MD/DO + residency > PA/DNP in terms or training

Since when is taking the shorter, less difficult path so well rewarded??

PAs and NPs and god forbid, DNPS, all should practice under the supervision of a physician. otherwise, med school is the only option.


It drives me nuts when NPS claim superiority over PAs. Now these DNPs will be the equivalent of a physician??

more and more i regret not becoming a dentist....
 

elftown

10+ Year Member
Dec 30, 2008
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Attending Physician
Hmmm not a bad idea. Let's choose a fun religion though ... like bringing back the gods of Greek mythology. I think it would be way more badass all around.



'Oh you're Catholic. Me? Oh, well I worship Zeus ... sacrifice to Poseidon sometimes, etc.'
I was gonna say Zoroastrianism would've been a cool one to do. But I'm down with the whole Zeus and Hercules thing.
it's a done deal.
You picked the wrong religion. The Mormons were the correct answer.

http://www.southparkstudios.com/clips/152270/