How much does PA school miss out on medical school

[NontradCA]

Well, I use SDN as a resource, so I don't see why not. I don't think all med students and physicians are taking time out of their busy lives to peruse this bloated thread, but it's certainly possible that a small number are. And the experiences shared here may be helpful, especially if the readers have begun to doubt the skills of, and worry about the ambition for independence among, midlevels.

The answer is no. While I can see your point SDN as a resource severely diminishes after entering med school. What's going on here is bickering. Don't justify it by thinking you're saving some of those lowly med students and physicians.

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[FNP_Blix]

Not sure why you guys are responding to this thread. We need to stop giving things like this the time of day. Like arguing with some random nurse on the internet isn't going to help anything. He obviously has inferiority issues.

It also is derailing the thread. Can we put things back on topic?

Actually I don't have an inferiority issue. I truly believe in independent NP practice and the purpose it serves. That is, to improve access to healthcare services for millions of people and provide safe affordable care. I'm here debating because this is a public forum, and the vitriol you guys spew is unwarranted. I have every right to defend my position.

 

[NontradCA]

Actually I don't have an inferiority issue. I truly believe in independent NP practice and the purpose it serves. That is, to improve access to healthcare services for millions of people and provide safe affordable care. I'm here debating because this is a public forum, and the vitriol you guys you spew is unwarranted. I have every right to defend my position.

Take this bs to your lawmakers. It's serving no purpose in this thread. Read the rules of the forum. You don't have the right to derail threads to spew your propaganda.

 

[YoungDoc25]

No you're wrong again. There is nothing unethical about comparing two practices head to head. There are already plenty of independent nurse led practices out there? So why don't we see physician led studies comparing them? It's because they are afraid of what the results will be and an argument made from ignorance is better than from nothing at all.

If there’s nothing unetheical and you’re so sure you’re equal to me, do a legitimate study analyzing factors that equate safe and effective care. Not something that asks a patient how they feel about the questions you asked or the time spent in the room. By all means, make another MSN Research Elective 4001 class to carry out the study. Something tells me that the body willing to twist a study to convey a message is probably the one going to come out on bottom when a legitimate study comes out. That seems to fall within your ethical limits as a noctor, so go for it. I would never send my patient to someone I knowingly could outperform in every aspect of medicine. That doesn’t fit my ethical standards, as I’m sure many of my colleagues feel as well. Sorry to let you down.

 

[FNP_Blix]

If there’s nothing unetheical and you’re so sure you’re equal to me, do a legitimate study analyzing factors that equate safe and effective care. Not something that asks a patient how they feel about the questions you asked or the time spent in the room. By all means, make another MSN Research Elective 4001 class to carry out the study. Something tells me that the body willing to twist a study to convey a message is probably the one going to come out on bottom when a legitimate study comes out. That seems to fall within your ethical limits as a noctor, so go for it. I would never send my patient to someone I knowingly could outperform in every aspect of medicine. That doesn’t fit my ethical standards, as I’m sure many of my colleagues feel as well. Sorry to let you down.

The studies out there show many more comparisons besides patient satisfaction that demonstrates safe and effective care, published by physicians as well, I should reiterate. We have far more data in support of my argument than you do, and if you have a better idea for giving everyone the opportunity to access healthcare services, besides waiting it out another 20-30 years for adequate numbers of physicians to be produced, then let me know. In the mean time, I will carry on doing what I do best, which providing safe, affordable, and effective healthcare services for my patients.

 

[FNP_Blix]

Take this bs to your lawmakers. It's serving no purpose in this thread. Read the rules of the forum. You don't have the right to derail threads to spew your propaganda.

Hey I wasnt the one bashing physicians publicly like you were doing to NPs. You guys were and thread was already derailed before I came here.

 

[YoungDoc25]

The studies out there show many more comparisons besides patient satisfaction that demonstrates safe and effective care, published by physicians as well, I should reiterate. We have far more data in support of my argument than you do, and if you have a better idea for giving everyone the opportunity to access healthcare services, besides waiting it out another 20-30 years for adequate numbers of physicians to be produced, then let me know. In the mean time, I will carry on doing what I do best, which providing safe, affordable, and effective healthcare services for my patients.

I look forward to seeing your profession be dismantled

 

[IntheClouds4ever]

Actually I don't have an inferiority issue. I truly believe in independent NP practice and the purpose it serves. That is, to improve access to healthcare services for millions of people and provide safe affordable care. I'm here debating because this is a public forum, and the vitriol you guys spew is unwarranted. I have every right to defend my position.

Those millions of people needing improved access to care is vastly rural populations.. until DPNs are "required" to practice in these areas, you are spewing idealized hope and vitriol handed to you by your lobbyists by claiming you want to "improve access to healthcare services"

Even then, you will have a far narrower scope of pracitce compared to a family physician.. mid-levels have their place and are useful but this debate is ridiculous. You don't have near the education or experience that a physician does and it's laughable that anyone thinks it's equal. If you wanted to be called "Doctor" inside the clinic, you should have went to Med school..

 

[DubbiDoctor]

Those millions of people needing improved access to care is vastly rural populations.. until DPNs are "required" to practice in these areas, you are spewing idealized hope and vitriol handed to you by your lobbyists by claiming you want to "improve access to healthcare services"

Even then, you will have a far narrower scope of pracitce compared to a family physician.. mid-levels have their place and are useful but this debate is ridiculous. You don't have near the education or experience that a physician does and it's laughable that anyone thinks it's equal. If you wanted to be called "Doctor" inside the clinic, you should have went to Med school..

In what ways do FNPs in States that allow for independent practice have a more restricted scope of practice than that of family physicians?

 

[FNP_Blix]

I look forward to seeing your profession be dismantled

Won't happen, so don't hold your breath.

 

[IntheClouds4ever]

In what ways do FNPs in States that allow for independent practice have a more restricted scope of practice than that of family physicians?

Most family physicians in rural areas run ERs, serve as hospitalists, and could perform exact same scope as an general Internist. Meaning they are educated and experienced enough to take care of the more complicated, chronic patient with comorbidites whereas a mid-level is generally expected to refer these patients on..

 

[FNP_Blix]

Those millions of people needing improved access to care is vastly rural populations.. until DPNs are "required" to practice in these areas, you are spewing idealized hope and vitriol handed to you by your lobbyists by claiming you want to "improve access to healthcare services"

Even then, you will have a far narrower scope of pracitce compared to a family physician.. mid-levels have their place and are useful but this debate is ridiculous. You don't have near the education or experience that a physician does and it's laughable that anyone thinks it's equal. If you wanted to be called "Doctor" inside the clinic, you should have went to Med school..

It's in urban areas as well. Ghettos and indigent populations arguably struggle more with access than anybody else. The scope we hold is only growing state by state. You won't see any "requirements" to practice independently in rural areas because people higher than you or I see that the access issues go far beyond that. This is a real issue and not just a pawn to advance our agenda. If you don't believe that, then you're delusional. And the physicians that agree with this point, like the physician I referenced earlier that wrote for the NEJM actually says we should be thankful for nurse practitioners because without us, it would be a mess right now.

 

[DubbiDoctor]

Most family physicians in rural areas run ERs, serve as hospitalists, and could perform exact same scope as an general Internist. Meaning they are educated and experienced enough to take care of the more complicated, chronic patient with comorbidites whereas a mid-level is generally expected to refer these patients on..

There is a significant percentage of NPs, however, who never in any circumstances consult primary care physicians.
"The data revealed wide variability and inconsistency in the supervision of NPs in Florida, as detailed below. Each measure of supervision—percentage of time the physician on site,percentage of records reviewed, and percentage of required consults—ranged
from 0 to 100%, across the spectrum of NP experience. Males
worked without a physician on site more often and had fewer
record reviews than females. NPs with doctorates worked without
a physician on site more often, had fewer record reviews, and fewer
required consults than NPs without a doctorate. Twelve percent of
respondents worked with no physician on site, no record reviews,
and no required consults."

"Another wrote, “There is no supervision or collaboration. I have never met my collaborating physician and he does not
come to the clinic in which I work. He signs DME [durable medical equipment] orders for reimbursement but only after I sign
them! He never sees my patients.”

http://www.journalofnursingregulation.com/article/S2155-8256(17)30017-0/pdf


And this is Flordia, a state without independent practice for physicians. Like it or not, a significant percentage of NPs believe themselves to be be FPs and internists equals.

 

[IntheClouds4ever]

It's in urban areas as well. Ghettos and indigent populations arguably struggle more with access than anybody else. The scope we hold is only growing state by state. You won't see any "requirements" to practice independently in rural areas because people higher than you or I see that the access issues go far beyond that. This is a real issue and not just a pawn to advance our agenda. If you don't believe that, then you're delusional. And the physicians that agree with this point, like the physician I referenced earlier that wrote for the NEJM actually says we should be thankful for nurse practitioners because without us, it would be a mess right now.

As I said earlier, I believe mid-levels have their place an dare useful.. my question is this "how does independent practice Mid-levels increase the access to care if you aren't increasing their numbers?" -- mid-levels are hired to see patients so I'm confused how lobbying for independent practice going to increase access? It's not. It's a political argument for legislation.

 

[FNP_Blix]

As I said earlier, I believe mid-levels have their place an dare useful.. my question is this "how does independent practice Mid-levels increase the access to care if you aren't increasing their numbers?" -- mid-levels are hired to see patients so I'm confused how lobbying for independent practice going to increase access? It's not. It's a political argument for legislation.

How can you not see that it improves access. Just do the math. If there are more providers to deliver healthcare services, then more of the population can be served. Even in specialty areas where there is no indigent populations or difficulties paying for healthcare services (e.g., elective procedural areas), NPs serve a role in increasing volume and reducing wait times and readmissions. NPs that do practice independently, or even in collaborative agreements (e.g., Florida) still boost access. The ability to utilize a NP, at a fraction of the price and with quality services, in a satellite clinics or what have you are prime examples of how this has improved access. And It most certainly has. And not just at the macro level, but at the micro level as well. Why should an NP need a MD behind his/her name to sign off on scripts for diabetic boots? This is an example of the kind of hinderances that NPs resent are trying to do away with.

 

[IntheClouds4ever]

There is a significant percentage of NPs, however, who never in any circumstances consult primary care physicians.
"The data revealed wide variability and inconsistency in the supervision of NPs in Florida, as detailed below. Each measure of supervision—percentage of time the physician on site,percentage of records reviewed, and percentage of required consults—ranged
from 0 to 100%, across the spectrum of NP experience. Males
worked without a physician on site more often and had fewer
record reviews than females. NPs with doctorates worked without
a physician on site more often, had fewer record reviews, and fewer
required consults than NPs without a doctorate. Twelve percent of
respondents worked with no physician on site, no record reviews,
and no required consults."

"Another wrote, “There is no supervision or collaboration. I have never met my collaborating physician and he does not
come to the clinic in which I work. He signs DME [durable medical equipment] orders for reimbursement but only after I sign
them! He never sees my patients.”

http://www.journalofnursingregulation.com/article/S2155-8256(17)30017-0/pdf


And this is Flordia, a state without independent practice for physicians. Like it or not, a significant percentage of NPs believe themselves to be be FPs and internists equals.

This proves my point in the post above. Mid-levels are already seeing patients. Giving independent practice rights doesn't "increase access to care". They are performing the same job they always have and not increasing any ability to see more patients. The independent practice rights isn't an argument about increased access to healthcare or other political propaganda spewed by their lobbying organization.

 

[DubbiDoctor]

They can choose, but a decent PA will know when they are in over their head and will call the physician. If it is a known patient with a complex issue the doctor will likely come talk to them anyway.

This may be the case with PAs, but almost 40% of NPs who work in collaborative care practices (with physicians) do not believe that they should defer certain patients, presumably with complex problems, to physicians. The idea that physicians handle the complex cases sounds good in theory, but doesn't seem to be true in practice, which is why I aim to avoid primary care.

"We asked respondents whether in their work setting they agreed with the statement that “nurse practitioners typically defer certain types of patient care services and procedures to the primary care physician.” Among respondents in collaborative practice, 88.9% of physicians agreed, as compared with 61.3% of nurse practitioners (P<0.001). Clinicians who agreed with this statement were asked to identify the types of services that were primarily handled by physicians: 43.8% of physicians and 21.1% of nurse practitioners cited care for more complex cases; 11.2% and 15.2%, respectively, cited specific diagnoses or disease groups; and 19.1% and 36.8%, respectively, reported that physicians handled procedures and postoperative care, with the remaining responses accounting for less than 5% of the total."

MMS: Error

 

[IntheClouds4ever]

How can you not see that it improves access. Just do the math. If there are more providers to deliver healthcare services, then more of the population can be served. Even in specialty areas where there is no indigent populations or difficulties paying for healthcare services (e.g., elective procedural areas), NPs serve a role in increasing volume and reducing wait times and readmissions. NPs that do practice independently, or even in collaborative agreements (e.g., Florida) still boost access. The ability to utilize a NP, at a fraction of the price and with quality services, in a satellite clinics or what have you are prime examples of how this has improved access. And It most certainly has. And not just at the macro level, but at the micro level as well. Why should an NP need a MD behind his/her name to sign off on scripts for diabetic boots? This is an example of the kind of hinderances that NPs resent are trying to do away with.

Mid-levels are already seeing patients.. giving independent practice rights isn't going to "add more providers".. it just lets current providers not have any oversight

 

[FNP_Blix]

This proves my point in the post above. Mid-levels are already seeing patients. Giving independent practice rights doesn't "increase access to care". They are performing the same job they always have and not increasing any ability to see more patients. The independent practice rights isn't an argument about increased access to healthcare or other political propaganda spewed by their lobbying organization.

But you're missing the point. Our numbers are growing exponentially. By 2025, when the "silver tsunami" supposedly will hit, there will be enough NPs to hopefully mitigate the access crisis that looms ahead. Right now, we are showing force in numbers. The amount of time it takes to produce 1 family care physician, you will have 2 or maybe 3 NPs entering primary care.

 

[IntheClouds4ever]

But you're missing the point. Our numbers are growing exponentially. By 2025, when the "silver tsunami" supposedly will hit, there will be enough NPs to hopefully mitigate the access crisis that looms ahead. Right now, we are showing force in numbers. The amount of time it takes to produce 1 family care physician, you will have 2 or maybe 3NPs entering primary care.

And Osteopathic colleges are growing exponentially...

By your argument we should do away with medical doctors for anything other than sub speciality surgical procedures

 

[FNP_Blix]

This may be the case with PAs, but almost 40% of NPs who work in collaborative care practices (with physicians) do not believe that they should defer certain patients, presumably with complex problems, to physicians. The idea that physicians handle the complex cases sounds good in theory, but doesn't seem to be true in practice, which is why I aim to avoid primary care.

"We asked respondents whether in their work setting they agreed with the statement that “nurse practitioners typically defer certain types of patient care services and procedures to the primary care physician.” Among respondents in collaborative practice, 88.9% of physicians agreed, as compared with 61.3% of nurse practitioners (P<0.001). Clinicians who agreed with this statement were asked to identify the types of services that were primarily handled by physicians: 43.8% of physicians and 21.1% of nurse practitioners cited care for more complex cases; 11.2% and 15.2%, respectively, cited specific diagnoses or disease groups; and 19.1% and 36.8%, respectively, reported that physicians handled procedures and postoperative care, with the remaining responses accounting for less than 5% of the total."

MMS: Error

False. We are absolutely drilled on when to refer and most of us do recognize our limitations. I wan't to protect my behind just as much as any of you do. I evidence this statement by our law suit numbers and the trust that the public has in us. We are extremely safe providers and continue to prove to be year by year.

 

[FNP_Blix]

And Osteopathic colleges are growing exponentially...

By your argument we should do away with medical doctors for anything other than sub speciality surgical procedures

Osteopathic colleges may be growing, but not exponentially. Also, look at the number of MD/DOs going into family medicine residencies. This number is growing but very slowly and is at best, in comparison to population aging and growth, stagnate. You can produce many medical schools, but if costs continue to rise for med students, limitations on hours worked during residency are not curbed, and if residency spots don't become more prevalent, there will be an enormous shortage of physicians. This is already projected to be the case. So you should be THANKING the nursing profession for having the for sight to mitigate this issue.

 

[FNP_Blix]

By your argument we should do away with medical doctors for anything other than sub speciality surgical procedures

And no, we absolutely need physicians. However, we need NPs too especially now because there will not be enough physicians to balance out the demand by 2025. We need all hands on deck and NPs are key members right now in mitigating all this.

 

[IntheClouds4ever]

And no, we absolutely need physicians. However, we need NPs too especially now because there will not be enough physicians to balance out the demand by 2025. We need all hands on deck and NPs are key members right now in mitigating all this.

Again, I've already said mid-levels are useful in helping with access but I'm confused about how independent practice rights are supposed to "increase access" when these mid-levels are already seeing patients.

 

[DubbiDoctor]

And no, we absolutely need physicians. However, we need NPs too especially now because there will not be enough physicians to balance out the demand by 2025. We need all hands on deck and NPs are key members right now in mitigating all this.

Why are physicians needed in primary care, if, as you say, NPs are just as effective?

 

[FNP_Blix]

Again, I've already said mid-levels are useful in helping with access but I'm confused about how independent practice rights are supposed to "increase access" when these mid-levels are already seeing patients.

Okay yes, there are already NPs practicing and seeing patients independently, but the access issue is still far far from being solved. And there are 28 other states that don't yet have independent NP practice authority. North Carolina and Pennsylvania will likely do it soon, however, shortage issues are not just confined to rural areas. In short, we still need more providers. Of note, as more NP enter the workforce (mainly to provide primary care services), there won't even be enough physicians to reasonably provide oversight. What I mean by this is that most states have limits on how many mid-levels a physician can "collaborate" with. In order to meet the demand, we actually need both more physicians and mid-level providers to (1) provide reasonable oversight over greater numbers of mid-level providers, and (2) to offer physician expertise as we still do need more physicians. In the mean time however, the number of mid-levels is vastly out pacing the production of physicians and so therefore will need unimpeded practice authority to adequately provide healthcare services in all areas of the country. This is a macro level example.

At the micro level, there are issues with certain services that NPs can't provide that are well within their scope of practice. Like the example I gave before about the diabetic boot. You don't need an MD to sign off on DME like that, and NPs are well within their qualifications to make the judgement call to prescribe that equipment.

 

[FNP_Blix]

Why are physicians needed in primary care, if, as you say, NPs are just as effective?

This is a great point of debate. However, NPs realistically do not claim to be better than physicians or equal to physicians. However, it is presumed that NPs can do about 90% of what a physician can do after aprox. 1-2 years of oversight by a physician in primary care setting. Physicians will likely find a niche in overseeing NPs, skimming profits off the top, and doing the other 10% that NPs cannot do. Note that a vast majority of NPs choose to work in collaborative arrangements anyways because we still want the medical expertise of a physician when we are experiencing a diagnostic conundrum. That is why many NP led practices actually hire the part time services of a physician, as that primary care physician acts more as a consultant to that NP led practice.

 

[IntheClouds4ever]

Okay yes, there are already NPs practicing and seeing patients independently, but the access issue is still far far from being solved. And there are 28 other states that don't yet have independent NP practice authority. North Carolina and Pennsylvania will likely do it soon, however, shortage issues are not just confined to rural areas. In short, we still need more providers. Of note, as more NP enter the workforce (mainly to provide primary care services), there won't even be enough physicians to reasonably provide oversight. What I mean by this is that most states have limits on how many mid-levels a physician can "collaborate" with. In order to meet the demand, we actually need both more physicians and mid-level providers to (1) provide reasonable oversight over greater numbers of mid-level providers, and (2) to offer physician expertise as we still do need more physicians. In the mean time however, the number of mid-levels is vastly out pacing the production of physicians and so therefore will need unimpeded practice authority to adequately provide healthcare services in all areas of the country. This is a macro level example.

At the micro level, there are issues with certain services that NPs can't provide that are well within their scope of practice. Like the example I gave before about the diabetic boot. You don't need an MD to sign off on DME like that, and NPs are well within their qualifications to make the judgement call to prescribe that equipment.

Everyone knows we need more providers.. independent practice doesn't add more providers, it just means less oversight. Mid-levels supervising mid-levels is nonsense and does nothing for safe practice. You'll have to provide data showing that #of mid-levels will outpace the #of real doctors capable of actual oversight for me to even acknowledge that sort of conjecture.

You've already said mid-levels will need to be able to collaborate with physicians which underscores the need for physician supervision over mid-levels since they obviously aren't equally trained or capable to handle the breadth of medical issues in a given area.

 

[FNP_Blix]

Everyone knows we need more providers.. independent practice doesn't add more providers, it just means less oversight. Mid-levels supervising mid-levels is nonsense and does nothing for safe practice. You'll have to provide data showing that #of mid-levels will outpace the #of real doctors capable of actual oversight for me to even acknowledge that sort of conjecture.

You've already said mid-levels will need to be able to collaborate with physicians which underscores the need for physician supervision over mid-levels since they obviously aren't equally trained or capable to handle the breadth of medical issues in a given area.

Then go to you're legislature and demand the right to be able to oversee more mid-level providers. Because as more NPs enter the market, their demand will continue to grow whether you sign off on it or not. By allowing for independent practice, it boosts access to services because their wont be the extra step of a physician having to review charts or being their to ensure that a NP is properly managing a patient's high blood pressure (again we are well within our education to provide a majority of primary care services). So yes you're right, independent practice laws don't create more providers, but what it does do is allow for the providers that are already there and entering the work force the ability to provide more services and expand to deliver services in areas where physicians wouldn't otherwise practice. And yes, NPs do outpace physicians in production. That's actually pretty easy to find. But here is an article for you.

 

[deafdealer]

Some care is not better than no care. Despite the fact that NPs don't care to practice in the middle of Mississippi any more than doctors do. The fact is that your training is a joke, your outcome studies are flawed and motivated for political gain, and your DNP degree exists only to confuse pts because of your well-deserved inferiority complex. You have less training than a beautician--it's an absolute tragedy that you're let anywhere near pts if we're being completely honest. It might not be today, or tomorrow, but the public will eventually catch on to how poorly NPs are educated/trained, and that will spell the end of you. Your equal pay movement might be your downfall even before this.

 

[FNP_Blix]

Some care is not better than no care. Despite the fact that NPs don't care to practice in the middle of Mississippi any more than doctors do. The fact is that your training is a joke, your outcome studies are flawed and motivated for political gain, and your DNP degree exists only to confuse pts because of your well-deserved inferiority complex. You have less training than a beautician--it's an absolute tragedy that you're let anywhere near pts if we're being completely honest. It might not be today, or tomorrow, but the public will eventually catch on to how poorly NPs are educated/trained, and that will spell the end of you. Your equal pay movement might be your downfall even before this.

In proportion to physicians, NPs are much more likely to practice in rural areas than physicians (9-10% of physicians versus 15-18% of NPs), and many more NPs are credentialed in primary care. Our eduction is not a joke and is adequate to provide the services we've been providing for 5 decades now. You're wishful thinking about the public "catching on to how little educated we are " is just crap because nurses today are more educated than ever before. When NPs were invented, it was little more than a certificate program. Suggest you learn to accept this or you won't be very happy as a physician as most healthcare workers that you will be around are nurses.

 

[SurgDoc95]

In proportion to physicians, NPs are much more likely to practice in rural areas than physicians (9-10% of physicians versus 15-18% of NPs), and many more NPs are credentialed in primary care. Our eduction is not a joke and is adequate to provide the services we've been providing for 5 decades now. You're wishful thinking about the public "catching on to how little educated we are " is just crap because nurses today are more educated than ever before. When NPs were invented, it was little more than a certificate program. Suggest you learn to accept this or you won't be very happy as a physician as most healthcare workers that you will be around are nurses.

Please do us all a favor, and yourself for that matter, and stop responding. The fact is that the DNP degree is around and will likely stay due to the ridiculous amounts of influence nursing unions have. It is absolutely NOT a necessary degree as a nurse practitioner with a masters degree was perfectly capable of handling their current duties. All the DNP degree is now is an unnecessary ego inflation device for nurses who wanted to be “doctors” but didn’t want to go to medical school. They aren’t useless, actually far from it, but the fact remains that a doctorate in nursing should never have been a degree. It is and always should’ve been a support role for physicians the same way that PAs are. They serve a role and a vital one, but as a mid level provider NOT an autonomous round about way to become a primary care PHYSICIAN.


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[FNP_Blix]

Please do us all a favor, and yourself for that matter, and stop responding. The fact is that the DNP degree is around and will likely stay due to the ridiculous amounts of influence nursing unions have. It is absolutely NOT a necessary degree as a nurse practitioner with a masters degree was perfectly capable of handling their current duties. All the DNP degree is now is an unnecessary ego inflation device for nurses who wanted to be “doctors” but didn’t want to go to medical school. They aren’t useless, actually far from it, but the fact remains that a doctorate in nursing should never have been a degree. It is and always should’ve been a support role for physicians the same way that PAs are. They serve a role and a vital one, but as a mid level provider NOT an autonomous round about way to become a primary care PHYSICIAN.


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I disagree, and think it is a necessary degree. We need doctorally prepared nurses and PhDs in our profession to continue advancing our profession and body of knowledge, in addition to becoming educators. Fortunately, the trend of DNPs and independent practice nurse practitioners will continue to grow state to state for the foreseeable future.

 

[SurgDoc95]

I disagree, and think it is a necessary degree. We need doctorally prepared nurses and PhDs in our profession to continue advancing our profession and body of knowledge, in addition to becoming educators. Fortunately, the trend of DNPs and independent practice nurse practitioners will continue to grow state to state for the foreseeable future.

Here’s your chance to make a convincing argument to all of us as to why that is necessary. Don’t give us any of the “the nursing profession needs this” crap. Lay out why for medicine and health care as a whole it’s necessary to have PhDs and DNPs.


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[FNP_Blix]

Here’s your chance to make a convincing argument to all of us as to why that is necessary. Don’t give us any of the “the nursing profession needs this” crap. Lay out why for medicine and health care as a whole it’s necessary to have PhDs and DNPs.


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I just told you. Nursing is it's own science and profession, contributing it's own knowledge to healthcare (e.g., Care delivery models made by nursing theorists used in healthcare systems nationwide). We need PhDs and DNPs to be the ultimate authority in our profession, nurses to guide our professional fates (not physicians), and to teach the future generation of nurses.

 

[SurgDoc95]

I just told you. Nursing is it's own science and profession, contributing it's own knowledge to healthcare (e.g., Care delivery models made by nursing theorists used in healthcare systems nationwide). We need PhDs and DNPs to be the ultimate authority in our profession, nurses to guide our professional fates (not physicians), and to teach the future generation of nurses.

That’s literally the answer I asked you not to spew because it doesn’t address the why that is necessary question. Until you can give us an answer and an explanation why DNPs are necessary (not going to touch on PhDs because they are not necessary) please stop. Sorry OP for contributing to derailing your thread


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[DexterMorganSK]

I just told you. Nursing is it's own science and profession, contributing it's own knowledge to healthcare (e.g., Care delivery models made by nursing theorists used in healthcare systems nationwide). We need PhDs and DNPs to be the ultimate authority in our profession, nurses to guide our professional fates (not physicians), and to teach the future generation of nurses.

All the reasons you are stating here can be done at the BSN/NP level, there is no need for a DNP degree. You can literally get a DNP online within a short time and some cash. It's a disgrace to the rest of the nursing community.

If you guys wanted to be a called "Physician" then you should have gone to medical school. Period.

 

[FNP_Blix]

That’s literally the answer I asked you not to spew because it doesn’t address the why that is necessary question. Until you can give us an answer and an explanation why DNPs are necessary (not going to touch on PhDs because they are not necessary) please stop. Sorry OP for contributing to derailing your thread


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That is a valid answer though. We don't need physicians telling nurses how to deliver care. DNPs and PhD nurses are the one's developing care models that ensure quality in nursing care. This translates to various things like cost effectiveness, nosocomial infection prevention, and patient compliance, among many other things. Nurses are the experts in medical and healthcare services implementation. But to back up what we do, we need evidence based studies to demonstrate nurse's value and effectiveness. That is where the DNP and PhD nurses come in. They are the ones contributing to this body of knowledge. This includes nurse practitioners as well. DNPs are better prepared than MSNs to take already existing evidence based research and apply it to a practice setting. They also possess investigator capabilities and have expertise in research, research statistics and epidemiology.

 

[SurgDoc95]

That is a valid answer though. We don't need physicians telling nurses how to deliver care. DNPs and PhD nurses are the one's developing care models that ensure quality in nursing care. This translates to various things like cost effectiveness, nosocomial infection prevention, and patient compliance, among many other things. Nurses are the experts in medical and healthcare services implementation. But to back up what we do, we need evidence based studies to demonstrate nurse's value and effectiveness. That is where the DNP and PhD nurses come in. They are the ones contributing to this body of knowledge. This includes nurse practitioners as well. DNPs are better prepared than MSNs to take already existing evidence based research and apply it to a practice setting. They to possess investigator capabilities. They have expertise in research, research statistics and epidemiology as well.

Yeah no. That is a dangerous line of thinking that nurses and that the nursing profession does not and should not go down. With that line of thinking, how long is it until you start believing nurses don’t need to answer to physicians at all and can choose the best treatment plan for patients? A nurse is a nurse and has a very set role in care delivery. If you don’t like your scope of practice or want true autonomy go to medical school. If you don’t believe that a physician should have the end say in patient care then you are part of the problem and not the solution.


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[FNP_Blix]

Yeah no. That is a dangerous line of thinking that nurses and that the nursing profession does not and should not go down. With that line of thinking, how long is it until you start believing nurses don’t need to answer to physicians at all and can choose the best treatment plan for patients? A nurse is a nurse and has a very set role in care delivery. If you don’t like your scope of practice or want true autonomy go to medical school. If you don’t believe that a physician should have the end say in patient care then you are part of the problem and not the solution.


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Related to medical decisions, yes, physicians are the ultimate authority. But not with nursing, and most certainly not with all of healthcare.

 

[SurgDoc95]

Related to medical decisions, yes, physicians are the ultimate authority. But not with nursing, and most certainly not with all of healthcare.

Nursing care no, but healthcare as a whole and especially medical decisions yes physicians should be.


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[SterlingMaloryArcher]

Nursing is currently in dire need of doctorally prepared clinicians, researchers, and professors. The objective of the DNP is to have more qualified nursing professors, investigators, and stronger clinicians. There is debate in the nursing world as well if the DNP actually creates a stronger clinician. However, a DNP will be able address broader issues in healthcare and nursing as equal members at the table. Nurses should always be able to guide their own fates, govern their own profession, and have an equal say in how healthcare is delivered in this country. A DNP will promote that.

And their is no propaganda that we are trying to push. We are addressing a real shortage to medical services in both rural and urban areas, across multiple specialties. With an additional 20 million people now insured through the ACA, the nurse practitioner has a relevant role delivering healthcare services. Physicians cannot do this alone.

TBH I think healthcare has a "too many chiefs, not enough indians" problem

 

[FNP_Blix]

Nursing care no, but healthcare as a whole and especially medical decisions yes physicians should be.


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There are many players that make decisions in how healthcare should be ran in this country. Physicians are no better than nurses when it comes to this decision making process. Nurses are equally important as we are at the front lines and constitute the largest sub set of healthcare provider in all of healthcare. We have enormous influence and like physicians, can bring healthcare in this country up, or to a screeching halt. That is, in part, why advanced practice nurses have been able to proliferate like they have. We have over the years been able to demonstrate our value and have been there to answer the call in multiple eras and arenas, including medicine's lowest moments (i.e., physician shortage mitigation).

 

[FNP_Blix]

TBH I think healthcare has a "too many chiefs, not enough indians" problem

This may be so, but physicians have been acting as the only chief for too long. There are other players in the game, and we deserve a say as well, especially nursing.

 

[SterlingMaloryArcher]

This may be so, but physicians have been acting as the only chief for too long. There are other players in the game, and we deserve a say as well, especially nursing.

Yikes!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[SurgDoc95]

There are many players that make decisions in how healthcare should be ran in this country. Physicians are no better than nurses when it comes to this decision making process. Nurses are equally important as we are at the front lines and constitute the largest sub set of healthcare provider in all of healthcare. We have enormous influence and like physicians, can bring healthcare in this country up, or to a screeching halt. That is, in part, why advanced practice nurses have been able to proliferate like they have. We have over the years been able to demonstrate our value and have been there to answer the call in multiple eras and arenas, including medicine's lowest moments (i.e., physician shortage mitigation).

No the nursing profession is so vast in numbers that telling you no simply wasn’t possible. Nobody is discrediting the work nurses do as they are very important. What’s being disputed is the role and the need to doctorate level trained nurse practitioners. They are NOT needed except for those in the nursing profession who, like you it seems, are hell bent on making sure physicians and apparently med students recognize you as equals. It is an ego inflator and not necessary for healthcare in our country. I’m obviously not going to convince you, but just know that virtually none of us, the next and current generation of physicians, agree with what your selling.


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[FNP_Blix]

No the nursing profession is so vast in numbers that telling you no simply wasn’t possible. Nobody is discrediting the work nurses do as they are very important. What’s being disputed is the role and the need to doctorate level trained nurse practitioners. They are NOT needed except for those in the nursing profession who, like you it seems, are hell bent on making sure physicians and apparently med students recognize you as equals. It is an ego inflator and not necessary for healthcare in our country. I’m obviously not going to convince you, but just know that virtually none of us, the next and current generation of physicians, agree with what your selling.


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Until physicians concede to the fact that nursing are equal players in healthcare, then we won't get anywhere with this discussion. I already explained to you the value of the DNP, so not going to repeat myself on that one.

 

[SurgDoc95]

Until physicians concede to the fact that nursing are equal players in healthcare, then we won't get anywhere with this discussion. I already explained to you the value of the DNP, so not going to repeat myself on that one.

That won’t happen. Nurses are a vital cog in keeping a hospital running but you essentially just stated why the DNP was created. It’s an artificial way to force physicians to recognize you as “equal” and has no real benefits to patient care.


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[FNP_Blix]

That won’t happen. Nurses are a vital cog in keeping a hospital running but you essentially just stated why the DNP was created. It’s an artificial way to force physicians to recognize you as “equal” and has no real benefits to patient care.


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Then you and I, or any other nurse will have nothing to really talk about. There will always be discord between our two professions, and nursing will always and forever continue to seek it's own path away from medicine. At least I know I will. I will lead the next generation, and get politically involved to take nursing even further than it has. Until then, we will continue to take our progress in strides.

 

[SurgDoc95]

Then you and I, or any other nurse will have nothing to really talk about. There will always be discord between our two professions, and nursing will always and forever continue to seek it's own path away from medicine. At least I know I will. I will lead the next generation, and get politically involved to take nursing even further than it has. Until then, we will continue to take our progress in strides.

What you should do is stop being automatically standoffish when it comes to this topic. From the very start of your time on this thread you have been aggressive and pushing an agenda and that’s the least effective way to get any of us to listen to you. Best of luck to you but it’d be appreciated if you’d stop posting on threads that have nothing to do with the agenda you seek to push.


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