Steven, this is your first post in several years. Are you currently a medical student somewhere?
Indeed, almost done, but sad to see how the future docs are going in to a medical field that is being taken over in front of their faces and do nothing to stop it. So sad, so sad... by the way BBender , was it necessary to make fun of my post , here is your wake up call, and my proof, check it out.
Hey we forgot to laugh about this, check out what I found on the Internet, lets all laugh about how they take our jobs. I especially like the part where I cite the Precedent of the AAFP(AMA delegates) criticizing what is going on, I am sure he is a clown in his work, yea right, grow up people , this isnt south park, its America, and your studying to lose your job to an NP, no matter how you slice it. Get it? And by the way, to be a Doctor, you have to be a mature person, just a little tip for you guys.
AMA Delegates Oppose DNPs as Medical Team Leaders
Midwifery, Medical Imaging Also Topics at Annual Meeting
By Cindy Borgmeyer Chicago
6/25/2008
Delegates at the recent annual meeting of the AMA House of Delegates here left little room for doubt when it came to their views on the appropriate role of nurses in patients' medical care. Although nurses -- including those with a terminal degree in nursing -- are welcomed as part of the medical team, physicians still need to take the lead.
Despite strongly worded opposition from national nursing organization representatives who attended the meeting, the delegates adopted a resolution that called for new AMA policy stipulating that doctors of nursing practice, or DNPs, "must practice as part of a medical team under the supervision of a licensed physician who has final authority and responsibility for the patient."
The delegates further directed the AMA to oppose a recent move by the National Board of Medical Examiners, or NBME, which earlier this spring announced (6-page PDF; About PDFs) it would develop and administer a certification exam for graduates of DNP programs.
ACADEMY TESTIMONY FOCUSES ON DNP SCOPE, CLINICAL TRAINING
AAFP President-elect Ted Epperly, M.D., of Boise, Idaho, clearly voiced the Academy's support for the resolution during testimony to the AMA Reference Committee on Legislation on June 15, citing multiple concerns the AAFP has previously expressed (Members Only) about the DNP issue.
Perhaps chief among those concerns are the precise nature of the nursing practice doctorate and the vast differences in clinical training requirements between the DNP degree and a medical or osteopathic doctorate, Epperly noted.
"The current doctor of nursing practice refers to nurses who have a doctorate for reasons of education, research and scholarly work," he said. "It is not a clinical doctorate."
In fact, Epperly added, a DNP candidate completes only about 500 hours of additional training after receiving his or her master's degree. "That compares to about 9,000 to 15,000 hours of work that it takes a physician to become a primary care physician and a true doctor," he said.
In his testimony, Epperly also criticized the NBME's recent announcement that it would begin administering an assessment exam to graduates of DNP programs, saying the national board had "crossed the line" in making this decision. "This is not the National Board of Nursing Examiners, it's the National Board of Medical Examiners," he noted.
NBME LAYS OUT PLANS TO ADMINISTER DNP EXAM
In a recently published article in The National Board Examiner (6-page PDF; About PDFs), the National Board of Medical Examiners described its plans to administer the doctor of nursing practice, or DNP, exam.
"The DNP examination will assess the knowledge and cognitive skills necessary to support advanced clinical practice by DNP graduates. It will be comparable in content, similar in format and will measure similar competencies and apply similar performance standards as Step 3 of USMLE," the article reads, referring to the U.S. Medical Licensing Examination.
"Step 3, the last in the USMLE sequence of examinations, provides a final assessment of physicians assuming independent responsibility for delivering general medical care," the Examiner article continues. "The DNP examination will assess some of the competencies assessed by Step 3 and will be administered to DNP graduates for the first time in November 2008."
NURSES DENOUNCE AMA'S DNP MEASURE
Following up on a June 11 letter (3-page PDF; About PDFs) from the American Nurses Association, or ANA, to the reference committee, Eileen Carlson, J.D., R.N., associate director of government affairs for the ANA and an official observer from that association to the AMA House, spoke against the resolution in the reference committee hearing. She urged that the measure be withdrawn or defeated, noting that the nursing community views this issue as one of expanding access to care and pointing out that some 22 states now permit some level of independent nurse practice.
Finally, Carlson questioned the AMA's attempt to intercede in what she said the nursing profession sees as an internal issue. "It is no more appropriate for the AMA to regulate nursing practice than it would be for the ANA to regulate medical practice," she told reference committee members.
WHEN IS A DOCTOR NOT A DOCTOR?
Another point Epperly made in his reference committee testimony on the DNP resolution -- that use of the term "doctor" in a clinical care setting can mislead patients if it's not reserved solely for physicians -- also pertains to another measure AMA delegates adopted June 17. That resolution calls for the AMA to "advocate that professionals in the clinical setting clearly and accurately identify to patients their qualifications and degree(s) attained." The resolution also directs the AMA to develop model legislation to help states implement that action and to support state legislation that would make misrepresentation a felony.
AMA delegates also dealt with numerous other professional issues, adopting resolutions that call for the AMA to:
advocate for licensure only of those nurse-midwives who have been certified by the American College of Nurse-Midwives,
support state legislation requiring appropriate physician and regulatory oversight of nurse-midwives,
continue to monitor states' midwifery licensure and scope of practice activities,
work with state medical societies and medical specialty organizations to safeguard maternal and neonatal health with regard to midwifery issues,
support state legislation acknowledging that hospitals or appropriately regulated birthing centers are the safest settings for labor and delivery,
oppose legislative and regulatory efforts to restrict the delivery of advanced imaging services provided by qualified physicians in accordance with established clinical guidelines and technical standards, and
ensure that physicians of all specialties engaged in providing needed imaging services to their patients have an equal say in developing quality and efficiency measures for those services.
Rather than a generic focus of education, Nurse Practitioners are able to specialize in an area of study they desire (e.g. Pediatrics, Family Practice, Adult, Geriatric, etc.), and provide care within the scope of their expertise. As well, Nurse practitioners in certain states can be psychiatric clinicians and perform similar practice (though at a different level) as a psychiatrist would.
Salary.com: Nurse Practitioner salary (25th-75th percentile) is $67,166 $78,497. Generalist physician salary (25th-75th%) is $115,260 $152,715.
Wikipedia: According to numerous salary reports throughout the years, CRNAs remain the highest compensated of all nursing specialties. Their average reported annual salary range in 2006, reported by the AMGA Medical Group Compensation and Financial Survey, was $140,396. The mean annual salary for an anesthesiologist in the United States in 2006 was $184,340. [1]
Whats my point? Fair question. First, NPs have the same scope of practice as any physician. This is clear from my first statement about NPs specializing. Whatever specialty you want as a physician, theres an NP that can do the same thing. But surely not for surgery?! is the cry of retort. Well I promise you that within the next 10 years, some politician is going to realize that Hey! PAs and Surgical Techs can pop out gallbladders just as well as a surgeon can!
Also note the salary differences. Now I cant find information regarding the various NP specialties, but compare the lowest specialty to the most basic NP, the salaries are comparable, and the highest NP position to the highest (according to MSN.com) paid physician. When you do, youll note that physicians do, in fact, win. And NPs must do 2 years of post bachelors work and one year of work experience (for a total of 3 years) compared to the 4 years post-undergrad for a physician. Big whoop. One year.
Well please note, the average med student graduates with around $200K in debt, while, according to Barry.edu (a school in FL that has both NP and PA programs) the PA program (the more expensive of the two) is $24,810.00 per year. This is roughly equivalent to medical school. However, youre paying twice as much in med school because you go to school for twice as long. Also, one of the 3 requisite years for NP school is clinical experience. This is a paid job. RNs make (again, 25th-75th%) $49,479 $59,114. That means that if a med student and an NP were compared at the same time, 4 years post undergrad, the med student would be out $200,000 (roughly) and the NP would be out $521 (rounding to $25K/yr for both programs, and using the 25th percentile for RNs). Add the interest on a med school loan, and that puts you at about $600,000 paid back (bc you pay back about 3x what you borrow, esp the financial geniuses that make up our MD population).
Now lets say that no matter what you do, you make $30,000/year more than your equivalent NP. You figure that after 30 years of practice (putting you at the nice comfortable retirement age of 66 for those of us that took the direct route) and youre up $900K. Worth it, right? Well we havent incorporated malpractice insurance. Have you ever heard of anyone suing their NP? I sure as **** havent. Factor in 30 years of malpractice insurance bills, and Ill promise you it brings you right back to even (not to mention that physicians salaries are trending down relative to inflation while all nursing salaries are trending up). Couple that with the hours worked by an NP relative to an M.D. and the paperwork/legal hassles handled by an MD that arent worried about by NPs, and the conclusion is obvious.
Do the same thing for the same amount of money, and have a better quality of life. Become an NP.
NBME Development of a Certifying Examination for Doctors of Nursing Practice
This white paper delineates the National Board of Medical Examiners (NBME) rationale for providing assessment services to the Council for the Advancement of Comprehensive Care (CACC)*, a leadership group in the Doctor of Nursing Practice (DNP) community. Through articulation of the rationale for developing this examination, this document reaffirms the NBMEs commitment to its mission to protect the health of the public by providing high quality assessment services to healthcare professional organizations. NBME Mission To protect the health of the public through state of the art assessment of health professionals. While centered on assessment of physicians, this mission encompasses the spectrum of health professionals along the continuum of education, training, and practice and includes research in evaluation as well as development of assessment instruments. The NBME has a tradition of assisting many health professions in developing assessment instruments to assess qualifications and assure patients that individual professionals meet standards defined by their profession. NBME initially provided voluntary certification for physician licensure; however, for nearly 50 years, NBME has provided assessments for a range of others in the health professions. In addition to the several American Board of Medical Specialties member boards and other medical professional organizations currently served, NBME clients also include the American Association of Medical Assistants, the American Physical Therapy Association, and the National Commission for the Certification of Anesthesiologist Assistants. The NBME first assisted in the preparation of assessments for advanced practice nurses and physician assistants more than 30 years ago. Providing a DNP certification examination is aligned with the NBMEs mission and its history.
* Since the initial agreement between the NBME and CACC, CACC has established the American Board of Comprehensive Care as the certifying body for DNPs (see
http://www.abcc.dnpcert.org/about.shtml).
2
The CACC Certifying Exam On March 17, 2008, the National Board of Medical Examiners (NBME) entered into a contractual agreement with the Council for the Advancement of Comprehensive Care (CACC) to develop a certification examination for qualified graduates of Doctor of Nursing Practice (DNP) programs across the United States. The Certification Examination will assess the knowledge and skills necessary for nurse clinicians to provide safe and effective patient-centered comprehensive care. The Certification Examination is envisioned as one element of a three-part process for DNP certification. Candidates must first possess an active license as an advanced practice nurse. Second, they must successfully complete the educational requirements of the DNP program. The DNP degree builds on nursing licensure as an advanced practice nurse by adding expanded coverage of the knowledge and skill relating to both the nursing and medical aspects of care for complex illness. Finally, successful candidates must pass the certification examination. The examination is intended to offer an additional level of assurance to the public that graduates from the various educational programs have met a similar standard with regard to the domains assessed in the certification process. The DNP Certification Examination utilized the test blueprint developed for USMLE Step 3 as a basis for its design; however, a CACC-appointed expert committee made final decisions regarding the actual test design to be used, and the resulting design has different dimensions than the Step 3 examination. The exam will utilize test items previously used in the USMLE Step 3 examination; no items in current use in USMLE will appear in the CACC exam. The CACC-appointed expert committee will establish its separate pass/fail standard, informed by information about the pass/fail standard for USMLE Step 3. The exam will be shorter than USMLE Step 3, will contain a different mix of multiple-choice questions, and will initially not use the computer-based patient management simulations that are part of USMLE Step 3, although this test format will be added in the future. CACC will define eligibility requirements for taking its examination; these requirements will differ substantially from USMLE Step 3 requirements, for example, no formal clinical skills assessment or test of fundamental science knowledge will be prerequisites.
Mayo School of Health Sciences
I Love the Program goals, check them out, seem familiar, kind of like training to be a MD. Hahahah, you guys still dont get it.
Program Description
Mayo School of Health Sciences (MSHS) offers a Cardiology Nurse Practitioner (NP) Fellowship which accepts one new graduate per year from an accredited nurse practitioner school. As a result of the program experience, the fellow will to be more competitive for cardiology specialty nurse practitioner positions and have increased security in the job market.
The fellow will be selected after submitting three letters of recommendation, transcripts from baccalaureate and masters schools, statement of personal intent and the interview process. The NP must have an Arizona NP license and Drug Enforcement Administration (DEA) provider number at the onset of the program. A 12-month didactic program will provide clinical experience in all aspects of cardiovascular disease including: cardiac diagnostics, cardiac health and prevention, interventional cardiology, electrophysiology cardiology, peripheral vascular disease, valvular heart disease, advanced heart disease and adult congenital heart disease. These rotations are primarily at inpatient setting at Mayo Clinic Hospital (MCH) but may have limited rotations with subspecialty providers at outpatient settings at Mayo Clinic Specialty Building (MCSB). A certification of completion will be provided by the Mayo School of Health Sciences upon completion of the program.
The didactic program will provide 300 didactic/classroom hours and 1,700 clinical/preceptored hours. The didactic learning will consist of Cardiology Rounds, Cath Lab Conferences, Echo Conferences, EP Conferences, lectures, research utilization, journal clubs, self-learning case studies
Program Goals
The Cardiology Nurse Practitioner Fellowship aims to help the participating fellow:
Understand cardiovascular diseases pathophysiology, clinical presentations and prognosis
Develop diagnoses, formulate a treatment plan and follow-up on patient response to treatment
Discuss evidence-based medicine practices using highest-quality cost-effective care
Develop organizational skills to manage patient caseload throughout hospital stay including admission, daily rounds and dismissal, while remaining cognizant of the patients emotional, physical and spiritual needs
Educate patient and families regarding disease process including primary and secondary cardiac prevention
Develop effective communication skills with collaborating physicians and allied healthcare team
Transition student to nurse practitioner role
Accreditation
Continuing Medical Education (CME) hours will be provided by Medical Education for medical conferences sponsored by Mayo Clinic and Continuing Education Unit (CEU) hours for nursing licensing renewal will be provided by nursing approved courses at Mayo Clinic and outside national educational conference allotted in this program. Mayo Clinic Arizona will be applying for American Nursing Credentialing Center (ANCC) CEUs for formal lectures throughout the hospital rotations.
