FMbound said:
FPs need to provide a better service to compete. NPs have a tendency to be kinder to the patient, but don't always have all the answers. If FPs can be kind and provide patient education, I think that will translate to a better product and people will want an FP.
I would much rather see an MD than NP, but not when the MD is a goof.
Folks, if you went through seven years of training (medical school and residency) to learn a career that can be performed by somebody with two years of training then I suggest you call your medical school and demand a refund.
The fact is that in any profession, a large part of the work is of a fairly routine nature which can be handled by a reasonably intelligent high school graduate. When I was an engineer for example, I didn't spend my whole day working on breathtakingly novel, ground-breaking engineering calculations. A lot of my day was spent doing fairly mundane things like detailing drawings, plugging numbers into sophisticated structural analysis programs, or estimating costs.
Interestingly enough, there is a class of engineering employee called
design-draftsmen who's job it is to help engineers with some of the grunt work of engineering. They are roughly analogous in the engineering profession to PAs and NPs in the medical profession. That is, they are intelligent, well-trained technicians who usually have an Associates degree in their field.
A good design-draftsman is an asset to any engineering firm and we used to pay pretty good money to keep them working for us. On the other hand, design-draftsmen are not engineers and typically (but not always) lack the knowledge to be both
responsible and
accountable for a project.
I suspect it is the same with PAs and NPs. It doesn't take a medical degree, for example, to know the tests to order and the treatment for garden variety stable angina. I'm sure most MICU or ED nurses know exactly what to do for even more serious problems than that. On the other hand the same nurses might find their knowledge taxed by a more complicated patient.
I am not saying that every physician is a veritable Marcus Welby or that NPs can't understand complicated patients. Obviously some very intelligent people choose to be PAs or NPs because they don't think the benefits of medical school outweigh the time commitment. On the other hand, in the aggregate, the entire system of medical education is set up to ensure that physicians are well-trained and capable, without question, of being responsible for patient care in every situation.
In other words, you are being paid the big bucks for ten percent of your work week when you are not on auto pilot.
This does not apply to neurosurgeons and the like, of course, who's
every action requires precision and skill which cannot be learned in two years.
As you may know, I failed to match into emergency medicine and had to settle for low-prestige family medicine residency program in the hinterlands of North Carolina at a backwater called Duke. Apparently the town of Durham doesn't even have street lights. Since I am new to the family medicine community here on SDN I am amazed at the attitudes around here. I have never had anything but respect for the various family medicine physicians I have encountered in medical school and it has never occured to me that they could be replaced by NPs or PAs. They are, with apologies to specialists, physician's physicians. Real doctors, so to speak, who's knowledge is broad and while not as deep as a typical specialist's in his field not shallow either.
I suspect that a lot of you who have not started medical school yet or are still in first and second year will realize that there is a vast difference in the knowledge base of Physician compared to an NP.
) I just want to thank those of you that rely on facts and not rumor and realize that although there are similarities between PAs and NPs there are evolving important differences!!
