NP's required to have doctorates in 2012...anyone else see issues with this?

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eOh the most annoying thing happen to me in high school. Just wanted to share. My HS statistics teacher got a PhD online in Statistics from Colorado State. It was mid-way in the semester and he would correct everyone and say: "It's Dr. ____ NOT Mr. ____".

NO one called him DR the whole semester and it drove him nuts....🤣
 
She wasn't 'stirring the pot' so much as she was pointing out how things work in her state. Well, at least if you ignore the ridiculous/unsubstantiated "physicians are a dying breed" claim... :laugh:

Seriously, though, who cares what Nurse Practicioners call themselves? Frankly, I think it would be easier if they went by 'Dr'. There are nurse practicioners at the clinic where I volunteer, and I never know what to call them... :laugh: Seriously, just calling them Dr. Smith would be so much easier.

In my State, more and more student/Physicians are unwilling to spend 10-12 years in College just to give up 50% of their profits (before taxes) on insurance, so a lot of them are moving into specialties leaving a huge need for more Physicians.
 
In my State, more and more student/Physicians are unwilling to spend 10-12 years in College just to give up 50% of their profits (before taxes) on insurance, so a lot of them are moving into specialties leaving a huge need for more Physicians.

And apparently those 10-12 years in college aren't really necessary to care for a patient's life. Lets forget about minimum GPAs and MCATs. Instead we should all just coast through college and become a DNP and call ourselves doctor! 👍

In case anyone here was wondering, the education a DNP receives is MUCH different than that of a physician. There is very little biomedical science and virtually no pathophysiology of disease. I will leave it at that. Them calling themselves 'doctor' is the least of our concerns. The fact that they think they are qualified to care for patients with multiple complex comorbidities is what is alarming.
 
In my State, more and more student/Physicians are unwilling to spend 10-12 years in College just to give up 50% of their profits (before taxes) on insurance, so a lot of them are moving into specialties leaving a huge need for more Physicians.
The problem there is that DNP does NOT equal Physician. If there's a doctor shortage and doctors/hospitals want DNPs to take on some of the load under proper supervision, then that's fine. I don't think anyone has a problem with that.

But allowing DNPs to practice completely independently and market themselves to the public as doctors is, in my opinion, a slippery slope. What's next? A unknowing patient wanders into a clinic run by Doctors of Medical Assistantry, thinking that they're being treated by MDs? 🙄

For further explanation, see what I wrote on the other thread: http://forums.studentdoctor.net/showthread.php?p=8955467#post8955467
 
The problem there is that DNP does NOT equal Physician. If there's a doctor shortage and doctors/hospitals want DNPs to take on some of the load under proper supervision, then that's fine. I don't think anyone has a problem with that.

But allowing DNPs to practice completely independently and market themselves to the public as doctors is, in my opinion, a slippery slope. What's next? A unknowing patient wanders into a clinic run by Doctors of Medical Assistantry, thinking that they're being treated by MDs? 🙄

For further explanation, see what I wrote on the other thread: http://forums.studentdoctor.net/showthread.php?p=8955467#post8955467

Though I understand you general argument (which is the most common) I disagree with the implication that people/patients are so ignorant that they are unable differentiate between a MD and a DNP and how the difference would effect their treatment. I give the public much more credit than that. I have a DNP I see for most things but I know there are certain conditions I would not go see him for. People are much smarter than the you may be giving them credit for.
 
Though I understand you general argument (which is the most common) I disagree with the implication that people/patients are so ignorant that they are unable differentiate between a MD and a DNP and how the difference would effect their treatment. I give the public much more credit than that. I have a DNP I see for most things but I know there are certain conditions I would not go see him for. People are much smarter than the you may be giving them credit for.

What a person in training to become a DNP is able to differentiate is not necessarily the same as what the general populous would. I could care less what DNP's call themselves, but there is a valid concern about complete autonomy for DNP's. It seems you see no difference between DNP and MD, you seem to imply care would not be different. That is what most here have a problem with, and to be honest, bothers me a bit thinking of where this could lead.

I learned the most from a NP while shadowing, she was amazing and knew more than lots of the physicians (combined). That being said her training is in patient care, which is exactly as it should be, but not exactly the same as MD. If you want to be a physician go to med school and do it....
 
"It seems you see no difference between DNP and MD, you seem to imply care would not be different."

Huh? I find it weird that you got that idea from this sentence

"I have a DNP I see for most things but I know there are certain conditions I would not go see him for. People are much smarter than the you may be giving them credit for."

It seem to me my point was that there is a "DIFFERENCE". I doesn't take my one year of college to deduce the difference between a DNP and an MD.
 
Huh? I find it weird that you got that idea from this sentence

I doesn't take my one year of college to deduce the difference between a DNP and an MD.

Actually I was taking it from your earlier posts:

I will be practicing in AZ where DNPs have complete autonomy with no legal requirement for MD oversight. I will be working in my own practice as a general practician. In my state I would be considered a Dr. (hence the doctorate) and can/must refer to my self as a Dr and DNP. Both set of letters must be in my title. I know this makes a lot of MD's pre-MD's nervous and upset but you have to understand that physicians are a dying breed do to the Political/economic environment. DNP's are only filling a medical void. Not creating one.

so a lot of them are moving into specialties leaving a huge need for more Physicians.

First let me say I'm not trying to upset you or anything, in fact if you read the first of the thread I was one of the ones who said I didn't care what DNP's called themselves. Also I misread and thought you were actually in a DNP program, that your not explains quite a bit. Not trying to be mean but you have alot to learn still about the whole issue and practice of medicine (as do I). I've been in healthcare for probably longer than you have been in school of any kind so thats why I joined in the discussion.

Your posts are worded in such as way as to imply your going to be a physician, thats why I responded as I did. The simple fact that you said you must refer to yourself as Dr. should have alerted me. I have no problem with NP's or DNP' or PhD's who call themselves Dr. I really dont. I just have a problem with people expecting to partake in patient care in a manner different or out of context with their training. I would say the same thing to an MD specialist say a thoracic surgeon, trying to handle longterm medical issues. (just an example guys, pipe down).
 
why does everyone need a doctorate? if you're unwilling to put the time/effort to become an MD/DO, then I don't think we should create new degrees to appease everyone, so they can get their jollies off being called doctor. if they want nurses to get more training, great; but I see no need in arbitrarily creating new degrees. why not just change the requirements for NP to incorporate more training?
 
why does everyone need a doctorate? if you're unwilling to put the time/effort to become an MD/DO, then I don't think we should create new degrees to appease everyone, so they can get their jollies off being called doctor. if they want nurses to get more training, great; but I see no need in arbitrarily creating new degrees. why not just change the requirements for NP to incorporate more training?

Same reason we now give out multiple gold medals at the Olympics.....
 
Actually I was taking it from your earlier posts:





First let me say I'm not trying to upset you or anything, in fact if you read the first of the thread I was one of the ones who said I didn't care what DNP's called themselves. Also I misread and thought you were actually in a DNP program, that your not explains quite a bit. Not trying to be mean but you have alot to learn still about the whole issue and practice of medicine (as do I). I've been in healthcare for probably longer than you have been in school of any kind so thats why I joined in the discussion.

Your posts are worded in such as way as to imply your going to be a physician, thats why I responded as I did. The simple fact that you said you must refer to yourself as Dr. should have alerted me. I have no problem with NP's or DNP' or PhD's who call themselves Dr. I really dont. I just have a problem with people expecting to partake in patient care in a manner different or out of context with their training. I would say the same thing to an MD specialist say a thoracic surgeon, trying to handle longterm medical issues. (just an example guys, pipe down).

My Post are not worded in a way that implies am going to be a Physician. I come from a Family of Doctors. My Father has a PHD in Psychology (his patients call him Dr.), My Brother is a Physician (his patients call him Dr.) and my Younger Brother is a DDS (his patients also call him Dr.). So I have a general understanding of the medical establishment. Why are we not complaining about them being refer to as Dr.'s. I think it is because MD's and Do's feel there 10-12 years of schooling is being undermind by the DNP programs. I is alot more about sore toes that it is about facts. Also, I never said I must refer to myself as a Dr and why that would raise any flags I don't know, are you a legal scholar also? I said "can/must" which is totally different and held it's own context. So what what your point? The only thing you said was that I am uneducated and don't know what I am talking about.
 
. My Father has a PHD in Psychology (his patients call him Dr.).

He isn't referred to as "doctor" when he's in the hospital setting (possibly with the exception of a psych ward). Patients are not as smart as you give them credit for. To them, when they are in a hospital bed and someone introduces themselves as "doctor", the pt believes this is their MD/DO. End of story.
 
My Post are not worded in a way that implies am going to be a Physician. I come from a Family of Doctors. My Father has a PHD in Psychology (his patients call him Dr.), My Brother is a Physician (his patients call him Dr.) and my Younger Brother is a DDS (his patients also call him Dr.). So I have a general understanding of the medical establishment. Why are we not complaining about them being refer to as Dr.'s. I think it is because MD's and Do's feel there 10-12 years of schooling is being undermind by the DNP programs. I is alot more about sore toes that it is about facts. Also, I never said I must refer to myself as a Dr and why that would raise any flags I don't know, are you a legal scholar also? I said "can/must" which is totally different and held it's own context. So what what your point? The only thing you said was that I am uneducated and don't know what I am talking about.

Whoa there tiger, calm down.

Re-read my posts, I never said anything about having a problem with people being called doctor....I believe thats three times now in this thread I've said it. Misplaced hostility much? (Dang, anyone remember that old 311 song misdirected hostility? Just thought of it...showing my age....ADD wut?).

Sorry, anyway.

My issue is with your posts, not your grasp of the medical "establishment".
Not sure where the "legal scholar" came in, but yes its a hobby of sorts. My brother is a constitutional attorney working in the supreme court. Again, my ADD is getting the better of me.

Bottom line here man, your attacking the wrong person. I have no issue with you or anyone else being called Dr. I have a problem with people trying to or expecting to be involved in patient care beyond their training.

I think I just figured out your hostility. Family all highly educated, you still in undergrad.... Dont take it out on me man, I'm just pointing out what I see. You came in here and starting posting things like your "viewed as a physician", you "must refer to yourself as Dr.", your taking up slack for a lack of physicians....etc. I never said you were uneducated or stupid, stop trying to read stuff into my posts, you seem a little hostile buddy.
 
Not sure where the "legal scholar" came in, but yes its a hobby of sorts. My brother is a constitutional attorney working in the supreme court.
That's awesome. Which justice does he work for?
 
I do question the title of doctor for DNPs because the DNP curricula doesn't really expand their clinical knowledge much. It's just a bunch of fluff courses (ie. nursing theory/activism, stats) thrown in, for the most part. Here's an old post of mine discussing the differences between NP/DNP and medical school curricula:

Here's a sample curriculum from a BSN-DNP program (at Duke): http://nursing.duke.edu/wysiwyg/downloads/Sample_Post_BSN_DNP_Adult_MAT_Plan.pdf

You need 73 credits to go from a college degree to a doctorate. That turns out to be less than 3 years.

Now, let's look at the fluff courses that aren't really clinically useful: Research Methods (3 credits), Health Services Program Planning and Outcomes Analysis (3 credits), Applied Statistics (2 credits), Research Utilization in Advanced Nursing Practice (3 credits), Data Driven Health Care Improvement (4 credits), Evidence Based Practice and Applied Statistics I & II (7 credits, since you told me medicine is not evidence based), Effective Leadership (2 credits), Transforming the Nation's Health (3 credits), DNP Capstone (6 credits), Health Systems Transformation (3 credits), Financial Management & Budget Planning (3 credits).

Here are the clinically useful courses: Population-Based Approach to Healthcare (3 credits), Clinical Pharmacology and Interventions for Advanced Practice Nursing (3 credits), Managing Common Acute and Chronic Health Problems I (3 credits), Selected Topics in Advanced Pathophysiology (3 credits), Diagnostic Reasoning & Physical Assessment in Advanced Nursing Practice (4 credits), Common Acute and Chronic Health Problems II (3 credits), Sexual and Reproductive Health (2 credits), Nurse Practitioner Residency: Adult Primary Care (3 credits), Electives (12 credits).

So, out of the 73 credits needed to go from BSN to DNP, 37 credits are not clinically useful. In addition, the number of required clinical hours is 612 hours (unless I miscounted something)!! Wow! And the NP program is designed the same way, with a bunch of fluff courses (11 credits out of 43 required are fluff) and requires 612 hours as well: http://nursing.duke.edu/wysiwyg/downloads/AdultPrimaryCareCurriculum_2.pdf





Here are the curricula to several other programs:
It's kinda scary how inadequate that training is in order to practice medicine independently. You can't really count prior nursing experience as time practicing medicine because you weren't practicing medicine during that time nor were you thinking in a medical manner (ie. the way a physician would). Nursing clinical hours might help you transition into medicine but they are NOT a replacement for medical clinical hours.





Now, just for comparison, let's look at a med school curriculum. I'll point out all the fluff courses here too. Here's an example from Baylor School of Medicine for M1/M2 (http://www.bcm.edu/osa/handbook/?PMID=5608) and for M3/M4 (http://www.bcm.edu/osa/handbook/?PMID=7463):

Fluff courses at Baylor School of Medicine during M1/M2 years ONLY: Patient, Physician, and Society-1 (4.5 credits), Patient, Physician, and Society-2 (6 credits), Bioethics (2.5 credits), Integrated Problem Solving 1 & 2 (10 credits).

Useful courses at Baylor School of Medicine during M1/M2 years ONLY: Foundations Basic to Science of Medicine: Core Concepts (14.5 credits), Cardiovascular-Renal-Resp (11.5 credits), GI-Met-Nut-Endo-Reproduction (14 credits), General Pathology & General Pharmacology (6.5 credits), Head & Neck Anatomy (4.5 credits), Immunology (5 credits), Behavioral Sciences (6.5 credits), Infectious Disease (13 credits), Nervous System (14 credits), Cardiology (4.5 credits), Respiratory (3.5 credits), Renal (4 credits), Hematology/Oncology (5 credits), Hard & Soft Tissues (3 credits), Gastroenterology (4 credits), Endocrinology (3.5 credits), GU/Gyn (3 credits), Genetics (3 credits), Age Related Topics (2.5 credits).

For only the M1/M2 years at Baylor, there's 162.5 total credits. Out of these 162.5 credits, 23 credits are fluff.

Core Clerkships during M3 (useful clinical training): Medicine (24 credits, 12 weeks), Surgery (16 credits, 8 weeks), Group A selective (8 credits, 4 weeks), Psychiatry (16 credits, 8 weeks), Neurology (8 credits, 4 weeks), Pediatrics (16 credits, 8 weeks), Ob/Gyn (16 credits, 8 weeks), Family & Community Medicine (8 credits, 4 weeks), Clinical Half-Day (includes Clincal Application of Radiology, Clinical Application of Pathology, Clinical Application of Nutrition, Clinical Evidence Based Medicine, Longitudinal Ambulatory Care Experience, and Apex -- 23 credits).





So, without even taking into consideration M4 electives and required subinternships (which are usually in Medicine and Surgery), medical students already have a far superior medical training than NPs or DNPs. Other examples of med school curricula:
You can get a BSN to DNP in about 3 years according to many programs I've looked at. Medicine involves 4 years of medical school and a minimum of 3 years of residency before allowing independent practice. Here's the math:





BSN to DNP: 2.5 - 3 years of training; longer if courses taken part-time; 600-1000 clinical hours!
BS/BA to MD/DO: 4 years med school + 3-5 years residency: 7-11 years of training; not possible part-time; clinical hours > 17000

To me, the DNP just looks like a glorified MPH. Take a look at Loyola's MSN to DNP program for example. Not "worthy" (if that makes sense) of the title of doctor, IMO. Not only that, there's no standardization of their education and you can earn a doctorate online while stepping foot on campus one week/semester or so. Yea, no thanks.

I honestly don't have a problem with midlevels. I do have a problem with midlevels pushing for independent rights and mandating all NPs to become "doctors" is one more step in that direction.
 
Whoa there tiger, calm down.

Re-read my posts, I never said anything about having a problem with people being called doctor....I believe thats three times now in this thread I've said it. Misplaced hostility much? (Dang, anyone remember that old 311 song misdirected hostility? Just thought of it...showing my age....ADD wut?).

Sorry, anyway.

My issue is with your posts, not your grasp of the medical "establishment".
Not sure where the "legal scholar" came in, but yes its a hobby of sorts. My brother is a constitutional attorney working in the supreme court. Again, my ADD is getting the better of me.

Bottom line here man, your attacking the wrong person. I have no issue with you or anyone else being called Dr. I have a problem with people trying to or expecting to be involved in patient care beyond their training.

I think I just figured out your hostility. Family all highly educated, you still in undergrad.... Dont take it out on me man, I'm just pointing out what I see. You came in here and starting posting things like your "viewed as a physician", you "must refer to yourself as Dr.", your taking up slack for a lack of physicians....etc. I never said you were uneducated or stupid, stop trying to read stuff into my posts, you seem a little hostile buddy.

Let relax a bit. There is no hostility here. Never in any of my post did i say anything to the effect that I "must be referred to as a Physician" you just pulled that out of thin air. here is my original post.

"I am pre-nursing right now. I am working towards my DNP degree. I will be practicing in AZ where DNPs have complete autonomy with no legal requirement for MD oversight. I will be working in my own practice as a general practician. In my state I would be considered a Dr. (hence the doctorate) and can/must refer to my self as a Dr and DNP. Both set of letters must be in my title. I know this makes a lot of MD's pre-MD's nervous and upset but you have to understand that physicians are a dying breed do to the Political/economic environment. DNP's are only filling a medical void. Not creating one."

No body here is upset. I am just here for some dialect. I have no problem with considering myself nothing less than a DNP and would only impress that as a practicing professional. My comment "must" (which was really can/must and was within context) pertains to legal classifications in my state. I "CAN" use the term Dr. while practicing and "MUST" use the classification of DNP. That why I asked if you where a legal scholar because you had an issue with that statement "must/can" was a legal clarification. If anyone feel DNP's are less less than competent to practice general healthcare that is a valid and understandable position that I would love to discuss however your claims of me having a sense of inferiority due to being an undergrad is just puerile and your condescension is immature showing your lack of intellectual integrity and professionalism which is one thing "I feel" the whole medical establishment needs a little work on.
 
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I do question the title of doctor for DNPs because the DNP curricula doesn't really expand their clinical knowledge much. It's just a bunch of fluff courses (ie. nursing theory/activism, stats) thrown in, for the most part. Here's an old post of mine discussing the differences between NP/DNP and medical school curricula:



To me, the DNP just looks like a glorified MPH. Take a look at Loyola's MSN to DNP program for example. Not "worthy" (if that makes sense) of the title of doctor, IMO. Not only that, there's no standardization of their education and you can earn a doctorate online while stepping foot on campus one week/semester or so. Yea, no thanks.

I honestly don't have a problem with midlevels. I do have a problem with midlevels pushing for independent rights and mandating all NPs to become "doctors" is one more step in that direction.

Well, you're cherry picking fluffy courses to make a point. I don't see why a pre med, such as yourself (or me), would be in any place to start disparaging future coworkers. The one thing that every opponent of DNPs is missing is a study that shows that patient outcomes are compromised when a DNP is their primary care giver. The study would also have to show that they would have been better off if they hadn't seen anyone, MD or DNP, since I would imagine that most states with completely autonomous DNPs are making such laws to fill a PCP void.

Also, a lot of doctoral programs aren't standardized. Professional programs often are, but there are indeed nursing boards that have to be passed. It seems odd to me that you're writing up any posts comparing two different curricula, given that you haven't completed (or started) either one.

Whether or not these degrees are necessary is a totally different discussion, but I don't think someone who's wrapping up their bachelors (or masters) has any place in determining what constitutes a "real" doctorate.
 
Well, you're cherry picking fluffy courses to make a point. I don't see why a pre med, such as yourself (or me), would be in any place to start disparaging future coworkers. The one thing that every opponent of DNPs is missing is a study that shows that patient outcomes are compromised when a DNP is their primary care giver. The study would also have to show that they would have been better off if they hadn't seen anyone, MD or DNP, since I would imagine that most states with completely autonomous DNPs are making such laws to fill a PCP void.

Also, a lot of doctoral programs aren't standardized. Professional programs often are, but there are indeed nursing boards that have to be passed. It seems odd to me that you're writing up any posts comparing two different curricula, given that you haven't completed (or started) either one.

Whether or not these degrees are necessary is a totally different discussion, but I don't think someone who's wrapping up their bachelors (or masters) has any place in determining what constitutes a "real" doctorate.
No. It's on them (NPs/DNPs) to show us that they're safe. It's not up to opponents to do a study showing otherwise. And I'm not cherry picking fluff courses; I went through their entire curricula. It's pretty much the same at every NP/DNP curricula I've looked at. Take a look yourself if you don't believe me. But I'm definitely not cherry picking any courses. Also, the NPs/DNPs pushing for indendency in primary care but this doesn't mean that they're not going to pursue specialties once they have a foothold; I know no one likes slippery slopes, but there's a good chance something like this might happen based on previous history of the nursing community encroaching more and more into medicine (ie. CRNAs, etc).

Why is it odd that I'm comparing curricula? I don't have to go through both in order to analyze them. I've gone through enough schooling to realize when I'm looking at BS and when I'm not. What do you think you learn in a course labeled nurse theory or activism? Definitely not pathophys. The DNP is a clinical degree. Where are the clinical courses? You don't need multiple stats courses to gain clinical competency. Why does it only take around 1000 clinical hours to gain a doctorate after a BSN when physicians aren't allowed to practice independently until they have >12000 clinical hours? There's already a nursing PhD if one wants to focus on research. The DNP is touted as a clinical doctorate, yet it offers not much more than an MPH.
 
Let relax a bit. There is no hostility here...

however your claims of me having a sense of inferiority due to being an undergrad is just puerile and your condescension is immature showing your lack of intellectual integrity and professionalism which is one thing "I feel" the whole medical establishment needs a little work on.

LOL.
Ok, so sense there is no hostility 🙄 allow me to be completely honest. First, I understand what you were trying to say now, your sentence structure and grammar was a little confusing. That being said you could have just explained yourself rather than go on the attack. Throwing "big" words around doesn't make your point (in fact it makes your posts seem ostentatious). If we want to talk about "puerile" how does someone being condescending show a lack of intellectual integrity? C'mon man, calm down and stop trying to write those "gotcha" phrases. Your not going to change any minds about DNP's and general practice that way. Bottom line is the "clinical" degree of DNP is lacking in clinical training. Call yourself whatever you like (for the fourth time) I have no problem with anyone using the title Dr. I just have a problem with the apparent lack of training for clinical degrees especially the DNP where they are touted as physicians. If the degree was more clinical in its training, I wouldn't have a problem at all. You will be much better received (on premed forums or among physicians) if you drop the superiority act and just communicate without trying to sound ubber intellectual.

I honestly don't have a problem with midlevels. I do have a problem with midlevels pushing for independent rights and mandating all NPs to become "doctors" is one more step in that direction.

I agree, using the title of doctor is moot in my mind, the idea of touting NP's as general practitioners with complete autonomy is where my issue begins. You want complete autonomy to practice medicine as a GP, go to med school. The training is simply different.

The one thing that every opponent of DNPs is missing is a study that shows that patient outcomes are compromised when a DNP is their primary care giver. The study would also have to show that they would have been better off if they hadn't seen anyone, MD or DNP, since I would imagine that most states with completely autonomous DNPs are making such laws to fill a PCP void.
Your missing the point. Its not opponents of DNP's, its opponents of DNP's training making them able to be physicians. I learned the most from a NP while shadowing, but her training is simply not that of a physician. The DNP training doesn't bridge that gap. Period.

Also, a lot of doctoral programs aren't standardized. Professional programs often are, but there are indeed nursing boards that have to be passed. It seems odd to me that you're writing up any posts comparing two different curricula, given that you haven't completed (or started) either one.

Whether or not these degrees are necessary is a totally different discussion, but I don't think someone who's wrapping up their bachelors (or masters) has any place in determining what constitutes a "real" doctorate.
First, nursing boards are just that, they are not USMLE or COMLEX.

Second, why exactly is it someone with an education can't look at and compare two sets of curriculum? The whole "you must experience it to understand" is trite. We aren't talking about knowing the material, but its acceptable that someone could understand enough about classes to compare these two curricula.
 
He isn't referred to as "doctor" when he's in the hospital setting (possibly with the exception of a psych ward). Patients are not as smart as you give them credit for. To them, when they are in a hospital bed and someone introduces themselves as "doctor", the pt believes this is their MD/DO. End of story.
Yeah, pretty much.
 
I have been forced to see a DNP a couple times in my life when I got sick up at college and away from my home. They are as good as a friend telling you to take advil when you have a headache...

OK... maybe not that bad, but still. Why would anyone in their right mind want to trust someone with less training/exprerience with their health? I was misdiagnosed by a DNP... I was told I had a viral infection and there was nothing I can do but rest (she checked the nose and all that stuff). Couple days later I felt worse, went back and demanded to see a MD and he did the same exam and diagnosed me with acute sinusitis and gave me an antibiotic. I felt better 24-hours later. The funny thing is, this MD was actually with a student-NP in training and he was explaining to her how he could tell what I had.
 
What's the study data comparing outcomes between DNP's and MD's with similar years "out in the field?"

I like how all the premeds are getting really worked up over this issue MD graduates arent exactly lining out the door for primary care. If teh outcomes are the same, then the DNP's are providing a valuable service and filling a vital need.
 
I don't see a problem with a doctorate in nursing(DNP) in an academic setting. The problem I have is that there is a strong lobbying effort to introduce that doctorate in a clinical setting. The lobby led by Dr. Mundinger (DNP) of Columbia is basically a ploy to replace PCPs or at least co-join that specialty of medicine. I think I read somewhere that 50% of DNP couldn't pass a diluted Step 3 exam. That doesn't bode well for their argument. Medical doctors are required to pass all three in order to gain independent licensed practice.

Physical Therapy is a doctorate degree yet they are not in a hurry to call themselves doctors in clinical settings. Imagine what that would mean for MDs/DOs that specialize in PM&R? :laugh:........Oh well.........
 
No. It's on them (NPs/DNPs) to show us that they're safe. It's not up to opponents to do a study showing otherwise. And I'm not cherry picking fluff courses; I went through their entire curricula. It's pretty much the same at every NP/DNP curricula I've looked at. Take a look yourself if you don't believe me. But I'm definitely not cherry picking any courses. Also, the NPs/DNPs pushing for indendency in primary care but this doesn't mean that they're not going to pursue specialties once they have a foothold; I know no one likes slippery slopes, but there's a good chance something like this might happen based on previous history of the nursing community encroaching more and more into medicine (ie. CRNAs, etc).

Why is it odd that I'm comparing curricula? I don't have to go through both in order to analyze them. I've gone through enough schooling to realize when I'm looking at BS and when I'm not. What do you think you learn in a course labeled nurse theory or activism? Definitely not pathophys. The DNP is a clinical degree. Where are the clinical courses? You don't need multiple stats courses to gain clinical competency. Why does it only take around 1000 clinical hours to gain a doctorate after a BSN when physicians aren't allowed to practice independently until they have >12000 clinical hours? There's already a nursing PhD if one wants to focus on research. The DNP is touted as a clinical doctorate, yet it offers not much more than an MPH.

You're right, you don't have to supply a study. But on the same token, without one, you can't make an argument against the safety of DNPs.

I clicked on the first result when I typed in dnp curriculum on google, and they DO have to take pharmacology, pathophysiology, management of acute and chronic health problems, etc., so yes, you were cherry picking. Comparing it to an MPH is ridiculous, since it does consist of a good amount of clinical education. Is it enough? I, nor you know. I think you're losing sight of the fact that DNPs are not going to be getting plastic surgery residencies, or become dermatologists; they'll be in primary care.

One last thing: for all the talk of encroachment, I have never heard of any doctor, PCP or otherwise, struggling to find a job. CRNAs are trained and supervised by anesthesiologists; I don't think you can really call that encroachment. If CRNAs are able to do what anes does, but for cheaper, then they're a valuable commodity. In a restaurant, you don't need an executive chef to do all of the slicing and dicing, so you hire other people to do it. Is that encroachment, I think not.
 
I don't see a problem with a doctorate in nursing(DNP) in an academic setting. The problem I have is that there is a strong lobbying effort to introduce that doctorate in a clinical setting. The lobby led by Dr. Mundinger (DNP) of Columbia is basically a ploy to replace PCPs or at least co-join that specialty of medicine. I think I read somewhere that 50% of DNP couldn't pass a diluted Step 3 exam. That doesn't bode well for their argument. Medical doctors are required to pass all three in order to gain independent licensed practice.

Physical Therapy is a doctorate degree yet they are not in a hurry to call themselves doctors in clinical settings. Imagine what that would mean for MDs/DOs that specialize in PM&R? :laugh:........Oh well.........

That thing about the diluted Step 3 is so ridiculous. It's like saying, a math phd wasn't able to pass a diluted physics phd exam. Yes, there is a peripheral relationship, but that doesn't mean that someone from one discipline will succeed in the other. Nurses aren't trained to take the Step exams, so no duh, they don't do well on them.

So there's an overzealous lady at Columbia. Big deal, it's one person. Do you think she speaks for all DNPs? It's akin to saying that the AMA represents all physicians. Let them be called doctor, and when a study comes out that shows that they're unable to practice in the capacity that they currently do, I'll change my tune.

BTW, if you read the article on wikipedia, you can see that it's not an academic degree, it IS a clinical one. Of course it will be used in a clinical setting. Had you read about what it was before you attacked it?
 
That thing about the diluted Step 3 is so ridiculous. It's like saying, a math phd wasn't able to pass a diluted physics phd exam. Yes, there is a peripheral relationship, but that doesn't mean that someone from one discipline will succeed in the other. Nurses aren't trained to take the Step exams, so no duh, they don't do well on them.
If that said math teacher wants to teach physics, then yes he should be able to pass the standardized physics test. DNP can't argue for independent medical practice in primary care if they can't pass the standardized test taken by PCPs. What criteria should be used to judge competency? As of now, DNP curriculum is not standardized everywhere so the USMLE is the only crude means to test their medical knowledge.

So there's an overzealous lady at Columbia. Big deal, it's one person. Do you think she speaks for all DNPs? It's akin to saying that the AMA represents all physicians. Let them be called doctor, and when a study comes out that shows that they're unable to practice in the capacity that they currently do, I'll change my tune.
Fine. Ms. Mundinger is one lady but she gets a lot of publicity so her stance must be addressed and scruntized. AMA is the largest physician body, they don't represent all doctors but they are a strong lobbying group so most lawmakers and the media pay attention to what they do whether or not they agree with them on certain issues. Also I'm not sure why you're placing the burden of proof on others to show whether DNPs are qualified or unqualified. You don't place untested drugs in the open market and play "wait and see" to see if it works or not.

BTW, if you read the article on wikipedia, you can see that it's not an academic degree, it IS a clinical one. Of course it will be used in a clinical setting. Had you read about what it was before you attacked it?
Wikipedia is now your source for evidence? Nice. As has already been stated, the "clinical " aspect of the degree is debatable. Since it's non-standardized, in some universities, they are basically taking MPH classes. While in others it's a loopsided combo of qualitative courses with some clinical science thrown in.
 
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@zinciest: Did you seriously just cite wikipedia as a source? You realize that any idiot can write those articles, right?
 
I'm not really opposed to the DNP using the title doctor, or even providing primary care. If we think about it, most PCP end up referring to specialists anything that is beyond a basic antibiotic, splint, etc. Do we really think a DNP or NP couldn't do just that? However, the issue comes in when DNP;s begin treating medical conditions. This is not where their training is and its not why (most) of them went to nursing school. Nurses (for the most part) have a reason they didn't go to med school, they have a heart for nursing. Those that found they have a heart for medicine should bite the bullet and go back to school as many of us non-trads are doing.

Complete autonomy for DNP's? I'm not so sure I support, but we do need more primary care workers. What is causing an issue is that some DNP's are for one reason or another inching towards using those terms like physician and PCP. Honestly I could care less, but its about patient care, bottom line. It has to be. Should we allow people who have lesser training an no license for medicine, practice medicine? The ego comes in (on both sides) when words like "lesser" are used, but why? You chose to go to DNP school rather than MD school. No one is saying your a lesser person, but you simply dont have the same training and education that a physician does. If this were more about patient care and less about ego, things would be different.

If we could all just understand how we could impact a patient as a team (MD,DO, and DNP) things would be much better. The problem is the ambiguity of the language and dissemination of information regarding these kinds of programs. Here is an interesting article where MD's were upset about the language of the certification exam for DNP's. Article. Seems the "use of USMLE Step 3" questions and such seems to be causing some issues.

All in all, an interesting debate.
 
@zinciest: Did you seriously just cite wikipedia as a source? You realize that any idiot can write those articles, right?
Truth. Evidently not every idiot can conduct thorough research on the internet :meanie:. And zinciest- 'that thing' about the Step 3 is not useless. A PsyD is also considered a clinical degree, but all clinical degrees are not the same and such a degree would be useless in a hospital setting (except in the psych ward, as mentioned earlier). IMO, any other person holding a doctorate besides an MD or DO should not be referred to as 'Doctor' in a hospital setting.
 
@zinciest: Did you seriously just cite wikipedia as a source? You realize that any idiot can write those articles, right?

So you're disputing that it's a clinical doctorate and not a research one? That's the only thing that I cited from wikipedia.
 
If that said math teacher wants to teach physics, then yes he should be able to pass the standardized physics test. DNP can't argue for independent medical practice in primary care if they can't pass the standardized test taken by PCPs. What criteria should be used to judge competency? As of now, DNP curriculum is not standardized everywhere so the USMLE is the only crude means to test their medical knowledge.

Well, maybe they could come up with an exam that only tests things in the DNP scope of practice, not in the entire scope of MD practice as Step 3 does. I agree that there needs to be some standardization of the programs.

Fine. Ms. Mundinger is one lady but she gets a lot of publicity so her stance must be addressed and scruntized. AMA is the largest physician body, they don't represent all doctors but they are a strong lobbying group so most lawmakers and the media pay attention to what they do whether or not they agree with them on certain issues. Also I'm not sure why you're placing the burden of proof on others to show whether DNPs are qualified or unqualified. You don't place untested drugs in the open market and play "wait and see" to see if it works or not.

Well, obviously you can't see if there outcomes are comparable if they're not actually practicing. So far, I haven't seen any news articles or dateline episodes that focus on how dangerous DNPs are. BTW, there are very few completely autonomous ones, most are answerable to a physician.


Wikipedia is now your source for evidence? Nice. As has already been stated, the "clinical " aspect of the degree is debatable. Since it's non-standardized, in some universities, they are basically taking MPH classes. While in others it's a loopsided combo of qualitative courses with some clinical science thrown in.

It's not as debatable as you and Kaushik would like to think. Check out these curricula:

http://nursing.duke.edu/modules/son_academic/index.php?id=109

http://fpb.case.edu/DNP/curriculum.shtm

I picked the first two curricula that popped up on google, so these were not cherry picked. Also, the only thing I cited on wikipedia was the fact that it was a clinical degree. That's not to say it is completely successful, but are you arguing that it might be a research degree??

My main point with all of this is not that I think DNPs should be independent. All I'm saying is that we need to have some degree of rapport, especially with future colleagues. Also, it's good to be educated on this stuff, and since we're all premeds who haven't attended either medical school or DNP school, I think we should give these programs the benefit of the doubt, at least until we work with DNPs and develop some frame of reference.
 
But on the same token, without one, you can't make an argument against the safety of DNPs.

No, it doesn't work that way; this is not even the same token. The burden of proof lies on the one making the initial claim; you can't say whatever you want and then put the expectation on others to prove you wrong. If DNPs want to assert that they can take on an independent primary care role, then they should demonstrate that they possess the concrete qualifications to do so (i.e. take a standardized exam that all PCPs must pass to obtain a license to practice).
 
My main point with all of this is not that I think DNPs should be independent. All I'm saying is that we need to have some degree of rapport, especially with future colleagues. Also, it's good to be educated on this stuff, and since we're all premeds who haven't attended either medical school or DNP school, I think we should give these programs the benefit of the doubt, at least until we work with DNPs and develop some frame of reference.

We don't give any drug that pharmaceutical companies produce such "benefit of the doubt"; why should practitioners themselves get the same freedom? Easy answer; the patient's health and safety should come first. This isn't an insult to DNPs; it's just reality. The issue isn't rapport among colleagues, and it shouldn't be about ego; it's about knowing exactly what role you or I, as a (future) healthcare practitioner, plays in the system to ensure the best care of the patient. I have absolutely no problem with DNPs/PAs taking on a primary care role as long as they can sufficiently demonstrate proficiency in the field according to standardized qualifications that we all must pass to practice medicine.
 
We don't give any drug that pharmaceutical companies produce such "benefit of the doubt"; why should practitioners themselves get the same freedom? Easy answer; the patient's health and safety should come first. This isn't an insult to DNPs; it's just reality. The issue isn't rapport among colleagues, and it shouldn't be about ego; it's about knowing exactly what role you or I, as a (future) healthcare practitioner, plays in the system to ensure the best care of the patient. I have absolutely no problem with DNPs/PAs taking on a primary care role as long as they can sufficiently demonstrate proficiency in the field according to standardized qualifications that we all must pass to practice medicine.

I agree. There should be a standardized exam to pass. But Step 3 has a much wider scope than extremely basic primary care.
 
Not really. Step 3 is what we take to be licensed to practice independently as physicians, and as far as I know, it's not specialty-specific.

OK, but it's still a test that people with much more training than DNPs take. I obviously don't know what's covered on it.
 
You're right, you don't have to supply a study. But on the same token, without one, you can't make an argument against the safety of DNPs.

I clicked on the first result when I typed in dnp curriculum on google, and they DO have to take pharmacology, pathophysiology, management of acute and chronic health problems, etc., so yes, you were cherry picking. Comparing it to an MPH is ridiculous, since it does consist of a good amount of clinical education. Is it enough? I, nor you know. I think you're losing sight of the fact that DNPs are not going to be getting plastic surgery residencies, or become dermatologists; they'll be in primary care.

One last thing: for all the talk of encroachment, I have never heard of any doctor, PCP or otherwise, struggling to find a job. CRNAs are trained and supervised by anesthesiologists; I don't think you can really call that encroachment. If CRNAs are able to do what anes does, but for cheaper, then they're a valuable commodity. In a restaurant, you don't need an executive chef to do all of the slicing and dicing, so you hire other people to do it. Is that encroachment, I think not.
Like both myself and others have said, the burden of proof is on the NPs/DNPs, not the critics. Otherwise, based on your logic, I can say that there exists a certain invisible magical bunny that controls every aspect of your life and since you can't disprove it, it must exist. Does that make sense to you?

The programs you looked at were most likely BSN to DNP programs which include courses from the NP curricula. The NP curricula does have some pathophys, pharm, etc courses. Take a loot at the DNP curricula instead of clicking on whatever google returns to you first. So once again, no, I was not cherry picking. Comparing it to an MPH is perfectly accurate since the DNP doesn't really expand any clinical knowledge. Unless of course, nurse activism helps you diagnose and treat patients better.

And as I mentioned, getting their foot into primary care is just the first step. I know slippery slopes are no fun, but take a look at CRNAs trying to expand into pain medicine, etc. Heck, even look at NPs adding the "doctorate" which isn't much more than a glorified MPH. Previous nursing history suggests that they won't be happy with only primary care. Like you said, primary care isn't where the money is. Who is to say they won't like to get their hands on dermatology or any other non-procedure heavy (ie. not surgery) fields?

Also, you're wrong about CRNAs needing to be supervised. They don't need any anesthesiologist supervision. They can function autonomously. I don't have the link on hand, but they even tried to expand their scope of practice into pain medicine after taking a weekend course on it. I believe pain medicine is actually a year long (maybe longer?) fellowship undertaken after residency. Crunching down a year long fellowship into a weekend course sounds like a great way to expand practice scope without putting in the effort. I believe the Louisiana courts denied the CRNAs this. Not entirely sure though but if you look at Taurus's posts, he has one where he discusses this and provides links.
 
i'm inclined to agree; if you are unable to pass a step 3-like test, required to practice independently as a physician, then don't whine about not being able to be independent. you can't have it both ways.

physicians are trained so rigorously for a reason; I don't think we should let the standard of care drop.
 
i'm inclined to agree; if you are unable to pass a step 3-like test, required to practice independently as a physician, then don't whine about not being able to be independent. you can't have it both ways.

physicians are trained so rigorously for a reason; I don't think we should let the standard of care drop.
Why only Step 3? What about the 2 years of preclinical training, the two years of clinical training (where you put in several thousand hours), Step 1, both the Step 2s, and residency? Why do they get to skip all that?

A physician has gone through a minimum of 4 years of med school and 3 years of residency before practicing independently. Why should anyone else get shortcuts? Especially when their training is not even close to the same level that physicians receive?
 
Why only Step 3? What about the 2 years of preclinical training, the two years of clinical training (where you put in several thousand hours), Step 1, both the Step 2s, and residency? Why do they get to skip all that?

A physician has gone through a minimum of 4 years of med school and 3 years of residency before practicing independently. Why should anyone else get shortcuts? Especially when their training is not even close to the same level that physicians receive?

i totally agree with you, I was being very lenient 🙂.
 
OK, but it's still a test that people with much more training than DNPs take. I obviously don't know what's covered on it.

Hence most of the posters' points that DNPs/PAs should know their place in the medical profession and not overextend themselves without the proper training/credentials.
 
Why only Step 3? What about the 2 years of preclinical training, the two years of clinical training (where you put in several thousand hours), Step 1, both the Step 2s, and residency? Why do they get to skip all that?

A physician has gone through a minimum of 4 years of med school and 3 years of residency before practicing independently. Why should anyone else get shortcuts? Especially when their training is not even close to the same level that physicians receive?

👍😀

If DNP's get to practice independently... you think their mal pract. insurance will be as high as physicians or higher (less training as family doc/general internist=higher risk)? If so, does that mean their salary will increase proportionally also? I might withdraw my acceptances for c/o 2014 and go the DNP route. They seriously have the best of both worlds. The grass is not greener on the other side for them lol
 
Seems to me that PA's should be more upset about this than MD/DO's. The distinction exists even between them (another topic altogether). Whats the difference now?

I think DNP's should have their own licensure exam to take that is primary care specific. They should also have restrictions on prescriptions and even the care of some medical issues. If we are serious about patient care and doing this honestly to solve the lack of PCP then DNP's should handle basic, what I call "urgent care medicine". Refer specific issue to physicians and handle just the very basic PCP type issues. If thats the case, restrictions and specifics should be acceptable.

It seems however that ego is coming in to play on both sides. MD/DO's dont want anyone being called doctor or encroaching on their turf while DNP's seem to want the prestige, power, or money that comes with the MD/DO degree. Thats why I dont like the use of the Step 3 for SNP's either. It leaves too much overlap room for a DNP to feel: "I took the same test a physician did, I can practice medicine like them". Thats just a bad situation to begin with, why not (if again we are serious about solving problems and not just about ego and money) have very specific and different exams, licensure procedures, and scope of practice? Sure a PCP and a DNP would overlap a bit, but not if things are well clarified to each.

However it doesn't address the DNP specialization. I have worked with NP's that are very specialized and thats good and needed. There just needs to be clear distinctions between a mid level and MD/DO. We could even make a DNP be "above" a mid level, make up a new tier if you like, but keep it separate from MD/DO because it is different. Haha, we could call them "top shelf" practitioners.
 
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