Nurse practitioners are better than MDs

[Psai]

This thread is exhibit A for the common phenomenon of random allied health student (almost 100% nursing) who does not believe in the value of their field so they come to SDN to try to validate their existence. It's a time honored tradition as old as Burnett's law.

The only problem is that these people without any relevant experience or education actually believe the crap they spout. I wonder why this inferiority complex is so prevalent in nursing and why it seems to be a formal part of their education.

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[Rekt]

This thread is exhibit A for the common phenomenon of random allied health student (almost 100% nursing) who does not believe in the value of their field so they come to SDN to try to validate their existence. It's a time honored tradition as old as Burnett's law.

The only problem is that these people without any relevant experience or education actually believe the crap they spout. I wonder why this inferiority complex is so prevalent in nursing and why it seems to be a formal part of their education.

They have classes on spreading their propaganda and using social media to defend themselves. It's pretty much an occult now.

 

[762513]

This thread is exhibit A for the common phenomenon of random allied health student (almost 100% nursing) who does not believe in the value of their field so they come to SDN to try to validate their existence. It's a time honored tradition as old as Burnett's law.

The only problem is that these people without any relevant experience or education actually believe the crap they spout. I wonder why this inferiority complex is so prevalent in nursing and why it seems to be a formal part of their education.

If the thread is resorting to personal attacks I guess I'm done here. You win?

 

[Mad Jack]

Patient satisfaction is inversely correlated with outcomes, at least in the hospital setting. NPs like the one in the OP promise a compliant, pleasant facade that literally kills patients. But hey, at least they'll die happy.

Patient satisfaction linked to higher health-care expenses and mortality

 

[fourandtwo]

The way the one NP on this thread vs the way physicians and future physicians defend their viewpoint says it all. I am seeing the NP mainly uses n=1 logic while the physicians/future physicians use evidence based data to support their arguments. I wonder how this difference in thought process plays into their role in healthcare?

 

[OneStepAhead]

No evidence for this, but here’s my take:

MDs on average are better than DOs and FMG/IMGs.

NPs and PAs on average are probably worse than DOs, similar to worse than FMG/IMGs (depending on where they train).
)

MDs better than FMGs ? says who? This must be some joke if not a very ignorant post.

 

[Psai]

If the thread is resorting to personal attacks I guess I'm done here. You win?

I already won when I attended a legitimate degree program. Hope you can do something about those insecurities that doesn't involve constantly trying to tear others down. Rah rah nurse practitioners

 

[deleted103644]

MDs better than FMGs ? says who? This must be some joke if not a very ignorant post.

On average, it’s fairly undeniable. There are obviously brilliant FMGs and stupid US MDs, but as I said, on average.

As I said, the distributions are broad enough that there is overlap between all sets of credentials in terms of provider quality, however you measure that.

 

[762513]

I already won when I attended a legitimate degree program. Hope you can do something about those insecurities. Rah rah nurse practitioners

So not knowing where I go to school you are saying my education is "illegitimate." Continue being an ambassador for your profession. Explain to me how explaining that NP's deliver safe care is tearing someone down. I'll be right here, waiting.

 

[lemurcatta]

All you need is 10% of NPs agreeing with her and that's destructive to our profession. Why? Because of the # of NPs graduating in the next 10 years. Their strength is in numbers and unity for legislation.


Lets be real here. Most midlevels have no idea what to do in any remotely complex situation. They rely very heavily on looking things up then ultimately ask the physician what to do or do something to buy time. This does not mean that all doctors know everything. It simply means that it's very uncommon to find a midlevel that actually knows how to work up, diagnose and treat anything complex.

They take their time chitchatting with patients and are cheerleaders for the patient's medication compliance. The first part drives up "patient satisfaction" surveys. The second part drives up outcomes in so called "studies" when looking at NPs vs. Drs. But how does any of it correlate to better outcomes in real medicine? It doesn't.

The level of ignorance, or hyperbole, here is stunning. Lets be real here, you haven't seen enough of the real-world if you think this is the case.

 

[flightnurse2MD]

The level of ignorance, or hyperbole, here is stunning. Lets be real here, you haven't seen enough of the real-world if you think this is the case.

I know right? It's like being a Maserati in a world of Kias...

 

[ThetisAntithesis]

*Sigh*
This post...
Read every page of it.
I'm an NP. I don't think NPs should have full practice authority. NPs are not even close to being comparable to MDs.... Thinking this is dishonest and prideful. I think NPs should have a residency program and board exams every so often (more than the initial certification). Imagine my surprise when I found my sister who is an MD "studying"... She's been practicing for a minute.
I would've done a residency if I had found one. I'm planning on going back to med school... The lack of appropriate medical knowledge is overwhelming.
I work in Primary Care, its hard but I like it. I consult my collaborating MD a few times a wk. I am grateful they're there and wouldn't take the chance or money if it meant being "Independent".
That being said, I don't feel MDs should be so dismissive of NPs (or other mid-levels) or not train them because of this 'Us vs Them' mentality. But s*** I'd be mad too after all that school and loans...
Lets see how I feel when I get into med school and come out on the other side.

 

[deleted103644]

Why?

I think I know what you’ll say, but I’ll let you answer for yourself.

A new for-profit DO school founded by an anti-science institution.

Yes, I would trust a reputable NP program more than “physicians” from that program.

 

[SLC]

*Sigh*
This post...
Read every page of it.
I'm an NP. I don't think NPs should have full practice authority. NPs are not even close to being comparable to MDs.... Thinking this is dishonest and prideful. I think NPs should have a residency program and board exams every so often (more than the initial certification). Imagine my surprise when I found my sister who is an MD "studying"... She's been practicing for a minute.
I would've done a residency if I had found one. I'm planning on going back to med school... The lack of appropriate medical knowledge is overwhelming.
I work in Primary Care, its hard but I like it. I consult my collaborating MD a few times a wk. I am grateful they're there and wouldn't take the chance or money if it meant being "Independent".
That being said, I don't feel MDs should be so dismissive of NPs (or other mid-levels) or not train them because of this 'Us vs Them' mentality. But s*** I'd be mad too after all that school and loans...
Lets see how I feel when I get into med school and come out on the other side.

For me, as a soon to be board certified FamMed doc, it’s less about the loans and fear of encroachment on my career. I get a ton of offers every day for jobs, and I took out the loans knowing they’d be a burden, and knowing there would be mid-levels.

To me it’s the thought that an NP is truly safe in an independent practice environment that freaks me out.

I’ve done 4 years of med school, and 3 years of intense post-graduate training. I’ve still got stuff to learn. How much more then does an NP, with less didactic education and far far less clinical education than me?

If we’re being honest, the gap is wide. It’s not a dig at NP’s, just a statement of fact.

 

[Ho0v-man]

*Sigh*
This post...
Read every page of it.
I'm an NP. I don't think NPs should have full practice authority. NPs are not even close to being comparable to MDs.... Thinking this is dishonest and prideful. I think NPs should have a residency program and board exams every so often (more than the initial certification). Imagine my surprise when I found my sister who is an MD "studying"... She's been practicing for a minute.
I would've done a residency if I had found one. I'm planning on going back to med school... The lack of appropriate medical knowledge is overwhelming.
I work in Primary Care, its hard but I like it. I consult my collaborating MD a few times a wk. I am grateful they're there and wouldn't take the chance or money if it meant being "Independent".
That being said, I don't feel MDs should be so dismissive of NPs (or other mid-levels) or not train them because of this 'Us vs Them' mentality. But s*** I'd be mad too after all that school and loans...
Lets see how I feel when I get into med school and come out on the other side.

Please come back when med school ramps up so you shut these folks down.

 

[Lawpy]

I would absolutely trust an NP from Columbia over a DO from Liberty University.

Why?

I think I know what you’ll say, but I’ll let you answer for yourself.

A new for-profit DO school founded by an anti-science institution.

Yes, I would trust a reputable NP program more than “physicians” from that program.

I don't like LUCOM but it's a nonprofit DO school.

 

[flightnurse2MD]

*Sigh*
This post...
Read every page of it.
I'm an NP. I don't think NPs should have full practice authority. NPs are not even close to being comparable to MDs.... Thinking this is dishonest and prideful. I think NPs should have a residency program and board exams every so often (more than the initial certification). Imagine my surprise when I found my sister who is an MD "studying"... She's been practicing for a minute.
I would've done a residency if I had found one. I'm planning on going back to med school... The lack of appropriate medical knowledge is overwhelming.
I work in Primary Care, its hard but I like it. I consult my collaborating MD a few times a wk. I am grateful they're there and wouldn't take the chance or money if it meant being "Independent".
That being said, I don't feel MDs should be so dismissive of NPs (or other mid-levels) or not train them because of this 'Us vs Them' mentality. But s*** I'd be mad too after all that school and loans...
Lets see how I feel when I get into med school and come out on the other side.

Come find me when you need a Letter of Recommendation for your AMCAS application...

 

[deleted103644]

I don't like LUCOM but it's a nonprofit DO school.

Is it?

Still wouldn’t trust it.

Would never in a million years hire someone who graduated from it.

 

[SLC]

A new for-profit DO school founded by an anti-science institution.

Yes, I would trust a reputable NP program more than “physicians” from that program.

Non profit, and exists under the auspices of the same accrediting body that other DO schools do.

But as I suspected, you opposition seems rooted in your prejudice against the patent institution, probably mostly because of its religious nature, rather than the quality of the graduates (which is still an unknown as none have entered residency yet).

 

[Lawpy]

Is it?

Still wouldn’t trust it.

Would never in a million years hire someone who graduated from it.

Yep: www.liberty.edu/lucom/index.cfm?PID=27151 and Liberty University College of Osteopathic Medicine - Wikipedia

Tbh, I think the graduates are fine. I just personally really dislike the school and its authoritarian conduct.

 

[Lawpy]

Non profit, and exists under the auspices of the same accrediting body that other DO schools do.

COCA should be criticized for allowing easy and proliferative DO expansion though. I can definitely understand johnnydrama's argument but for different reasons.

 

[You shall know the Truth]

I don't like LUCOM but it's a nonprofit DO school.

What is the problem with Liberty? They are not anti science, they have research opportunities and compete against other schools. There students score well on the mcat and go off to MD/DO schools. Now if you don’t like their beliefs, that’s fine, but don’t discredit students from liberty as you may work with some in the future.

 

[Lawpy]

What is the problem with Liberty? They are not anti science, they have research opportunities and compete against other schools. There students score well on the mcat and go off to MD/DO schools. Now if you don’t like their beliefs, that’s fine, but don’t discredit students from liberty as you may work with some in the future.

Read this: What is the WORST medical school?

Just to clarify, I previously said that I think LUCOM students/graduates are fine, it's just that the school itself is problematic.

 

[Fission Chips]

If you're asking for limitations clearly given in the study, I have to assume you either didn't read it or you're trying to troll as so many people on SDN are. Either way its not a great way to debate the rigor of a study on these forums. Good luck to you as well.

It is painfully obvious that I'm not asking for the limitations of the study... are you that obtuse or just that poor at reading comprehension?

EDIT: And yeah, I totally didn't read the article despite the fact that I'm quoting directly from it, and asking your defense of their conclusions. Seriously, don't you have to pass some sort of test to ensure a basal level of intelligence before you can go to DNP school?

Me: I'm sorry, I don't understand your defense of their conclusions, but I'd love to hear more about them.
You: I'm not going to walk you through the limitations section.
Me: I didn't ask for the limitations section; I'm asking about your interpretation and defense of some of their conclusions.
You: You're a troll.

Great discussion man.

 

[SLC]

COCA should be criticized for allowing easy and proliferative DO expansion though. I can definitely understand johnnydrama's argument but for different reasons.

Agree 100%; but I disagree that LUCOM grads deserve discrimination because of the parent institution. Not when they complete the med school curriculum and pass board certification just like anyone else.

 

[Ho0v-man]

Is it?

Still wouldn’t trust it.

Would never in a million years hire someone who graduated from it.

The worst graduate from any DO school is still light years ahead of any NP. They understand medicine on a level that an NP doesn’t know exists. I worked with people who graduated from “reputable” NP programs. Unproctored, untimed tests that are open book, open notes, with google searches. Lots participation points for online discussion boards too. One of them was boasting about being auto-accepted without interview or GRE bc her gpa was above 3.0! IIRC LUCOM screens for interviews at a 500 mcat. That’s not too tough tbh. But even that is tougher than the NP licensure exam and that’s just to get them to look at your application.

 

[deleted103644]

COCA should be criticized for allowing easy and proliferative DO expansion though. I can definitely understand johnnydrama's argument but for different reasons.

Oh no, I share your reasons.

If it had met LCME requirements, I would be less snarky about it.

COCA clearly has far too low a bar.

 

[deleted103644]

The worst graduate from any DO school is still light years ahead of any NP. They understand medicine on a level that an NP doesn’t know exists.

Just to be clear, you’re vouching for every DO ever saying that they are better than every NP ever.

Good luck with that.

And that level that you mention, is it the one where you learn OMM?

Don’t think I could attain that level either without hallucinogens.

 

[Lawpy]

Oh no, I share your reasons.

If it had met LCME requirements, I would be less snarky about it.

COCA clearly has far too low a bar.

That's one of the major reasons why I support combining the two degrees into one and having LCME be the sole accrediting agency.

 

[Lawpy]

The worst graduate from any DO school is still light years ahead of any NP. They understand medicine on a level that an NP doesn’t know exists. I worked with people who graduated from “reputable” NP programs. Unproctored, untimed tests that are open book, open notes, with google searches. Lots participation points for online discussion boards too. One of them was boasting about being auto-accepted without interview or GRE bc her gpa was above 3.0! IIRC LUCOM screens for interviews at a 500 mcat. That’s not too tough tbh. But even that is tougher than the NP licensure exam and that’s just to get them to look at your application.

What are your thoughts involving Caribbean graduates vs NPs?

 

[762513]

It is painfully obvious that I'm not asking for the limitations of the study... are you that obtuse or just that poor at reading comprehension?

EDIT: And yeah, I totally didn't read the article despite the fact that I'm quoting directly from it, and asking your defense of their conclusions. Seriously, don't you have to pass some sort of test to ensure a basal level of intelligence before you can go to DNP school?

Me: I'm sorry, I don't understand your defense of their conclusions, but I'd love to hear more about them.
You: I'm not going to walk you through the limitations section.
Me: I didn't ask for the limitations section; I'm asking about your interpretation and defense of some of their conclusions.
You: You're a troll.

Great discussion man.

You stated "Yet they are able to conclude "Patients cared for by APPs were less like to visit an ER for COPD compared to patients care for by physicians" without addressing those exact same confounding variables?"

Its clearly not "painfully obvious" that you read the limitations of the study. If you had read the limitation you would have said something like 'I am unsure I could draw these same conclusions based on the limitations of the study.'

 

[W19]

On average, it’s fairly undeniable. There are obviously brilliant FMGs and stupid US MDs, but as I said, on average.

As I said, the distributions are broad enough that there is overlap between all sets of credentials in terms of provider quality, however you measure that.

I will do you a favor. By the way, I will be a US graduate in 2 months...

Similar Outcomes for Care by Foreign vs U.S.-Trained Doctors

 

[nowaysanjose]

*Sigh*
This post...
Read every page of it.
I'm an NP. I don't think NPs should have full practice authority. NPs are not even close to being comparable to MDs.... Thinking this is dishonest and prideful. I think NPs should have a residency program and board exams every so often (more than the initial certification). Imagine my surprise when I found my sister who is an MD "studying"... She's been practicing for a minute.
I would've done a residency if I had found one. I'm planning on going back to med school... The lack of appropriate medical knowledge is overwhelming.
I work in Primary Care, its hard but I like it. I consult my collaborating MD a few times a wk. I am grateful they're there and wouldn't take the chance or money if it meant being "Independent".
That being said, I don't feel MDs should be so dismissive of NPs (or other mid-levels) or not train them because of this 'Us vs Them' mentality. But s*** I'd be mad too after all that school and loans...
Lets see how I feel when I get into med school and come out on the other side.

Idk if it's because they want to "sound" or "act" like real doctors but every NP I've worked with has had this nonchalant attitude about medicine in general. They think they know it all already. I get scared every day that I'm going to forget something or miss something so I'm constantly, furiously reading and I still feel inadequate, granted Im just finishing third year. I see this in my peers all the time but never in NPs and it's honestly frightening.

The only way I can fathom someone approaching medicine this way is that they literally must have such a poor fund of knowledge to just be ignorant of all the ways they can mess up.

 

[762513]

Idk if it's because they want to "sound" or "act" like real doctors but every NP I've worked with has had this nonchalant attitude about medicine in general. They think they know it all already. I get scared every day that I'm going to forget something or miss something so I'm constantly, furiously reading and I still feel inadequate, granted Im just finishing third year. I see this in my peers all the time but never in NPs and it's honestly frightening.

The only way I can fathom someone approaching medicine this way is that they literally must have such a poor fund of knowledge to just be ignorant of all the ways they can mess up.

You should meet more people.

 

[Ho0v-man]

Just to be clear, you’re vouching for every DO ever saying that they are better than every NP ever.

Good luck with that.

Yes. At the end of the day one practices medicine and is held to higher standards over a longer more arduous training process. The other doesn’t even claim to practice medicine but instead practices advanced nursing whatever-ness which apparently translates to receiving an online degree and memorizing algorithms.

What are your thoughts involving Caribbean graduates vs NPs?

Carib grad all day! At the end of the day if they’re practicing that means they completed a residency program which means that 1) any hiccups in undergrad medical education should be ironed out by now and 2) they’ve proven many times over that they possess a knowledge base that no NP has. It’s not even close. The only time an NP has any semblance of an advantage is comparing an NPs knowledge of a field that the NP works in but the doc doesn’t.

 

[deleted103644]

I will do you a favor. By the way, I will be a US graduate in 2 months...

Similar Outcomes for Care by Foreign vs U.S.-Trained Doctors

It’s anecdotal, but the variance on FMGs is far too high, and despite that study I’m sure the average is below the average for US MDs.

Some of the best and many of the worst physicians I have interacted with have been FMGs, and the FMGs who manage to work at top academic institutions are mostly fantastic and have met a higher bar than the US MDs who work there.

But when you go to the community hospitals, it’s a different story. The low tier residencies just need warm bodies, and the people trained are not up to par.

And no doubt that US IMGs receive worse training that US MDs.

 

[Stagg737]

Is it?

Still wouldn’t trust it.

Would never in a million years hire someone who graduated from it.

How do you feel about Loma Linda graduates?

COCA should be criticized for allowing easy and proliferative DO expansion though. I can definitely understand johnnydrama's argument but for different reasons.

This is not unique to DO schools though. If you compare the DO vs. USMD expansion over the last 5-10 years and approved schools for the next 5 the numbers are the same. So blaming DO expansion for anything is foolish when the LCME is allowing literally the exact same thing to happen.

 

[W19]

It’s anecdotal, but the variance on FMGs is far too high, and despite that study I’m sure the average is below the average for US MDs.

Some of the best and many of the worst physicians I have interacted with have been FMGs, and the FMGs who manage to work at top academic institutions are mostly fantastic and have met a higher bar than the US MDs who work there.

But when you go to the community hospitals, it’s a different story. The low tier residencies just need warm bodies, and the people trained are not up to par.

And no doubt that US IMGs receive worse training that US MDs.

Well, that's your opinion...

 

[W19]

It's amazing that a profession that relies on us (i.e physicians) a lot for their training has the cojones to say they are as good as the people they rely on to hold their hands for the first few years when they are out practicing.

 

[762513]

It's amazing that a profession that relies on us (i.e physicians) a lot for their training has the cojones to say they are as good as the people they rely on to hold their hands for the first few years when they are out practicing.

One lady said that to make more money, nothing more.

 

[W19]

One lady said that to make more money, nothing more.

I was a nurse (probably still) and I can tell you that it is a sentiment that many NP share... I have a NP friend that told when I started med school that she is learning the same thing in NP school that I am learning in 4 years.

 

[libertyyne]

It's amazing that a profession that relies on us (i.e physicians) a lot for their training has the cojones to say they are as good as the people they rely on to hold their hands for the first few years when they are out practicing.

see they have the heart of a nurse.

How do you feel about Loma Linda graduates?



This is not unique to DO schools though. If you compare the DO vs. USMD expansion over the last 5-10 years and approved schools for the next 5 the numbers are the same. So blaming DO expansion for anything is foolish when the LCME is allowing literally the exact same thing to happen.

this is disengenous. It is like looking at 5000 muders in NYC and 5000 Murders in a San Jose and calling them equal. You and I both know DO schools have expanded more rapidly compared to their initial size and that the standards for COCA are absurdly low compared to LCME. DO's went from being 1/8th the total graduating seniors to 1/4th.

 

[Mad Jack]

On average, it’s fairly undeniable. There are obviously brilliant FMGs and stupid US MDs, but as I said, on average.

As I said, the distributions are broad enough that there is overlap between all sets of credentials in terms of provider quality, however you measure that.

The only studies I've ever seen on the topic showed FMGs to have superior outcomes to MDs and far superior outcomes to US-IMGs. Without more recent data, however, I am reluctant to judge any ACGME residency trained provider.

 

[flightnurse2MD]

I was a nurse (probably still) and I can tell you that it is a sentiment that many NP share... I have a NP friend that told when I started med school that she is learning the same thing in NP school that I am learning in 4 years.

I think APNs are safe and competent providers that work well in a healthcare team model. I only get mad/frustrated/annoyed when APNs believe they should practice independently- not that I discredit their education, but because they're discrediting mine. It says to me I wasted all my time and $120K doing a postbac, studying for the MCAT, and thus far completed the grind of medical school and about to start a 4-5 year residency this July when all I had to do was a 2-3 year online curriculum with 3-day-per-week clinical rotations.

 

[deleted103644]

The only studies I've ever seen on the topic showed FMGs to have superior outcomes to MDs and far superior outcomes to US-IMGs. Without more recent data, however, I am reluctant to judge any ACGME residency trained provider.

Maybe, my experience may be coloring my judgment on this one.

Most of these studies are crap though, and usually have agendas.

Maybe something truly nationwide using CMS data?

 

[flightnurse2MD]

So she had you convinced that MD is same as DNP at the end of this conversation. That's what it sounds to me.

wtf is this weak sht.

Seriously? Come on, brah.

 

[Mad Jack]

Maybe, my experience may be coloring my judgment on this one.

Most of these studies are crap though, and usually have agendas.

Maybe something truly nationwide using CMS data?

I'd be fine with whatever, but I want data. I know that your opinion and mine are likely colored by the local IMG markets, which vary widely based on geography, as are the local MD populations.

 

[762513]

I think APNs are safe and competent providers that work well in a healthcare team model. I only get mad/frustrated/annoyed when APNs believe they should practice independently- not that I discredit their education, but because they're discrediting mine. It says to me I wasted all my time and $120K doing a postbac, studying for the MCAT, and thus far completed the grind of medical school and about to start a 4-5 year residency this July when all I had to do was a 2-3 year online curriculum with 3-day-per-week clinical rotations.

I’ve never heard a single NP discredit a physicians education. What I have heard them ask is in the age of specialized medicine, is a family physician over prepared for primary care?

 

[flightnurse2MD]

I’ve never heard a single NP discredit a physicians education. What I have heard them ask is in the age of specialized medicine, is a family physician over prepared for primary care?

Depends on your patient population and whether or not they are a transgender, type II diabetic, with fibro, MS, chronic renal insufficiency, CHF, COPD-mediated emphysema, and a med list as long as my arm with an equally impressive allergy list. And let's be honest, a lot of PCPs are also acting psychiatrists, dermatologists, and rheumatologists because of lack of access or 6-months minimum waiting to see one.

 

[nlax30]

I’ve never heard a single NP discredit a physicians education. What I have heard them ask is in the age of specialized medicine, is a family physician over prepared for primary care?

Not when that family/primary care physician is at times the patient's first contact with the medical "system", the gateway to specialized care, and the one who a lot of times picks up on a serious underlying disease.

The issue some of us have is that you really 'don't know what you don't know'. If that's the case then an independent practicing NP will likely be 'ok' for the majority of basic algorithmic based care of a number of chronic diseases, but the moment something is overlooked due to lack of a good strong medical knowledge base (which comes from learning the language and basics in medical school, followed by years of standardized, focused clinical training) then bad things can happen.