Nurse practitioners are better than MDs

[AnatomyGrey12]

There’s about a million topics on SDN stating that MD schools offer better, more standardized clinical training than DO schools.

By your logic, shouldn’t my hospital spurn DOs?

(Note: I don’t harbor any bias against DOs or osteopathy, but the irony here is tangible)

And that’s what happens when DOs apply for residency...

This is a straw man for multiple reasons, mainly because, even with COCA having slightly less stringent standards than LCME, as a DO student I still have to take 3 levels of standardized national board testing, go through intense clinical training (COCA has the same requirements as the LCME) and ultimately go through an accredited residency. Your argument is only valid if DO schools have no oversight whatsoever compared to MD schools, which is not the case. I will have more clinical experience after 3 core rotations than required by any NP program, and that is assuming 40hrs/week lol

Please educate yourself before you compare apples to coconuts as an argument.

---

Members don't see this ad.

 

[Lawpy]

So then the argument is that PA school has more standardization than NP school?

I thought we were discussing parity?

I thought COCA was terrible, and doing a bad job?

Because in 99% of the threads here the sky is falling, but then in this thread COCA does a good job of standardizing education?

COCA is responsible for accrediting DO schools and schools need to pass several requirements to be successfully accredited. COCA has more lenient accreditation standards than LCME, but things like online DO programs won't get accredited.

DO students also have to take COMLEX and shelf exams to apply/match into residency. They are difficult exams to study for and do well.

 

[Redpancreas]

There’s about a million topics on SDN stating that MD schools offer better, more standardized clinical training than DO schools.

By your logic, shouldn’t my hospital spurn DOs?

(Note: I don’t harbor any bias against DOs or osteopathy, but the irony here is tangible)

Former nurse with a LizzyM of 63 spends entire day bragging on other threads about an allopathic acceptance (mean LM of 71) and how he’ll be humble about it and starts ****ting on smarter DO students the first chance he gets. What a gem.

 

[RNthenDoc]

And that’s what happens when DOs apply for residency...

This is a straw man for multiple reasons, mainly because, even with COCA having slightly less stringent standards than LCME, as a DO student I still have to take 3 levels of standardized national board testing, go through intense clinical training (COCA has the same requirements as the LCME) and ultimately go through an accredited residency. Your argument is only valid if DO schools have no oversight whatsoever compared to MD schools, which is not the case. I will have more clinical experience after 3 core rotations than required by any NP program, and that is assuming 40hrs/week lol

Please educate yourself before you compare apples to coconuts as an argument.

Ah, okay. So you feel you have parity to MDs, but state that NPs don’t have parity to PAs.

And when confronted, you are trying to compare DO to NP. (irrelevant as all get-out. Lol!)

............Please don’t insinuate that I’m not educated, either. My self-esteem doesn’t require a pissing match so I’ll leave it at that.

 

[RNthenDoc]

Former nurse with a LizzyM of 63 spends entire day bragging on other threads about an allopathic acceptance (mean LM of 71) and how he’ll be humble about it and starts ****ting on smarter DO students the first chance he gets. What a gem.

Plz explain how I’m doing anything of the sort?

 

[KnuxNole]

Better consult cards, pain management, pulm and nephrology then, and it’s not just NP’s doing that.

Why the hell would a PCP consult those specialties so quickly? Are they the ones that I roll my eyes at that pan-consult for every little thing. That's just....pathetic. There's a right and wrong way to consult. I would expect a family physician to know the basics. There is 0 reason to consult pain management. And for basic COPD....pulm? They would laugh at you and tell the patient to get a new PCP.

 

[libertyyne]

I'm not going to get into COCA standards because that's a separate issue, but your point about equivalency is moot when looking at things at the national level. Adding 5,000 murders to the national count is the same whether they take place in NYC or SJ, the percentage within the bubble is irrelevant.

It's not disingenuous to say they're growing at the same rate overall when they are in fact growing at the same rate overall in terms of actual numbers. Even when the growth in terms of percentage rate differs. That is unless you're going to argue that the rate of growth is compounded based on percentage, which is incorrect. By doing so, you're basically falling into Simpson's paradox.




Saying we shouldn't hire flight attendants to fly a plane doesn't mean you want to put an end to the career of flight attendant, and saying "no one should hire flight attendants" isn't calling for that either. It's saying you stop the expansion and prevent an oversaturation and over-reach of scope by cutting off demand and essentially setting a cap. It's not a hard concept to grasp.

1. They are literally not growing at the same rate. Growth rates incorporate denominators. How would you explain proportion of seniors changing if they were growing by the same rate? So it is disingenuous.
2.Standards are pertinent, because guess who has better oversight and ensures that a higher quality of clinical training sites and quality of education is maintained. Hint doesnt start with a C. Which city would it be safer to stay in NYC or SJ with the rates of murder being so disparate. One trend of growth represents a small consistent growth over years and the other looks uncontrolled. They are not equal. It is ironic that you are invoking simpsons paradox considering you are completely ignoring quality.

 

[Lawpy]

Ah, okay. So you feel you have parity to MDs, but state that NPs don’t have parity to PAs.

And when confronted, you are trying to compare DO to NP. (irrelevant as all get-out. Lol!)

............Please don’t insinuate that I’m not educated, either. My self-esteem doesn’t require a pissing match so I’ll leave it at that.

NP education is not standardized. PA education is standardized. DO education is standardized. MD education is standardized. Even Caribbean/IMG/FMG students successfully matching into US residencies have to take Step exams and successfully complete training, pass more board exams and become board-certified/licensed.

 

[KnuxNole]

The MD vs. DO fights are hurting the cause, while the NP is sitting in the back with their tea grinning.

 

[Lawpy]

The MD vs. DO fights are hurting the cause, while the NP is sitting in the back with their tea grinning.

I'm actually concerned as to whether people are intentionally misreading clearly stated arguments and are arguing for the sake of arguing.

 

[MedicineZ0Z]

There’s about a million topics on SDN stating that MD schools offer better, more standardized clinical training than DO schools.

By your logic, shouldn’t my hospital spurn DOs?

(Note: I don’t harbor any bias against DOs or osteopathy, but the irony here is tangible)

Because the COMLEX exams exist. What do the NPs have? There's no measure for baseline knowledge competency.

 

[libertyyne]

So then the argument is that PA school has more standardization than NP school?

I thought we were discussing parity?

I thought COCA was terrible, and doing a bad job?

Because in 99% of the threads here the sky is falling, but then in this thread COCA does a good job of standardizing education?

what ever coca's faults. it is still better than any accrediting body or self imposed standards/checkpoints NPs have.

 

[MedicineZ0Z]

The MD vs. DO fights are hurting the cause, while the NP is sitting in the back with their tea grinning.

Much more so when it comes to specialty vs. specialty.

 

[RNthenDoc]

NP education is not standardized. PA education is standardized. DO education is standardized. MD education is standardized. Even Caribbean/IMG/FMG students successfully matching into US residencies have to take Step exams and successfully complete training, pass more board exams and become board-certified/licensed.

...you do know that Nurse Practitioners are boarded, right?

They don’t take three-step boards, as they aren’t physicians. The reason this level of practice has less standardization is because it is in its infancy. It certainly needs to change, and unification would be great, but right now there are multiple degree levels, multiple experience levels and all sorts of other things that will become a nightmare to remedy.

...and instead of being constructive and pushing for positive change, this thread gives gems like:

“I’ll never help them learn”
“I’ll never hire them”

Which is ironic to me.

This isn’t my fight to fight, but gosh it seems counterproductive for the amount of effort being invested here.

 

[AnatomyGrey12]

And when confronted, you are trying to compare DO to NP. (irrelevant as all get-out. Lol!)

Wut? Did you even read my posts?

 

[flightnurse2MD]

Much more so when it comes to specialty vs. specialty.

Much more so when it comes to specialty vs. specialty.

And egos versus egos....

 

[RNthenDoc]

Because the COMLEX exams exist. What do the NPs have? There's no measure for baseline knowledge competency.

You know NPs take boards, right? I know this pales in comparison to having a huge, national, beurocratic oversight, but there is a measure for baseline competency. It’s boards.

We can say that they aren’t enough, and I’d even agree. But the above is demonstrably false.

what ever coca's faults. it is still better than any accrediting body or self imposed standards/checkpoints NPs have.

This is likely very true, and makes sense as an argument.

 

[RNthenDoc]

Wut? Did you even read my posts?

Yes. You chided me about comparing apples to oranges and then literally spoke about how much more clinical education you’ll have as a DO vs an NP.

It made me belly laugh, and really, that’s what SDN is for, right? Blowing off steam by laughing.

 

[MedicineZ0Z]

You know NPs take boards, right? I know this pales in comparison to having a huge, national, beurocratic oversight, but there is a measure for baseline competency. It’s boards.

We can say that they aren’t enough, and I’d even agree. But the above is demonstrably false.



This is likely very true, and makes sense as an argument.

You know how ridiculously easy it is, right? Someone posted a set of sample practice questions reddit and it showed how much of a joke it is. It was right off their official website.
One liner easy questions where you can get half of the exam wrong and still be an NP vs. 4-6 brutal board exams that last 9 hours each (2 days for one exam). Lets be real here...

 

[Stagg737]

1. They are literally not growing at the same rate. Growth rates incorporate denominators. How would you explain proportion of seniors changing if they were growing by the same rate? So it is disingenuous.
2.Standards are pertinent, because guess who has better oversight and ensures that a higher quality of clinical training sites and quality of education is maintained. Hint doesnt start with a C. Which city would it be safer to stay in NYC or SJ with the rates of murder being so disparate. One trend of growth represents a small consistent growth over years and the other looks uncontrolled. They are not equal. It is ironic that you are invoking simpsons paradox considering you are completely ignoring quality.

1. Which is why I said Simpson's Paradox. Looking at raw numbers can tell a different story than percentages, which is why I rarely take percentages seriously without some knowledge about the raw numbers. This may not be a true case of Simpson's, but the concept is still relevant.

2. Simpson's Paradox has nothing to do with comparing quality, it just addresses disparities between raw data and the manipulation/interpretation of said data. We're also not discussing points in which comparing the DO and MD degrees are relevant and have actual data supporting them (like ACGME match outcomes), I was simply pointing out that criticizing COCA solely on the basis of allowing expansion is short-sighted when the LCME is allowing literally the same thing.

 

[Lawpy]

...you do know that Nurse Practitioners are boarded, right?

They don’t take three-step boards, as they aren’t physicians. The reason this level of practice has less standardization is because it is in its infancy. It certainly needs to change, and unification would be great, but right now there are multiple degree levels, multiple experience levels and all sorts of other things that will become a nightmare to remedy.

...and instead of being constructive and pushing for positive change, this thread gives gems like:

“I’ll never help them learn”
“I’ll never hire them”

Which is ironic to me.

This isn’t my fight to fight, but gosh it seems counterproductive for the amount of effort being invested here.

The major reason why there is a hostile attitude to NPs is simply arrogance combined with ignorance on part of NPs. It's literally the Dunning-Kruger effect in healthcare settings:

If NPs want respect, they need to stop disrespecting and insulting physicians by claiming to be equivalent or superior to them despite having significantly less education and less experience. The lack of standardization in their education does not help. There needs to be a strict accreditation agency that eliminates all the scam online NP programs and forces remaining NP programs to be serious about education quality. Once the education quality improves and NPs acquire realizations of their roles in the healthcare (and some humility), they will stop insulting their colleagues and will be able to work and contribute positively to the healthcare team.

 

[RNthenDoc]

You know how ridiculously easy it is, right? Someone posted a set of sample practice questions reddit and it showed how much of a joke it is. It was right off their official website.
One liner easy questions where you can get half of the exam wrong and still be an NP vs. 4-6 brutal board exams that last 9 hours each (2 days for one exam). Lets be real here...

SO, now we’ve established that there IS a standardization, and now we’ve shifted the argument to saying it isn’t stringent enough.

That is a completely different argument, but sounds valid to me!

and I certainly don’t think anybody in the know would compare NP boards to physician boards. Even in a better world there shouldn’t be parity there, right?

 

[lemurcatta]

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.

It's often not even a 2-3 year online curriculum. USC now has a 21 month fully online FNP program.

 

[RNthenDoc]

The major reason why there is a hostile attitude to NPs is simply arrogance combined with ignorance on part of NPs. It's literally the Dunning-Kruger effect in healthcare settings:

If NPs want respect, they need to stop disrespecting and insulting physicians by claiming to be equivalent or superior to them despite having significantly less education and less experience. The lack of standardization in their education does not help. There needs to be a strict accreditation agency that eliminates all the scam online NP programs and forces remaining NP programs to be serious about education quality. Once the education quality improves and NPs acquire realizations of their roles in the healthcare (and some humility), they will stop insulting their colleagues and will be able to work and contribute positively to the healthcare team.

You’re asking for less hostility while throwing a Dunning-Kruger meme up. I can see how this discussion between the two disciplines might get... strained.

 

[MedicineZ0Z]

SO, now we’ve established that there IS a standardization, and now we’ve shifted the argument to saying it isn’t stringent enough.

That is a completely different argument, but sounds valid to me!

and I certainly don’t think anybody in the know would compare NP boards to physician boards. Even in a better world there shouldn’t be parity there, right?

Playing with words doesn't justify their license.

 

[Lawpy]

You’re asking for less hostility while throwing a Dunning-Kruger meme up. I can see how this discussion between the two disciplines might get... strained.

Except the Dunning-Kruger effect is an accurate description. It is a fact that NP education is significantly worse than MD/DO education (and also worse than PA education).

Also, the NPs were the ones who initiated the anti-physician message by claiming to be equivalent or superior to them and demanding independent practice. Physicians (and students/residents in training) actually put up with NP abuse and are just venting their frustrations online. That's completely understandable and justified.

 

[libertyyne]

1. Which is why I said Simpson's Paradox. Looking at raw numbers can tell a different story than percentages, which is why I rarely take percentages seriously without some knowledge about the raw numbers. This may not be a true case of Simpson's, but the concept is still relevant.

2. Simpson's Paradox has nothing to do with comparing quality, it just addresses disparities between raw data and the manipulation/interpretation of said data. We're also not discussing points in which comparing the DO and MD degrees are relevant and have actual data supporting them (like ACGME match outcomes), I was simply pointing out that criticizing COCA solely on the basis of allowing expansion is short-sighted when the LCME is allowing literally the same thing.

1. I do not support any growth at the way it currently exisits lCME or COCA. But lets not equate the two growth rates, because it simply isnt true. Do you honestly believe that the match outcomes for newer MD schools is close to the match rates for newer DO schools? If LCME grew at the same rate as COCA we would have 80K+ seniors graduating at this point.

 

[AnatomyGrey12]

The reason this level of practice has less standardization is because it is in its infancy.

NPs have been around for decades (that’s not really “in its infancy”) and there isn’t even a loosely standardized list of things they should generally know and that should be taught at every program... there are multiple programs that don’t even include advanced classes in pathophysiology and the whole degree is mostly “Nursing ethics” and other crap like that. This isn’t even to mention the clinical education aspect.

Pre-clinical education is the same at every MD and DO school simply with differing methods of delivery and then there are standardized core rotations they must successfully pass. PA’s learn an abbreviated version of those things (standardized) and then do the equivalent of a medical student’s core rotations. My point is that NP programs are so vastly different why should I have to sift through the mountains of programs to figure out which ones are good when I can hire any PA and know what their base level of competency should be? And no the NP “boards” are not a standardization

Yes. You chided me about comparing apples to oranges and then literally spoke about how much more clinical education you’ll have as a DO vs an NP.

It made me belly laugh, and really, that’s what SDN is for, right? Blowing off steam by laughing.

Go read the sequence of posts again.

 

[Redpancreas]

Plz explain how I’m doing anything of the sort?

By trying to create an equivalency between unjustified DO discrimination with justified NP discrimination. NPs are basically people who want to be doctors without going to medical school. I have never seen such a profession in healthcare, business, or engineering.

What we should do is create a program for students with wealthy parents who were unable graduate high school. Have them complete an online tutorial in medical terminology with a quiz at the end, let them shadow an RN student for a day, and then stick them in the hospital and say they’re not just equal to NPs, but better because they can literally do everything some certified NPs can do, but they don’t lose their patience and mock patients.

 

[RNthenDoc]

Except the Dunning-Kruger effect is an accurate description. It is a fact that NP education is significantly worse than MD/DO education (and also worse than PA education).

Also, the NPs were the ones who initiated the anti-physician message by claiming to be equivalent or superior to them and demanding independent practice. Physicians (and students/residents in training) actually put up with NP abuse and are just venting their frustrations online. That's completely understandable and justified.

I’d certainly believe that NP education is lesser than MD/DO (it’s not even the same discipline...). I think the only smart comparison is to PA.

I guess my frustration is that there is more venting and misinformation than there is tangible political action that could actually improve patient care.

 

[libertyyne]

I’d certainly believe that NP education is lesser than MD/DO (it’s not even the same discipline...). I think the only smart comparison is to PA.

I guess my frustration is that there is more venting and misinformation than there is tangible political action that could actually improve patient care.

not teaching NPs is literally tangible act of resistance. Why teach someone who stands for gaining full practice authority with 1/3 rd of the training.

 

[Lawpy]

I’d certainly believe that NP education is lesser than MD/DO (it’s not even the same discipline...). I think the only smart comparison is to PA.

This is an important point. Despite not being the same discipline, NPs are claiming to be equivalent to MD/DO, if not superior. That's the purpose of this thread and related threads on the matter, which is why the medical folks are frustrated by this topic. Comparing NPs with PAs is definitely reasonable.

Midlevels serve important roles in the healthcare setting. Tensions however arise when there are competitive and superior feelings involved. The healthcare team should be collaborative, not competitive.

I guess my frustration is that there is more venting and misinformation than there is tangible political action that could actually improve patient care.

Part of the reason for this controversy is due to lack of political action on part of physicians. Midlevels are politically active and have lobbied for independent practice rights in many states. The fact that physicians haven't done much politically is a disappointment on their part.

Unfortunately, given the anonymity of internet forums, it's far easier to vent than to act.

 

[RNthenDoc]

NPs are basically people who want to be doctors without going to medical school.

This is the attitude I’m arguing against, but I can see that the butthurt masses aren’t going to see beyond emotion.

If any SDNers truly believe the above I have to say that I’m sad.

I’m sure there are some NPs who want to be doctors without going to medical school. But to paint with a brush that broad is pretty terrible.

It’s a losing argument here, and as I said I don’t really have a dog in the fight. I just try to speak up when I see people dogpiling unecesarily and without any constructive action being done.

I guess my career has just been magical in that I have rarely encountered an NP or PA who wasn’t fantastic in their role, and who worked within a sharply defined scope that they enjoyed. Really, I don’t think there are that many “monster” NPs, but it isn’t my job to advocate for them. I got the lulz I came for but it’s bedtime now.

 

[libertyyne]

This is the attitude I’m arguing against, but I can see that the butthurt masses aren’t going to see beyond emotion.

If any SDNers truly believe the above I have to say that I’m sad.

I’m sure there are some NPs who want to be doctors without going to medical school. But to paint with a brush that broad is pretty terrible.

It’s a losing argument here, and as I said I don’t really have a dog in the fight. I just try to speak up when I see people dogpiling unecesarily and without any constructive action being done.

I guess my career has just been magical in that I have rarely encountered an NP or PA who wasn’t fantastic in their role, and who worked within a sharply defined scope that they enjoyed. Really, I don’t think there are that many “monster” NPs, but it isn’t my job to advocate for them. I got the lulz I came for but it’s bedtime now.

NPs have lobbied for and obtained full practice autonomy in 23 states , and continue to do so everyday. Why would I want to problem solve with them? They want to be part of the "team" yet push for independence from the team .

 

[Lawpy]

I guess my career has just been magical in that I have rarely encountered an NP or PA who wasn’t fantastic in their role, and who worked within a sharply defined scope that they enjoyed. Really, I don’t think there are that many “monster” NPs, but it isn’t my job to advocate for them. I got the lulz I came for but it’s bedtime now.

You're probably lucky. Unfortunately, many of us (myself included) have had bad experiences with NPs in real life and can completely understand and sympathize with the frustrations.

 

[RNthenDoc]

This is an important point. Despite not being the same discipline, NPs are claiming to be equivalent to MD/DO, if not superior. That's the purpose of this thread and related threads on the matter, which is why the medical folks are frustrated by this topic. Comparing NPs with PAs is definitely reasonable.

Midlevels serve important roles in the healthcare setting. Tensions however arise when there are competitive and superior feelings involved. The healthcare team should be collaborative, not competitive.



Part of the reason for this controversy is due to lack of political action on part of physicians. Midlevels are politically active and have lobbied for independent practice rights in many states. The fact that physicians haven't done much politically is a disappointment on their part.

Unfortunately, given the anonymity of internet forums, it's far easier to vent than to act.

Thank you for the measured response.

I am personally scared by the escalation of independence of NPs, but I don’t like to see its use as a trigger to rip on an entire profession so broadly. I’m a little sore about it, as I recently lost a really fantastic NP.


What I’d like to see is data gathering, proposals for educational and licensing reform, and a little more cohesion overall. If you think NP vs. MD is bad, you should see the vitriol between RN and NP elsewhere on the internet (but again.... absent from my apparently-charmed practice).

 

[NYCdude]

Anyone ever notice how all nurses are just GOING to NP school as opposed to "trying to get into" NP school? There's something to be said for the weed-out process that is pre-med being lost as well. NP schools accept everybody and fail nobody--there's absolutely no barrier based on intellectual capacity.

Isn't it kind of freaking insane that sometimes residents have to repeat years for unsatisfactory performance or even get kicked out but NP's just waltz through online classes and end up in a similar position (able to practice medicine?) Like what the hell is going on? How does this country and/or government allow such diametrically opposed paradigms in medical education to exist?

 

[Lawpy]

Thank you for the measured response.

I am personally scared by the escalation of independence of NPs, but I don’t like to see its use as a trigger to rip on an entire profession so broadly. I’m a little sore about it, as I recently lost a really fantastic NP.


What I’d like to see is data gathering, proposals for educational and licensing reform, and a little more cohesion overall. If you think NP vs. MD is bad, you should see the vitriol between RN and NP elsewhere on the internet (but again.... absent from my apparently-charmed practice).

Agreed. The first step should be to end nonsense like this:

 

[Redpancreas]

If you think NP vs. MD is bad, you should see the vitriol between RN and NP elsewhere on the internet (but again.... absent from my apparently-charmed practice).

Honestly, from what I’m hearing, NPs are the only aggressor here. They create false equivalences with those actually liable for healthcare decisions (MDs/DOs), they don’t get along with their superiors (PAs), and they antagonize their modest equals (RNs).

 

[RNthenDoc]

Agreed. The first step should be to end nonsense like this:

I saw when she posted that. Pretty hilarious.

Serious question, though.... Would a free market eventually quash practices like hers?

If she truly cannot deliver on what her clients want, if a physician can truly deliver the same more competently, won’t the market eventually correct? This is a tangential discussion, and I obviously don’t think the right thing to do is to wait for that to happen... this lady is probably dangerous.

But still, the best surgeons in my town are known for outcomes... surely a snake oil salesmen will eventually run out of victims in the digital age?

 

[RNthenDoc]

Honestly, from what I’m hearing, NPs are the only aggressor here. They create false equivalences with those actually liable for healthcare decisions (MDs/DOs), they don’t get along with their superiors (PAs), and they antagonize their modest equals (RNs).

So, you DO realize that you’re using antagonistic language here, right? Saying that an NP is = RN? I hope it’s a conscious choice, because i found it pretty funny

I mean, if RN=NP, and if NP>MD/DO according to that lady’s crazy tarot card advertisement.... you’ve just given me quite a compliment.

 

[Redpancreas]

So, you DO realize that you’re using antagonistic language here, right? Saying that an NP is = RN? I hope it’s a conscious choice, because i found it pretty funny

I mean, if RN=NP, and if NP>MD/DO according to that lady’s crazy tarot card advertisement.... you’ve just given me quite a compliment.

I said RN=NP, but never said NP>MD/DO (which should be obvious if you read the first sentence). You can’t take my statement and then combine it with someone else’s statement I directly contradict, and then call the compilation my argument. I’m not sure why this has to be explained to you.

 

[RNthenDoc]

I said RN=NP, but never said NP>MD/DO (which should be obvious if you read the first sentence). You can’t take my statement and then combine it with someone else’s statement I directly contradict, and then call the compilation my argument. I’m not sure why this has to be explained to you.

Dude, chill. I was making a joke.

 

[MedicineZ0Z]

Isn't it kind of freaking insane that sometimes residents have to repeat years for unsatisfactory performance or even get kicked out but NP's just waltz through online classes and end up in a similar position (able to practice medicine?) Like what the hell is going on? How does this country and/or government allow such diametrically opposed paradigms in medical education to exist?

It is indeed mind blowing. Everyone in medicine is held to such a high level and then some of these people go onto becoming sell outs.

 

[Redpancreas]

Dude, chill. I was making a joke.

I thought you were too when you said called NP=RN “inflammatory language” when it’s 100% true, but I guess you’re being serious?

 

[MedicineZ0Z]

I saw when she posted that. Pretty hilarious.

Serious question, though.... Would a free market eventually quash practices like hers?

If she truly cannot deliver on what her clients want, if a physician can truly deliver the same more competently, won’t the market eventually correct? This is a tangential discussion, and I obviously don’t think the right thing to do is to wait for that to happen... this lady is probably dangerous.

But still, the best surgeons in my town are known for outcomes... surely a snake oil salesmen will eventually run out of victims in the digital age?

False.

1. NPs do in fact deliver what patients want. They spend 30 minutes chitchatting about life, order tests the patients wants with 0 indication and give the meds the patient wants even when they aren't needed.

2. Lot of chief complaints self-resolve with or without intervention eventually.

3. A sick person won't be seen by an NP.

When you combine those three - it's easy to get away with stuff.

 

[RNthenDoc]

I thought you were too when you said called NP=RN “inflammatory language” when it’s 100% true.

I mean, if I was an NP I’d probably be inflamed if someone said I held no more competence than an RN.

If that’s what you believe that’s fine..... I do disagree with that, but it’s not my job to change your mind.

 

[Redpancreas]

I mean, if I was an NP I’d probably be inflamed if someone said I held no more competence than an RN.

If that’s what you believe that’s fine..... I do disagree with that, but it’s not my job to change your mind.

So I guess I’m not an expert on the matter, but why would an NP be more qualified than an RN?

 

[RNthenDoc]

False.

1. NPs do in fact deliver what patients want. They spend 30 minutes chitchatting about life, order tests the patients wants with 0 indication and give the meds the patient wants even when they aren't needed.

2. Lot of chief complaints self-resolve with or without intervention eventually.

3. A sick person won't be seen by an NP.

When you combine those three - it's easy to get away with stuff.

You’re making this gig sound like easy money... maybe I should rethink my goals... hmmmm

 

[Stagg737]

1. I do not support any growth at the way it currently exisits lCME or COCA. But lets not equate the two growth rates, because it simply isnt true. Do you honestly believe that the match outcomes for newer MD schools is close to the match rates for newer DO schools? If LCME grew at the same rate as COCA we would have 80K+ seniors graduating at this point.

I agree with the bolded, but it doesn't change the issue with "rate" of expansion.

The issue with match outcomes is again irrelevant to the point I was making, but if you want to compare match rates then no, they're not that different. Marian has a match rate of 99%. Alabama-COM had an AOA match rate of 100% and a NRMP match rate of 86% with 100% placement. Those are the two newest schools to have classes go through the match. Considering the national mean match rate for USMD schools is 95% I'd say the new DO schools are doing just fine in terms of rate. If you want to talk about outcomes in terms of where they match I won't argue that one, but looking at just match rate there's no significant difference at this time.

Also, do you really think that if there were already as many DO schools as MD schools that COCA would be accrediting new schools at an equivalent percentage as they are now? Of course they wouldn't! It would be the same raw numbers, which is why I'm saying the argument using percentages is ridiculous and we should be using the physical numbers instead. I thought that would be obvious.

This is the attitude I’m arguing against, but I can see that the butthurt masses aren’t going to see beyond emotion.

If any SDNers truly believe the above I have to say that I’m sad.

I’m sure there are some NPs who want to be doctors without going to medical school. But to paint with a brush that broad is pretty terrible.

It’s a losing argument here, and as I said I don’t really have a dog in the fight. I just try to speak up when I see people dogpiling unecesarily and without any constructive action being done.

I guess my career has just been magical in that I have rarely encountered an NP or PA who wasn’t fantastic in their role, and who worked within a sharply defined scope that they enjoyed. Really, I don’t think there are that many “monster” NPs, but it isn’t my job to advocate for them. I got the lulz I came for but it’s bedtime now.

I think you're underestimating the number that falls into the first bolded category. It's by no means the majority, but it's a significant enough number (and certainly enough of them are vocal about it) that it needs to be addressed. As long as other NPs aren't standing up against their own who are over-reaching, someone else needs to.

To the second bolded, come on some of my rotations with me and I'd bet you'd change your mind pretty fast. I've met more than a few who I felt needed significant oversight (more than they were receiving) and a couple who I legitimately considered reporting to the state Board of Healing Arts because they were so incompetent, and one of them was very vocal about how NPs should be allowed to practice without supervision.