Shameful action by the NBME, but the AAFP fights back!

[G-Man82]

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The AAFP vs. the NBME on equating DNPs with Primary Care physicians. This article is being discussed in the FP forum.

I thought I'd bring up the fact that the AAFP is actually making a strong statement on the scope of practice for DNP/APNs with regard to that of FPs. This is what the ASA needs to do, too. Be the one to make the initial statement, not just respond to something the AANA states, regardless of how ludicrous the AANAs statements/studies are. The article deals more with licensure, hence the NBME, but isn't this what is already happening in the case of solo CRNAs? They get to play the role of the Anesthesiologist, and the public is none the wiser?

 

[mdage]

Scary!
The health care in this country is going down. People are settling for what is cheaper. I worked with an NP, who wanted to treat a patient lactic acidosis with PH 7.35 with bicarb.

 

[GasEmDee]

I have been taking some time to reacquaint myself on these issues, since they have become more acute.

I was reading an old thread on Allnurses.com. They do REALLY believe they are equivalent, in multiple facets of medicine. It is just amazing, and there were a few physicians over on that board who argued until they were blue in the face, to no avail.

We should just create hospitals, staffed by CRNAs and NP only. Hand them the ICUs the ORs and the outpatient clinics. Then just let the public decide. And let them have equal liability for equal responsibility.

As for the NBME, it has always been about money. Case in point: the STEP 2 CS exam.

The AAFP vs. the NBME on equating DNPs with Primary Care physicians. This article is being discussed in the FP forum.

I thought I'd bring up the fact that the AAFP is actually making a strong statement on the scope of practice for DNP/APNs with regard to that of FPs. This is what the ASA needs to do, too. Be the one to make the initial statement, not just respond to something the AANA states, regardless of how ludicrous the AANAs statements/studies are. The article deals more with licensure, hence the NBME, but isn't this what is already happening in the case of solo CRNAs? They get to play the role of the Anesthesiologist, and the public is none the wiser?

 

[cableguy]

From the article:

"In the letter, the Academy insists that the NBME "cease and desist this misguided effort to delude the American people" into thinking they receive the same breadth and depth of care from a nurse as they do from a physician."

About time.

 

[WholeLottaGame7]

Just another reason to not not go into anesthesiology because of "competition" from CRNAs; the fight is spreading to all fields of medicine, and will be fought on multiple battlegrounds.

 

[cfdavid]

Just another reason to not not go into anesthesiology because of "competition" from CRNAs; the fight is spreading to all fields of medicine, and will be fought on multiple battlegrounds.

Indeed. I almost think the NP/DNP's are going to be more of a headache to some other professions than the militant CRNA's are towards ours.

The silver lining is that it will (and already is for sure) bind physicians closer together on these issues.

 

[Laryngophed]

Indeed. I almost think the NP/DNP's are going to be more of a headache to some other professions than the militant CRNA's are towards ours.

The silver lining is that it will (and already is for sure) bind physicians closer together on these issues.

Wouldn't it be about time?

 

[cfdavid]

Wouldn't it be about time?

No arguement there. Seriously, I'm seeing a lot of backlash in terms of resident (thus future attendings obviously) attitudes towards NP's. I've worked with some really pleasant NP's but often they do not know their limitations.

 

[Taurus]

Advanced nursing practice is not just an anesthesiology or FP problem. It is a problem that affects all of medicine. The nurses don't just want primary care. They want to control referral patterns. If they control primary care, then they can choose who to refer to. Why refer tp that dermatologist when they can refer to a nursing derm specialist who has completed a "derm residency"? And so on. All physicians need to understand how serious this issue is and step up to prevent it from happening.

 

[brisbane]

So I'm just a nobody MS3, but these types of conversations that I come across on the web make me little uneasy about going into primary care....
http://doctorsofnursingpractice.nin...doctor?id=3119958:Topic:7383&page=18#comments
Is this going to continue spiraling out of control?

 

[cfdavid]

So I'm just a nobody MS3, but these types of conversations that I come across on the web make me little uneasy about going into primary care....
http://doctorsofnursingpractice.nin...doctor?id=3119958:Topic:7383&page=18#comments
Is this going to continue spiraling out of control?

Yes it is, IMHO. It's a reality we're all going to need to deal with. How we deal with it, is clearly still being played out. Coordinated efforts are going to be most successful, and this could happen as multiple specialties discover this monster together, and decide that collaboration is in their best interest.

 

[G-Man82]

I was having a discussion with an Anesthesiology resident earlier today about the issue of mid-levels across the fields. He pointed out a fact that I agree with: This is our fault, not because we wanted it to happen, but because from early on as medical students to residents, we are always taught to be nice and let things slide when dealing with others. That way, mistreatment of residents and students goes uncorrected, and then we carry that way of thinking into our lives as Attendings. Seriously, some CRNAs and midlevels are awful to residents, but we just let it go thinking that one day we'll be their boss. But, their lobby is like pancreatic cancer: insidious until you realize your whole body is yellow and there's nothing you can do about it but palliate.

 

[SleepIsGood]

I think we need to build a solid foundation TOGETHER with FPs. I think our two professions, FP and Anesthesiology, are the key areas where these nurses are playing doctor. I think we need to bring it together and go on a public campaign or the likes of one. What do you all think?

 

[CrazyJake]

During my internship, I was working in the ER..sitting right beside a PA. I asked how long she had been working in the ER and she proceeded to tell me that this was just a short-term gig till she started her fellowship in OB-GYN and after that 1 YEAR...she'd be running her own OBGYN practice.

I love to drink, but hadn't had a drink that nite...but man I thought I was loaded. She was serious as all get out.

Don't think this is just us vs CRNA's...not at all - it's ALL of medicine. In some regards, we've survived the CRNA storm that other specialties are about to face from midlevels.

CJ