I think nursing is constantly trying to define and redefine itself and it's totally unnecessary. "Tu quoque or the appeal to hypocrisy is an argument that intends to discredit the opponent's position by asserting the opponent's failure to act consistently in accordance with that position. This attempts to dismiss opponent's position based on criticism of the opponent's inconsistency and not the position presented. However, only a master’s degree is required to become a nurse practitioner. And I'll even take this example one step further.. What happens when the "collaborative" physician just starts treating this well educated, well respected, and well experienced NP like a resident? How should we expect someone with 3600 hours' experience (approximately 1 year of residency) to perform? Same reason that I didn’t go to medical school and become a MD. Today is my birthday so this is extra-great. e.g. I agree with you Pamela, the RN should consider becoming an NP instead. Chiropractors attend graduate-level health colleges to treat disorders of the bones, nerves, muscles, and ligaments. Evidence promoting NP quality is always slandered as poor. So if hospitals and insurance companies can lobby for legislation that lets the nurse do what a doc can, they get what they see as the same service much cheaper. The NP has published papers, run clinical trials, and gets referrals from across the state by all sorts of clinicians. Cookies help us deliver our Services. It attempts to show that a criticism or objection applies equally to the person making it. This is based on what I've seen during my time with all three career paths as well as wisdom given to me from doctors, PA's, and NP's. “You have to know too much to do primary care,” she concluded. RELATED - DNP vs MD. We both went to medical school, they just get paid a lot more.". Interactive NP Scope of Practice Law Guide. Today, the American Association of Colleges of Nursing (AACN) and the American Association of Nurse Practitioners (AANP) recommend that all new nurse practitioners earn a doctor … I’m a woman but not particularly interested in having kids but you can definitely still do that as a doctor (some fields are better than others). I literally have 30 minutes of work to do every 15 minutes. I focused on that same paragraph. Even fellowship-trained subspecialists find the breadth of primary care challenging. /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. Nurse practitioners work for substantially less than primary docs. Why not change the request from higher pay for doctors to less schooling costs for doctors? When I was doing my internship, 15 years ago, a fellow intern told me about a patient she had seen in the clinic whose voice was hoarse. I'm leaning towards becoming a PA but my decision isn't close to being concrete. The patient asked what the difference was between a CRNA and an MD anesthesiologist. The MD’s are reporting NP’s refer to specialist more. Further I doubt that many NP's will actually elect to open an independent clinic. It must at least partially be due to the business model - residents are cheap workers. Doctors of reddit, why did you choose to go to medical school instead of NP or PA school? Press J to jump to the feed. Evidence against them is never scrutinized. There's just no way a new NP could be proficient with only 600 hours of clinicals. There are pros and cons to letting midlevels be primary care providers but perhaps from a selfish future physician point of view, maybe we should be paying primary care mode than peanuts of current salary when compared to specialists. Boomer doctors have not been good stewards for the next generation of doctors. "I understand this system (as a Doctor); I am advocating for someone else's interests possibly at my own expense (increased pay for a different specialty from a competitive poor of resources); I understand the benefits of primary physicians, had the opportunity to become one but chose a different specialty (implicitly a lack of rewards or encouragement contributed to that decision).". They also get compensated fairly well relative to the amount of schooling they have to do and the amount of liability they have to take on. Of course NP’s are not trained like doctors. Archived. Side-by-Side Comparison: NP vs Physician (MD or DO) Below is a side-by-side comparison of doctors and NPs, including the typical timeline to practice, responsibilities, education, licensure, and professional resources. We worked with an CRNA, and one day I overheard a snippet that made me sort of....irked. It's the pay that drives this entire issue. I can never understand why NPs would want to rid themselves of physician oversight. My intern year, I rotated through the preop testing clinic, where we saw sick patients (usually ASA 3 or 4) prior to surgery. I feel like I am as smart if not smarter than many physicians that I have worked with, but that occupation just doesn’t fit my personality. Whenever someone says "in my opinion" when they're writing, I always wonder if they also sometimes say "in someone else's opinion.". Many people are pushing for NP's to have doctorates, and the program I'm going into provides that. The site may not work properly if you don't, If you do not update your browser, we suggest you visit, Press J to jump to the feed. In general I'm appalled at the state of nursing education beyond the most basic level, but that is a conversation for another time. Also, the ability to change specialities without going back to school. I am not knocking down the profession of nursing, what I am annoyed with is NURSES/NP's claiming to be equivalent to MD's. It's just the truth. It adds nothing clinically, it is only for the "title". Join my SubReddit Here: https://www.reddit.com/r/DoctorMikeIn this SR I will be chatting with you guys about published videos, medical topics, and more. Is there any other type of person who could be more knowledgeable and less biased? licensed and independent healthcare clinicians concentrated on managing patient's health conditions including treating injuries and illnesses 75% Upvoted. Want to watch more amazing Reddit stories? I can never understand why NPs would want to rid themselves of physician oversight, and I know several who agree with me. Doctors/therapist of Reddit, do you have any "no, that's not normal" stories? I worked as an advanced practice nurse for nearly 6 months, and hated each new day more than the previous. an inch of faxes every morning, and 15 minutes to see a patient with 5 chronic problems and 3 complaints (account for documentation time, and that's 90 seconds per problem). Not here anyways. Practicing under a physician is important because we have fundamentally less training and school. A lot of things had gone down in the medical profession over the last 100 years but I'd have to say that the last 10 years or so have to have been some of the worst for doctors as a profession. By using our Services or clicking I agree, you agree to our use of cookies. report. She had no idea what was wrong with him, but her primary-care instructor, on a routine pass by, immediately diagnosed goiter, an enlargement of the thyroid gland. Check out our playlist! But I just want to point out the poor citation of evidence. I'm going back for my psych NP starting in the fall, and it's a long haul and not an easy overnight thing. It establishes a go-to advisor for difficult cases. I'm not sure if a PA is even a masters - maybe it is - from what I understand it's 2 years after your BA. Lifetime Donor. /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. As pharmacists, physical therapists, audiologists, and others began requiring doctorate degrees, nurse practitioners followed suit. In the current medical environment, the business model that has not been working for physicians is unlikely to work much better for NPs. Why are we ok with less and less training and more independence for everyone? I doubt this truly has to do with creating "access" as Nursing Leadership would say. I did: http://www.acponline.org/clinical_information/journals_publications/ecp/novdec99/hemani.htm. The militant ones & the lobbying groups believe they are not lesser providers, but rather equals. It used to be that nurses became NPs after many years of bedside nursing, so they could use their clinical expertise in a job that was perhaps less hard on the body, with a more predictable schedule. “Physician” was used traditionally to describe a medical doctor, and King Henry VIII granted the first charter to form the Royal College of Physicians in 1518. We're not completely protected, but it does help. From reddit. He would have been defending his turf if he was a primary care physician though. perhaps from a selfish future physician point of view, maybe we should be paying primary care mode than peanuts of current salary when compared to specialists. Please read the rules carefully before posting or commenting. The NP teaches at the local university regarding HTN management and has been invited to speak at national conferences regarding his or her work. Please read the rules carefully before posting or commenting. share. To clarify, although the person being attacked might indeed be acting inconsistently or hypocritically, such behavior does not invalidate the position presented.". They allowed other more quickly and cheaply trained health professionals to take over their practice. To be clear though- the level of training Doctors receive is unparalleled in the medical field. chare. Yes, this is the appeal of nursing for me. Instead this falls on the physician. From 15 years ago (1999)? The NP teaches at the local university regarding HTN management and has been invited to speak at national conferences regarding his or her work. Do you think any recent internal med grad is going to be able to adequately "oversee" this NP? Hier sollte eine Beschreibung angezeigt werden, diese Seite lässt dies jedoch nicht zu. I'm not saying all NPs are like this, but some are, and deserve the respect they have earned. If you are not sure if you even like medicine I think getting in the throes of it somehow (whether it’s shadowing or a job) will help you decide. Continuing with the medical Reddit thread series this episode is on second opinions that saved lives! There may be other viewpoints but … 5+ Year Member. For the complete article go to Nurses are Not Doctors. Apr 30, 2014 . This seems like the kind of thing that would come with experience more than just straight knowledge, right? As a practicing nurse, I agree. I actually don't believe nurses are doctors. Even fellowship-trained subspecialists find the breadth of primary care challenging. Although I'm not convinced that he's really an anesthesiologist . I don't want to be a doc. anon456, BSN, RN. We shouldn't be. This legislation strikes me as another step in the on-going process of needing to be viewed as legitimate. Doctors of reddit, why did you choose to go to medical school instead of NP or PA school? Not really. They graduate as doctors of chiropractic degrees, but they are not medical doctors. You can't make up for that in a few years with a few hundred clinical hours. by Rebekah Bernard MD January 16, 2020 share … Medical knowledge is only getting more complex. We will not approve surveys that are not directly related to nurse practitioners and their careers. However, I would not ask just any doctor to help me with a patient in transport- so there is a difference even amongst doctors they are not all the same. 0 Likes. While the nurses did seem to have higher utilization, the difference was NOT statistically significant. Although this is not the DNP nurse's intent, it can be misconstrued negatively. The NP has published papers, run clinical trials, and gets referrals from across the state by all sorts of clinicians. Boomer doctors have not been good stewards for the next generation of doctors. It sounds better than a primary care physician saying we need to increase pay for primary care physicians. I think that the whole medical ecosystem only works if we all know our role and do it to the best of our ability. So, the short answer is yes - a DNP nurse may be referred to as "doctor," however, some states have legislation surrounding this. But with collaborative agreement legislation, the NP is legally unable to work without strings attached. Did anyone read the study he uses as the crux of his argument? I work with several NPs in the ICU setting that are just as good as, if not better than, the MD's who are also on duty. They choked the supply of trained doctors, and did not allow it to keep pace with the demand. There are also the physicians who treat NP's like they're not good enough and should never expresss a difference of opinion with their supervising MD's. Typically it involves a number of charts reviewed over the prior month long period. Of course not. I wonder how many people realize the disparity in hours trained (1600 vs a minimum of 12,000)? 2. I find it troubling how GPs are considered to be beneath other doctors - this seems to be very common in the U.S. I could easily be a NP but its not what I am interested in. This is the most poignant paragraph in my opinion: Medical school graduates, after two years of classroom instruction and two years of clinical training, are not considered fit to practice medicine independently. EDIT: I can't believe it. Just do med school if you have the GPA/MCAT for … Thank you so much for the gold! Is it onerous oversight? One had had 20 years of bedside nursing experience before becoming an NP, one with 2 years....and that one is honestly not very good, but she doesn't really have to be, since she can refer things up if necessary. It is a special case of ad hominem fallacy, which is a category of fallacies in which a claim or argument is rejected on the basis of fact about the person presenting or supporting the claim or argument. Her reply: "Nothing. Who cares about prevention? Find more subreddits like r/NPD -- A place for those who suffer from a narcissistic personality to talk about their problems and get support. Of Course, It’s Not That Simple. As an experienced PA who has worked in primary care, cardiology, ED, and now as a hospitalist, I do wonder why NP's would find it necessary or desirable to sever a formal supervisory role with physicians. If you're not a specialist, it must be because you aren't good enough. Of course we do, we are not trained to manage complex medical problems. Doctors go to medical school for four years and then have specialty training after that. I'm not a doc. Advanced practice isn't for everyone, and I found myself in a similar sitiuation. Let me paint you a picture. Posted by 2 years ago. Edited May 1, 2014 by tnbutterfly. We get thrown everything under the sun and have to deal with it. They choked the supply of trained doctors, and did not allow it to keep pace with the demand. (She ended up specializing in cardiology.). hide. You are not, you were trained in the NURSING SCOPE of practice. 4 Likes. A nurse practitioner (NP), also known as an Advanced Registered Nurse Practitioner (ARNP), provides primary care and performs tasks comparable to those of a doctor, from prescribing medication to ordering tests and interpreting the results. That seems about as credible as you can get, actually. https://youtube.com/playlist?list=UUEqKKebvZbAQoD3NRIn4jaQ Fresh AskReddit Stories: ? An NP is working in a hypertension clinic, has been for 10-15 years. Reactions: 1 users Reply. Patients can often get an appointment to see an NP sooner than they can get in to see a doctor. Despite the difference in title, they're more alike than you think. Why hire enough cardiologists to meet demand, when a cardiology resident could do a lot of the work for a lot less? 3 comments. If you've been a nurse for 5 years it makes more sense to just do NP and up your pay/responsibility vs going back to medical school. They allowed the license to practice medicine become meaningless without completion of a long, underpaid residency program. The word “doctor” is over 2,000 years old, aptly derived from the Latin doctus, meaning to teach or instruct. Press question mark to learn the rest of the keyboard shortcuts. Many medical offices and hospitals offer care provided by nurse practitioners, commonly referred to as NPs. New comments cannot be posted and votes cannot be cast. Now, an NP can be pretty good at a lot of things right out of school - managing certain illnesses/diseases, educating patients, preventative care, etc - but there are many things that really require experience in order for someone to be proficient, and I don't think 600 hours is enough experience. Article about the importance of primary care physicians, mentions we need to do more to encourage med students to choose to become primary care physicians. Of course not. They often train the residents and they provide very good input and collaboration on a patient's care. Jan 7, 2018. Looks like you're using new Reddit on an old browser. Physical therapists, pharmacists, and nurse practioners either already have or are all moving toward doctorates. It's the same reason for the bullshit DNP degree. Also, whether you are an MD/DO or an NP commenting on this matter, I ask you to please demonstrate your pros/cons in a constructive and respectful way. Press question mark to learn the rest of the keyboard shortcuts, RN - harm reduction | supervised injection | medicine. They allowed the license to practice medicine become meaningless without completion of a long, underpaid residency program. VA Goes Too Far on NP Independence — Doctors' morale suffers, and patient care may follow suit. New comments cannot be posted and votes cannot be cast. I do think there is a substantive move toward credential prestige. That kind of pressure, along with the high stakes, drive people away. Like a resident for the duration of their professional career? A fair comparison of training could be comparing a Navy Seal (MD) to a very good personal trainer (DNP or NP)- it’s just not the same. Some feel that "nurses shouldn't pretend to be doctors." I've had two different NPs as PCPs for the past ten years (both operating as part of a team with MDs). I really like how this article is written! Yet in New York State next year, nurse practitioners with perhaps even less clinical education will be allowed to do so. GravelRider SDN Lifetime Donor. Medical students give a lot of time and money to their education, and when they are done, they face have years of overwork and underpay....meanwhile watching PA and NP students zip past them into practice and family life. All questions related to NP admissions, brick and mortar vs. online programs, and direct entry NP programs along with any posts related to NP school admissions should be posted in the weekly prospective NP thread. Ideally I'd like to stay in the ED - don't know if that makes a difference although I've never seen an NP in the ED. That level of generality necessarily leads to a lack of depth in knowledge. The Doctor of Nursing Practice (DNP) is designed to prepare experts in clinical nursing practice or in systems-focused roles outside of direct patient care. We are also not trained to see a patient every 7 minutes. As it stands now, they have a pretty awesome setup in that they are almost completely protected from liability in their practice. Wondering if it's OK to see a nurse practitioner instead of your usual doctor when you're not feeling well? Makes me want to improve on my writing skills. This is a highly moderated subreddit. If any of that doesn’t describe you, you’d probably be happy with being a PA or NP. It seems to me that nurses are some of the last true generalists in medicine. I think it's nice to hear from someone who is specialized for reasons other than thinking primary care sucks. The real problem with primary care is not the pay, but the working conditions. Hospitals are employing more and more docs, for a number of reasons. save. I have a feeling that's mostly because they're years removed from primary care and have forgotten what they didn't practice. I know this is a very lengthy post, but I've been so torn between the NP and MD path that I'm not sure how to condense everything into a few short sentences. The medical side of practicing independently is not the difficult part, it's compliance and billing. I would not say the choice between being a doctor and mid level is primarily a financial decision, though. The average NP student even completing school would not pass USMLE Step 1. If you could go back would you change your path? I'm an anesthesiology resident. But yes, I think people look down on nurses like all we do is take orders. If so, what abnormal habit/oddity did the patient have thinking it was normal? Most people pursuing NP is a combination of being more comfortable with the nursing model and convenience. Now nurses are becoming NPs straight out of nursing school, because it's cheaper/easier than going to med school. This is a highly moderated subreddit. Although my decision will not be heavily based on the responses I receive on this thread I am curious as to whether you, as MD's prefer to work with PA's or NP's and why? By removing false barriers to practice, such as the not-adhered-to guidelines requiring physicians review medications, therapeutics and lab results ordered by NPs — all content covered in NP school —would allow the team to focus on what truly matters: patient care. Close. If you could go back would you change your path? It is the pinnacle of practice-focused nursing degrees, building upon previous nursing knowledge with advanced courses in quality improvement, evidence-based practice, and systems leadership. The biggest driver for high physician pay is that most physicians will start their professional career with more student debt than a mortgage. Do you think any recent internal med grad is going to be able to adequately "oversee" this NP?