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Doctors like to assert, maintain control and continuously patrol over their territories; at least some do. In a recent post on THCB, “Nurseanomics” by Maggie Mahar addresses the heated debate over the difference between a doctor and a nurse. Mahar takles the question that Legislators in twenty-eight states are dealing with. Should a nurse practitioner (NP) with an advanced degree provide primary care, without an M.D. being in charge? But another pressing question that needs to be addressed is: Should nurse practitioners be called doctors (DNP)? (DNP is a Doctor of Nursing Practice.) That is the question that I will address here. I reached out to the medical community to get their reaction. It’s not surprising that the immediate response of some doctors when asked if nurse practitioners should be called doctors (DNP) is “No!” evidenced by Dr. Stangl’s comment.
“NO! Nurse practitioners should NOT be called “doctors” because they are NOT! While many NPs do an excellent job of handling certain types of problems in certain settings, they do not have near the depth or length of education that physicians do and should be credited for what they Do have, which is their nursing background and expertise.” Susan Stangl, MD
Take a look at this comment that appears in THCB:
“An NP has mostly on the job training…they NEVER went to a formal hard-to-get into school like medical school,” wrote one doctor. “I have worked with NPs before, and their basic knowledge of medical science is extremely weak. They only have experiential knowledge and very little of the underpinning principles. It would be like allowing flight attendants to land an airplane because pilots are too expensive. HEY NURSIE, IF YOU WANT TO WORK LIKE A DOCTOR…THEN GET YOUR BUTT INTO MEDICAL SCHOOL AND THEN DO RESIDENCY FOR ANOTHER 3-4 YEARS. NO ONE IS PREVENTING YOU IF YOU COULD HACK IT![his emphasis]”
It’s clear that for these doctors, the simple answer is No. After all, why would doctors want additional prey in their territory? Even with the shortage of primary care physicians, doctors aren’t looking at nurses to help fill the void. The medical profession is quick to respond, and in some cases, with outlandish comments (evidenced in Mayer’s post) against a group of professionals who have earned an advanced degree. I posed the question again to my (yes) colleagues in the medical community. The question again: Should nurse practitioners be called doctors (DNP)? Doug Farrago, MD, explains:
“It is about the word DOCTOR. If you want to be a doctor, then by all means, I implore you to become one. We need you. The training is a bitch and; unfortunately, a gauntlet you have to get through. You don’t get that in NP school. You will be all the better for it, though. It really comes down to paying your dues. You just can’t call yourself one because you, well, just want to. Nurse practitioners came about to strengthen the healthcare system by making them “physician extenders” not “physician competitors”. By going this new route the NP group has made this relationship uncomfortable at best. I will get “hate email” over this but I didn’t do anything. The NPs are blatantly changing their strategy, demanding to be called doctors and are in direct competition with us yet I know they will rip me for pointing this out. The bottom line is the you are not a doctor. You are an nurse practitioner. It is a fact and it is not demeaning to say it. It is just a term. Get over it. I call myself the KING of medicine but just because I call myself one doesn’t mean I am one. Or does it?”
OK, I believe this is where we need to dissect the question. Although the question is simple and direct, it is being answered very quickly, without stepping outside the box. Doctors have a tendency to stay within their own territory. Yes, Dr. Farrago it is about the word “Doctors.” So when the question, “Should nurse practitioners be called doctors (DNP)”? is asked, the immediate reaction from most doctors, adamantly is “no!”. When you think about the question, the answer makes sense; a nurse is a nurse, so how can a nurse be called a doctor? That is the black and white response, but like many questions and areas in life, there’s more than black and white, we need to look into the gray areas for a different approach. We need to step outside the box. Remember, the question is should nurse practitioners be called doctors (DNP)? It does not ask if nurse practitioners should be called medical doctors. (In that case, there’s a simple answer and that would be no, not unless they attended medical school and obtained the Doctor of Medicine Degree.) Kevin Soden, MD, medical journalist has this to say:
“This is a fairly straightforward answer. A nurse practitioner should not be called doctor unless they have gone through a well-defined course of study showing mastering of a prescribed content like any other doctorate program. The danger that I can see for the lay public is the confusion that may arise if a person gets a doctorate degree in nursing and when they see patients, they or their staff refer to themselves as doctor. The average patient might think they are seeing a medical doctor with more advanced training in diagnosis and treatment. It’s important that the patient be educated in this regard.”
Here’s an interesting comment by Michael Blumenfield, MD -
“I see more downside to upside to calling NPs “doctor” in the hospital setting. It would suggest to patients that nurses who were not NPs were somehow not as important, responsible or critical to the patient’s care. In fact at times the opposite is true i.e. in trauma and critical care units etc as well as other places [take out psych] such as psych units etc where they have just as important roles and have had as much training as NP. I see this as even more important than the blurring of identification with physicians which might create some minor problems. Nurses deserve a great deal of respect which I believe that they have. I would hope that the hospital environment not become the place for working out political agendas.”
Time to scrutinize the question, Let’s look at the history. What does doctor mean?
Doctor originates from the Latin word (gen.: doctoris) which means teacher, it is abbreviated “Dr” or “Dr. and it’s used as a designation for a person who has obtained a doctorate-level degree.
Doctorate “is an academic degree or professional degree that in most countries represents the highest level of formal study or research in a provided field. In some countries it also refers to a class of degrees which qualify the holder to practice in a specific profession, such as law or medicine. Examples of the former are the Ph.D. (Doctor of Philosophy) and the S.J.D. (Doctor of Juridical Science), while examples of the latter include the U.S. degrees Doctor of Medicine, and the Dutch Professional Doctorate in Engineering.”
Doctorate dates back to the Middle Ages, the Medieval Era as a license to teach.
The first university, the University of Bologna, was founded as a school of law by four famous legal scholars in the 12th century, and the first academic degrees were all law degrees, and the first law degrees were doctorates as stated in Wikipedia.
Theology, law, and medicine were the earliest doctoral degrees.
The term “doctor” refers to an individual who has earned a degree of Doctor of Philosophy, or Ph.D. Beyond academia and in the classical professions, such as medicine and law, professional doctorates emerged such as the Doctor of Medicine M.D. (an abbreviation of the Latin Medicinæ Doctor), Doctor of Osteopathic Medicine D.O.
While many US lawyers and physicians who pursue purely academic and research careers in law and medicine do so after having earned a J.D. or M.D., respectively, these degrees are considered professional doctorates because most who earn them pursue careers as working professionals. In more recent times, other professional doctorates have emerged such as the EdD (usually held by school administrators), the DBA and the DPA (nearly always earned by prior recipients of the M.B.A. and the M.P.A., who continue to pursue ongoing professional careers in business and public administration) and the Doctor of Physical Therapy (DPT.)
There are other health professions such as physical therapy, podiatry, dentistry, chiropractic medicine, optometry, and veterinary medicine, where the title “doctor” is used professionally.
What is the issue?
First, it is true that some doctors can be territorial, but is this really the issue? I had a long conversation with a good friend of mine who’s a medical doctor and not surprisingly, he’s not a proponent of nurse practitioners being called doctors. He said, “The problem as I see it is that the academic term “Doctor” is distinctly different than the common understanding of “Doctor”. Having Nurse Practitioners use the term “Doctor” just mixes up the two uses and is confusing for the majority of people. If somebody wants to be a common “Doctor” then they need to go to medicals school and residency.” He adds, “…territorial is irrelevant. PATIENTS go to their DOCTOR. That is just common vernacular that has developed over several centuries.” While medical doctors aren’t the only doctors; does the issue become academic vs. institution. Is it okay to call a nurse practitioner “Doctor” when he or she is in an academic setting and NOT in an institutional setting? Shouldn’t it go both ways?
Heated Debate
This ostensibly will remain an intense heated debate. Kevin Pho, MD, founder of KevinMD writes a blog addressing the role of nurse practitioners. “Merely bringing up this idea brings out the worst in turf battles, with most discussions devolving into nurse versus doctor cat-fights,” writes Kevin Pho, MD.
Cat-fights we can do without – team is the best approach
KevinMD writes, “…doctors and nurses have to realize that it’s the patients who come first, and to care best for them, a team-based approach is needed.” Will this debate lead to cat-fights between doctors and nurses? As health care continues to change, perhaps it’s time we move out of the box and greet the DNP, the doctor, the teacher, the doctorate as a health care provider. If DNP is a Doctor of Nursing Practice, that simply means that they are teachers of nursing practice; it does not mean they are medical doctors. And yes, in regards to Dr. Soden’s comment, what simply needs to be done when the DNP sees a patient is to introduce her or himself and make it clear that she/he is a Doctor of Nursing Practice, not a medical doctor. DNP will be an asset to patients, but it’s important to realize what Dr. Blumenfield points out. There are many exceptional nurses who provide excellent care and they may not be an NP or DNP. It’s important to note that there are health care professionals who believe that by obtaining the highest level of learning, that they should be called doctors.
“OF COURSE THEY SHOULD BE CALLED DOCTORS,” says Michael Butler, DC, MS, R NCS T says in an email. He adds, “THEY PASSED CERTIFICATION OF HIGHER LEVEL OF LEARNING. THE PATIENTS THEY SERVE RECOGNIZE THEIR EXPERTISE.” Bonnie Marting, DNP, ARNP replies: “Regarding the question of whether NPs should be called doctors: Using the term “doctor” implies a higher education than the masters prepared nurse practitioner. It is an excellent opportunity to introduce the patient to the ever-evolving world of healthcare and the extent of the education this type of healthcare provider has. It does not confuse one with “physician”, simply clarifies.”
Bottom Line
We need to tread the waters very carefully here. The last thing health care needs are fighting nurses and doctors. Both groups are professionals with advanced degrees and we need to recognize that each entity in health care is unique and special. While medical doctors aren’t the only doctors; does the issue become academic vs. institution. Is it about titles and territory? Or is it about the patient? It’s vital that in the 21st century and with changing health care policies, that it’s time that both doctors and nurses work together as professionals for the good of the patient. No matter the title and the number of degrees, it’s vital that communication with patients is transparent and that they know who you are and are not misled.
Questions to think about
- In a hospital setting, should medical doctors be the only doctors allowed to use the title doctor?
- Lawyers can technically be called doctors since they obtain a Juris Doctorate degree, but they do not use that title. Should the same go for nurse practitioners that obtain the Doctorate of Nursing Practice (DNP)? Should they obtain the DNP but not be called doctor in a hospital setting to minimize any confusion to patients?
- Will patients be confused by a nurse practitioner calling themselves doctor?
- If nurse practitioners are very clear in introducing themselves as a doctor of nursing practice, will that alleviate the confusion?
- Should nurse practitioners be called doctor only in an academic setting and not in a hospital setting?
- Is it time to change the “common vernacular” of Doctor? – Doctor in a hospital setting does not necessarily now mean medical doctor since the advent of the DNP.
- Should Colleges and Universities along with the American Association of Colleges of Nursing present an ad campaign to the general public to educate them on the new title of nurse practitioners? After all patients should not be misled, and transparency is critical.
Your turn: What do you think? Should nurse practitioners be called doctors (DNP)?
Barbara Ficarra, RN, BSN, MPA is the executive producer and host of the Health in 30® Radio Show and founder of Healthin30.com, a featured writer on Huffington Post, and an administrative head nurse at a teaching hospital.
OK, let’s stop the crap. Many studies show that an NP providing primary care does so at a level equal to an MD (the AMA sponsored one such study and it was published by JAMA see: http://jama.ama-assn.org/cgi/content/abstract/283/1/59.) The AMA sponsored study was published in 2000–and we are still having this conversation and it is driven by MDs that quote AMA studies when it pleases them and ignores them when it is a strike against their position.
So, here’s the deal:
NPs are as good as MDs or primary care. (AMA says so—see above)
DNPs are NPs who are as good as MDs for primary care.
So, DNPs and MDs are both doctors with essentially the same outcomes in primary care.
Thus, a Doctor in a primary care setting (which may include a hospital folks!) is a Doctor whether he/she is a DNP or an MD.
Does the DNP role compete with MDs in primary medicine specialties? Yes, and as it should. The AMA and its approved medical schools cannot produce enough MDs to fill the demand required. Therefore, the DNP folks are stepping up—it’s just supply and demand.
So, do DNPs want to be seen as primary care doctors? YES, and anyone who says differently is dissembling.
But wait, this fight has happened before. The AMA fought the DO crowd as they expanded beyond high-class chiropractic and became physicians.
SO, will the DNPs need to expand their training as they come of age as a respected member of the primary care team? Yes, and it will–after all no outside group is forcing the DNP designation.
Finally, the AMA and the MDs and DOs need to step back and realize that the DNPs are showing up and the genie is out of the bottle.
Oh, and to all the MDs posting that it’s not about the title–I agree–so stop arguing and fighting the title. If a DNP can provide the same level of care as you then why should you worry that this exceptional provider of primary care is calling her/himself by the same title as you? After all, it’s not about the title. Or is it?
Randall, regarding your claim that MDs have allowed (after a fight) DOs to work as equals and, as such, should allow DNP to work as such… please note:
MDs and DOs adhere to the same academic schedule: 4 years of undergraduate work, 4 years of strenuous graduate work (of which 2 years are academic and 2 years are clinical in nature), 3-5 years of post graduate work (internship and residency), 1-2 years of post residency fellowship (often), and 1-2 years of fellowship involved research (less often). Please note that at each step of education there is a terribly difficult selection process that each individual must pass through, or else their medical training is discontinued.
Thus, physicians who are colloquially referred to as “doctors” by the general population must complete between 11 and 17 years of highly competitive and strenuous training before they can practice clinically and independently in their respective field. It must, therefore, be implied, that during this 11 to 17 years of difficult work that 11 to 17 years of valuable knowledge and ability has been obtained. Understanding this, the knowledge and ability of nurse practitioners who complete 6-8 years of (arguably less competitive and, possible, less strenuous) work is nearly 50% of that obtained by a DO or MD.
I completely agree with Bryan. One should not compare the academic lengths of an MD and a DO with an NP.
When it comes to it, it’s just a title right? My mother can be called a doctor if she wants. But is she one? No. When it really breaks down to science knowledge and training, MD and DO’s have more experience before actually going out and heal.
I work at a clinic as an interpreter where there’s 3 NPs and 2 MDs and a DO. Most of the time after NPs see a patient they leave the patient room to ask a MD or the DO questions before going back into the room. I never see that with MDs or DOs. NP’s are gentle and extremely sweet and take their time with every patient. Bu just in a general practice clinic I can see the difference between an NP, DO and MDs, on who has more training and knowledge than the other.
I guess the question is: Is an NP an equivalent PHYSICIAN to a MD and a DO.
And this is coming from a interpreter/patient not a health professional.
exactly- you are not a health care professional
and yet she is exactly correct. Surveys of patients have overwhelmingly shown that patients prefer the word “doctor” to refer to the MD/DO and not to someone else with a doctorate unrelated to medicine.
DNPs want to be called doctor in a hospital/clinic setting to confuse the patients. Shouldn’t they be proud of their own training and not try to piggy back on the reputations of a different group of professionals?
Here is the truth:
A physician trains for 4 years of undergrad, 4 years of medical school, a year of internship, 2-6 years of residency (depending on the specialty) and 1-3 additional years of fellowship for subspecialtiy training. At each point along the way, there is a weeding out process and only the best and brightest advance to the next level. This occurs at the MCAT level when applying to med school. It occurs after year two of medical school when you take step I of the USMLE. It occurs at the end of 3rd year of medical school as you utake step II of the USMLE. It occurs at the end of every clerkship as you take the national shelf exam for each specialty (medicine, surgery, psych, pedi, ob/gyn etc). It occurs at the end of medical school as you compete nationally for the best internships and residencies. Once in your intern year, you clear step III of the USMLE before you can get a license to practice. Each year of residency, you take the in training exam which helps determine if you get to advance to the next level of training. If you get past that, you apply to fellowships where only a small percentage are accepted to the most competitive spots. Once you finish residency, you get to take a written board exam, many of which are so difficult that the pass rate is in the 70 percent range. If you pass the written exam, you get to sit for the oral exam (one of the most stressful experiences any person can ever be subjected to). The pass rate is 70-80% for many oral exams. At the same time, many young doctors are enrolled in fellowships or paying their dues doing additional “chief” years so that they can be eligible for 1-3 year fellowships. All of this time, still being paid minimal salaries and working long hours. Once finished with fellowship, then they must sit for their subspecialty board exams. Once complete, it is now time for recertification in their primary board within the next couple of years. And so it continues. At any step along the way, the weak or unqualified are weeded out.
Compare that to this:
A person decides they want to be a nurse. They enroll and take science courses for non science majors for a couple of semesters. They do their clinical rotations following other nurses around and implementing physician orders. They graduate and get a job within 2-4 years of making the decision to be a nurse. They are in high demand because all of their nursing colleagues with any ambition are either nurse practitioners or clipboard carriers. They are paid well and work hard. They see additional opportunity and sign up for a DNP, CRNA, or NP program and 2-3 years later, they are done, all the while earning a great living as a nurse while doing the entire DNP or NP process through on line courses at their own convenience. They arrive at the end of training with no debt and no sweat equity and very little actual “medical knowledge.” At no point in the process was there a weeding out process to separate the qualified from the unqualified. Their entire time is spent following physician orders and not in formulating treatment plans or learning how to diagnose the difficult patients. It is assumed that if you make the decision to go to nursing school, you will be a nurse. If a person makes a decision to go to medical school, their is only a small chance that their dream will come to fruition because most get weeded out along the way and most don’t have the drive and stamina to complete the mission.
Meanwhile, nurses join their nursing political action committee and lobby the politicians to claim equality. In their minds, they really believe it. That is the scary part. “They don’t know what they don’t know.”
And here we are years later having this argument over the internet about who is better at being a “doctor” or who should be called “doctor.”
Hopefully, after reading the above, the general public will be educated about the paths required to achieve each degree.
Nurses and physicians are not equal and the public should not be deceived to believe that they are. If a person wants to be a real doctor and be called so in a hospital clinical setting, do the work needed and go to medical school.
The public deserves to know the truth and not be deceived by the militant nursing PAC’s along the way that wish to gain by legislation and hospital policy what physicians have achieved through hard work and education. So, yes, that upsets me when they claim equality with only a fraction of the education and experience.
This thread is as dumb as it gets. As a medical student I am not worried about who gets called what. I will be the best physician I can be. Yes I stated best PHYSICIAN, not DOCTOR. I will be working as a physician. Doctor of _____ represents the level of education you receive. Doctor of jurisprudence, level of education- title of position, Lawyer… Doctor of Medicine, level of education- title of position, Physician… Doctor of Nursing Practice, level of education-title of position, Nurse Practitioner… Doctor of Philosophy in XYZ level of education-title of position, Researcher, Professor, Janitor and etc. You’d think that people with the highest level of education could find something more beneficial to have discussions and debates about.
^^^^naive^^^^
Of course you don’t care. You are already representing yourself as an MD in your screen name. When you actually earn it and another group tries to claim equality, you will mind. You just haven’t been through it yet. You are in the early stages of your training and you have not seen the actions behind the scenes to marginalize the role of the physician in medicine. Go ahead with your beliefs while we work to right the ship. You should hope we do a good job so that there is something left for you when you get done with medical school with your $200 K in debt and a nurse has just taken your job that you earned through blood, sweat, and tears because you and others were asleep at the switch. Ultimately, it will be the patients that suffer as they receive substandard medical care. The public will not even realize most of the time, because the differences will be subtle. The delayed diagnosis that leads to increased morbidity and mortality. The failure to rescue in an emergency situation. The inappropriate prescription etc.
Well one thing is true assumptions will make an @ss out of you. MD, those are my initials, 200 k in debt… it would be more like 350k, but I have a scholarship to cover all my expenses. Once again focus is on the wrong thing. People would not care if Earl the mechanic could get them well as long as they got well. I went the medical school route because I like all the additional information that we must process. Will we use all of it??? Good chances is no, especially once we specialize, but I am sure you can attest to that. I just feel instead of debating and worrying about who has what TITLE, lets worry about who has the proper skill set… if a MD gets beat out of a position by an NP… then maybe it was more factors involve other that level of training. Don’t give me the “it’s because the NP is cheaper hiring option”. If they are then you have to “sell” yourself to be a better option. That goes to all, other MD’s/DO’s or whoever is applying for the position. Is that not how the free market works???
Actually MD 20/20 is the one who is NOT naive here. His/her concern in on patient care and service provided, and not some personal issue that you may seem to be having. I am not quite sure why, but “Gern Blanston” seems to be extremely insecure. It is coming through rather desperate and narcissistic if you ask me.
As it was posed, “if a MD gets beat out of a position by an NP… then maybe it was more factors involve other that level of training.”
To MD20/20,
Your cover is blown. You are not a medical student. Your speech is straight out of the canned speeches that militant nursing organizations use. Even on the internet, you are portraying yourself as something you are not. Where do the lies end? Your initials?? Nice try at recovery but the rest of your diatribe gave you away.
^^^^^ Since the end of this thread is close I will reply here…My diatribe? Have you not proofed all of your comments on this site? So what’s next, the 20/20 means I “want to be an ophthalmologist”? Wrong, try Trauma (Emergency Medicine). You are a true idiot and it is sad to see you in the physician community. My case in point is all physicians are doctors not all doctors or physicians. Let’s worry being the best at healthcare and the rest will work itself out.
See the December, 2010 editorial by Jeff Susman, M.D., Editor-in-Chief, The Journal of Family Medicine:
http://www.jfponline.com/Pages.asp?AID=9173&issue=December_2010&UID=
I think Dr. Susman’s analysis of the issue is highly objective and one that Congress, and the AMA and its constituents should seriously consider.
See the editorial by Jeff Susman, M.D., Editor-in-Chief, in the December, 2010 issue of The Journal of Family Practice:
http://www.jfponline.com/Pages.asp?AID=9173&issue=December_2010&UID=
What I find interesting about this debate is that it revolves solely around doctors and nurses. Plenty of other healthcare professionals in hospital settings that are NOT M.D.s are referred to as “doctors” but somehow that doesn’t seem to cause as much debate as the idea of a nurse being called “doctor”.
In the units where I work, Pharm.D’s and psychologists are referred to as doctors. Podiatrists and Optometrists and Dentists are always referred to as doctors but these practitioners are not MDs anymore than DNPs will be but there seems to be no concern with calling them “doctors”.
For anyone to say that nurses should be the ONLY healthcare professionals who are not allowed to call themselves doctors when they obtain a doctoral degree really suggests that this is debate is about something else.
As a patient, I know it will be confusing to have the MD/doctor and the NP who is a “Doctor’s assistant” with the same clinical title. Recognizing academic credentials are important and a doctorate in Nursing means being at the top of the nursing profession. If we call a NP “doctor” it will imply to the patients that the NP has the same academic credentials of the MD/doctor…isn’t this a form of ‘fraudlent misrepresentation” …?
May be the solution is to call the NP with a doctorate in nursing:”Doctor-Nurse” and the MD/Doctor: “Medical Doctor” …by this logic, we can then call the specialist who has more education than the MD/GP: “Medical Doctor Specialist” … or, maybe the clinical title of “Doctor” should be confined to the MD only as this would serve to simplyfy the confusion caused by the perceived need to be the “top dog” – afterall, the patient should come first; not our egos.
Rita,
A nurse practitioner is an advanced practice nurse, and not a “Doctor’s assistant.” In many states they can work independently.
In fact, the terms “physician extender” or “doctor’s assistant” are not appropriate when referring to a nurse practitioner (and can actually be rather offensive).
I agree with Vic. A NP is totally not a “doctor’s assistant.” Otherwise they would have been in a PA’s program instead as they are the real physician assistants. I really think that if somebody has no clear idea of what a certain thing is, or what this debate is referring to as per “titles” and terminologies– it is much better to keep silent because ignorance only makes this debate complicated. I suggest to anyone who wants to comment here to really research what is what first before even adding more confusion to public.
And oh… why can’t some people accept it when ‘ceasar’s should get ceasar’s as it is due?’ If these NPs have finished a doctorate degree, they are entitled to a name just as anyone is who finished such level. They may or may not asked to be called as such but I don’t think public are that dumb not to distinguish between different doctorate levels as to MDs, Pharmacists etc. Questions about MDs protesting about NPs not deserving the title is really obnoxious now. This is not a stone age. Nurses have come a long way already and not “all” of them really can be under the MDs’ skirts or pants like it was of the war’s era. It’s disgusting how these protesting title greedy people defend their points of argument, when really and truly, it’s just a matter of wanting to be on a “higher ground.”
As of the pharmacists not really minding what they should be called; hello?!! they don’t do primary care….should they even join the confusion? And mind you they really appreciate it when we address them drs at work even if it’s a joke! Soooo, give them their title too- they earned it! A doctor title is not only in the medicine world.
rediculous.
your spelling indicates why you never went to med school
These providers (physical therapists, eye doctors, pharmacists) are called “doctor” under a seperate pretense. When I go to the eye doctor, I expect to see a qualified professional of the highest possible degree of training who can manage the care of my eyes. Same for my medications when dealing with a pharmacist. If I am an inpatient in the hospital, I expect that someone who introduces themselves as “doctor” has the highest possible degree of training (both clinical and didactic education) in whole-health-care management. While a DNP does have the highest degree of training in his/her respective field (and, in most cases, is among the most qualified primary care providers), I don’t believe that they have the highest degree of training to deal with ALL diagnoses and ALL care-planning. I do believe, in many circumstances, that my care can be managed by a DNP. But, if I were to have a multifactorial health issue that required detailed knowledge of obscurely atypical pathology/pathophysiology, I know I would MUCH rather my care be handled by a qualified medical doctor. I could see myself being confused by a DNP introduced simply as “doctor”.
When a pharmacist comes into the room and introduces herself as “doctor”, I understand the limits of her knowledge, the background of her education, and the scope of her practice. When I visit a doctor for health-care, I would like the title “doctor” to define the limits of THAT person’s knowledge, the background of THAT person’s education, and the scope of THAT person’s practice. Because DNPs provide the same type of care as primary care medical doctors, the term doctor, to me, does not allow me to make the distinctions listed above. While DNPs are as competent and as capable as primary care MDs/DOs in many respects, this is not true in 100% of cases. They do not have the same knowledge, education, and scope as medical doctors. I want to know WHO I am dealing with so that I, as a patient, can make the best decisions about my own care. If I think that I have a health issue that would be better addressed by a medical doctor because of its complexity, I would like to know what my provider’s qualifications really are.
I understand that a doctoral degree in any field is tough to come by and involves rigorous training, but I don’t believe that the scope of a DNPs care and knowledge is equal to that of a medical doctor in all cases. I want to know what I’m dealing with so that I AS A PATIENT CAN BE MORE EQUIPPED TO MAKE MY OWN DECISIONS.
Annemarie, I’m going to assume you are a student in a DNP program or are a licensed DNP. If so, congratulations! Regardless, you need to understand that these decisions are NOT TO BE MADE BY EITHER DOCTORS OR NURSES! These decisions should stem from your patients. Ultimately, we are what it is all about. Don’t allow a system to be created that doesn’t allow patients to innately know the qualifications of their providers.
Patient, I agree when you say “I don’t believe that the scope of a DNPs care and knowledge is equal to that of a medical doctor in all cases.”
You are absolutely right, they are different. However, it is important to note that “different” should not imply “lesser.”
The scope of practice and philosophy of a DNP is different than a MD, with its own advantages, strengths and of course weaknesses. While I agree that in certain situations (especially those involving complex pathophysiology) I would prefer a MD, in other situations (in which the needed care transcends to different realms of health and well-being) I might opt for a DNP.
Here is where the problem in this argument is:
Physicians (MD’s) – are generally trained in primary care OR a specialty
A physician is NOT trained to handle ALL of your medical issues.
A primary care MD will take care of general complaints
when you need care for some problem such as your heart or your kidneys – your primary MD will REFER you out to a specialist. – Such as a CARDIOLOGIST or a NEPHROLOGIST
The NP with their DNP will also sse you for their specialty or for primary care – If the DNP is a family NP then they will treat primary care – if they have specialtized in OB/GYN then they will deliver babies and care for mothers just like an OB.GYN
If you have a problem with your heart or your kidneys, the DNP will refer you out to a CARDIOLOGIST or a NEPHROLOGIST
My point is that MD’s cannot care for all problems, that is why there are specialists and the DNP also cannot care for all problems.
Too much emotion. The facts: there is in the state of Minneosota, at the University of Minnesota a curriculum in which a Nurse Practioner can obtain a Doctorate in Nursing. The course work is completed in approximately an 18 month time frame, costs about $18,000. Much can be done on-line. It’s used mostly for those who teach in academic centers- their pay and advancement is better. Unfortunately, in private practice medicine, this Doctorate in Nursing does not confer any higher payment from third party contracts. A nurse practioner is reimbursed about the same as an MD for a similar patient encounter, whether they have this doctorate or not. This is why most don’t get this degree. I work with 8 NP’s in my OB/GYN practice and have an excellent relationship with them and find them to be quite competent in their care. But they don’t want to be called “Doctors” simply because they don’t have that degree.
Robert Stocker MD
Exactly – and if they did have the DNP (Which is a clinical nursing doctorate) they would most likely want to be called doctor – because that is what their degree is – I would also clarify to patients that they are a DNP as opposed to an MD – if that matters to the patient.
All through nursing school, they learn little science and more sociology… All of a sudden at a dnp level you expect them to grasp the scientific principles which form the foundation of medical practice? So you build the foundation after you have built the building. Interesting! Why have dnp? Just increase the intake for the medical course. Or do away with doctors altogether. Phase them out and let there only be nurses. I don’t know how it is in the us, but in india, only those students chose to become nurses who tried, but couldn’t qualify to get through the premedical test. After qualifying as nurses, they tend to introduce themselves as ‘doctor’ even if they only have a diploma in nursing. So i do believe that a lot of this has to do with the coveted prestige that they couldn’t get, and can’t stomach the different prestige that they enjoy. The msc nurses do try to overstep their bounds but their lack of knowledge of fundamental science and resultant errors become readily apparent due to their symptomatic and experiential approach to problem solving. As far as “experienced nurses getting same level of knowledge as an md” goes, 10 years of experience probably gives them what a student in medschool knows. That same student 10 years after residency would know a lot more than an equally experienced nurse. And the training an md receives is pyramidal with a wide base in fundamental sciences then life sciences then human biology and then finally in medical sciences tapering off to subspecialities. A nurse is trained more in social studies shifts to basic applications in medical sciences and continues as a straight pole to basic applications in subspecialities. A pyramid is definitely more stable than a pole. Statistical conclusions cited by nurses are based on the outcome of a small sample of diseases, even a basic knowledge of statistics (a fundamental SCIENCE and not sociology hence incomprehensible to nurses as they have little scientific background) should tell you that more diverse the sample studied, the more accurate is the inference to the actual truth. How do you judge competence on the basis of only 3 conditions and those too, among the easiest to diagnose and relatively easy to treat. Surely, there are more diseases than just the 3 mentioned, seen in primary care. Are the others not important? Well, they are to the patient atleast and nurses are definitely more concerned about the patients than the doctors! The sad part is that the ones to offer an “honest” and “unbiased” opinion are the ones with even less knowledge about the field than the nurses so there isn’t much more to expect from them. However, let the nurses be prepared to take the same responsibilities and risks as the physician if they wish to enjoy the same status as the physicians. I’m proud to be a doctor and why shouldn’t i expect that prestige when i have given the best years of my youth in the long and arduous study of the science for 8 years, sacrificed leisure and time with my family, spent 90 hours a week, including 2 spells of 32 continuous hours of clinics (sometimes on holidays when others are enjoying) for 4 years as compared to truncated syllabus for 5 and a half years, 8 hour clinical shifts, 52 hours a week for 6 months and 3 hour clinical shifts at 21 hours a week for 2 years?
The ego driven Medical Doctors here need to support their position with studies and not unsubstantiated opinion. The bottom line is that studies, as referred to above, clearly support that nurse practitioners provide care equivalent to that provided by physicians. If the care provided is equal, is there even a concern if a patient confuses a Medical Doctor with a Doctor of Nursing, apart from the Medical Doctor’s ego? I think not. The danger of title confusion among patients is unsubstantiated and ridiculous. If a Nurse Practitioner achieves a doctorate level education, the title Doctor is a clear and accurate description of the degree conferred.
Well said… I am a “Doctor of Medicine” student, but you are so right. This fight is so asinine. Doctor is the level of educate one receives. Physician, Professor, Plumber and etc. are the title of your job. The going rhetoric is patients get confused if people other than physicians use the title doctor, well if doctor is the highest level of education and also translates “teacher” why not just educate people on level of education and title of position if confusion is truly the problem???
JD, those real prospective, double blinded, randomized, controlled studies will never be done because they are not ethical. You take 500 patients in each arm of the study and tell them they will never be seen by a physician and will at no point have the option of being seen by a physician but instead will be seen by a “nurse doctor,” no matter how sick or complicated the patient may be. What IRB would allow that? It is unethical and the public would not buy into it. The scandal would be bigger than the Tuskegee syphilis experiment.
If I spend (at least) 4 years in graduate level nursing courses to complete my DNP, someone had better call me “Dr”. If those who receive a PhD in engineering, philosophy, or psychology are called “Dr”, then why would it make sense to deny a Nurse Practitioner the recognition of advanced education and training? I understand that it may be confusing to patients, but one simple sentence could easily clear up any confusion. Something like, “My name is Dr. So-and-so; I received my doctorate in nursing practice.” Personally, I wouldn’t mind NOT being called “Dr.” in a clinic setting, but the fact that I would be denied this well deserved title really rubs me the wrong way. Respect for one another in a health care setting is crucial for the recovery of a patient, and it is unprofessional for providers to have such harsh views of one another. An ad campaign to the general public about the role of the Nurse Practitioner is a great idea.
Ultimately, doctors of nursing and doctors of medicine entered the health care field to provide better lives for others, and they should work together to achieve a common goal.
If it took you four years, you were on a part time track, or you failed some of your on line nursing philosophy classes. And no, I will not be calling you doctor.
Ms. Ficarra,
The various responses to your question ”should nurse practitioners be called doctors (DNP)?” have raised several issues; appropriate use of the title of doctor, formal education of doctors of nursing practice (DNPs), scientific foundation of DNPs, clinical experience and collaboration. I will speak to two of these issues; patient outcomes for those treated by nurse practitioners (NPs) and use of the title of doctor. You quoted a physician as saying, “They only have experiential knowledge…” and “it would be like allowing flight attendants to land an airplane.” Presumably, this meant allowing DNPs to practice independently was similar to allowing flight attendants to land a passenger plane. These comments show either an ignorance of DNP education and training or an emotional loss of objectivity. A nurse practitioner that has earned a doctorate degree in nursing practice has a minimum of seven years of college education. This education includes courses in the hard sciences such as chemistry, biochemistry, anatomy, physiology, pathophysiology and genetics to name a few. Additionally, DNPs are licensed registered nurses and pass certifying board exams to practice as advanced practice nurses in an area of specialty. The licensure and certification process ensures competency and public safety. Doctors of nursing practice, as well as other NPs are fully qualified to promote health and disease prevention, as well as independently diagnosis and manage health issues within her or his specialty area.
The Journal of the American Medical Association (JAMA) published the results of a clinical trial in which 1,316 subjects were randomly assigned to the care of either a nurse practitioner or physician. After six months of care the researchers, which included four physicians, concluded that there were no appreciable differences in patient outcomes between the two groups (Mundinger, et al., 2000). A two-year follow-up study by Lenz, Mundinger, Kane, Hopkins, and Lin (2004) supported the original findings. Numerous other studies have since supported similar findings in other populations and settings. Nurse practitioners are trained to take care of patients and they do it well. There can be no reasonable analogy made between patient care rendered by a nurse practitioner and a flight attendant landing an airplane.
You quote another physician, Dr. Doug Farrago as stating “you just can’t call yourself one [a doctor] because you, well, just want to.” While this statement is technically correct, it is irrelevant to the conversation. This discussion is about nurses using a title they have legitimately earned. I believe Dr. Farrago’s additional comments get to the real issue physician’s have with DNPs. Dr. Farrago continued by categorizing NPS as “in direct competition with us.” In your article, you presented a history of the title of doctor. You additionally present numerous other examples of various fields which award doctorate degrees so I wont restate these here. I was encouraged to see the comments by Dr. Kevin Soden who agreed that if a nurse has completed doctorate education then it would be appropriate to use the title of doctor. Doctors of nursing practice have done just that, completed a doctorate program of study.
Lastly, I cannot help but feel there is a gender issue involved in this debate. Historically, physicians were primarily men and nurses primarily women. A 2011 survey has shown that the gap between male and female physician’s pay is actually widening, even when adjusted for hours worked and area of specialty (Reuters, 2011). Similarly, a 2006 study showed that male NPs earned between 7.9 and 8.2% more pay than their female counterparts (Newland, 2006). This is relevant because in our society financial compensation is linked to one’s value and power in the market place, and therefore value and power in society. From this standpoint, women are not as valued in the workforce as men. We now have a predominately male dominated group feeling economically challenged by a predominately female group. The physician responses seen in this blog reflect an emotionally driven attempt to deny nurses use of a rightfully earned degree title and limit use of their training due to fear of economic infringement. In light of well documented support for the care provided by nurse practitioners, these emotional responses are astounding.
References:
Ficarra, B. (2011). Nurse Practitioners – Doctors? The Health Care Blog. Retrieved from http://thehealthcareblog.com/blog/2010/05/12/nurse-practitioners-doctors/
Lenz, E. R., Mundinger, M.O., Kane, R.L., Hopkins, S.C., & Lin, S.X. (2004). Primary care outcomes in patients treated by nurse practitioners or physicians: Two-year follow-up. Medical Care Research and Review, 61, 332-351. doi: 10.1177/1077558704266821
Mundinger, M.O., Kane, R.L., Lenz, E.R., Totten, A.M., Tsai, W.Y., Cleary, P.D., …Shelanski, M.L. (2000). Primary care outcomes in patients treated by nurse practitioners or physicians. The Journal of the American Medical Association, 283(1), 59-68. doi: 10.1001/jama.283.1.59
Newland, J.A. (2006). 2006 Nurse practitioner salary & practice survey. The Nurse Practitioner: The American Journal of Primary Health Care, 31(5), 39-43.
Reuters. (2011). Pay gap between male and female doctors widens. Retrieved from http://chicagobreakingbusiness.com/2011/02/pay-gap-between-male-female-doctors-widens.html
I have read so many of these arguments over the years, and all of them are the same. There are a few people saying they had a great experience seeing a nurse practitioner, a few saying they will never see one again, or they don’t know what they are talking about. Then i see the angry frustrated MD, arguing that all DNP’s are doing nothing but trying to play doctor. Then there is the actual ARNP that says all they want to do is use they title that they earned and provide the care they are trained to give. Every one of these blogs, comments, yada yada yada are all the same. I have sat back and read most of these comments on this one and i just cannot sit here and not say anything. To the few MD’s that have said so many demeaning, and degrading comments about nurses, you all should be ashamed of yourselves. I could never imagine working with any of you people. You want to call yourselves superior to us because you have an MD after your name. I have worked with some amazing doctors and some amazing nurses, I have also worked with some terrible on both ends. They were all colleges of mine and I would never in a million years talk down, or degrade any of them like you all have in this post.
To the doctor from india or wherever, as to say i became a nurse, and then a DNP because I wasn’t smart enough for med school, made me laugh. I went to a tech school for my LPN right after high school, all i ever wanted to do was help people. Being a doctor was my number one goal but i wanted to start right away. A year after I finished my LPN i decided i wanted to work on being an MD. I double majored through school in nursing and pre-med. I worked as an RN through most of it. I hit a cross roads at that point wondering what i wanted to do. After taking the MCATs i and being accepted to med school (don’t ever tell me i wasn’t smart enough to get in, I held a 3.6 GPA while double majoring, and working full time, and scored a 34 on my MCATs)
My life was flipped upside down right before the start of my second year of med school, when an unfortunate accident almost killed me. It was a long recovery, and at that point i decided that i wanted to stay in nursing. After my recovery i went back to work, and also started working on my NP. I now have my DNP and I have my own practice. I am partnered up with one other DNP, and an MD, who approached me for the opportunity to start this practice. The doctor i work with does not oversee me, but does in fact collaborate with me. I have never and will never do anything out of my scope of practice. Oh and i do carry and pay for my own malpractice ins.
For the most part i understand where both sides are coming from, and I agree that it can be confusing when not identified in the right manner. But to say i am trying to be a fake doctor, and use a title that i did not earn is an outright insult. When i was a charge nurse, I remember a couple of physical therapists, enter a room and introduce themselves by saying, “Hello my name is DR. Smith and I’m your physical therapist. Now how come no one ever chastised them for using the title Dr. in a clinical setting. They did in no way have their MD, just a DPT. Yet to this day they are still able to use that title, and you all have not said one word. And I have a good friend who is a chiropractor, one of the best in this state. (not my opinion, he rated as the second best in our state) He uses the title Dr. when he sees patients, but hes not an MD. Should he stop as well, because he is going around telling patients he is a doctor, but has not received his MD. For the most part my patients know when they enter they are seeing a NP, when i introduce myself to new patients, I always address myself as Dr. Carr, and tell them that i am the Nurse practitioner. I have never not identified myself as a physician, nor have I ever not told the patient, that i am a nurse practitioner. It is also on my name badge, and my name and title are embroidered on my lab coat.
It is all a pointless war between nurses and doctors. I for one am tired of doctors like the ones that have posted on this site, and pray to God that i never have to work with any like you, and that no one i know ever has to be a patient of yours. We can just put the he said she said BS to bed, and call this argument what it is. A large group of doctors claiming they should be the only ones to carry the title DOCTOR. They funniest part is most of you have missed or forgotten the part where MD’s had to fight at one time to use the title of doctor. It was originally used only for students who had reached the highest level of their law degree. The term doctor originated as meaning teacher in the first place, not medical care giver. Lets teach each other, i know that i would not be where I am today if it wasn’t for the Doctor that i am partnered with at my practice. He has also learned a lot from me, with my nursing background. At the end of the day its all about the patient( i couldn’t care less if you guys say NP’s only say this to try and end an argument because my first priority is my patients, not what you all think) not the titles, or the bureaucracy.
Dr. Thomas Carr, ARNP, DNP
^^^ nurse ^^^
“How come no one ever chastised them for using the title Dr. in a clinical setting. They did in no way have their MD, just a DPT. “. It’s a superiority complex. For many years nurses have been the individuals who relegated to a inferior position compared to a doctor. Of course the MDs are feel that their territory is being crowded when a nurse who has a doctorate degree wants to be called a Doctor. They don’t want to share the title with a profession with a simple nurse! That’s a crock!!! Why the hell do MDs go to med school? To walk around with a big ego and look down their noses at the Nurses, or to practice their skill which is to HELP PEOPLE!!!
Sure, and paralegals are the same as attorneys, right? It is all for the client’s benefit, so why would those jerk attorneys be upset if paralegals started calling themselves attorneys. Everyone knows it is the paralegals that do all of the grunt work behind the scenes and often have the best ideas to help a client. It would be selfish and egotistical to not let them call themselves attorneys.
Flight attendants should also be able to have the same rights and privileges as pilots. They have been on just as many flights. Sure, most of their career has been spent taking orders from the cockpit crew, but they are the real customer advocates and care for the whole passenger. Not just worrying about the one area, the cockpit. Senior level flight attendants know just as much as these newbie pilots about the airline industry. Pilots are just jerks that are trying to sleep with all of the hot flight attendants. Anybody could do what they do, especially flight attendants that have been doing this for years.
Architects are another arrogant group. I know plenty of people who have built awesome decks and sheds. They are outstanding carpenters and can build circles around most architects I know. There is no reason that these people should not be immediately elevated to architecture status. The degrees and wasted time for architects is their own problem. There is no study that exists that shows that architects are better architects than a really good carpenter.
Dental assistants are just as knowledgeable about the teeth as dentists. There is no reason that they should not take a few online courses and then open their own practice. Pulling teeth??? How hard is that? Don’t even get me started on orthodontists…their assistants are the ones doing all of the work and the orthodontist pops in for a quick little look see. They don’t need help with formulating a treatment plan. They could learn that easily on line in a matter of a few weeks. Arrogant orthodontists!!!
You sound quite bitter. And your point is rather flawed. If you bothered to learn about what NPs do, you would realize that they are “advanced practice nurses,” trained and educated specifically to formulate treatment plans. In your comments you are rather quick to pull the trigger and judge other disciplines on their level of expertise and training. Mind you, anyone with a lot of money, average intelligence, and some free time can go to the Caribbean (or many other schools in the USA) and become a doctor in medicine. We have all seen it happen.
Luckily most physicians I know are not in the stone age as you appear to be (and actually appreciate the collaborative relationship with other advanced care providers – including NPs and DNPs).
Anonym,
The point is, people are taking shortcuts and trying to gain, through legislation and hospital policy, something they did not gain through education. A doctor of nursing practice curriculum does nothing to improve a nurse’s ability to diagnose or care for a patient. Look at the curriculum and try to defend that. It is a degree invented to blur the lines and mislead the public. Nurses have a long history of adding extra letters behind their name that mean nothing. Just look at their titles. It is ridiculous. They finally got to the point where they decided a few on line courses would constitute a doctoral degree and somebody bought off on the idea and here we are having this argument. Show me where in your “doctoral” curriculum that you did anything on line that made you better qualified to diagnose or treat a patient. I will show you medical school, residency and fellowship that were all years of doing just that…preparing physicians to better care for patients. These were not years spent at a keyboard doing google searches to finish a term paper for “night school” while earning a nurses salary during your day job. This was years of lives spent dedicated to learning a trade, while nurse have been lobbying politicians and then sneaking in the back door to arrive at the same place and say “we are equals.” Pardon me if I am appalled by that.
Does this seem doctorate worthy??
Conceptual Foundations of Nursing
Ethics for the Health Professions
Health Promotion and Epidemiologic Methods *
Scientific Writing *
Teaching in Nursing *
Interpreting Health Care Policy
Organization & Leadershp Concepts in Health Care
Analytical Core for Evidence-Based Practice
Applied Informatics to Evaluate Hlth Care Outcomes
Evaluating Research Evidence for Health Care I *
Evaluating Research Evidence for Health Care II *
Seminar in Grantsmanship *
State of Nursing Science *
Advanced Practice Core
Advanced Clinical Practicum I *
Advanced Clinical Practicum II *
DNP Capstone Course I
DNP Capstone Course II *
Ha. So, you were one of the rare nurses smart enough to get into medical school, but you were not willing to put in the work to do it, so you took a short cut. No matter how much you dress it up or how sad your sob story is, you should not be called Dr in the clinical setting.
The fact that you even made the statement that your friend is the “2nd best chiropractor” in your state illustrates your lack of understanding.
Just so you know, I feel the same way about PT’s calling themselves Dr.
Chiropractors and dentists can call themselves Dr for all I care. When someone goes to a chiropractor, they know that. When someone goes to a hospital or a doctors office and someone introduces themselves as doctor, the patient expects they are speaking to a DO or and MD. It is called truth and transparency.
A doctorate gotten on line is as legitimate as a hoaky on line PhD. Don’t kid yourself that paying a bunch of money and taking on line courses in nurse management and philosophy is really a doctorate. It is as cheap and phony as all of the other on line degrees and I can’t believe it has gotten to the point it has. You and all others who have gone this route have paid for a doctorate that cost you dollars and time wasted with on line internet courses and a couple of college level “dissertations” that amount to nothing more than on line internet searches.
What a joke.. How come no one is actually looking into what these DNP requirements are. The courses are a joke. Any nurse with money, a little bit of time, and an internet service provider is going to have a DNP within a few years. All at very little personal sacrifice and very little actual knowledge.
Ahh how this takes me back. I’ve been a internal medicine hospitalist for about 4 years now, and I started my first job as a hospitalist when I was 26.
My first job was in Philidelphia. I loved the job and my 7 on/ 7 off schedule and had 2 PA’s and 2 NP’s working with me-all which were almost 5-20 years older than me. I respected them and their experience which made my job a whole lot easier. It was a good team, but there were two people that caused me distress. An NP and an PA. They were both experienced and in their 40′s. One day, a patient came in with severe pain on her foot, where we saw a small sore. The two men were simply convinced it was just a small infection, but the tests did not add up. I suspected is was something more, so I told them to wait and run a few blood tests. I reviewed the tests myself after and went home.
The next day I came back to find out, they had stepped out of their grounds by lieing and telling the patient they were medical doctors and given the patient a bactrin which had caused complications causing her to go in septic shock. When i confronted the men they both snapped and told said
“We are just as qualified as you are.
“You doctors think you’re just the **** because you wasted your lives in medical school and residency. I know just as much and even more than you do and i should be earning as much.”
I called security right after and the two men were stripped of their right to practice medicine and sued for pretending to be doctors. I quickly called a oncologist because i believed the sore to be skin cancer and he confirmed and treated her and thank god, he saved her life.
I don’t have a problem against NP’s or PA’s. I honestly love them, but they SHOULD NOT overstep their boundaries and try to be doctors. They should know their limits and leave so should doctors.
I completely agree. As I have with Bryan’s comment towards the beginning of the comments.
NP’s should know their limits. If they are an NP then I do not think they should be called doctors. BUT if they have exceeded towards DNP then yes, they should be called doctors, doctor in nursing. And should address their patients as a doctor in nursing practice. No matter what anyone says, there will always be a difference. There’s a reason why in undergrad pre-med students take more math more physics and more science than nursing students.
I’m a pre med student that runs an organization on campus that seeks out MDs, DOs, RNs and NPs as special guest speakers. There were two NPs that came to our classroom and I asked them what’s the difference between MD’s and NPs. The answer was, I quote: “There isn’t, I don’t know why we have doctors! Just kidding. We are equal. They just have tee bit more training. We are no different at all.”
I really didn’t like their answer. But nodded anyway. Please don’t tell me you have a BSN, and a Masters and you are equal to an MD and DO that had double the schooling you have and trainining =(
As I continue my schooling in DNP, I’m less and less impressed with Medical Physician’s Knowledge and Talent. Like Dr. Carr, I could of been a physician if I wanted to, I did just as well on My MCATs and was accepted into Medical School. But nursing’s ability to see the whole picture, and more importantly to see the patient in that picture, is what drew me in. I serve the patient not the ailment. I see more than just numbers.
I also do not think it is fair for a Doctorate of Nurse Practitioner to include what they have a Doctor in. Physician’s don’t, Therapists don’t, Professors don’t. Physician’s need to stop living in the past where all they did was tell nurses what to do and sit back for the data to come in. They are scared because their distinction will no longer be superior.
We are a healthcare team who serves the patient, plain and simple.
DNP’s do not aspire to be MD’s. DNP’s are experienced nurses with advanced degrees and many many hours of clinical experience. The recent shift in policy to expand Nurse Practitioner programs, to include additional courses to fulfull doctoral levels of education, has caused much debate amongst us as well as our collegues concerning what we should call ourselves. We have no intention of misleading the public into believing that we are doctors of medicine. But we are doctors of nursing practice and have earned the right to utilize the title. Doctors of medicine do not own the word “doctor”, and if they don’t want the rest of the doctoral prepared community to use the same title they use than I think they should be tasked with coming up with a new title for themselves.
Physician: medical school
Doctor: anyone who gets a doctorate
As a basic RN and Paramedic I am shocked at how poorly every MD I have seen could not or just did not care enough to allow me to take a full breath when listening -lung sounds. Most in fact did not bother. My fellow Nurses and Paramedics tend to spend more time assessing Patients than I have been given by any MD. That has been my experience. MDs if I’m lucky will look up to say hi. Most of the time PCPs have there face in the clipboard, throw a script at me, usually an antibiotic, that i did not need and walk out of the exam room. Most PCPs rush rush and act like they don’t care,,Abt resistance is the direct cause of the I don’t care PCP not explaining that pts do not need an Abt for a cold. Keeps me busy giving Vancomycin in the HH infusion industry. Majority of MDs are not that great and how often do they really wash there hands. I’m not a DNP or NP but
The ones I know are like detectives and good luck getting pain Meds through them if your addicted to narcs. MDs could learn from a good Dr of Nursing Practice.
^^^^^ concur
Now maybe you know how LPN’s who have worked in every facet of nursing and have even run buildings (assisted living) and been in management feel when we are not considered nurses.
To hear how so many physicians are upset regarding DNP’s using thier Doctorate title is heart wrenching. It seems to me that physicians will continue to belittle nurses, no matter how smart the nurse is, or how many advanced degrees the nurse obtains. It doesnt take a rocket science to understand the educational level between the DNP and MD. Nursing programs are very demanding and rigorous. No, it doesnt compare to Medical school, but its no cake walk either. Registered Nurses, LPNs, And Advanced Practice Nurses are the glue to HealthCare, without nurses healthcare wouldnt survive. Since the MDs have much education beyond any APN, why dont MDs attempt to run clinics and hospitals without RNs, LPNs, and APNs. Maybe medical school and residency revealed to them how to work without nurses!!!!!!!
I agree with you 100%. The medical field would be lost without nurses. They are wonderful at what they do and very bright and caring. They are, however, not doctors. Inventing a phony degree out of thin air and calling it a doctorate is shenanigans. That is what people are upset about. This is not about diminishing the role of nurses. This is about exposing the scandal that is being perpetrated across the country by nursing schools and nursing leadership.
When a patient is looking for care they primarily look for an MD or a DO. I don’t know anyone who would be looking for a Nurse Practitioner (no offense, just the way it is).
If a patient notices their physician is not a Medical DOCTOR, they won’t want to call that person a doctor, regardless of whether the Nurse Practitioner wants to be thought of as that. If the nurse has reached a doctorate level, and wants to be regarded by others as a doctor, he or she will have a hell of a time trying to do so.
…And this is coming from a Doctor of Veterinary Medicine.
I beg to differ Dr. Vet, I am a hospitalist DNP who also has a busy clinic practice based on the patients who dumped their MD after meeting me. I have numerous letters and referrals from patients of MD’s doing exactly what you say doesn’t happen, they rather see me as a DNP than their old MD. Most of the time because the MD misdiagnosed them, didn’t listen, was to busy etc. I see more patients admitted to the hospital because of poor medical treatment than anything else. Just another little note, at my hospital, the preferred provider to place central lines is the DNP, why you asked? The hospital did a two year study on infection rates, complications and patient satisfaction the DNP outcomes were so superior the hospital administrators asked us to re inservice the almighty doctors. So yeah, your way off, it is not how it is. Sorry! The public is smart! Just because you have an MD doesn’t relate to better care. I can tell you one thing that scares the hell out of me about doctors, they don’t ask for help when they don’t know something and they really don’t know what they don’t know because they have been trained to think they know it all. If you want to know the real difference between a DNP and MD, that’s it! I know that I can’t know everything, but will damn sure find someone who does, which is usually a specialist MD, that should help the ego log. Thanks
Name the hospital that prefers DNP’s do their central lines. I smell something fishy here.
I have several different vets for my horses and some of them have NOT be a doctor of veterinary medicine but a bachelors in veterinary medicine (ie the BVSC) and still call themselves a doctor and have Dr. soandso on their badge
I think part of the problem is the disconnect between what to address someone and their profession. I have no problem with a DNP introducing themselves or being referred to as “Dr. Smith” just as a dentist, pharmacist or professor would. But just as a dentist would never tell anyone that they are a doctor, nor should a DNP.
The role of the nurse practitioner (NP) began in the 1960’s, when Loretta Ford (nurse) and Henry Silver (pediatrician) developed a continuing education program in response to the health care demands for primary care providers in underserved and rural areas. The NP role has evolved over time. Educational and clinical training has become more rigorous, as it should. The health care need of the 1960’s has not changed drastically; however, the face of health care has become more complex.
The Doctor of Nursing Practice (DNP) as the terminal degree for the NP is a natural progression of the advancement of the nurse practitioner role in health care. There are some individuals in health care who do not believe NP’s should be called doctor in the clinical setting despite having earned the degree. I do agree nurses should identify themselves as Dr. XYZ followed by, I am the nurse practitioner.
More recently, the use of the title of “doctor” by NP’s has been receiving a lot of opposition and attention from physician groups who oppose NP’s using the title in clinical practice. Physician groups have gone so far as to lobby the New York Senate legislature for sole ownership of the title. Senate bill (S02250) was introduced in January 2011, the purpose was to define who and who cannot use the term “doctor.” According to the state Assembly’s website the bill
“Restricts use of the title “doctor” in advertisements to medical doctors, dentists, chiropractors, veterinarians, podiatrists, and optometrists who have received a degree in the appropriate profession and have met all professional requirements of the appropriate program registered by the New York state education department or accredited by an accrediting organization acceptable to such department or are otherwise licensed to practice in the state of New York.”
The bill was referred to the New York Senate Consumer Protection Committee.
Any NP who has completed a doctoral program has earned the right to be called doctor by virtue of their education and should not expect anything less. NP’s are not physicians, nor do they pretend to be. They are however, nurses who are skilled clinicians.
According to the Institute of Medicine 2010 report, The Future of Nursing
“Nurses with DNPs are clinical scholars who have the capacity to translate research, shape systems of care, potentiate individual care into care needed to serve populations, and ask the clinical questions that influence organizational-level research to improve performance using informatics and quality improvement models”
The semantics surrounding the use of the title “doctor” detracts from the bigger issue of a troubled health care system and the need for a unified voice from both physicians and nurses to address the growing health care crisis.
Respectfully,
Kim Kintz, Adult Nurse Practitioner and Doctoral Student
Oregon Health & Science University
Portland, Oregon
This really made me confused. My question, what is a Nurse Practitioner? reading through this topic gave me an idea that they may have a lot of similarities when it comes to their practices but I think Nurse Practitioners will still be like nurse. To me it’s like they are higher than RNs but they are not as high as MDs when it comes to the skills and knowledge, the ‘know how’ and the ‘how to’. Thank you for sharing your opinion on this.
I’m a Pharmacist, and ex-nurse. I have a DPharm, and do introduce myself as Doctor, but never outside work. It seems that Nurses have a chip on their shoulder, and always will. There are many idiotic Doctors, usually the younger ones, who’ve helped nurses develop that inferiority complex, but then again Nursing by definition is in place to assist. They focus on CARE, and not as much treatment. Sure they do care about the patient more than the MDs,but they don’t have the same skill set. I’ve seen:
-Nurses telling me they know more about drugs than Pharmacists, lol.
- Nurses prescribe dose strengths that don’t exist.
- Lecturers at Nursing school take cheap shots at Docs.
- Saying that they do all the Docs job anyway etc
To every Nurse reading this, if u keep stressing about your status, you are pathetic and should know that you’ll always be lower than Docs. Any Doc is higher up the ladder. But that’s if u choose to look at it like that. And some Docs need to respect the nursing staff more, especially interns. Nurses should defo get paid more, but anyone who thinks Nurses have the same calibar inMedical practice, as they certainly do in Nursing, needs to see a doctor. I know far more about drugs than the Docs, but that doesn’t mean I’m equal to an MD in his proffession.
I think you miss the point of the discussion. The article specifically talks about advanced practice nurses, who have reached a doctorate level of training (DNP). As a PharmD you refer to yourself as “Doctor” while at work, so why shouldn’t a DNPs?
It surprises me that you mention that “Nursing by definition is in place to assist,” especially since you state that you were/are a nurse yourself. I would be curious to know the source of such definition (since in my nursing career I have never heard of such).
While RNs focus largely on “care,” perhaps you should become more acquainted with the role of a Nurse Practitioner. As the AANP defines “NPs are advanced practice nurses who provide high-quality healthcare services similar to those of a physician. NPs diagnose and treat a wide range of health problems. They have a unique approach and stress both care and cure. Besides clinical care, NPs focus on health promotion, disease prevention, health education and counseling.”
Throughout my nursing education, I have not heard once of nurses taking cheap shot at medical doctors. If anything, they always emphasize the optimal team work mechanics and the specific roles of each professional. Moreover, it is immature and rather ignorant for you to say that “nurses will always be lower than Docs.” It is not very hard to comprehend that both roles are different (and there is no better or worse, inferior or superior).
However you seem to miss this point as well when you state “I know far more about drugs than the Docs, but that doesn’t mean I’m equal to an MD in his profession.” Your profession is DIFFERENT of a MD, so evidently you would not be equal, but that does not mean that one has to be better. The same holds true for DNPs. They are not trying to be MDs. They expand their training, education and knowledge to provide high-quality care (without ever forgetting their nursing roots). As the AANP states, “NPs have distinguished themselves from other healthcare providers by focusing on the whole person when treating specific health problems and educating their patients on the effects those problems will have on them, their loved ones and their communities.”
So are DNP equal to MDs? Of course not. Are they “worse” or “lower” to MDs? No. They are simply different, with their own set of skills, strengths and weaknesses, just like any other health care provider.
I apologize, but there is no way you are a “DPharm”. Really?
I have a great deal of respect for people who pursue nursing and those who pursue medicine. They are meant to serve as complimentary parts to a person’s wellbeing and for their healthcare needs. Bearing this in mind, true, by all technicality, a doctorate level program earns a person the right to use the title “Doctor.” However, we should definitely tread carefully when dealing with the public in the health setting when using titles such as these, so as to not confuse and mislead…that would not be helpful whatsoever and may cause a patient to be mistrusting. Careful consideration should be given to the intent for seeking out the doctorate in nursing, are nurses wanting to expand their horizons to improve healthcare and move nursing into a highly recognized and trusted field or are they just wanting the title? Anyone going to school for a title would be a bad fit in the healthcare system and they need not apply.
Considering the amount of work to achieve a DNP level (in addition to the number of years), I doubt that “just wanting a title” would ever be a reason for a nurse to choose to go back to school to become a NP (or DNP for that matter). The scope of practice of a NP is different, as it focuses in an advanced-practice specialty.
NPs order, perform and interpret diagnostic tests, diagnose and treat acute and chronic conditions, prescribe medications and other treatments, manage patients’ overall care, spend time counseling patients, etc.
I’m sorry, I made a couple of mistakes;
- As a PharmD. I do NOT refer to myself as Dr at work.
- Nurses are not “lower”, however, if a person obsesses about titles and privliges at work, then they will inevitabely convince themselves that they are lower.
I do think that Medicine is going backwards if Pharmacists and Nurses are given prescriber rights, solely to free up a Doctors time. he govt doesn’t want to spend in the nation’s welfare, and so is trying to buy cheaper labour by handing over physician roles to others.
I have had this argument with many of my colleagues. I do not think that DNP’s should be called doctors because they are simply not Doctors. I am an Infection Control Practitioner and am Director of Infection Control . However, my credentials are BSMLS, (ASCP,(M)), MPH (CIC), Phd (ABMM), quite different from a nurse and a Doctor. However, as Director I found myself in the line of fire between nursing staff and the medical staff (MD and DO’s). Doctors refused to call DNP’s Doctors because they are simply not Doctors. Nurses do not have the appropriate education to be called Doctors. I am quite disguised when an DNP introduce themselves as Doctors because it is very misleading to patients and to fellow colleagues. Its an insult to individuals whom have dedicated their life to science and whom have achieved academic success to become Doctors. I will NEVER call a nurse a Doctor because:
1) They believe that they know more than everyone.
2) They can run the hospital with out any other profession
3) They only needed basic science class.
4) Their egos are extremely high
I wil never call a nurse a Doctor
wow. I guess ignorance is bliss.
Do they call you doctor? You should be called Dr. ___ because you are a doctor just like when we called our professors Dr. _____ because they were an EdD or a PhD the DNP should be called doctor because that is their educational level – keep in mind that many of these are administrators and professors.
Mr Carr, you are in fact a nurse.
As a patient, parent, military veteran and paramedic, it is my duty to inform you that I would never allow my children or myself, to just “settle for a nurse, instead of having a real doctor.
Why did you just stop at nursing and not persue that Medical Degree?
You call it your practice
You say you collaborate not confer with the doctor like you are on the same level as that doctor?
You can do surgery? You seriously have the knowledge and training to do surgery consults and the procedures?
I find that difficult to believe.
Personally I say no thanks.
My husband is a PA, and doesnt call himself a doctor…..
“Why did you just stop at nursing and not persue that Medical Degree?”
- You are not “just” settling for a nursing doctorate degree. You are choosing it because of its philosophies and approach of care.
“You can do surgery? You seriously have the knowledge and training to do surgery consults and the procedures?”
-Can all MDs do surgery? Ask this to psychiatrists, pediatricians, pathologists, etc….
And, your husband does not call himself doctor because he is a physician assistant, that is his actual title. The degree for a PA is not doctorate level. So he is not a doctor, nor a physician. He is a physician assistant, which is just as important member of the medical community.
My point is we do not call ourselves something we are not.
When one of these nurses come in and state “hello, I am Doctor Collins” that is misleading and a lie.
Want that title? Go to school and earn it.
Also go look at the education needed to obtain a Medical degree and a nursing degree… to claim a nurse is equally educated, is ingorant as well as a bold faced lie.
You miss the point of the article and discussion. Nobody is asking whether nurses (RNs) should be called doctor. The article clearly discusses the use of ‘Doctor” for nurse practitioners (DNPs).
A DNP is indeed a doctor. A doctor of nursing practice. They have earned the “Doctor” title by achieving that level of education. The same is true for any one else who has earned any doctorate degree.
Refer to the article above more attentively. It explains in very simple terms all the fundamentals that you seem to be missing (e.g. origin of the title, degrees, etc).
Does he have his doctorate degree? If not, why would he? I have never met a NP who calls themselves a doctor unless they have EARNED their doctorate degree- ya know- post graduate degree…
Internists do not do surgery. Nor can do a surgery consult. Only SURGEONS can do a surgery consult.
A DNP has earned a doctoral degree in advanced nursing practice not in medicine, this individual has worked hard and met all the demands of the program and deserves to be recognized as doctors in nursing practice. The problem arise with the title being so long and the public’s preference to acknowledge the public by shortcutting the title; a doctor is not called medical doctor is called only doctor. The fear is that when the DNP introduces self as doctor in nursing practice the public will just take the short cut and call them doctors; it is just a matter of getting used to the long title and acknowledging what the person deserves. It wouldn’t be fair to call a medical doctor “medic” just because we want to take the short cut would it?
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After reading several of these posts, I realized that there seems to be a fundamental misunderstanding of what this issue is really about. Doctors of Nursing Practice DO NOT WANT TO BE PHYSICIANS!!!! If we did, we would of gone to medical school (And yes, I had the grades to attend medical school). I chose nursing! I keep reading all these comments from MD’s about how DNP’S are inferior in knowledge and do not go through the same depth of education and therefore are trying to be “fake doctors.” I do not want to be a physician, and did not choose my degree so I could pretend to be one. I do not pretend that my education will prepare me to do what a medical doctor does. I am not qualified to practice as a physician, and that is not what the DNP’s are trying to say. I think the physicans are misunderstanding. DNP’S are qualified to practice as a Doctor of Nursing and the curriculum adequately prepares them for that role. The issue here is that MD’s, and much of the general public, misuse the word “doctor” and interpret it to mean physician… and this is not correct. I have a friend who received her doctorate in the culinary arts, and so she is basically a doctor of food! LoL. A “doctor” is just someone who obtained a doctorate level of education. I don’t want to be called physician Blackwell, or be mistaken for a physician. In fact, I am very much a proponent for a specific title for us like Prac. Blackwell instead of Dr. Blackwell because I WANT my patients to know that I am something different. I have a different skill set, scope of practice, and unique method of practice based upon my background in nursing…and many patients prefer it! I don’t WANT to be mistaken for a physician. It does, however, infuriate me that physicians apparently think they own the title of “doctor” and I can’t receive the due respect of that title even though I earned it. Again, let me reiterate this because many seem confused, I did not earn the right to be called a physican…but I did earn the right to be called a doctor if I want to. I would also like to say that I see what some of the MD’s are saying… Many patients think “doctor” means physician, and I can definitely see how this could confuse the general public, because it seems to have confused many of the physicians and nurse practioners alike responding to this post. We all just need to accept that the face of healthcare is changing! If there isn’t a place for the DNP’S in the medical field, then they will disappear. Physicians need not feel like we are trying to step on your toes! Don’t you guys want help with the large patient loads? DNPs know that medical doctors are a wealth of knowledge, and utilize and depend on them accordingly. Why does it have to be a competition?
In the state of Texas, nurses are allowed to use the title “Doctor,” but also must follow with the appropriate credential such as DNP or PhD (Texas Board of Nursing, 2011) as many states require as a result of physicians. Why are physicians so concentrated on oppressing nurses? This oppression occurs in the workplace and has extended out into attempts to control the profession of nursing. In the workplace, changing this has been a very long road and still has miles to go. Interestingly, at one point administration did not blink an eye at the mistreatment of nurses at the hands of physicians and this continues in some organizations. Now physicians and the American Medical Association seek to continue oppressing nurses through dictating the use of the prefix of “Doctor” when we have the doctoral degree.
The origin of the term doctor comes from the latin term meaning to “teach, show, cause to know” in 1300, then in 1400 the meaning “holder of the highest degree level in a university” was used. But it was not until 1600 that the term was used in meaning a “medical professional” (Harper, 2012). A nurse with a doctorate is a medical professional and received the highest degree of education at the university level. The designation of “doctor” is not owned by medical doctors and should not be treated as such. Other professions use the title of “doctor” if they have completed the educational level of doctor.
If the importance of a care provider identifying one’s credentials and licensure is important then physicians should not discriminate against nurses. The American Physical Therapy Society (2012) supports the use of the title of “Doctor” being used by physical therapist who have completed a doctoral program. Do doctors who went to allopathic school or osteopathic school have to identify their credentials clearly to the public? No, but they should because sometimes they misrepresent themselves. All people have the opportunity for misrepresentation such as in the case of a physician trained in family practice but practices as a dermatologist enters a room with a patient and state “I am doctor so and so, I am not a dermatologist but will act as one today?” No. Dentists, veterinarians, doctors of psychology, and doctors of pharmacy all utilize the term as well, but have not received the attacks nursing has endured. So what is the basis for their argument?
DNP curriculum is not the same as medical doctors, has different material involved, but is no less a doctorate. If nurses wanted to be physicians, then we would go back to medical school. Many nurses view their form of practice as superior to the medical doctors, because we show more care and give more education to the patients. Medical doctors are not prepared for the roles DNPs and Phds of nursing are prepared for, but still assume the roles such as leaders in committees. Most doctors spend 4 years of college, 4 years of medical school, then years of residency being isolated from people. Medical school does not include any class on leadership, but medical doctors are taught that they are to assume authority through simply the position of medical doctor. Medical Doctor only grants one the right to serve people in their ailments, nothing else.
American Physical Therapy Society. (2012). Retrieved from http://www.apta.org
Douglas Harper (2012). Online etymology dictionary. Retrieved from
http://www.etymonline.com/index.php?term=doctor&allowed_in_frame=0
Texas Board of Nursing. (2011). When the profession is nursing and the title is Doctor. Texas State Board
Of Nursing Bulletin, 42(3), 4. Retrieved from http://www.bon.texas.gov/about/pdfs/july11.pdf
I think its time to educate the general public regarding the title of ‘Doctor’. The title is not just for MDs only anymore. With doctorate degrees being held by nurses, pharmacists, physical therapists, and other healthcare disciplines, the public needs to understand that those having the highest level of education within their specific discipline have earned the title.
A doctorate is the highest degree available in any field of knowledge. Nurses that have worked for the highest degree available in their profession have earned the doctorate degree, therefore, have the right to be called “doctor”. A mathematics professor, sociology professor, or biology professor at the university level that has earned their doctorate are called “doctor”. Why is it different that a nurse that has earned his doctorate should not be called by the same title? There are arguments about the possible confusion of role in the eyes of the patient. Nurse practitioners should clearly identify themselves as “Dr. So-and-so, nurse practitioner”. The truth of the matter is that nurses are entering more specialty and advanced roles. Some are independently practicing. The Doctorate of Nursing Practice (DNP) is not a physician, but is an important health care professional helping to ease the burden of the physician shortage. The advanced practice nurse should be viewed as a complement to, not in competition with the physician.
Recently, there has been consideration given to requiring universal board certification of both physicians and doctorate of nursing practice nurses. The supporters believe that those that pass the certification could then earn the title of “doctor”. Like any hot topic, there are valid points worthy of review on both sides. The bottom line about the title of “doctor” is that it refers to highest degree available to any field of knowledge, that includes nursing.
Haha I have to say this is funny. DNP and that mudslinger did a test on the so called physician equivalent DNP. The nurses took a WATER-DOWN version of the USMLE (which is the easiest exam a physician will take on their quest to becoming board-certified) and 50 PERCENT FAILED. Thats quite scary. The national average for physicians is about 90 percent. Yet, they’re still equal right? Its funny because I actually hope DNPs start going into business. Lawyers will love it. I can already picture all the lawsuits. Yes DNP are superior because they are nicer and more patients like them right?
Mudslinger and her minions are actually not very well liked in the nursing community (which are mostly NPs) and actually reject this idea of the DNP. http://allnurses.com/nurse-practitioners-np/dnps-taking-certification-301106-page2.html
I have talked with NPs who attended medical school and had their eyes opened to the things they just didn’t know. I can understand the want to become doctorate, but implying it to be better or as good as your boss is a very stupid way of doing it. All I can say to you nurses is
WHY DID YOU BECOME A NURSE IF YOU DIDN’T WANT TO BE CALLED NURSES?
Look at the PA’s. They want to change their names to Physician Associate and they are getting help from all over the place because they didn’t overstep any boundaries.
Although I can see your want to increase your role, most DNPs I’ve met are in an executive role and barely practice medicine. Its the high ego-ed nurses who just HATE being called being “a nurse” that is doing damage to this.
I am a very intelligent, trustworthy and passionate nurse. I am proud to be a Nurse Practitioner. I don’t need to be called Doctor to get my job done.
I have a hard time believing you are a NP.
Anyway, DNPs are not trying to overstep any boundaries. Simply trying to be respected. Again, they are not better nor worse than MDs. They are just different professionals, with their own set of skills and knowledge.
Opps I went back and took a look. Its STEP 3 not Step 1.
There is no need for disagreement or arguement on this topic. The word -doctor- as stated above, originally refered to teacher. As things stand currently, almost every discipline has a terminal degree which comes with the title of “doctor”. Even though the word commonly refers to medical doctors, it does not belong them. As for the possible confusion of patients, as long as we educate the patients regarding what kind of “doctor” we are, I see no problem there. A big part of healthcare today is increasing patient awareness through education, our patients are more than capable of understanding the difference in their health care providers, we just have to teach them.
You must realize, many nurses not only carry an undergraduate degree in nursing, but also a bachelors degree in other fields of study. I myself am a Nurse Practitioner, and I have a BS in Medical Microbiology and Biotechnology, and yes all the prerequisites for medical school. There are many nurses who hold similar backgrounds, and to say nurses are not educated in the sciences is completely incorrect. As a future DNP, I assure you I can grasp scientific principles.
I am a DNP student but also a nurse practitioner in a large community hospital. What I am learning in my program I am actively applying to my practice. Once graduated I plan to wear the DNP embroidered next to my name as I will be very proud of the credential and I will explain it if patients or others ask…. but may not incorporate the title of “Doctor”. I like the personal (first name basis) and professional relationship that my patients, my physicians, and I share. Many times when a patient’s condition begins to deteriorate…. the attending physician is no where around or like the other day..one MD tapped me on the shoulder and asked me softly “You got this?” and I confidently nodded “yes” and he left the room The physician is comfortable with the nurse practitioner handling their patients on an emergent basis. as they know we will contact them with questions or situations outside of our scope of practice…………….I’m saying all of that to say……I think that titles are secondary…….primary is how confident and comfortable with the provider the patient is…..after all healthcare is all about the patient!…I do not want to get into a shouting match about titles…it takes time away from patient care.
However our doctors do not refer to the DNPs, PharmDs, as “doctors” but they do however refer to the psychologists (PhD) as “doctor” makes you want to say…uummm…
Honestly, if my name was changed to hospital affiliate tomorrow, I would still go to work and do my best to take care of my patient’s needs. I have interviewed various DNPs for jobs in my practice, and quite frankly I’ve grown to really appreciate the Nurse Practitioners. The Doctors of Nursing Practice always seemed to make the way we address them a priority. To me there was no difference in clinical ability between the two and the NP seemed more patient friendly. I absolutely love the NPs that work with me because they are respectful and good at what they do, and in return I show them my utmost respect as well. Having the title Dr. does not automatically give you the respect some of you put before your patients. MDs and DOs themselves are not respected if they fall behind the standard set by the physicians. What does having Dr. do for your job as a health care professional? Heck, some days I don’t ever wear my white coat and introduce myself as Mr. instead of Dr. because it plays no role in helping me be a better physician.
In my opinion Nurse Practitioners are so good at what they good because they don’t have to worry about everything. All these health-care providers want independence but say that their model is different and what not. It makes no sense to me. When I enter a room, I question the patients on their problem as fast as I can so I can move on to the next patient who needs me. As I worry about making sure the patient gets the right treatment, my NP then has the opportunity to really get to understand and get the know the patient without a care about the next patient or billing or any of the annoying things that I will have to attend to later. While I’m in surgery or running tests they spend as much time as needed on the patient and that is why all my patients love them.
This is what health care should be like, A TEAM APPROACH. Not bickering about a title as if it will help you do your job better. Take away the physician from the equation and what do you have? You have a Nurse Practitioner who won’t be as effective because they will be too occupied worrying about their next patients, billing, and getting sued. I will take an NP over a DNP any day and many of my colleagues agree with me on this.
Very well said! Thank you!
It is a sad day when we cannot unite and celebrate the progression of a discpline. I wonder what happened to the words ” healthcare team”. Whether you are called doctor or not, we all are here to accomplish the mission of promoting health.
Nurses have come a long way as did every other healthcare profession in developing the members of the discpline. So now we have evovled to the the DNP. I do not see the problem. Other members of healthcare should celebrate that nursing took the initiative to improve on a profession so that your team members are even more valuable contributors to the team. Applaud!
It is a sad day when a group tries to gain through deception what another group earned through education and hard work. One group took a dangerous shortcut. When you cut corners, the quality will eventually suffer. I am sorry that I do not celebrate made up doctoral degrees.
I am very concerned and discouraged after reviewing all these thoughts regarding the debate of having DNPs called doctors. I do not understand why this should even be an issue if a DNP has completed and earned the right to be addressed as a doctor. The comparison of the term doctor being used for physicians and nurses is valid and does occur in practice, but why the huge debate? Is there a serious problem with other doctors, such as pharmacists, philosophers, etc not being able to use their earned doctor title because it causes confusion? Why just the fight with nurses. I know physicians and nurses practice together as a team and if this is only about not causing confusion. Then it is simple to have the nurse practitioner identify herself as Dr. Reed, Nurse Practitioner and have the physician identify himself by their appropriate title. Do not rob the DNP of the right to use their justly earned title of Dr. just because their might be feelings of NPs trying to grab some of physicians’ turf. In the healthcare world containing a shortage of primary care practitioners there is plenty of pie to go around. We should all work as a team and collaborate our focus in providing the best care for our patients, and not focus our energy on silly arguments about titles.
Honestly this is a moot point. The fact remains anyone who got their RN, then got an MSN one year later, then did a diploma mill online DNP (with your “thesis” projects on whatever) is not equivalent to someone who did 4 years of a b.s in biological sciences (Inositol triphosphate? tyrosine kinase receptor anyone? clathrin coated pits pathway? these are all the basis of physiology, oh wait i forget you went to nursing school), 4 years of medical school , then 3-4 years of residency (17,000 hours). Vs 5-7 years of on the job training. Please, just like the Rph, the Master of physical therapy now doctorate of physical therapy. ITS DEGREE CREEP. 90% of you could not pass USMLE 1, 2, 3, CK and then take the american board of internal medicine board exam every 10 years. but its all good right? because you got your patient’s A1c below 7 and they loooove you cause you spend 40 minutes cause of your reduced panel size. give me a break. The most dangerous thing in medicine is deluding yourself into thinking you know more than you actually do.
Does a nurse have a choice in what they are titled once they have received the highest level of education in nursing? I think it comes down to attitude and demands. I am a nurse who is considering expanding my education and wanting to become a NP. With the new educational guidelines, it appears that it is just the way it is going to be DNP.
We all know when professors with a Ph.D demand to be called doctors, they are simply trying to get more respect and admiration. But in reality, we cringe to the idea of having to call them doctor.
Dear MD and DO’s,
I have respect and admiration for the hours and slave labor you had to go through in medical school and residency. I personally would never want to take the title of doctor away from you. You earned it fair and square. I did not make the rule that after i graduate I will have the title Doctor of Nursing Practice. After all is said and done I will have gone through 15 years of school some full time, some part time. But I know you suffered more and didn’t have the luxury of doing online school. But guess what? You still make more money then we do. We still have to work under you. You are still “ABOVE” us. It’s going to be okay.
DNP – Doctor of Nursing Practice
MD – Medical Doctor
The only reason why the MD’s are kicking up a big stink is because they feel that the DNP’s are taking their beloved title away from them.
That’s not the agenda for DNP’s. The DNP title is an academic title similar in concept to a Doctor of Philosophy or Doctor of Science. It is supposed to be the highest level of education a NURSE can achieve in their vocation.
Something to be respected and proud of.
Furthermore, nurse practitioners who have the appropriate medical training according to the American Medical Association, provide PRIMARY CARE services comparable to that of PRIMARY CARE MD’s.
To reiterate what Jim Stalians had previously posted
“The Journal of the American Medical Association (JAMA) published the results of a clinical trial in which 1,316 subjects were randomly assigned to the care of either a nurse practitioner or physician. After six months of care the researchers, which included four physicians, concluded that there were no appreciable differences in patient outcomes between the two groups (Mundinger, et al., 2000). A two-year follow-up study by Lenz, Mundinger, Kane, Hopkins, and Lin (2004) supported the original findings. Numerous other studies have since supported similar findings in other populations and settings. ”
IS THIS NOT POSITIVE EVIDENCE THAT NURSE PRACTITIONERS ARE VALUABLE?
If the medical exams required to be written by all NP’s in differing states and provinces in Canada hold NP’s to a certain standard that is acceptable within our own medical community, then there should be no bickering.
Nursing and Medicine are opposite sides of the same coin. If there were no nurses, MD’s would be SCREWED and if there were no MD’s, nurses would be SCREWED.
It is a TEAM effort.
As long as a NP and MD do their jobs within their scope of training and put the patient first then everyone wins.
Jim stalians, Dr Carr, Annemarie and other bonafide nurses, (you are my role models) urologist and a host of other health practitioners who hav thrown sentiments to the background and viewed this dicey issue objectively know what’s good for the best for our teaming clients. Because nurses are the caretakers of the health industry, we have come of age to hold sway and secure firmly our rightful place in the medical field. Gone are the days when physicians were seen as gods, and nurses, handmaidens. From all i have gathered, it is clear to me that physicians and some health professionals are just being clogs in the wheel of nursing profession’s success and are not ready to work as team members they are for reasons which can be diagnosed as obcessive compulsive disorder and are in a denial stage of reality, or better still, altered level of consciousness with a glasgow coma scale score of 4.I am still waiting to see a physician who can do wat a nurse can do. Its analogous to the popular jingle ”what a man can do, a woman can do better”. So just calm your nerves and do not trespass into our territory, it would be detrimental to our clients’ safety.
All of this talk is pathetic.. The title of doctor is used for anyone with a phD. Doctor of history, sociology, religion and on and on. MDs do not own the title of doctor. With that being said, I am a 20 year RN and NP. I do not see the value of the DNP education as of yet and have not pursued it because of that. If I ever did, I would never introduce myself and a doctor. I chose to be a nurse. I was premed and accepted into medical school. Some life events changed the course for me and I became an RN. I thought about MD school prior to going to NP school and ALL the doctors I worked with discouraged me and were huge advocates of NP school. Reasons given were malpractice insurance, length of education, running a business, lower reimbursement costs, health care reform etc. NPs can do great things and are at their best when colloborating with MDs in my opinion. Comparing MDs to NPs is like comparing apples to oranges. NPs do not have the same education and are not Physician equivilants. All my life I have heard people pumping themself up over how much better they are then others. Reminds me of 5th grade history and talking about the Puritans. FP MDS are dumb, internal medicine is better….specialists are the really smart ones, no I think it is surgeons, LVNS don’t know anything, only RNs and of course I mean BSNs…..Everbody get over yourself!!!! No shame in being a nurse, no shame in being a doctor. The world needs both. Grow up.
Ok… This article is a little weird. When they say that nurse practitioners want to be called “doctor” they don’t mean MD (which stands for medical doctor). It would be DNP (which stands for doctor of nurse pratitioner). Obviously there would be a difference. The reason they want nurses to get their DNP is because they are trying to make the training to become an NP a little longer and more uniform throughout. Its like if you were to get your doctrate in physical therapy. Nobody is saying that they have an MD. So… this argument is just stupid. That would be like doctors getting angry at a guy who gets his doctrate in philosophy or ecomnomics and threw a fit because we started their name with “Dr.”
If a DNP can not be called a doctor, then neither should a PhD. The title DOCTOR is one of prestige….it is a title achievement and I can only say “how dare you try and take that away because of your own insecurities!” Did the people who have earned those titles work any LESS harder that you did? Did you know that to become a DNP you have to go through 5 YEARS (4 years bachelors, 2 years masters and 1-2 years for the DNP)of educational training, which doesn’t included the experience requirements (minimum 2 years and preferable 5 years) to get into a DECENT graduate program to become a DNP? Not only do they have to renew their license to be a nurse to be also hold that specialty. A regular doctor only spends 4 years (grueling as are the years to become a nurse) to become an MD: Medical Doctor. You are a DOCTOR of Medicine. A PhD is a Philosophical DOCTOR. A DNP is a DOCTOR of Nursing Practice. A JD, is a Juris DOCTOR.
If DNPs should be called doctors, JDs (any lawyers) should be called doctors, too. How come no lawyers address themselves as doctors??
Nice try, but it is what it is. Just be happy with what/who you are.
BTW, Ph.D., by definition and tradition (almost 1000 yrs), is the highest achievable academic degree in any field.
To me, DNP is a made-up degree. If you are an NP and want a doctorate degree, you should get a Ph.D. in nursing, which is much more rigorous than DNPs, btw.
Agree! A made up degree which is a shortcut or an end around through the back door. Do the work if you want the title.
Nicole,
A doctor only trains for 4 years?? You have apparently been drinking the kool aid the nursing instructors are giving you. A physician trains for 4 years of undergrad, 4 years of medical school, a year of internship, 2-6 years of residency (depending on the specialty) and 1-3 additional years of fellowship for subspecialtiy training.
Nurses attend college to gain a nursing degree in 2-4 years and work as a nurse making good money and take on line DNP classes at night and call it equivalent. And you wonder why physicians are upset while you pass off blatant lies as the truth?
“Let ladies who wish to be doctors as well as nurses train themselves in an appropriate medical school, and leave the humbler but no less honorable profession of nursing to those who have the common sense to see that the training of a nursing institution can never make them properly qualified medical practitioners.” — Sir Seymor Sharkey commenting upon the establishment of institutionalized nursing schools, 1880.
Things don’t change much. Those with power and status will always struggle to preserve the status quot, and all the trappings thereof.
James Melworth, Doctor of history.
Here is the truth:
A physician trains for 4 years of undergrad, 4 years of medical school, a year of internship, 2-6 years of residency (depending on the specialty) and 1-3 additional years of fellowship for subspecialtiy training. At each point along the way, there is a weeding out process and only the best and brightest advance to the next level. This occurs at the MCAT level when applying to med school. It occurs after year two of medical school when you take step I of the USMLE. It occurs at the end of 3rd year of medical school as you utake step II of the USMLE. It occurs at the end of every clerkship as you take the national shelf exam for each specialty (medicine, surgery, psych, pedi, ob/gyn etc). It occurs at the end of medical school as you compete nationally for the best internships and residencies. Once in your intern year, you clear step III of the USMLE before you can get a license to practice. Each year of residency, you take the in training exam which helps determine if you get to advance to the next level of training. If you get past that, you apply to fellowships where only a small percentage are accepted to the most competitive spots. Once you finish residency, you get to take a written board exam, many of which are so difficult that the pass rate is in the 70 percent range. If you pass the written exam, you get to sit for the oral exam (one of the most stressful experiences any person can ever be subjected to). The pass rate is 70-80% for many oral exams. At the same time, many young doctors are enrolled in fellowships or paying their dues doing additional “chief” years so that they can be eligible for 1-3 year fellowships. All of this time, still being paid minimal salaries and working long hours. Once finished with fellowship, then they must sit for their subspecialty board exams. Once complete, it is now time for recertification in their primary board within the next couple of years. And so it continues. At any step along the way, the weak or unqualified are weeded out.
Compare that to this:
A person decides they want to be a nurse. They enroll and take science courses for non science majors for a couple of semesters. They do their clinical rotations following other nurses around and implementing physician orders. They graduate and get a job within 2-4 years of making the decision to be a nurse. They are in high demand because all of their nursing colleagues with any ambition are either nurse practitioners or clipboard carriers. They are paid well and work hard. They see additional opportunity and sign up for a DNP, CRNA, or NP program and 2-3 years later, they are done, all the while earning a great living as a nurse while doing the entire DNP or NP process through on line courses at their own convenience. They arrive at the end of training with no debt and no sweat equity and very little actual “medical knowledge.” At no point in the process was there a weeding out process to separate the qualified from the unqualified. Their entire time is spent following physician orders and not in formulating treatment plans or learning how to diagnose the difficult patients. It is assumed that if you make the decision to go to nursing school, you will be a nurse. If a person makes a decision to go to medical school, their is only a small chance that their dream will come to fruition because most get weeded out along the way and most don’t have the drive and stamina to complete the mission.
Meanwhile, nurses join their nursing political action committee and lobby the politicians to claim equality. In their minds, they really believe it. That is the scary part. “They don’t know what they don’t know.”
And here we are years later having this argument over the internet about who is better at being a “doctor” or who should be called “doctor.”
Hopefully, after reading the above, the general public will be educated about the paths required to achieve each degree.
Nurses and physicians are not equal and the public should not be deceived to believe that they are. If a person wants to be a real doctor and be called so in a hospital clinical setting, do the work needed and go to medical school.
The public deserves to know the truth and not be deceived by the militant nursing PAC’s along the way that wish to gain by legislation and hospital policy what physicians have achieved through hard work and education. So, yes, that upsets me when they claim equality with only a fraction of the education and experience.
Well said Gern. I agree completely. You want to be named doctor in a hospital setting? Then do the work and go to medical school, do a residency and put in the minimum of 10,000 hours of hard work it takes to become one.
“Diagnostic criteria for 301.81 Narcissistic Personality Disorder (DSM IV – TR)
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
(3) believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
(4) requires excessive admiration
(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
(8) is often envious of others or believes that others are envious of him or her
(9) shows arrogant, haughty behaviors or attitudes”
Reference:
American Psychiatric Association. (2000). Diagnostic and statistical
manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
^^^ Yes, that fits the DNP demanding to be called doctor in a clinical setting to a tee.
Especially this one:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
Just from reading the comments here, I believe it would apply more accurately to you, Mr. Blanston.
Particularly:
(3) believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
(4) requires excessive admiration
(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
(8) is often envious of others or believes that others are envious of him or her
(9) shows arrogant, haughty behaviors or attitudes
I’m an aging baby boomer. I worry about what is happening to our medical system. I have been healthy and have taken good care of myself but I realize that my health will fade through the years. I want physicians, not nurses (of any variety) taking care of my wife and I and my friends.
It’s sickening to me that the old noble career of RN’s, who impact patients so much, are trying to be more than what their education warrants. You didn’t do the premed prereqs, you didn’t go to med school, you didn’t do residency. You’re not a medical doctor because you don’t have the knowledge and training. Be an RN and be proud of it. If you want to practice medicine go to medical school!
You are right to be worried. Stand up for the rights of you and others. Truth and transparency is needed. Not deception and outright lies.
Nursing is a noble profession. Why are so many nurses so ashamed of it that they want to portray themselves as something they are not? It is shameful.
Nurses are not ashamed of their profession. We are very proud of it, and this is why we seek further education to become better at what we do. NPs do not claim to be equals to physicians, and never have. The curriculum that you have been posting and claiming to be “night school as you work” standard, is not the case.
Nobody is lying here. However your opinions are so biased. It is a perfect example of the violence that nurses have been dealing with for many years. Luckily many physicians recognize and appreciate advanced practice nurses, something that you and “OLDONE” have a hard time doing. For your information, NPs are not something new, they have been around since the 60s, check your history (yes, you do not know it all).
True or false? You continued to work while you did your DNP and much of the course work was distance learning on line.
It depends what you consider “continued to work.” You imply that all RNs work full time as they work on their DNP (which from my experience in a top ranked/renowned school, it is not doable). Worked per diem – 1 to 4 shifts a month (simply to maintain affiliation with a health care system).
All of the course work was in classrooms and/or clinical sites (with the exception of “clinical research”). Hours upon hours spent in clinical training and research design/application. So my point is maintained, your opinion appears biased and judgmental. A DNP is hardly something that you just pay and do a couple google searches.
The DNP was a choice. For many reasons that do not include “taking a shortcut” (since it really is not one). I had the option between 2 great medical schools and 3 great doctorate in nursing programs (yes, all in which I was accepted). For reasons that you’d probably never comprehend I made my choice and do not regret it for one second. I am proud of being a nurse and happy to work with physicians, RNs, PAs, social workers, support staff, etc., that respect me for my professionalism and expertise in advanced nursing care.
Anyway, I am curious, what makes you so motivated to this “cause” of putting down advanced practice nurses? What makes you so resistant to a different point of view/philosophy? And why so threatened? NPs never wanted or attempted to take anybody’s place, the nursing model supports team work and collaboration. We respect the medical model and understand its importance. However, the nursing model and nursing care, advanced practice or not, is equally important to the overall care of the patient.
To TheNurse,
You are the exception to the rule if you were not able to work more than 3-4 shifts/month during your DNP studies. I’m not sure of your time management skills if that is the case. Most DNP programs are completely “on-line” and completed by nurses already in practice and living a long distance from the school they “attend.” I’m not sure why you didn’t get the memo on how it is done in the real world. Here is the blurb from one of the most popular programs:
The practice doctorate in nursing provides the terminal academic preparation for nursing practice. The *** *** University Doctor of Nursing Practice program is fully accredited by the Commission on Collegiate Nursing Education (CCNE), completely online, and designed to prepare students to assume clinical leadership positions in a variety of healthcare, business, government, and educational organizations.
And here is another blurb from another large state school program. They actually make you attend the actual campus 5 days a year:
The DNP is similar to other practice doctorates such as the MD, JD, and PharmD.
All students are expected to come to campus for a robust 5-day Resident Intensive Summer Experience (RISE) each year for the first three years of doctoral study. RISE attendance for part-time students may vary. Tentative dates for RISE are as follows: Yr. 2012-August 13th-17th.
Somehow, in my mind, the above statements don’t really add up. One sentence says it is similar to an MD or a JD. The next describes that you attend actual classes and show up on campus 5 days a year. Are you really trying to defend that as equivalent? Seriously???? See my typical curriculum post above. Let the public be the judge. This whole comment section is filled with DNP’s and DNP students who defend this as similar to an MD or a DO degree. That is disingenuous. It is human nature to try to justify this and it is not surprising that a DNP would argue indignantly to defend what they just spent their time and money on, but for the rest of the public who might read this, the truth needs to be told. You can call me bitter if you wish, but that is just a cop out argument trying to defend the indefensible stance that you and your ilk have taken in this matter. It is embarrassing for the medical community that it has gotten this far and embarrassing for AACN and AANA and all of the other militant nursing organizations who have propped this up through deception and lies with the help of Sebelius and other political leaders with an agenda. The fact that they have pushed it through so easily is a little (a whole lot) scary.
When you have children, will you teach them to gain as much as possible through deception and chicanery or will you teach them to put in the hard work needed to gain the in depth knowledge that is needed to practice medicine? Saying that the DNP provides as much real knowledge to practice medicine independently is akin to saying Dr. Seuss should be allowed to perform surgery.
If the general public accepts this, then they deserve what they get. If you have ever seen Mike Judge’s movie “Idiocracy,” you know what lies ahead.
DNPs are not trying to be a medical doctor. That’s why they are “doctor of nursing practice.” Different, not better nor worse. Most patients are becoming more educated and understanding the strengths of different professional roles within the health care system. This way they are able to make an educated decision on what or who to seek in different scenarios. I recommend you do the same.
I’m finishing up 3rd year of medical school and I already know more than the NPs that work in my hospital. These are NPs with 5+ years of experience. Several of them have already come to me (and the other M3s and M4s on service) before rounds with questions on their patients. Why, you ask? Because, multiple times, they’ve messed up during their patient presentations or failed to come up with a proper differential diagnosis and when the attending points that out and asks the med students, we end up answering correctly and generating appropriate differentials.
The fact is, even with just 3 years of medical school (and I still have a minimum of 3 years of medical training left), we can already come up with a larger, more accurate differential than most experienced NPs can. Why? Because we spend an entire rigorous year on pathology and pathophysiology, not just an easy online course (LOL!). For any given set of symptoms, the avg. 3rd or 4th year med student can come up with a longer list of differentials simply because we know more than the NPs.
Why don’t you guys lobby for allowing med students to practice independently? I want to save time and money (less tuition!). Let me practice independently now; I’ve already proven on the wards that my knowledge-base and training is superior to what DNPs receive.
^^^truthteller^^^
Thank you for the response. You are exactly correct. The DNP approach is similar to starting the Boston Marathon, running a mile, leaving the race and getting in a car, then going to have lunch and a nap, then getting back in the car to be dropped off a mile from the finish line. Then crossing the finish line basking in all of the glory and telling everyone how tough it was and how accomplished you are as a runner.
Don’t claim to have run the race if you didn’t. It is a lie. We don’t accept it in long distance running. Why do we accept it in the medical field?
Just out of curiosity for the nurses here. If a Certified Nurse Assistant at your practice told the patients and everyone else that they were a “nurse,” would that bother you. Would you feel as though they were misrepresenting their education? Would it bother you that it took you 4 years to get a nursing degree and a person that took a 3 month certifying class was representing themselves as your equal? Be honest with yourself. Would that rub you the wrong way a bit? I suspect a flurry of “incident reports” would be generated, wouldn’t they?
I work with many nurses, NP’s, and other advanced practice nurses. At the local level, I get along with them fine. TheNurse asked what I was so upset about up above. It is the lie being perpetrated by the nursing organizations on the national level to attempt to gain through legislation what physicians have gained through education. There is no shortcut when the lives of your loved ones are what is at stake. Nurses play a vital role in the care of patients. No one has ever questioned that. I do, however, resent when the nursing organizations and their militant members get on internet forums and claim equivalence to physicians based on an invented online degree that is nothing more than nursing philosophy classes and internet busy work for the purpose of lining the pockets of nursing educators and deceiving the public with bogus credentials that have no real medical application (see the typical curriculum outlined above). If no one explains the real truth, their deception sits out here on the internet for an unsuspecting person to read and believe as truth. If you tell a lie long enough, you can actually even start to believe it yourself. As long as they continue to deceive, I will continue to tell the truth to refute their lies.
Who cares what the nps want to call themselves, they just send patients to specialists like primary docs
First of all let me say I am neither a physician nor a nurse. I am a patient. Remember me? The one everyone seems to be arguing about? If anyone cares about my point of view on this topic, here it is.
I believe all patients have come to recognize the role of NP’s and DNP’s in the healthcare field. I along with many of my friends often opt to see the NP or if available a DNP instead of the MD when making an appointment for “small” ailments (I know every ailment could potentially be a symptom of something larger) like a sinus infection or other common ailments. Notice I said “opt” to see a NP or DNP. It is always my choice as to which member of my healthcare team I will see for that ailment.
When I opt to see the NP or DNP it is for the following reasons:
1. It is always quicker to get in to see the NP or DNP.
2. In my opinion and the opinion shared by my friends, both are very qualified to treat common ailments (see disclaimer above).
3. Given the choice I usually choose the DNP because it just makes sense the DNP has more education than the NP.
3. I know both my NP and DNP will consult with my MD on my treatment and care. I know that because it is made clear to me by my MD’s staff.
Sometimes I opt to see my MD. For things like my yearly physical and lab work I prefer my MD perform a comprehensive analysis of my overall health. Again, I don’t know if that is necessary but it is how I manage my own heath care. That is what gives me peace of mind. To each their own.
I do not confuse an MD with a NP or DNP. In my MD’s office the DNP is referred to as the Doctor-Nurse and the NP is referred to as the … well, NP.
I address my DNP as Doctor because that is what my MD calls her. That doesn’t mean I am a confused and consider the DNP to be the same as the MD. I recognize they have different skill sets. I consider it my MD’s job to ensure I am educated about the options I have for care while in her office.
For all the MD’s on this blog; thank you for your dedication to your field of practice. We need you and respect you for what you have done, not for your title. But be very clear, the days of seeing you as a demi-God are over. You are instead a cherished member of my health care team and I take your advice and counsel seriously, but not without using my own resources and common sense. That was my parent’s generation, not mine. (I am 49 yrs old).
One more thing then I will get off my soapbox. My parents live in a very rural area and were thrilled when a DNP opened a practice within 10 miles of their home. Even old as they are they are not confused about the skill set their new “Doctor” is bringing. They just like having someone close for common ailments rather than having to travel 40 miles to their “Real Doctor” as they call him. It’s a wonderful option for their small community.
For all the DNP’s on this blog; thank you for your dedication to your field of practice (nursing). Although I love my MD I sometimes want and need your extra level of caring for my whole health not just what I walked in the door complaining about that day. I know you are also very busy but I guess you are just better at bedside manner than my MD. Thank you for that.
For all the NP’s: Love you too and thank you for stepping outside the hospital and into my MD’s office to provide me with your knowledge and care.
So… that is what Ms. Average Patient has to say to this blog which by the way I came across because my friend said his daughter just got a medical degree as a Doctors Assistant. I admit I am still confused about what a PA is. LOL.
But I promise you I will figure it out. As will we all. Remember, we can be taught and we can learn.
Bottom line; do not under estimate your client base. We are much smarter than you think. I have been personally offended by Gern on this blog. Really, come on down from Mt. Olympus and join the rest of us when you are ready. My Doc is nothing like you even though she has the same credentials. She lifts up her “helpers” and shows them the upmost respect which in turn builds my confidence in their abilities.
Before you even start… I am not an MD nor a Nurse nor a NP nor a DNP nor a PA nor a… whatever else there is. I am a Project Manager with a Telecom company. I’m just a little tired of being an underestimated client/patient. I love having options managing my own healthcare. I don’t care what ANY of you label yourself. Just keep doing what you do.
It’s great that you know the difference between a nurse and a doctor. You’re still one of the rare patients who does though. Most patients think pretty much anyone with a white coat on is a doctor (ie. a medical doctor). There are multiple survey studies done on this that the majority of patients are confused as to who is actually providing care for them and what their credentials are.
I also work with DNPs who insist to their patients that they’re doctors and are equal to me and my physician colleagues. No, they’re not. I’ve spent 10 years in medical training AFTER college. They did an online degree in 2.5 years while still working! Can they diagnose a common cold the same as I can? Yea. But so can any mom who doesn’t have an ounce of medical training. Once a patient shows up whose symptoms are not “textbook” symptoms (ie. not classic symptoms), these nurse practitioners’ ability to form a differential diagnosis and rule out/rule in various processes breaks down. This type of critical thinking isn’t something you can develop overnight or part-time over 2-3 years. I’ve spent over 20,000 hours in clinical training alone (not even taking into account classroom education) and it still scares me how much there is that we don’t know. So, when I see these cocky NPs/DNPs with less than 10% of the training that I have claiming that their knowledge-base and expertise is equal to mine, that’s extremely insulting. These practitioners have less training than a 3rd year medical student does, as a previous poster mentioned. Do you want to be treated independently by a 3rd year med student?
All the NP/DNP degree is, is a shortcut. It’s for people who don’t want to put in the effort that’s required to truly become an expert. And that’s fine. Lots of people have family obligations and other extenuating circumstances that doesn’t allow them to be willing to go through a minimum of 7 years of rigorous training (not easy online courses). But, with that being said, they should not claim that they’re equal to those of us who do go through this intense medical training and have spent nearly a decade or more honing our skills as clinicians. There is no well-done study that shows equivalence between board-certified physicians and nursing midlevels. Some people will point to the JAMA study: that was significantly flawed study headed by a DNP who has publicly claimed that DNPs are superior (not just equal) to physicians. I wonder what the look on her face was when 50% of her DNP students failed a watered down version of the easiest Step exam physicians take. But this study got accepted to JAMA! Yea, so what? The Andrew Wakefield study regarding vaccination and autism got accepted into The Lancet, a far more prestigious journal than JAMA, and we know how bad that study design was.
So, ask yourself again. Do you want to be treated independently by someone who has less training than a 3rd year medical student? Do you trust them with something as important as your health?
PS. I don’t have any problems at all with NPs/DNPs that collaborate with physicians. These tend to be the best NPs/DNPs since they understand their limits and know when you get the physician in for help. I have a problem with independently practicing NPs/DNPs who think they know just as much as physicians and continue to handle issues themselves even when they’re in over their heads because of an ego issue. I’ve already had several patients referred to me who have permanent damage because their NP was unwilling to admit that he/she didn’t know what was going on but refused to send the patient to a physician. Two of those NPs are currently facing malpractice lawsuits.
PAs have more training in both the basic sciences and clinical training than any NP or DNP program offers. You don’t see PAs fighting for independent practice though. Know why? It’s because, with more education, you come to realize how complex medical issues are. Most of the time, you’re working with partial information and have to rely on what you learned in training to think through and solve problems.
I think my PA colleagues and the majority of physicians agree that PAs are better trained than DNPs are. Heck, compare the curricula yourself if you don’t believe me! If you have a choice between a PA and an NP or DNP, always go with the PA. Not only do we have better training and a better knowledge base, we also collaborate with physicians significantly (since we have to). This way, there’s always physician oversight in case we miss anything.
To all those nurses shouting that their nursing experience makes up for lack of clinical training in NP and DNP programs, not it does not. Your own nursing organizations published researching showing that prior nursing experience has no impact on how you function as an NP. Know why? Because as an NP, you’re practicing medicine, not nursing, while conveniently calling it “advanced practice nursing.” LOL! What a load…