By
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.
Wow. This has gone very far off. I don’t want to see war between two groups. Rather a mutal respect and interaction between the two groups working for the better of patients. I think each profession brings A LOT to the table… and there is certainly NO shortage of patients that we can both help.
I dont know how your friend can get a DNP online in 12-18 months without having a master’s degree first. If that’s happening, I agree, it’s NOT a proper education. I can imagine that this is an accredited program. If your friend is really serious about providing healthcare services… she should make sure she’s not just getting a piece of paper. I’ve never heard of floor RN to DNP in 12-18 months online. The goal of the DNP is really to augment an EXISTING master’s trained NPs education so that they are better at looking at reaserch and incorporating it into practice. With the advent of technology, there is more and more evidenced based practice that is coming into play and I think that is particularly where NPs are going to be useful in primary care.
I work in a large university health center, in a city where there are several large nursing schools. So maybe I am spoiled a little bit in terms of the quality of nursing education and nursing professionals.
I am NOT saying NPs replace physicians. They do not. But I do think that they deliver excellent healthcare and that they bring good to our community. Nursing is a wonderful practice and a great profession. Just like there are doctors that give medicine a bad name, there are nurses that do the same for nursing and Advanced Practice Nursing. Just like the non-board certified cardiologist who killed Michael Jackson using medications unsafely in a field he was not trained in… there are RNs and NPs that might mislead someone or do something unsafe. This is NOT every or even the majority of RNs and NPs, just and Michael Jackson’s doctor is not every doctor. It troubles me when people don’t see the benefit of NPs and when people are threatened by it– even angered by it.
I can assure you that the studies I reference were not “garbage.” I am not suggesting that NPs are going to become brain surgeons. But NPs do have a lot of value, especially in primary care. There are less an less MDs going into primary care, and really 90% of what a primary care MD handles can be handled by a seasoned NP. This is good for patients and good for physicians. NPs have been around for more than 50 years. They wouldn’t be growing as a group if they were not helpful.
There is a path for anyone who does not practice within their scope of practice and does not provide safe care. Patients will not tolerate bad care and are very ready to take legal action if something is done wrong. We don’t need a “witch hunt” in the meantime comparing apples to oranges. Nurses at any level are trained to work with other memebers of the healtcare team and refer things off that they are not trained to deal with. This is not different when one becomes an NP.
Kelly, it’s a matter of time before NPs start doing burr holes for subdural hematomas. CRNAs are fighting in every state to do X-ray guided spine procedures. They’re not trying to help the physicians. They’re trying to compete with them.
Making up a DNP degree has nothing to do with providing better care and everything to do with leveling the playing field between doctors and nurses. Nurses want the title of “doctor” but don’t want to do the work. And the public suffers. Ignorance and confidence is a bad combination. I’m really tired of patients getting mismanaged by NPs, CRNAs, etc. I see it all the time. So do my colleagues. We’re all tired of it. I’m not threatened by it, just annoyed.
Why do NPs persist? It’s not because they’re helpful. It’s because of the aggressive nursing lobby. Physicians have traditionally done a terrible job representing their own interests. They’re either complacent or simply too busy taking care of patients to get involved. The AMA Is completely ineffectual and naive. Only 15% of physicians are members. I’d love to see a public relations campaign by physicians. Perhaps a billboard that reads “Is your doctor really a doctor?”
I’ll add that it’s curious that nurses are okay recommending their brand of medicine to the public but always demand to be seen by the best board certified physician in town when health care problems affect them or their relatives. I say, go to a DNP.
The persistent “nursing lobby”? I have to say that made me chuckle a little. You don’t think the AMA is a stronger lobbying power than Nursing? That’s simly not true. The AMA has way more money and political power than the “Nursing Lobby.” (Can we at least agree that a doctor’s salary is higher than a nurse’s? And with money comes the ability to lobby?) The AMA has lobbied publically with ad campaigns to discredit DOs for many years (until they eventually stopped), chiropractors, and pharamcists. MDs used to diagnose patients, patients would take a diagnosis to a pharmacist and the pharmacist would select an appropraite medication. Thanks to the AMA they have made pharmacists nothing more than glorified pill counters in many (not all) pharmacy positions. You under estimate the lobbying power of the AMA greatly. They have changed our society so much that the public now worships the “allopathic medicine god” to the point that they have unrealistic expectations of science and medicine. People fall at the medical alter with such blind faith that they waste tens of thousands of dollars– even when things hit a point where medicine can not help they keep going.
Nurses are only just starting to get organized, which is a good thing I think. It is strange to me that you can have RNs with equal scopes of practice coming with so many different types of education… ranging from diploma nurse to bachelor’s degree. There is nothing wrong with becoming more unified. We arent even unified in a single lobbying group like the AMA. If there are issues with scope-of-practice that you have there is a path to deal with that. Most NPs are not crazy wing nuts that want to start drilling holes in peoples skills. There are a few… but I think that is human nature. It exists in the physician community too… just ask any “real surgeon” about how they feel about OBGYNs or Family Practitioners calling themselves “Surgeons” and by doing poorly performed c-sections. I feel there is a lot of research and patients who support that NPs are useful. Additionally necessity is the mother of invention… if they were not useful, they would not exist.
If you find issues with the care ANYONE with a license gives, why would you just “be annoyed” and not say anything. In general the healthcare world “covers-up” for each other way too much. Doctors do it. Nurses do it. PAs do it. They all do it. You wouldnt see that among lawyers, I can assure you.
Instead of just over generalizing that NPs are “crap,” use your knowledge to educate your co-workers about mismanagement and also report things are seriously mismanaged. We all have a responsibility to keep each other in check for our patients. This responsibility doesnt mean just writing off an entire group of professionals and it doesnt mean just looking the other way when we see something unacceptable.
Nurses at any level aren’t here to serve physcians. They are here to work with physicians to serve patients with healthcare needs. If someone nees intensive medicine for some specific disease, I agree a NP cant replace what an MD can do in all cases. However, there are many patients who simply need standard, well-established healthcare. Thats where the origin of the independent NP role came into play. I think both NPs and MDs working together make healthcare better for patients. Even in specialties NPs add value when working with MDs. As a nurse that is how I see it. As someone who works in a big academic medical center… that is how it plays out where I work. The raise you get when you finish your Masters and start as an NP is about 10%, not double. If you can tell me where I can double my salary… please let me know..
your statement is trying to establish NPs and MDs are equal. Simple math will tell you not. 20,000 hrs of hardcore training (ie residency) is lacking in NPs. NP boards are really dumbed down. NPs have the training of a 3rd year medical student so should we make 3rd year medical students take care of patients without supervision?
My statement does not establish them as equals. It does, however, support them as independent members of the healthcare system. NPs and MDs are NOT the same. At no point can you draw lines to identify a point where there is equal education. NPs have a professional license before they ever start their NP degree. They are already taking care of patients. Medical students do not. So NO, an NP is not the equivalent of a 3rd year medical student. If you have worked with any medical students on a regular basis (as I have) you might be aware that seasoned RNs can often add a lot of the education of medical students when they are on clinical rotations.
This education argument is ridiculous. Its an argument that is very easy to address too… (i.e. the advent of the DNP degree). If there really is an issue with an NP being incompetent take it to their state board- just as you would with an incompetent MD. That will fix any issues very quickly.
The rest of this is just arguing for the sake of arguing.
MDs rely heavily on the RNs suggestions and thoughts for patient care. RN, NP… are very aware of the patients conditions often more than the actual physicians are. We take of them on a daily basis a lot more than MDs do. Nurses have to pay attention to details than the doctor does because the never have the time to truly know their patients. NPs are advanced nurses, who has the training and experience and compassion MDs don’t have. 20,000 hrs of “hardcore” training is good, so why are nurses asked for suggestions. MDs rely on nurses and other MDs for suggestions on the healthcare of patients. so don’t “dummy down” a nurse or NP, because from the looks of it…nurses are asked more than you know about what to do for patients of how to treat them….by MDs. Just because you are an MD, does not make that they any smarter than the rest, just paid more…
Kelly, I like you. But I don’t agree with you. Nurses don’t make good doctors, not matter how hard they try. And I wouldn’t make a good nurse.
Is there a role for NPs? Sure. But they need to be supervised. Unfortunately, all that I see are overzealous, undereducated NPs who barely do more good than harm. DNP degrees will make the problem worse and confuse the public even more. The public is already confused about PAs, NPs, chiropractors, naturopaths, dentists doing plastic surgery (sic), etc.
PAs are trying to do the same thing as nurses. There’s a movement in the PA world to change PA from meaning “physician assistant” to “physician associate.” And Baylor apparently offers a “Doctorate of Physician Assisting,” which is nearly as silly sounding as “Nurse Doctor.”
You’re wrong about the nursing lobbies. They’re far more organized than doctors’ organizations, which is why nurses have been able to expand their scope of practice without opposition. The AMA used to be a potent force, but that was 25 years ago.
Advice on how to double your salary? Get out of academics.
I am not a doctor or a nurse… But the town I live in, the “doctors” if you will pretty much SUCK… They are rude, arrogant, and treat you like they have better things to do. All the while giving you minimal time, care and respect. (The ones I have seen at least) I took my son to THREE different pediatricians, INCLUDING the one who saw him in the hospital when he was born. This guy or “doctor” comes into our room, while he is on his cell phone, gives my brand new son a quick, half assed (excuse my language) once over. Then gives me the blessing of pulling the phone away from his mouth but not his ear, and asks me, “do you have any questions?” Then gets slightly irritated because I had the audacity to ask him some. Then sends me a bill in the mail for almost $800! Because his inadequate, and extremely inefficient office can’t get their ducks in a row, which ended up being a huge insurance problem for ME to solve. Now my family sees, yes, two nurse practioners. I see one, and my children, sees the BEST in my opinion, doctor. The only REAL doctor we have is my OB. She’s pretty awesome. My point is… You can slap a title on a pice of crap, and its STILL just a piece of crap. Let me guess… You’re a doctor??? Yeah there goes that arrogance thing I mentioned earlier. My NP, and now my children’s NP blows the docs outta the water.
Well, hey, thanks.
I don’t think nurses make good physicians. For the few NPs that have DNPs, I dont really care if they use the title doctor or not as long as they are clear that they are not a physician. Personally, I don’t want my patients to call me doctor. But I cannot speak for others.
I thought long and hard about if I wanted to go to medical school, and I chose nursing because I could accomplish what I want to accomplish best a NP. Nursing is not the same as being a doctor. It’s a great model of care though. It puts the patient’s enviornment, quality of life, and perception at the center of what you are doing and still takes into account proven medical treatments. Medicine really puts science in the center–and focusing on above all else treating conditions in a vaccum (which sometimes is GOOD and preferable!). Sometimes however, this is BAD. When we are talking about how so many chronic conditions are the result of poor patient complaince and poor self-care, I think the NP role is ideal. As an advanced practice nurse, my goal really is to work as a primary care provider and keep them out of the hospital. Its to figure out how help them manage their hypertension, obesity, diabetes, chronic pain, etc… and then refer things that are way outside of normal to specialists. Unlike chiropractors, naturopaths, and some other alternatives it takes into account medical advancements and does teach practioners to refer to physcians when something is too specific.
I think we both are coming from different perspectives. If I had to guess what type of attending you were, I would say you are probably a surgeon of some kind. And surgery is really is a tricky arena for so called midlevels. I think if any NP wants to get really specialized they have to be willing to accept medical supervision. I do not think NPs should be doing surgery on people and or doing procedures like drilling holes in their skulls. I agree, if you want to do that, go to med school. You’re an NP working on the nursing model of care… and while I beleive that should be independent in many aspects… I dont think that the operating room is the place.
PAs are bit of a different animal. They look similar to an NP in a hospital, but really there are more issues. At least NPs technically come from a different licensure, and they have a different model of care. PAs conversely were created for no other reason than to be an extension of the MD. They ARE trained on the medical model of care… and they think becoming a PA sounds great when they are 22… but they end up bitter and pissed when they are 52 and know more than the 36 yo MDs they are working for. (And don’t tell me that a good PA with 25 years of experience cant know was much a new attending… you know that is not true.) I dont agree with them getting a “doctorate in physician assisting” because they work on the same model of care. I think the best way to address this issue is for the AMA to lobby for medical schools to create a realistic bridge programs for PAs. It is not realistic to tell a PA that if they want independence that they need to go back and take 4 years of med school and 4 years of residency when they already have a MUCH higher level of competency than a first or second year resident. BUT, if you made something more realistic I think it would solve the PA issue. For example: Take a PA who has a Masters Degree and at least 4 years exerience in a certain area (lets say they are an internal medcine PA) and allow them to take a one year 12 month all intensive med school bridge program to fill in the gaps and then allow them to do a 2-3 residency in the area that they ALREADY have their 4 years of PA experience in (in this care internal medicine). Have them take all the same exams and boards, minus MCAT. I think that this is a very realistic way to practically add more medical doctors quickly that doesnt sacrifice on the amount of clinical practice or class room experience people have.
Kelly, I’ve never met an NP or PA who makes it clear that he/she is not a physician. Very few will correct the patient. So, I doubt that DNPs will.
I don’t understand your rationale for becoming an NP. You could’ve done all of that as a physician and you’d have far better training. But becoming an NP is far easier and far less expensive. So, I get it, even though you’re not admitting it.
A PA to MD pathway would be a disaster. Some PAs are really good at what they do. But even though they know how to do something they tend to not know why they’re doing it. That’s not “competence.” That kind of medicine is dangerous. NPs have the same deficit in their training. I don’t think that watering down admission criteria to the MD degree is the answer to delivering healthcare. It’s already bothersome that some oral surgery programs provide MD degrees for their oral surgery residents even though they never go to medical school (this phenomenon allows an oral surgeon in my hometown to do boob jobs).
But I am interested in an MD to DNP pathway. By your reasoning I already have a DNP. Or at least I deserve one. So, I’m looking forward to more flexible hours, less malpractice costs and coffee breaks every two hours . . .
Oliver, you clearly have a VERY skewed view of life. You need to remove the stick from your anal cavity and chill out. To say we have more flexible hours ( fine) less malpractice costs ( fine) but coffee breaks every two hours ( That is a gross misjudment and lumping in of a few shitty underachievers with us folks who have busted our asses to get where we are) I’m not afraid to admit it, I didn’t go to med school because I didn’t want the expense. I did however spend a pile of money on 2 bachelors degrees, a masters and a doctorate/phd. I never wanted to be a doctor. I happen to agree that NP’s should not and do not deserve the title of Doctor but your delivery is WAY off.
Ive have thought about this and would be in support of a pathway for NP to obtain MD. I dont think it would be a disaster, because I believe training would be as rigorous as anyone else obtaining and MD. It seems more logical than a DNP — which as much as I respect kelly points so far — I dont see the purpose of.
Keeping in mind, that afterwards they would be physicians… and not “nurses parading as doctors” as some are concerned of with the DNP
While I am open to more pathways to physician degrees for those who want that route, I don’t agree with eliminating the DNP or NP option. DNPs and NPs are not supposed to replace Physicians. I specifically chose the nursing role because I like the nursing model of care and I knew I could accomplish what I want as an NP. Even if it was offered to me at bo cost, with a living stipend, I would not become an MD. It doesnt work with the model of care that I am drawn to. The nursing doctorate doesn’t open up scope of practice. It really just is, at this point, for
Masters prepared NPs who want to obtain more education about nursing practice. While I think NPs can independently manage many things, I think the more specialized they get and the more complex their patients are… The more they have to refer to physicians and/or partner with them. While, the nursing model of care is simply not enough to support those patients alone.. most healthier people with few or no health issues still new healthcare and still need health management. Nursing is the best care model for these people. It’s about assessing patient, motivating them, and keepin them healthy. If something totally off the wall comes up, that’s where your MDs come in.
Honestly, I don’t care if someone calls me doctor or not… Im not drawn to the idea of using the term “doctor” personally, but I will not be told by an MD I cannot use the title.
This shouldn’t even be a debate answer=NO. If a NP/PA wants to be called doctor they should have went to medical school. The focus should be on the calling to the training. NP/PA are able to practice medicine and make a difference. The name of your degree is what you have been trained for, it is what it is. You are fortunate to have the independence you have to practice. This sounds more like jealousy than anything else. Quit comparing yourself to physicians and all the credit that you think they get and be grateful your in a good profession. Take pride in your work and title of NP/PA and the rest comes. I am a health care professional with an advanced degree myself.
I agree, title should correlate with training. I don’t think that anyone thinks a PA or NP should be called “doctor” if they do not have doctoral training. I am pretty sure if someone advertised themselves as Dr. Smith and they did not have doctoral training applicable to their advertised practicet… they can be charged with professional misconduct.
However, physicians DO NOT own the title of “doctor.” The term wasn’t invented to describe a physician. (Physician is the term they own- and one cannot call themselves a physician if they did not go to MD, DO, or equivalent medical school.) There are many examples on this blog that support that there are many professions that use the title doctor.
For me this is not about comparison at all. I am proud to be a nurse, I made a conscious choice to be a nurse instead of a physician. Those who feel the same way, but want to continue their education to become experts in their field may chose to get a Doctorate in Nursing Practice. It’s not about comparison or competition. It’s about saying to patients “I am a nurse practitioner who has spent a lot of time becoming an expert at what I do and how I care for my patients.” Patients have a right to educated providers. That’s why physicians started using the term… to describe that they are well trained, competent experts in what they do.
If you don’t agree with “bridge programs” for PAs, that’s fine. Everyone can have their own opinion. I personally think this is reasonable since PAs are trained on the medical model of care. A doctorate for a PA seems to make sense that it would bridge to MD. (For NPs on the other hand, it is technically a different model, and I don’t think a bridge to MD makes sense)
An advanced practice degree as an NP, PA , or any healthcare professional does not give one the title of “Doctor.” A doctorate does.
“So, I’m looking forward to more flexible hours, less malpractice costs and coffee breaks every two hours . . .”- its my belief that you are not even a physician. first off, if you HAD the requisite normative IQ necessary to become a physician, you’d have noted that the lessor malpractice costs for a FNP are SOLELY related to our BETTER provision of care, i.e. our care doesn’t result in LAW SUITS, as we actually KNOW how to provide high level, holistic medicine such that we DON’T get sued and have the correlative astronomical malpractice costs.
good care equals fewer lawsuits due to better outcomes and far better client relationships.
besides, with your written attitude as part on your DNP application, you wouldn’t stand a chance in HELL of being accepted. you’d probably be reported to your state’s medical board.
Amen!
“good care equals fewer lawsuits due to better outcomes and far better client relationships.”
What a naive statement – while most lawsuits are either dropped or settled, to suggest “good care” will keep lawsuits at bay is sad. Every physician knows this is just not true…
And we also know how to refer when something is beyond us. Unlike many MDs who end up with way more malpractice for failure to refer.
I want to do primary care. Nursing was the best way to get started. FNP was the best way for me to do it as a provider after 5 years in nursing. People graduating medical dont even see the value of using that kind of education to be family practice providers anymore. and if i went to med school i would feel the same. who wants to make $120,000 a year as an over worked pcp, when you can go be a gi doc and make $750,000. It doesn’t pay well compared to what else they can do. I knew what u wanted and picked a good path to it.
People learn to MDs in residency. Not medical school. After 15-20 years o practice MDs don’t remember any of the details of gross anatomy (except in the organs they now specialize in), systems they don’t specialize in, and every detail of the Krebs cycle and clotting factor cascade. Give me a break.
If you wanna be a good pilot, you should go to pilot school. Flight attendants make pretty sucky pilots. Nurses make sucky doctors. Amen.
PS. “fc” is illiterate.
yes, because being the winner of a prestigious writing award over 24,000 others made me that way. its called typing fast without looking at the result, realizing that many of those to whom i am responding aren’t worth the time to even bother doing so.
as for “jr”- its amazing how many of you physicians (and i assume you r a physician, or a poseur acting as one as a way to try to inflate your own ego where no one can tell, i.e. a blog) try to label ME as an egotist, which, as a 30 year meditator is a riot to read- as it proves that YOU r the ones’ whose “egos” are overly involved and don’t like being taken down a notch.
as for nurses “helping out doctors”- sorry, dude, but we do NOT exist to “help” you; maybe an RN does, but a FNP certainly wouldn’t; especially the majority of those who’ve responded on this blog.
and, ah, “jr”, writing on a blog that includes as many comments from NPs as it does a dying “STUCK” profession of MDs, actually writing of NPs as “they” even as THEY are in your audience of readers would be a better example of one with an ego problem. generally if one is speaking WITH another, he doesn’t refer to him/her in the third person directly in front of said “they.” now, THAT’s an ego problem, but you don’t see that , do you, cuz you r a high and mighty, actual DOCTOR, while those with the terminal NP degree of a DNP are just “theys”, and lowly one at that, apparently because we don’t help “real” doctors. what century do you live in?
something tells me ALL of you rage-fillled “DOCTORS” are bitter, old, and republican.
This post just demonstrates that you have a chip on your shoulder to accompany your ego. Yes there are doctors with tremendous egos, but I believe yours can rival even the holiest of doctor complexes… speaking from a patients point of view.
FC you come off as a troll. You are a prime example of nursing trying to exacerbate the tension between MD and Nurses. Honestly, you are the only one who has been coming off as the better one thorough this discussion. The other pro Dr.Nurse should be weary of you speaking on their behalf. I can just imagin how taxing it is as a patient, nurse or doctor to get any work done whiles managing you ego.
Bitter one *… excuse the tablet typo
“Jr says:”- “better”- yeah, cuz there’s NO such thing as a Freudian slip there, right, “Jr?”.
IF you r a physician, it would seem to be YOUR ego problem to hear the reality of the Doctoral NP world versus the coddled, oh so hardworking MD world- cuz no one else in medicine works anywhere near as hard as you do, right? and with ALL of the money and access to MAKE even MORE HIDDEN money via ownership of all things medical, office buildings, MRI
Centers, etc., you couldn’t simply be OVERLY greedy and egomaniacal, now could you?
You’ve ALL been HANDED a hereditary goldmine of graft and AMA lobbyists (in my CLEAR opinion and based on ANY reading of the way in which the AMA has and continues to operate- since they essentially incontrovertibly – through NO effort of yours, have maintained ownership of ALL things medical since the 1800′s due to the 100% takeover of each state’s/Federal legislative bodies over time from that early date through to today – in my CLEAR opinion.
an example, and for any young NPs or physicians here who are unaware of this reality, the AMA spent decades trying to DESTROY the chiropractic profession- with whole impunity. They were FINALLY taken to court where they LOST a protracted case filed AGAINST them by chiropractors in Federal court which fined them a massive amount of money, i believe, AND forced them to formally admit what they had done. Some things NEVER change.
Reality, a hard thing or the egomaniacal to accept. they think they’ll just hurl a few more demeaning adjectives at nurses, who, BELIVE ME, quite certifiably surpass the care provided by at least a goodly number of certainly new and older physicians, per a ream of valid studies. physicians todays are SO beyond bogus, they don’t even know how to practice the most basic of evidence-based medicine.
point in case, a 74 year old female, with no real history of UTIs got ONE- that itself was questionable via all of r/t lab results; YET she was immediately placed on a fluoroquinolone by a PHYSICIAN for 5 days. this would be the LAST abx choice any provider who KNEW what they were doing would have made in this case. further, the physician should have mentioned that she drink cranberry juice, along with taken Vitamin C while doing so. did she, of course not. she ought to be reported to the state medical board, as should have the next two recent and true physician stories.
another lovely physician heard a male patient complain of unremitting left ankle pain after reporting having taken quite a fall down and around the end of a moving escalator. she didn’t even bother to have him remove his contralateral shoe; simply told him he should wear “orthotics” because he had pes planus. not allowing this moron to get away with practicing such grossly subpar medicine- for which she got paid PLENTY and having written to her practice manager after the truth was revealed of her “care”, naturally there was not a SINGLE response. that said, i, the FNP, demanded that we see another doctor, who rightly ordered a lumbar spine MRI which showed the ACTUAL cause of his persistent ankle pain- THREE traumatically herniated discs. THIS is physician is STILL practicing medicine today.
another case involved another elderly female, who had a large SCC lesion, and the elderly dermatologist wanted to simply use cryotherapy to remove it UNTIL i stopped her and asked her why she was negating the updated standards that SCC lesions of HIS type are ALWAYS to be excised. she mumbled a series of lame excuses, hen set up the CORRECT surgical appt. i doubt she’d have attempted the same removal were the patient her daughter, grand daughter, etc.
three examples of about TWENTY that i, myself have had to correct, WHILE in the room. God only knows what happens when i’m NOT in the room. doctors are HARDLY gods. they suck, at least more and more.
as a former, much beloved, physician mentor, now den of a prestigious medical school said to me as a student, “don’t worry, a monkey can be trained to do most of what a physician does.”
I am a nurse working towards a DNP and will be done in 2.5 years. This fight about nurses being called doctor is out of controll. I have the highest respect for MDs and what they stand for. I have not gone through med school, but I have stood behind many residents guiding them and teaching them how to be become a MD. I consider that my residency for the last 20 years. I have patiently stood beside many soon to be MDs and helped them through the decision process of what do I order and why, think of the side effects, and etc… I am proud of that fact. I WILL introduce myself to my patients as Dr. SEW, NP. I WILL not pretend to be something I am not, which is a MD. I have however put in many years to get to this point of my life and feel I deserve the proper title of doctor but not to mislead others in believing I am a MD because I am not and I accept that. I do not mean to anger anyone but we must work together to advocate for the public on all levels. thanks for reading and take care to all of you!!!
I’m surprised by the concern of the doctors (M.D.). I am a newly graduate with my BSN interested in obtaining my doctorate in nursing. I don’t understand the what the big deal is. We know a nurse with a doctorate degree is not an M.D. by any means. But I do feel if I took the time and effort to get my doctorate degree is should be able to feel honor and privileged to consider myself a doctor (of nursing) not doctor (of medicine). Just as any one else who earned their PhD is called “doctor” a nurse should be able to wear that title just as proudly. No I don’t plan to go to medical school or nor do I want to go to medical school. As a student nurse and an LPN working with M.D.s in the hospital, they no longer have the care and bedside compassion as a nurse does. Is that the REAL problem…the public is starting to prefer NPs over MDs? If I am blessed to be able receive my doctorate, I will definitely refer to myself as Dr. Jackson, NP, but the NP will definitely be announced with the doctor so there will be no confusion as to my level of education or training. But I will give respect where respect is due and I will demand my respect when it’s due. Our main focus should be on providing safe and quality care holistically to each of our patients weather we are M.D.s or N.P.s
I am a Surgical Care Practitioner in the UK which is a bit like your Nurse Practitioner in th US. I work alongside a Consultant orthopaedic hand surgeon and have my own elective clinics. I see patients with a multitude of ailments but mostly Carpal Tunnel Syndrome. I do EMG nerve conduction, steroid injections and CTS decompression surgery. I am so worried that my patients think I am a medically qualified Doctor I give them a leaflet which describes my role and states in huge capital letters that I am NOT a doctor. They read it in clinic and after the consultation they say “thank you Doctor”! I have an MSc in Advanced Surgical Practice and am about to start my PhD. When i get this I will NOT use the title doctor unless I am teaching at the Uni. It’s just too confusing. I’m proud of my achievements but you can only be called a doctor (in the clinical environment) if you have a degree in medicine.
In your case I agree you should not use the title doctor, because it is a PhD, which is an academic doctorate. DNP (as PharmD, DPT, etc.) is a practice doctorate (which can be thought as a clinical doctorate). Nurses have the option to get PhDs in nursing too, but in the case of PhD, the title should be reserved to academia.
Wow, that’s what I was exploring for, what a material! present here at this webpage, thanks admin of this web site.
Wow. I stumbled across this thread while searching for ideas when considering whether or not I’d like to go through a DO education. I have my masters in nursing and work in surgical research. I do NOT want to be a physician as I, like Kelly, don’t believe that model of care works for me personaly in regards to how I’d like to treat patients. My brother is a physician and we have very interesting conversations as you can imagine. He wants me to go to medical school, I have absolutely no desire. I work with several wonderful surgeons who happen to also be wonderful people. I work with a FEW wonderful nurses, but MANY who have that chip on their shoulders that FC so clearly displayed. It’s a shame. My fellow nurses have destroyed my respect for nursing. I would never consider furthering my career in nursing. I will either do a DO program or a completely separate PhD, but definitely not in nursing. The bitterness, anger, eating of our young, and hatred has absolutely turned me off. I know the DNP dilemma will NOT help the MD/nurse animosity at all, but hopefully its not the patients who will suffer.
Renee,
Don’t forget that DOs are too physicians. I agree that they have a model of care that is a lot more holistic in its approach. However, they have integrated with MDs a lot and I believe they have lost a lot of their holistic philosophy once they get out into practice.
I hear what you are saying about RNs with chips on their shoulders. I moved to a different city to get away from unionized crazy people who are set in their ways. I work in a very large academic medical center, and I can assure you that the overwhelming majority of nurses do not have chips on their shoulders. They are wonderful professionals who embrace their model of care and work VERY collaboratively across the interdisciplinary team. Thats the benefit of being in a Level 1 trauma center surrounded by 6 schools of nursing. They only take the best of the bunch.
The bottom line is this regarding the MD/RN animosity… we all work for our patients. There is no such thing as getting one profession (like an MD) to be a champion of another (RNs,NPs,PAs,ODs,JDs,LMTs…. you name it…). Their expertise and preferance will always be in what their training is in. Of course they are going to reject something that doesnt mirror image their own training. While it’s good excersise to have engaging conversations with other professions (like you do with your brother)… don’t ever expect that you will change their mind.
The DNP dilema is not about making MDs feel better. Its about raising the bar in the nursing profession. The more focus people have on clinical issues and application of clincal research, the better it is for patients and the higher level of care provider you will have.
It wasn’t so long ago that physcians were a very poorly respected and poorly organized group. Their educations varied and their methods of practice varied from homeopathic doctors (who engaged in proecudes like blood-letting) to mad scientists. Somewhere around the 1900′s the profession got it’s act together and turned itself into the well respected and well paid profession it is today.
As the shortage for healthcare services grows I think it’s imperative the nursing raises the bar for its profession. Be a part of the change you want to see in the (professional nursing) world…
I wish you luck in your clinical journey. My advice to you is this: What level of licensure will allow you to accomplish what you want in a way that works for you (no one else, just you)? That’s the question I had to ask myself in order to sift through all the B.S. Because at the end of the day, it is about your ability and satisfaction. A physcian once told me this and I have found it very helpful “There are 3 As in medicine, and none of them are ‘academic. The three As are what patients really need and they are someone who is amiable, able, and available.” Whatever will lead you there, that’s the way to go.
I’m an RN and nurse educator who thinks the whole DNP process is a joke and another effort to make us a laughingstock. FNP or CNS designation wasn’t enough; we had to go the “APRN-BC” route because our physician colleagues were “board-certified”. It’s ridiculous and I don’t blame them for being offended, frankly. It’s like we are ashamed of our own credentials. We need to get this enormous chip off our shoulders about our indispensable role in the healthcare system instead of clawing for the esteem of physicians, which is what underpins all this IMO. You want to be a doctor? Then go to medical school. I’m personally very happy to be a damned good nurse.
I’m not really sure how getting more eduation or seeking certification that demonstrates competence makes someone “a laughing stock.” DNP programs are useful programs that teach NPs how to apply clinical research (where as a PhD focuses on conducting research mroe often). Education shouldn’t be found as offensive. Nursing is a fantastic model of care. Doctoral training exists for many fields. I don’t see an issue with people who want to better themselves and develop a profession. It has nothing to do with a physcian’s esteem. They are physcians. They have zero training in nursing. I do not expect them to be able to intelligently reflect on what a doctoral level education should look like for a profession different than their own.
I know a fair amount of DNPs and I don’t know any that really use the title “doctor.” (They could use it, but they just don’t). They didnt get the degree to get more money or increase their scope of practice… they did it because they wanted to gain a higher level of expertise in nursing provided healthcare.
“Lisa K says”- are you for REAL? i think not.
its more likely that you are either a physician or a “medical assistant” who THINKS that somehow she is a “nurse” as is often the case based on uncorrected misunderstanding by patients who call anyone who is female a “nurse”, esp elderly patients, for NO nurse in the world would allow him/herself to live in as debased a manner as you suggest ought to be the norm.
there is NO more a a reason for physicians to be called “Doctor” for having earned that designation as the terminal endpoint of their training; just as a FNP can NOW do, after many, many years of planning (of which i was part, so know firsthand the extreme seriousness in which this pathway for the designation of a DNP-C or other Nursing doctoral terminal degrees was discussed and undetaken, and believe, me, fake nurse “Lisa”, there was not a WORD spoken during this seminal 5 day Palm Springs, CA meeting around this VERY issue of ensuring that Nurse Practitioners would need to have doctoral Degrees by 2015, or be grandfathered in if they already WERE FNPs/NPs and didn’t wish to continue on with Doctoral educational programs, about Physician Doctors.
I, as a LONGTIME FNP-C, could CARE LESS about the world of physicians; know it quite well; work well with my COLLEAGUE physicians; and, should ANY of them ATTEMPT to treat me in some throwback way, they WILL hear about it and in a nanosecond.
trust me, “fake nurse, Lisa”, PHYSICIAN Doctors used to practice by “letting blood”, and practicing many, many other UTTERLY unheard of practices today- like when there was no such thing called antibiotics or any treatment for diabetics or eclampsia or any of a myriad of disease states that USED to cause death or prolonged agony, then death; – but Physician Doctors STILL still called themselves Doctors.
There is simply NO REASON on this planet earth that a well-deserved DNP-C NP should be called anything but what he/she is- a DOCTOR. If physicians do not like it- TOO DAm+ BAD!!!
Maybe the AMA can release its stranglehold on ownership of all of the ancillary big money PHYSICIAN-owned medical sites, then NPs may feel better about them overall.
Bottom line, the AMA has had a strangehold on “medicine” since its inception in the 1800′s, an would/will stoop to ANYTHING to ensure that only Physicians stand at the top of the heap. it may even be that the “Lisa’” of this comment line are flat out AMA plants.
For the love of nursing, please tone it down…. This isn’t coming off how you intend it to.
Kelly
You are the kind of nurse I love working with! Thank you for your opinions and comments. Sharing like that is the way to help others define what will and will not work for them in their theory and in their practice. Thank you again!
Renee
I myself do not think NP’s should call themselves doctors. I live in a very small rural town. At one time in this town there was a doctor who had a NP working for him. Needless to say she did most everything as he was a poor doctor. BUT he was not supervising her as he should have and most of the patients believed she was an actual MD as that is what she called herself. She was also calling in meds for people who she had not seen in the office. Ask most MD’s and they will tell you that you have to see a patient before calling in an antibiotic or several other medications. This was not happening. Several things were going on in the office that most lay persons would not know were against protocol. It was found out and reported. Needless to say they are no longer working in this community.
Sounds like there is a lot to that story that goes into quite a bit of professional misconduct for both the “MD” and “NP.” Any professional who doesn’t practice in accordance with their scope should be held accountable.
This hardly seems relevant to objecting to clinically prepared doctorates using their titles in their professional setting. Licensed Nurse Practitioners can practice autonomously in many states. In primary care, this would often include performing many of the same tasks that a physician does independently. In more tightly regulated states they are required to be supervised directly. Down the middle you have some moderate states that allow independent practice as long as they have a physician “collaborator” who reviews a certain percentage of the NPs cases every “x” amount of months.
The issues you bring don’t seem to be related to a competent, doctorate prepared NP using the title of “Dr.”
Rather, the actions you talk about seem to be related to two unprofessional professionals. One a physician, and one a nurse. Two very different educational backgrounds… but neither of whom were able to demonstrate evidence of proper practice. Just goes to show you… if someone is an unethical person, no level of education can save them.
How is this even a discussion? An NP isnt an MD. The training and the hoops to jump through dont compare. One is the top of their class for 16 years prior to schooling, the other was the average student.
Everyone wants to be called a dr nowadays.
‘Steven M says:”- such garbage, but given the OBVIOUS EGO problems of CERTAIN physicians, you’ve CLEARLY EXPOSED the real issue here. your MASSIVE EGO thinks that nurses WANT to get Doctoral Degrees because we “couldn’t” get into medical school.
your thought pattern is so wrapped up into your MASSIVE EGO, and what a bedside manner you must have as a podiatrist.
it turns out that anyone who seeks a PhD degree lives in just about the same IQ zone, so your silly, egomaniacal blather is just that. cut many toenails lately?
I have tried to avoid this blog for some time, as I feel that most of the comments on here are largely insensitive to the fact that this shouldn’t even be a topic of conversation. Why is this even open for discussion? it is only because we are nurses that this conversation even exists! we must be doing something right-otherwise why all of the hostility regarding a profession (nursing) allowing its members (nurses) the opportunity to obtain the highest level of education available (DNP). Nurses and physicians are apples and oranges so the people that compare the two professions make no sense. all of the health professions have a unique quality to contribute to the make up of the health care system and how that care is delivered to each and every one of its recipients. Patients have a right to choose and they have a right to know who is caring for them but there is no paradox in calling a nurse a doctor! I graduate with my DNP in August 2013. Can’t wait, it will be the greatest achievement academically and professionally for me because I have always enjoyed patient care and clinical nursing. the PhD was never an option for me and I struggled with wanting to pursue higher education in Nursing other than the Phd and beyond a masters degree and did not have that option. Now I do, now WE do! We should not have to suffer the ridicule of the AMA or any third parties because of their insecurity and persistence towards keeping us down. The newest ludicrous of all is the SB612 a new proposed law in florida-which is trying to make it a FELONY of the THIRD DEGREE for NURSES and NURSES only who introduce themselves using the title “Doctor” and do not disclose that they are not an MD or DO!! Seriously, I am HAPPY to be a NP and will be happy to be an NP with a DNP! Why would I want anyone to believe something that I am not? that would just make me look like a perpetrator, a fake, a phony-all things I am not!! when i graduate I may call myself Dr. and I may not-but it is my choice either way and your goddamn right when all is said and done whoever I am dealing with or caring for will know that they saw an NP!!
Where I live and practice NPs are calling themselves or letting themselves be referred to as “Doctor”,nonspecificly. Even patients who are sophisticated in medical customs have been taken in. At first I thought this was a rural condition and it was more due to my clients’ lack of knowledge. However, when I was talking to some physicians I found that this was occuring in larger areas, university cities, and, I found later, even in major cities. In the later case, the NP was careful to not refer to herself as “Doctor”. but her staff did so repeatedly.
A number of years ago, I lectured to a group of nurses as to their legal liability in the case of their growing proffesionalism and increasing demand to play a larger role in patient care. While we discussed the “captain of the ship” doctrine and the “deep pockets” rationale, I also pointed out to them about appearances. In those days I was talking more about the appearance of caring. Now I am going to say that if you put yourself out to look like a medical doctor …be prepared to be sued like one.
This should be embarrassing to any health care professional. Please know that this site can be seen by anyone. What would people think who just happen to find this site and see how nurses and doctors (M.D.s) are conducting themselves. The animosity is ridiculous…over the title “doctor”?…really!!!!
I finf it interesting that an ADN can hop over the critical thinking skils a BSN has and becone an NP quicker than a BSN four degree registered nurse can become an NP.An now there is a rush of MSN’s with not a lot of clinical experience to tale their boards before the 2015 DNP regulation comes into effect. That means that these fast track NP’s will still be out there, still practicing horrible healthcare. Programs that offer anybody with a bachelors degree in anything can enter a fast track NP program and become a registered nurse in 1 year and an NP in 2 yrs – I know I do not want of these NP’s as my clinician. nor do I want a fast track ADN to BSN be my nurse. By fast tracking to fill voids in the health care system is causing health care to fail in treatment of patients and is costing more money for the patient. Give me a 4 yr degree BSN, MD, DO any day That is my choice I do not want lousy care from fast trackers. PA:s at least they are retested not like NP’s – and who knows where their credentials come from – it’s fast track diploma’s bringing down the health care treatment to patients. To say the least with all the other health care issues our insurance companies and governement fight over.
I am not trying to insult you… But honestly, what are you talking about? There is no factual basis for your statements. NPs are BSNs that get MSNs and MS degrees. An ADN has to get their BSN before they can get an MS or MSN to become an NP. There has been a movement to further elevate the educational requirements to a doctorally prepared DNP level, which is further education on top of their Master’s. Most NPs are certified nationally, and all are certified by their State, just like any other professional.
Kelly, I kinda understand where Jad is coming from. A lot of online schools allow people to get their nursing license without going thru clinical and actually taking care of patients before getting their degree. I have no problems with ADNs getting their degree online because they have to have the clinical experience for that, but allowing someone with a bachelor’s in engineering should have a free ride to obtaining a nursing degree without the “work” going thru nursing school.
Do you honestly know of any programs like this that exist? Even if something has online components, you can’t get around the clinical hours. And your license comes from the state, not from some online school.
I went to school for a 4 year Bachelors of Science in Business. I graduated and worked for three years in medical sales. I really wanted to go back for nursing.
In order to even apply to a “fast track program”, I had to take 3 credits of anatomy I, 3 credits of anatomy II (both with labs), 2 credits of pharmacology, 2 credits of nutrition, 3 credits of statistics (which I could transfer from my business degree), 6 credits of psychology (one class which I could tranfer from my business degree), and 2 credits of physiology. All this BEFORE I could even apply to the “fast track” 12 month program. Then I went to school for 12 months (full-time, year round- 5 days a week) where I did all the core courses, and the same number of clinical hours that a student in any other nursing program has to do. I passed the same national exam as everyone else.
I can promise you… while some of the marketing things out there seem like they make it easy… it is not. It was a lot more work than if I had just enrolled in a 4 year degree program when I was 18 years old. I didn’t go for nursing because it was easier… I went for it because its really what I wanted to do.
“kelly”- actually, there’s a higher entry point for one to become an RN. That’s the BS, RN degree, which is a far more heavily science-based pathway than the BSN pathway to become an RN.
Though most RNs go your route, I’m proud to say I went the former, which clearly, in my early years of practice made a huge difference in how I was perceived on the job, and when I next got my masters as an MSN, FNP-C, I lamented that there wasn’t a similar pathway for that degree. The DNP seems a wonderful way to achieve that long ago now, for me, goal, and I WOULD be called “Dr.” when I was through and again in practice, though I would also make it clear to my patients that the world of medicine does NOT belong to physicians, that a majority of surveys/studies have shown higher patient satisfaction with FNP care, and that not all physicians graduated with an “A”, but are, like straight people over gay, to a WORLD of rights that earn them FAR more money and prestige, simply because the AMA OWNS medicine and will stoop to anything to ensure that that dynamic doesn’t change.
Just ask the chiropractic society whom they went after as “quacks” for decade until they were finally SUCCESSFULLY sued for trying to destroy an entire profession that was eating away at their sole economic ownership of any and every form of medicine, and were MADE to cease and desist, and apologize, if I recall it correctly.
they are EXCELLENT at what they do as a lobby, since they’ve been at it since, get this, the 1800′s, on a Federal and STATE level across America. Its time to cut them off, so to speak, at the knees, so that the playing field is an even one.
I am aware of the BS-RN. Infact, I hold a BS-RN, but I don’t usually make the differentiation. While (in theory) a BS-RN is a “higher academic degree” because it is conferred by the entire university… I wouldn’t go as far as to say it is “far more heavily science-based pathway than the BSN pathway.” BSNs from accredited colleges are perfectly acceptable degrees. The same holds true for a Master’s degree. You can go a MS degree or a MSN. I chose the MS degree, but I would not suggest that someone with an MSN has a problematic deficiency in their education.
I agree with you that a lot of the physician lobby has attempted to control healthcare. Physicians do control the medical model, but they do not and should not control healthcare. Honestly, it doesnt surprise me that they want to try though. There is no point in arguing with them though. They have no training in nursing. One will never get them to support another profession to the level that promotes advancement. And the good news is, we dont have to. We need to refine our own profession, provide value to our patients, and advocate for ourselves in terms of making sure state and federal policies enable effective nurse utilization. No one can do it for us.
Jad, I definitely agree with you on that. The medical field is not a field to be “toyed” with, peoples lives are at stake. I have been and LPN for 10 years and went to an accredited site down in class do clinical and paper work for 3 1/2 years, definitely not an online nurse or a “Bull Sh**Nurse” as i would call them. It is now being required that nurse practitioners get there doctorate which consists of another 3 years after getting a BSN (the real one). So that would put me at going to school to obtain my PhD in nursing a 8 year degree which i will wear the title of DNP proudly and will consider myself a “DOCTOR” of “NURSING” in every since of the word. Just like as in any field of getting a doctorate degree, you should be called “doctor”…just not of medicine and I will show my credentials proudly…….Jackie J, BSN to MSN and finally DNP!!!!…..like it or love it
There really is no “fast track.” The 12 month program for advance students are for students who already have a bachelors degree, plus they take about 15 credits before starting the 12 month part, then they do three semesters of clinical (hence the “12 months”). But really… It’s 6 years of college…
ADNs go back to school for around 18 months. They already have two years of college and a bunch of experience. This is hardly a “short cut.”
Very few jump right into their NP. It’s a minimum two year masters that most students space out over 3-4 years after they work a few years.
Instead of getting an alphabet soup after your name why do you go to medical school and earn an MD/OD? I’m an RN, BSN, EMT-I who is in my second year of medical school. Please keep patient confusion to a minimum and become a real doctor (MD/DO).
med NURSE, some nurses do not want to be an MD. MD’s tend to take out the care and compassion a “nurse” has and it’s been proven that people prefer NPs over MDs. Hopefully MDs will see that they so not have the compassion/patience that a nurse has and clean up their act. With you already being a nurse going back to med school, hopefully you won’t lose the compassionate side and prefer quality over quantity for the sake of the almighty $$$$.
so are you saying if you don’t go to “medical school” you are not a “doctor” even though the extra school and time is being put forth to earn that title? I’m sure a lot of educated professionals would have a lot to say about that comment!! We know there is a difference between a doctorate in a field and having an MD license. I wish people would stop being so hung up on titles and just enjoy life and alphabet soup. If i’ve earned my BSN, then progress to MSN and the DNP I’ve earned every alphabet in my “alphabet soup”. Dont try to take someone’s accomplishments aways simply because of the word “doctor”. Just like and MD feels proud about earning those letters, so should every one else in any other profession, including the nurses who paid their dues and earned their PhD (Doctorate).
This started as a new thread last night, but I wanted it to be a reply:
I don’t want to be a physician. I respect physicians, and I think that what they do is important. If you needed to go to medical school to accomplish what you want, I commend you. However, while they overlap in some ways the medical model is not interchangeable with the nursing model.
I became a nurse because I want to take that which is well established and use it to promote health and well being. I don’t want to put problems in a vacuum and treat issues as a new frontier to make some kind of discovery. I dont want to experiment, I want to care for and motivate people. I want to use well established treatments to put my patient’s quality of life and preferences at the center of everything I do. Our knowledge base of well established treatments has grown to the point that makes prescribing medications and making diagnoses appropriate roles. 80 years ago common medical conditions like asthma, diabetes, hypertension, etc were mysteries… Now they are not. Physicians are onto other things. This shows with the lack if residencies filled in primary care each year. 80 years ago, people never went to physicians like they do now. Physicians exisit to treat problems. That’s why the overwhelming majority specialize in something.
I became a nurse because I am interested in developing my assessment skills on what a healthy person looks like… Figuring out how to keep them that way… And figuring out who to send them to when they have a problem that needs to be put in a vacuum because it falls outside established guidelines of regular healthcare.
I don’t want to be a physician. I respect physicians, and I think that what they do is important. If you needed to go to medical school to accomplish what you want, I commend you. However, while they overlap in some ways the medical model is not interchangeable with the nursing model.
I became a nurse because I want to take that which is well established and use it to promote health and well being. I don’t want to put problems in a vacuum and treat issues as a new frontier to make some kind of discovery. I dont want to experiment, I want to care for and motivate people. I want to use well established treatments to put my patient’s quality of life and preferences at the center of everything I do. Our knowledge base of well established treatments has grown to the point that makes prescribing medications and making diagnoses appropriate roles. 80 years ago common medical conditions like asthma, diabetes, hypertension, etc were mysteries… Now they are not. Physicians are onto other things. This shows with the lack if residencies filled in primary care each year. 80 years ago, people never went to physicians like they do now. Physicians exisit to treat problems. That’s why the overwhelming majority specialize in something.
I became a nurse because I am interested in developing my assessment skills on what a healthy person looks like… Figuring out how to keep them that way… And figuring out who to send them to when they have a problem that needs to be put in a vacuum because it falls outside established guidelines of regular healthcare.
LOL nurses are funny. With all that you said in that last post about really wanting to be a NP, how about you get paid as a regular nurse and see how much you still want to be an NP. If you think you are doing this because of your own interest and intellect, dont ask for a pay raise when you go and sign your new contract. All this is BS, nurses who become NP’s do it for the pay raise, theres no other reason why. You can pretend all you like about calling your self Dr. so and so, NP. How about addressing yourself as “im Doctor of Nursing so and so”, and medical doctors will introduce themselves as “I am Doctor of medicine so and so” and we will see how fast the patient takes the words of the MD over the words of the NP. NP’s are glorified nurses, nothing else sorry to be blatantly honest. Your “residency” is nothing like a medical residency, yes i agree you may have guided them, but you have no idea of the actual science thats involved from a molecular to physical level. You just have treatment plans memorized and able to manipulate them, but cannot create them, which is a skill MD’s have. The papers you guys write are no where near the scientific level MD’s can research and write papers on.
Your argument is nothing more than an opinion. I can guarentee you that there is a physicist somewhere in Cambridge who thinks that it is insane that physcians have held the term “doctor” hostage. I think most people with even a marginal appreciation for what a physicist does would agree that someone who works in a lab, performs out of the box experiments, and writes paperson Quantum Mechanics that have the potential to change our understanding of the universe is far more elite, scholarly, and scientific.
So really, it’s all relative. I say, figure out what you want to accomplish, and do it. Get the highest education that you can that demonstrates expertise. That’s what the term “doctor” is supposed to mean. This is not about who is better than who.
If you want to be a surgeon and or a specialist with an interest in a specific disease process or pattern go to medical school. If you want to focus on overall health, well being, and quality fo life go to nursing school. There is no RIGHT or WRONG. We need both of these individuals in our healthcare system.
Unquestionably consider that which you said. Your
favorite reason appeared to be on the net the easiest factor to take note of.
I say to you, I definitely get irked while people consider concerns that they plainly don’t realize about. You controlled to hit the nail upon the highest as well as outlined out the whole thing with no need side-effects , other people could take a signal. Will likely be again to get more. Thank you
Excellent goods from you, man. I’ve understand your stuff previous to and you’re just extremely excellent.
I actually like what you have acquired here, really like what you are saying and
the way in which you say it. You make it entertaining and you still care for to keep
it wise. I cant wait to read far more from you.
This is actually a wonderful website.
Why is there no real discussion of the fundamental issues in this debate: money and control? To hear doctors crying foul regarding NPs becoming competitive as providers is laughable, if not plain outrageous. There has been a long and growing trend of doctors employing NPs (literally and figuratively), but not for such noble and enlightened reasons as better patient care or greater coverage. Doctors have no problem with NPs as long as it serves their purposes and desires, such as increasing the number of billable patient visits, extra call coverage, etc. In fact, many doctors allow and encouage their NPs to practice without much direct (or even regular) oversight or guidance as long as the NP is seeing an adequate number of patients to generate more revenue. And then, the NP is paid much less by their doctor/employer despite effectively providing an equal or greater level of care to the patient.
And that’s the real crux of this debate. Doctors may indeed have a greater amount of education, but that does not necessarily mean they provide better or more capable care in all cases or in all situations. In fact, it s rather presumptuous to both believe and assert that greater education necessarily means greater knowledge or capability. There are enough examples of the fallacy of that line of thinking to make it seem the exception rather than the rule.
The fact is that NPs serve many functions, including positions as educators and mentors to med students and interns at most major medical schools. They effectively act as primary care providers in many (doctors’) offices, nursing homes, and hospitals. They do the same rounds, they write the same notes and orders, they take the same call, they treat and counsel the same patients and families, and often, they do it all better than doctors. This isn’t a matter of debate, this is fact.
The fear doctors feel about losing their monopoly on the oh-so-beloved title of “Doctor” transcends issues of legitimacy and entitlement, and even their egotistical and vapid self-importance, cutting down to where it really hurts: the potential loss of money and control. NPs have struggled in a system that was engineered to limit their ability to reap the rewards of their abilities and services and they are tired of being taken advantage of for the sake of benefitting the disrespectful and dismissive medical doctor establishment. Doctors are now suffering the distaste of a healthy dose of their own medicine made from the seeds they planted and there’s no putting the safety cap back on the pill bottle again. Better learn to choke ‘em down docs, ’cause NPs have found their stride and the rest of the world is onto you!
I am a healthcare professional….a chiropractor…and I am considered a ‘primary’ care provider. As most concerns go in the healthcare arena…’Follow the Money’…..The Traditional Medical Care Universe does not like competition.