Are there any satisfied midlevels, or do they all want to be doctors?

[MissPickles]

Question for the midlevels hanging out here-

Why all the threads about midlevels (NPs and PAs) wanting to become doctors through various means (degree inflation (DNP) and bridge programs)? To me, the midlevel thing just can't be beat; I certainly have no problem not wearing the big girl pants all of the time for the trade offs of less debt, less time spent in training, and to a degree, less responsibility. No, you don't get to wear the big girl/boy pants all the time, if you do, go to med school.

Any NPs and PAs who are totally satisfied?

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[PrinceVersed]

I don't know of anyone who is ever totally satisfied with their job. But yes, I am sure there are a ton of PAs and NPs that love what they do. There is probably even a message board for NPs and PAs where they talk about the pros and cons of their fields. Just google around.

 

[drift]

I wouldn't generalize PAs and NPs together in this topic.

Its the NPs that want to become doctors through legislative and degree inflation (DNP). This is a "back door" option.

The PA bridge program is pretty much med school (minus ~2-3 specialty rotations) + a full residency. This is an AOA approved medical program. Certainly not comparable to any NP back-door options.

Although in my experience most midlevels I know are quite content with their careers and have no desire to replace me. Its the select few NP "leaders" that give the entire NP profession their rep and people tend to generalize NPs and PAs together so PAs also to a degree get that rep, but that isn't the truth.

 

[zenman]

I'm happy as I can be.

 

[MissPickles]

I guess I just feel really discouraged about some of the perceptions about mid-levels, mostly NPs, on this board. Prior to my reading this message board my impression was that both NPs and PAs had their respected roles within the medical profession. Additionally, I thought NPs and PAs basically accepted the fact that yes, the physicians are the higher ups/superiors. They have more training and sacrificed more to be able to wear the big pants. And that is how it should be.

I suppose it does not make sense to lump PAs and NPs together; and I am not necessarily saying that their efforts to be a "doctor" (MD/DO versus the DNP) are equally legitimate. If the PA bridge is significantly more rigorous (seems to be the consensus here) than the DNP, my main curiosity is why so many people who are midlevels or want to be doctors in the first place! Maybe my readings are skewed because this is, in fact, Student DOCTOR Network. Lol.

I think I am somewhat concerned because I have wanted to be a midwife (nurse midwife) for a few years now and I am finally getting my "poop in a group" to pursue that goal. There's so much negativity about advanced practice nursing that it's depressing me. And there is no equivalent role in the PA field for midwifery.

 

[deleted6669]

there is no equivalent role in the PA field for midwifery.

Actually there is although not a lot of folks have done it(yet).
there are obgyn 1 yr postgrad residencies for pa's that basically cover the cnm scope of practice and then some. a student of mine went to one of these programs and now works full time in ob/gyn with a pretty good scope of practice including managing high risk pregnancy, first assisting all ob procedures in the o.r., solo vag deliveries, first call to the er for obgyn emergencies, colposcopy, etc see www.appap.org for info on the OBGYN residency at montefiore in nyc.
regarding your initial question, I like my job probably 80% of the time. I'm still trying to figure out if the other 20% is worth 1 million dollars in opportunity cost and 6 yrs of my life( bridge program+residency ).

 

[zenman]

There's so much negativity about advanced practice nursing that it's depressing me. And there is no equivalent role in the PA field for midwifery.

Don't worry about it. Just do what you want to do.

 

[Charles_Carmichael]

There's so much negativity about advanced practice nursing that it's depressing me.

This negativity towards APNs was created by APNs, not physicians. Stop claiming to be equal/superior to physicians when you receive only a fraction of the training and I can guarantee a lot of this negativity will go away.

 

[PSYCHNP]

I guess I just feel really discouraged about some of the perceptions about mid-levels, mostly NPs, on this board. Prior to my reading this message board my impression was that both NPs and PAs had their respected roles within the medical profession. Additionally, I thought NPs and PAs basically accepted the fact that yes, the physicians are the higher ups/superiors. They have more training and sacrificed more to be able to wear the big pants. And that is how it should be.

I suppose it does not make sense to lump PAs and NPs together; and I am not necessarily saying that their efforts to be a "doctor" (MD/DO versus the DNP) are equally legitimate. If the PA bridge is significantly more rigorous (seems to be the consensus here) than the DNP, my main curiosity is why so many people who are midlevels or want to be doctors in the first place! Maybe my readings are skewed because this is, in fact, Student DOCTOR Network. Lol.

I think I am somewhat concerned because I have wanted to be a midwife (nurse midwife) for a few years now and I am finally getting my "poop in a group" to pursue that goal. There's so much negativity about advanced practice nursing that it's depressing me. And there is no equivalent role in the PA field for midwifery.[/QUOTE]

I don't understand you. You don't want to put in the time or money to become an MD yet you complain about a shorter/lesser educational route.

If you don't want to be ragged on for becoming a CNM then become an MD or PA. I don't know what we can tell you.

 

[dancingdoctor13]

Actually there is although not a lot of folks have done it(yet).
there are obgyn 1 yr postgrad residencies for pa's that basically cover the cnm scope of practice and then some. a student of mine went to one of these programs and now works full time in ob/gyn with a pretty good scope of practice including managing high risk pregnancy, first assisting all ob procedures in the o.r., solo vag deliveries, first call to the er for obgyn emergencies, colposcopy, etc see www.appap.org for info on the OBGYN residency at montefiore in nyc.
regarding your initial question, I like my job probably 80% of the time. I'm still trying to figure out if the other 20% is worth 1 million dollars in opportunity cost and 6 yrs of my life( bridge program+residency ).

Is the residency in NYC better than the one in Colton, CA? Is this person on SDN by any chance? I am a pre-PA student very interested in ob/gyn and would love to learn more about the scope and compensation that comes along with being a PA in this field. Thanks!

 

[oldiebutgoodie]

This negativity towards APNs was created by APNs, not physicians. Stop claiming to be equal/superior to physicians when you receive only a fraction of the training and I can guarantee a lot of this negativity will go away.

All the NPs I work with are happy in their role, do not want to be doctors, don't want to claim equality/superiority.

Kaushik and others, don't assume that the rantings of Mary Mundinger speak for the entire profession. I am curious, have you actually SPOKEN to an NP, or do you base your opinion on what you read on the internet?

There is just a disconnect between my experiences with midlevels (NPs and PAs) and what I read here. The NPs and PAs I work with are professional, know their role, and consult with their docs all the time.

Oldiebutgoodie

 

[deleted6669]

Is the residency in NYC better than the one in Colton, CA? Is this person on SDN by any chance? I am a pre-PA student very interested in ob/gyn and would love to learn more about the scope and compensation that comes along with being a PA in this field. Thanks!

both programs are good.
he doesn't post on sdn. I believe there is a society of pa's in obgyn that could give you more info on options.

 

[Dr Oops]

All the NPs I work with are happy in their role, do not want to be doctors, don't want to claim equality/superiority.

Kaushik and others, don't assume that the rantings of Mary Mundinger speak for the entire profession. I am curious, have you actually SPOKEN to an NP, or do you base your opinion on what you read on the internet?

There is just a disconnect between my experiences with midlevels (NPs and PAs) and what I read here. The NPs and PAs I work with are professional, know their role, and consult with their docs all the time.

Oldiebutgoodie

Not to derail the thread, but its not just mary mundinger, you have multiple nurses via multiple forms of media, claiming the same thing. Thats fine and dandy that you dont hear it in the workplace, because it would probably create a hostile work place, but there is a very real PR campaign going trying to dupe the public. The national nursing organizations support the whole "legislation instead of education" movement. Just because it may not happen on the wards doesnt mean its not a threat to patient care and doctor alike.

 

[MissPickles]

I guess I just feel really discouraged about some of the perceptions about mid-levels, mostly NPs, on this board. Prior to my reading this message board my impression was that both NPs and PAs had their respected roles within the medical profession. Additionally, I thought NPs and PAs basically accepted the fact that yes, the physicians are the higher ups/superiors. They have more training and sacrificed more to be able to wear the big pants. And that is how it should be.

I suppose it does not make sense to lump PAs and NPs together; and I am not necessarily saying that their efforts to be a "doctor" (MD/DO versus the DNP) are equally legitimate. If the PA bridge is significantly more rigorous (seems to be the consensus here) than the DNP, my main curiosity is why so many people who are midlevels or want to be doctors in the first place! Maybe my readings are skewed because this is, in fact, Student DOCTOR Network. Lol.

I think I am somewhat concerned because I have wanted to be a midwife (nurse midwife) for a few years now and I am finally getting my "poop in a group" to pursue that goal. There's so much negativity about advanced practice nursing that it's depressing me. And there is no equivalent role in the PA field for midwifery.[/QUOTE]

I don't understand you. You don't want to put in the time or money to become an MD yet you complain about a shorter/lesser educational route.

If you don't want to be ragged on for becoming a CNM then become an MD or PA. I don't know what we can tell you.

I never was complaining about a shorter/lesser educational route. If you re-read my original post, in fact, I described it as a benefit for mid-levels, with the trade off of less prestige/responsibility/money. Additionally, I said this was warranted; the MDs/DOs have more training and therefore deserve additional privileges.

The intent of my post was merely to talk to satisfied mid-levels who like their careers, and to hopefully get some validation that all MDs/DOs are not going to treat me like a piece of crap if I become a CNM or even a PA! Maybe it seems like a silly thing to post about, but for me, occupational satisfaction will be highly correlated with cooperating with other people in my profession and having satisfying interactions with these folks, whether they are "above me" or "below me" on the medical totem pole.

My additionally question or conflict is that I like what a CNM does, what their role is (non-complicated births) but I feel like advanced practice nursing has such a negative reputation, as though nurses want to "take over" health care. I think I have made it very clear that I have no interest in being a Nurse-Doctor (DNP) or whatever, and that I have NO issues deferring to a doctor when necessary.

 

[MissPickles]

Actually there is although not a lot of folks have done it(yet).
there are obgyn 1 yr postgrad residencies for pa's that basically cover the cnm scope of practice and then some. a student of mine went to one of these programs and now works full time in ob/gyn with a pretty good scope of practice including managing high risk pregnancy, first assisting all ob procedures in the o.r., solo vag deliveries, first call to the er for obgyn emergencies, colposcopy, etc see www.appap.org for info on the OBGYN residency at montefiore in nyc.
regarding your initial question, I like my job probably 80% of the time. I'm still trying to figure out if the other 20% is worth 1 million dollars in opportunity cost and 6 yrs of my life( bridge program+residency ).

Thanks a bunch of this info, I will be looking into it!

 

[MissPickles]

Not to derail the thread, but its not just mary mundinger, you have multiple nurses via multiple forms of media, claiming the same thing. Thats fine and dandy that you dont hear it in the workplace, because it would probably create a hostile work place, but there is a very real PR campaign going trying to dupe the public. The national nursing organizations support the whole "legislation instead of education" movement. Just because it may not happen on the wards doesnt mean its not a threat to patient care and doctor alike.

As somebody who may be a nurse in the future, I wish these people would just stop. The DNP is simply not equivalent to being an MD/DO. If you want to be an MD/DO, go to medical school. If not, do something else. Its just stupid.

 

[PSYCHNP]

I never was complaining about a shorter/lesser educational route. If you re-read my original post, in fact, I described it as a benefit for mid-levels, with the trade off of less prestige/responsibility/money. Additionally, I said this was warranted; the MDs/DOs have more training and therefore deserve additional privileges.

The intent of my post was merely to talk to satisfied mid-levels who like their careers, and to hopefully get some validation that all MDs/DOs are not going to treat me like a piece of crap if I become a CNM or even a PA! Maybe it seems like a silly thing to post about, but for me, occupational satisfaction will be highly correlated with cooperating with other people in my profession and having satisfying interactions with these folks, whether they are "above me" or "below me" on the medical totem pole.

My additionally question or conflict is that I like what a CNM does, what their role is (non-complicated births) but I feel like advanced practice nursing has such a negative reputation, as though nurses want to "take over" health care. I think I have made it very clear that I have no interest in being a Nurse-Doctor (DNP) or whatever, and that I have NO issues deferring to a doctor when necessary.

If you have no interest in being a "Nurse-Doctor (DNP)" then studying to become a CNM may not be the career path for you. Simply because the clinical doctarate may be the entry level for advanced practice nurses by the time you reach that stage of your education.

 

[Maybeknot]

As somebody who may be a nurse in the future, I wish these people would just stop. The DNP is simply not equivalent to being an MD/DO. If you want to be an MD/DO, go to medical school. If not, do something else. Its just stupid.

MissPickles, your quarrel is with "these people:"
- The American Academy of Nurse Practitioners
- The American College of Nurse Practitioners
- The Association of Faculties of Pediatric Nurse Practitioners
- The National Association of Nurse Practitioners in Women's Health
- The National Association of Pediatric Nurse Practitioners
- The National Conference of Gerontological Nurse Practitioners
- The National Organization of Nurse Practitioner Faculties

All of these groups have signed a letter which states, among many things,
"in the health care field, the term doctor is not limited to medical doctors... recognition of title 'doctor' for doctorally prepared nurse practitioners facilitates parity within the health care system."

 

[NYRN]

It's only on this board that you hear about the "grand takeover" of medicine by NP/DNP's.

I don't know any NP's that are looking to replace doctors, none that ever refer to themselves as "doctor" to the patient, or in any way attempt to function outside of the scope of practice of their training as people claim here on the board. There are several NP's hired by my hospital that work with specialist MD's like the stroke neurologist and the neurosurgeons.

Anyone here can believe/not believe anything they want, but I'm sure that they would agree with this:

The hospital has several specialists that are in high demand, and make the hospital $. The hospital wants to keep these MD's happy. If at any time the NP/PA's hired to work in their specialty were attempting to take charge over the care of the pt, mislead patients by hiding their title, or in any other way making the doc's job more difficult, they would be GONE in a hot minute. These midlevels that work with these docs at my place, have been there for years, and they have lasted that long because they have a great working relationship. The doc is the leader and the midlevel is their right hand man/woman.

Mary whatever her name is, and her 10 followers don't represent crap. They are a bunch of loons looking for publicity. In fact, I challenge any of you docs to go around the hospital and ask nurses and NP's if they know who Mary is. I bet you they have never heard of her.

 

[MissPickles]

I understand your point. My only interest in a CNM over a PA with an ob-gyn specialty comes from the more "holistic" (or non-complicated) births that CNMs do. There may not be much of a difference between that and what PAs do; I haven't found all the information about it just yet.

If you have no interest in being a "Nurse-Doctor (DNP)" then studying to become a CNM may not be the career path for you. Simply because the clinical doctarate may be the entry level for advanced practice nurses by the time you reach that stage of your education.

 

[MissPickles]

I do agree to some extent that MDs/DOs should not have a monopoly on the term "doctor", since one can be doctorally prepared in a number of fields. However, if the intention is to mislead patients, as I believe it may be in this case, then I am against it completely. There are some pharmacists, OTs, PTs, and chiropractors that go by "Doctor So-and-so" but in many cases they don't work right alongside the physicians (they work in their own departments or not even in a hospital setting) so its much clearer. I don't know how I feel about the word "doctor"...but I do know how I feel about misleading patients, and it is wrong.

MissPickles, your quarrel is with "these people:"
- The American Academy of Nurse Practitioners
- The American College of Nurse Practitioners
- The Association of Faculties of Pediatric Nurse Practitioners
- The National Association of Nurse Practitioners in Women's Health
- The National Association of Pediatric Nurse Practitioners
- The National Conference of Gerontological Nurse Practitioners
- The National Organization of Nurse Practitioner Faculties

All of these groups have signed a letter which states, among many things,
"in the health care field, the term doctor is not limited to medical doctors... recognition of title 'doctor' for doctorally prepared nurse practitioners facilitates parity within the health care system."

 

[MissPickles]

Most of the "real world" nurses, doctors, and PAs I have been talking to have said something along these lines. Basically, that within the walls of the hospitals/clinics/ect. if you treat your colleagues with respect and understand the leadership of the physicians, you will be just fine. I realize some physicians may feel threatened by the NP/DNP faction that wants to take over medicine. I just have a hard time believing that most people, consumers, physicians, nurses, PAs and other medical personnel alike, would believe that someone with LESS education could do a job equally or better. It just makes no damn sense!

It's only on this board that you hear about the "grand takeover" of medicine by NP/DNP's.

I don't know any NP's that are looking to replace doctors, none that ever refer to themselves as "doctor" to the patient, or in any way attempt to function outside of the scope of practice of their training as people claim here on the board. There are several NP's hired by my hospital that work with specialist MD's like the stroke neurologist and the neurosurgeons.

Anyone here can believe/not believe anything they want, but I'm sure that they would agree with this:

The hospital has several specialists that are in high demand, and make the hospital $. The hospital wants to keep these MD's happy. If at any time the NP/PA's hired to work in their specialty were attempting to take charge over the care of the pt, mislead patients by hiding their title, or in any other way making the doc's job more difficult, they would be GONE in a hot minute. These midlevels that work with these docs at my place, have been there for years, and they have lasted that long because they have a great working relationship. The doc is the leader and the midlevel is their right hand man/woman.

Mary whatever her name is, and her 10 followers don't represent crap. They are a bunch of loons looking for publicity. In fact, I challenge any of you docs to go around the hospital and ask nurses and NP's if they know who Mary is. I bet you they have never heard of her.

 

[oldiebutgoodie]

It's only on this board that you hear about the "grand takeover" of medicine by NP/DNP's.

I don't know any NP's that are looking to replace doctors, none that ever refer to themselves as "doctor" to the patient, or in any way attempt to function outside of the scope of practice of their training as people claim here on the board. There are several NP's hired by my hospital that work with specialist MD's like the stroke neurologist and the neurosurgeons.

Anyone here can believe/not believe anything they want, but I'm sure that they would agree with this:

The hospital has several specialists that are in high demand, and make the hospital $. The hospital wants to keep these MD's happy. If at any time the NP/PA's hired to work in their specialty were attempting to take charge over the care of the pt, mislead patients by hiding their title, or in any other way making the doc's job more difficult, they would be GONE in a hot minute. These midlevels that work with these docs at my place, have been there for years, and they have lasted that long because they have a great working relationship. The doc is the leader and the midlevel is their right hand man/woman.

Mary whatever her name is, and her 10 followers don't represent crap. They are a bunch of loons looking for publicity. In fact, I challenge any of you docs to go around the hospital and ask nurses and NP's if they know who Mary is. I bet you they have never heard of her.

Thank you. I am not alone in seeing that our PAs and NPs are not plotting the grand takeover. Although, I did see some of them eating lunch together the other day... perhaps making diabolical plans?

But again, have some of you on this thread actually TALKED to an NP? Do your NPs want to be called "doctor"? Or are you just basing this on what you read? (And BTW, I don't see y'all agreeing with everything the AMA says. )

Oldiebutgoodie

 

[deleted87716]

It's happening. I personally know a quasi-independent DNP who described herself as a "physician" on her web site. She quickly stopped after the BOM/BON contacted her.

She still calls herself "doctor," however...every chance she gets.

 

[fab4fan]

Yeah, well, this guy calls himself a "doctor" too. Anyone up for fighting with him over it?

 

[sarjasy]

It's happening. I personally know a quasi-independent DNP who described herself as a "physician" on her web site.

Anecdote.

She quickly stopped after the BOM/BON contacted her.

Did you say the BON? You mean nurses told her to stop? No way.

 

[clubcantholdme]

I am quite pleased with my role and have no desire to be called doctor nor become a doctor.

 

[zenman]

Did you say the BON? You mean nurses told her to stop? No way.

When I get my monthly BON newsletter there is always a long list of nurses who have been disciplined.

 

[sarjasy]

When I get my monthly BON newsletter there is always a long list of nurses who have been disciplined.

I was being sarcastic.

 

[NYRN]

It's happening. I personally know a quasi-independent DNP who described herself as a "physician" on her web site. She quickly stopped after the BOM/BON contacted her.

She still calls herself "doctor," however...every chance she gets.

This is clear misrepresentation and illegal. She should face charges or be forced to change his/her name.

 

[zenman]

I was being sarcastic.

I was covering all bases.

 

[zenman]

It's happening. I personally know a quasi-independent DNP who described herself as a "physician" on her web site. She quickly stopped after the BOM/BON contacted her.

She still calls herself "doctor," however...every chance she gets.

You have a link for our entertainment?

 

[sarjasy]

You have a link for our entertainment?

I'd like to see it too. I don't doubt it happened, but in the end, it is just an anecdote. There's a small percentage of idiotic NP's that see themselves equal to physicians and/or think the DNP makes them that way. Likewise, there's a small number of physicians (and others) that see this and conclude that a plurality (if not most) NP's think this way and are trying to take over medicine if not the world. Granted, my assumptions are anecdotal as well, but I've yet to meet an NP (other than on here) that even comes close to this kind of thinking and many on this forum have said the same. Statistically, if it were a common view, there would likely be more of us who have encountered them. In the end, the above described small group of physicians are expending a lot of energy beating to pieces a straw man.

 

[zenman]

I'd like to see it too. I don't doubt it happened, but in the end, it is just an anecdote. There's a small percentage of idiotic NP's that see themselves equal to physicians and/or think the DNP makes them that way. Likewise, there's a small number of physicians (and others) that see this and conclude that a plurality (if not most) NP's think this way and are trying to take over medicine if not the world. Granted, my assumptions are anecdotal as well, but I've yet to meet an NP (other than on here) that even comes close to this kind of thinking and many on this forum have said the same. Statistically, if it were a common view, there would likely be more of us who have encountered them. In the end, the above described small group of physicians are expending a lot of energy beating to pieces a straw man.

And they should be beating up on politicians...

 

[chimichanga]

Anectodes from physicians (on this site) are cited and (often) later quoted as supportive evidence.
But when non physicians cite an anecdote, it's conjecture...

I've been in nursing close to 20 years, worked in over a dozen hospitals in two states, and have been to countless symposiums, continuing ed, etc. I have seen overwhelming collaboration and a mutual respect among the different healthcare professions.

All the nonsense on this board is extremism on both'sides' (I hesitate at using sides, as we are all on the same side - the patients')

Sure there are 'outlanders' and 'interlopers' that pose as mid-level nurses, but they really are the minority. They just get all the press...

do these 'religious people' represent all of religion:

http://www.gotquestions.org/Westboro-Baptist-Church.html

 

[deleted87716]

You have a link for our entertainment?

http://thepracticesetfeeclinic.tumblr.com/page/7

The phrase "founder and physician" was later changed to "founder and health care provider." She also omitted her credentials in the original version.

The attached PDF file shows the original text before it was changed.

 

[zenman]

http://thepracticesetfeeclinic.tumblr.com/page/7

The phrase "founder and physician" was later changed to "founder and health care provider." She also omitted her credentials in the original version.

The attached PDF file shows the original text before it was changed.

I wonder if someone else wrote the text or if she did. In any case she should proof the work.

 

[Maybeknot]

It's only on this board that you hear about the "grand takeover" of medicine by NP/DNP's.

Mary whatever her name is, and her 10 followers don't represent crap. They are a bunch of loons looking for publicity. In fact, I challenge any of you docs to go around the hospital and ask nurses and NP's if they know who Mary is. I bet you they have never heard of her.

I realize some physicians may feel threatened by the NP/DNP faction that wants to take over medicine. I just have a hard time believing that most people, consumers, physicians, nurses, PAs and other medical personnel alike, would believe that someone with LESS education could do a job equally or better. It just makes no damn sense!

See, I would love if this was just an MD/DO "overreaction." It's not, though. I don't know how prevalent the DNP increased scope of practice is within the nursing world; I think it's crystal clear that within the nursing lobby, the DNP increased scope of practice movement is approaching ubiquity.

And I can't blame them. After all, if someone in power decided today that all residents could suddenly have complete autonomy, admitting, billing, and OR privileges... I'm sure there would be more than few that would take full advantage of the increased power (and corresponding $$$). I think the difference between the DNP movement and residents is that for most residents, when we graduate from med school we can finally start to appreciate what we don't know. The DNP's, I imagine, with the fraction of education and training, may not be able to make that distinction.

slightly off-topic (but not really).... One fascinating quote from the DNP propaganda literature, this one from the "Coalition for Patient Rights," a lobbying group that is made up of 38 or so nursing/allied health associations, including the American Association of Colleges of Nursing, the National League of Nursing, the American Association of Nurse Anesthetists, the American Nurses Association, etc.

The Coalition believes that it is inappropriate for organizations representing doctos of medicine and osteopathy (MDs and DOs) to advise legislators -- as well as consumers, regulators, policy makers, or payers -- regarding the scope of practice of other licensed healthcare professionals whose practices are authorized by law.

This was in specific response to the AMA's "Scope of Practice" white paper which examines multiple studies regarding NPs and DNPs. In short... the "Coalition of Patient Rights" doesn't want the experts in the field of health care providing their expert opinion on the appropriateness of scope of practice in the health care.

 

[deleted87716]

I wonder if someone else wrote the text or if she did. In any case she should proof the work.

There's no doubt that she used the term "physician" deliberately. A few days later, the following post appeared on her web site. It, too, was quickly removed.

 

[NYRN]

There's no doubt that she used the term "physician" deliberately. A few days later, the following post appeared on her web site. It, too, was quickly removed.

Her advertisement is very misleading, and both physicians and NP's should be against people like her. I have no issue with NP's setting up urgent care places, but the patients have to be informed in a clear manner that they are seeing an NP and not a physician.

There are several successful clinics run by NP's in NYC, and they are successful not because they are misleading patients, but because the patients that go there seek out NP's. These are private pay/insured patients who choose to go there. Misleading patients like the one above is not the way to run a business and makes good NP's look bad.

 

[deleted87716]

Her advertisement is very misleading, and both physicians and NP's should be against people like her. I have no issue with NP's setting up urgent care places, but the patients have to be informed in a clear manner that they are seeing an NP and not a physician.

Furthermore, her practice's actual web site (not her Tumblr blog that we were discussing above) contains no information whatsoever about her or her credentials.

This may not be illegal, but it's certainly potentially misleading. And, undoubtedly deliberate.

 

[sarjasy]

See, I would love if this was just an MD/DO "overreaction." It's not, though. I don't know how prevalent the DNP increased scope of practice is within the nursing world; I think it's crystal clear that within the nursing lobby, the DNP increased scope of practice movement is approaching ubiquity.

One fascinating quote from the DNP propaganda literature, this one from the "Coalition for Patient Rights," a lobbying group that is made up of 38 or so nursing/allied health associations, including the American Association of Colleges of Nursing, the National League of Nursing, the American Association of Nurse Anesthetists, the American Nurses Association, etc.
...
This was in specific response to the AMA's "Scope of Practice" white paper which examines multiple studies regarding NPs and DNPs. In short... the "Coalition of Patient Rights" doesn't want the experts in the field of health care providing their expert opinion on the appropriateness of scope of practice in the health care.

In one way it is an overreaction, in another way maybe not.

The AMA is a shell of what it once was for a whole host of reasons, but further lost credibility among many due to their jumping on the ObamaCare bandwagon (to the detriment of their members, IMO), which no doubt has/will further decrease their membership. (Ironically, if ObamaCare stands, it will likely dramatically increase the demand for NP's and PA's, and perhaps bring expanded scopes of practice with it.) Many, many physicians strongly opposed to the legislation and I personally think it was one of the worst pieces of legislation passed in American history. However, I'm am not going to rail against physicians as a whole, or attack them, or bash them because of the actions of the AMA or any other medical org for that matter.

Likewise, the actions of the ANA, AACN, and the other orgs you mention are not necessarily representative of RN's and NP's, especially in regard to expanding the DNP scope of practice.

Physicians concerned about the DNP and the those trying to make the DNP equal to MD need to take out their frustrations on those individuals and organizations through political action or whatever, NOT on NP's (DNP prepared or otherwise) in general, who in my belief overwhelmingly reject the notion of DNP and MD equivalence.

 

[deleted87716]

Physicians concerned about the DNP and the those trying to make the DNP equal to MD need to take out their frustrations on those individuals and organizations through political action or whatever, NOT on NP's (DNP prepared or otherwise) in general, who in my belief overwhelmingly reject the notion of DNP and MD equivalence.

In that case, they should speak up. Silence is complicity.

 

[Charles_Carmichael]

Physicians concerned about the DNP and the those trying to make the DNP equal to MD need to take out their frustrations on those individuals and organizations through political action or whatever, NOT on NP's (DNP prepared or otherwise) in general, who in my belief overwhelmingly reject the notion of DNP and MD equivalence.

In that case, they should speak up. Silence is complicity.

Exactly.

I don't know how much I believe in this "silent majority" idea. I've never seen a nurse/NP/DNP/CRNA/whatever speak out against this vocal "minority" in any setting except the rare few on anonymous forums. Where are the articles and editorials/correspondences to journals, etc, of nursing midlevels speaking out against this movement? I've never seen a single one.

This "majority" being silent sends me the message that they're either okay with what is occurring (which would make them a part of the "minority" now...) or that they don't care enough to speak out against it (so much for that whole thing about only nurses being patient advocates...).

Before one of you guys accuses me (and there's always someone who does), I'm not crying out that this is the end of the world. However, there is really no evidence to suggest that the "majority" of nursing midlevels are against this movement, so the better reaction for physicians to have, IMO, is what you call this "overreaction" and put an end to this BS that nursing midlevels are equivalent to board-certified attendings.

 

[zenman]

Exactly.

I don't know how much I believe in this "silent majority" idea. I've never seen a nurse/NP/DNP/CRNA/whatever speak out against this vocal "minority" in any setting except the rare few on anonymous forums. Where are the articles and editorials/correspondences to journals, etc, of nursing midlevels speaking out against this movement? I've never seen a single one.

This "majority" being silent sends me the message that they're either okay with what is occurring (which would make them a part of the "minority" now...) or that they don't care enough to speak out against it (so much for that whole thing about only nurses being patient advocates...).

Before one of you guys accuses me (and there's always someone who does), I'm not crying out that this is the end of the world. However, there is really no evidence to suggest that the "majority" of nursing midlevels are against this movement, so the better reaction for physicians to have, IMO, is what you call this "overreaction" and put an end to this BS that nursing midlevels are equivalent to board-certified attendings.

I'm not involved in any nursing organizations, mainly due to lack of time...ok lack of interest. I'm more interested in spending what little time I have on the right to bear arms. I could now move to Wyoming, get rid of a concealed carry holster, and get a nice one that matches my boots and looks real purty.

 

[zenman]

Just saw this one. She lists her qualifications. http://www.caskinandbody.com

 

[NYRN]

Exactly.

I don't know how much I believe in this "silent majority" idea. I've never seen a nurse/NP/DNP/CRNA/whatever speak out against this vocal "minority" in any setting except the rare few on anonymous forums. Where are the articles and editorials/correspondences to journals, etc, of nursing midlevels speaking out against this movement? I've never seen a single one.

This "majority" being silent sends me the message that they're either okay with what is occurring (which would make them a part of the "minority" now...) or that they don't care enough to speak out against it (so much for that whole thing about only nurses being patient advocates...).

Before one of you guys accuses me (and there's always someone who does), I'm not crying out that this is the end of the world. However, there is really no evidence to suggest that the "majority" of nursing midlevels are against this movement, so the better reaction for physicians to have, IMO, is what you call this "overreaction" and put an end to this BS that nursing midlevels are equivalent to board-certified attendings.

I honestly think that most NP's who are out there working in the real world are not aware of whats going on. They just go to work, do their jobs and go home. I really don't believe that they are sneaking behind the backs of the MD's they work for and lobbying at the state capital for equal practice rights.

Hypothetically, lets propose this situation:

In all 50 states, NP's are given fully independent practice rights in primary care specialties only. In order to practice in this capacity, and are held to the same standard of practice that MD's are which includes liability. Because the educational standards aren't close to being the same, and total independant NP practice is new, malpractice insurance is prohibitively expensive.

In addition to this option, NP's may choose to keep practicing in the same capacity that they were before the law went into effect. They may stay in collaboration with an MD, waive the right to independent practice, and do not face the same liability as the MD does. Malpractice insurance would remain the same, because the scope of practice hasn't changed.

I honestly believe that most NP's would choose the 2nd option. The NP's I know and have met really enjoy having the flexibility to work 12 hour shifts or normal office hours and go home, and they really do respect the knowledge of the MD's they work with. They feel that working with a great MD is a privledge and a great learning experience. I have yet to meet one NP that thinks they have a greater knowledge base than the doctor. They also don't want to be bothered with the work it takes to run their own practice. The people that jump ship to take the first option are going to be the people in the game for a long time, or they are going to be newbies who want the paycheck and will be put out of business by a lawsuit before too long and will either cause the law to be changed, or make it so difficult for an NP to practice independently that very few will actually try to.

 

[sarjasy]

In that case, they should speak up. Silence is complicity.

They should speak up. Don't know if I'd go so far as to say complicity. But here's the deal. Some nursing leader speaking out against DNP-MD equivalency isn't a very sexy story, and thus is less likely to get covered in the press. Someone claiming equivalence is controversial and stirs the pot, and thus gets the press coverage.

I also am not sure how many nurses are even aware of the controversy. It's pure speculation on my part, but judging from online nursing forums, fellow students, nurses I work with, etc. there is a surprising lack of knowledge about what the DNP even is, much less the controversy over those claiming it offers MD/DO equivalence.

Furthermore, if nursing is like most professions, the overwhelming majority aren't actively involved in outside professional organizations and activities. Something like only 30% of physicians are members of the AMA, for example.

 

[sarjasy]

This "majority" being silent sends me the message that they're either okay with what is occurring (which would make them a part of the "minority" now...) or that they don't care enough to speak out against it (so much for that whole thing about only nurses being patient advocates...).

Or they are unaware. I don't think it's fair to assume the worst, that somehow their silence means they tacitly condone or are ambivalent or are supportive.

However, there is really no evidence to suggest that the "majority" of nursing midlevels are against this movement,

Neither is there evidence that they support it. Let's keep in mind that we are both dealing with anecdotal sources of evidence. Until you or I can produce reasonably scientific polls that support our opinions, then they are just that - opinions. Having said that, it would seem to me that the best anecdotal sources would come from those on the "inside" - those in and around the nursing profession.

 

[Taurus]

Furthermore, her practice's actual web site (not her Tumblr blog that we were discussing above) contains no information whatsoever about her or her credentials.

This may not be illegal, but it's certainly potentially misleading. And, undoubtedly deliberate.

Anyone who has followed the DNP debate knew that this was inevitable. Actually, this is what Mundinger probably had hoped for. Confuse the public into thinking that DNP's are equivalent physicians.

This is why more states need to follow PA's lead and pass laws that require ID tags that clearly state your role and credentials. It's cases like this that will eventually make it happen.

New Pennsylvania law requires physicians to wear photo IDs