N.P vs MD/DO ?

[Hoody]

Last week my mom came home from her appointment with IM. Apparently she saw Natalie, a PA. They sent home a little flyer that said, "Hi, my name is Natalie, I'm a PA. I went to medical school and have the same medical training as medical doctors." I **** you not. I should scan the flyer, It's a blatant lie clearly intended to mislead the public. In fact I don't care how good Natalie is, saying you went to medical school and have identical training as a doctor is a lie and that shoots all your credibility out of the door. I can't believe the MD was endorsing this?! (WHATS UP WITH THAT TAURUS!?!). How is that anymore misleading than a nurse with a DNP or a PhD calling herself a doctor?

Last time I checked, people with PhDs are addressed as "Doctor." In other words, M.D. isn't the only degree that grants that holier than thou title. And, for the record, NPs with PhDs or DNPs must follow individual states regulations when addressing themselves as Doctors while in the clinical settings....In my state, you cannot address yourself as "Doctor" in the clinical setting even if you do have DNP or PHD.

Let's get real, those in the real world don't have time to care. And it makes no difference to the Patients....they barely listen to half the shizzz you say anyway. And, again, for Taurus's sake, lets reiterate that there have been just as many wrongdoings by doctors and PAs as there have NPs. Also, let it be known that there are no studies regarding the outcomes of Patients treated solely be MDs/PAs versus NPs.

In my state you can run your own NP practice completely independent of a physician. Yep. It's been this way for several years….so it's this whole "oh no Cali is letting NPs practice on their own" is OOOOOOLDDDD NEWSSSSSS. Get with the times. Perhaps if the Patient outcomes in these NP only run clinics were as awful as Taures and the like claim, you would hear about it and they would be shut down…..hmmmmm, makes you think eh?

Maybe you guys should do some REAL research and not SDN research before you drown yourself in tears.

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[Hoody]

They are now called "doctors" too!!

With your pharmD degree you will be called doctor too. And?

Lots of pharmacists around my work go by Dr.__________ as they prefer it that way and that's the way its listed on their name tag.

What's the difference???

You're a doctor of Pharmacy
I'm a doctor of Nursing
We have Doctors of Social Work
We have Administrators with PhD in business, public health.....they are also Doctors
And we have Doctors of Occupational Therapy.

You're confusing the meaning of Doctor. Perhaps you should be called Physicians instead….??

 

[tncekm]

With your pharmD degree you will be called doctor too. And?

Lots of pharmacists around my work go by Dr.__________ as they prefer it that way and that's the way its listed on their name tag.

What's the difference???

You're a doctor of Pharmacy
I'm a doctor of Nursing
We have Doctors of Social Work
We have Administrators with PhD in business, public health.....they are also Doctors
And we have Doctors of Occupational Therapy.

You're confusing the meaning of Doctor. Perhaps you should be called Physicians instead….??

Yeah, but the consideration that has to be made is what do patients think "doctor" means in a clinical setting? They think "physician".

I personally avoid the term doctor when referring to a physician or professor unless I'm addressing someone. "Doctor" is becoming a meaningless word, IMHO.

 

[Taurus]

"oh no Cali is letting NPs practice on their own" is OOOOOOLDDDD NEWSSSSSS.

Is this the same Cali where the governor recently fired most of the nursing board for incompetence?

Maybe you should be more careful of your use of examples.

Maybe you should use a better example like Texas where they are cracking down on FNP's who have no inpatient training and yet are working in hospitals.

Like I said, I don't care what NP's or CRNA's do. I just refuse to support anything they do and that includes their training and hiring. So I won't precept any NP or CRNA students. I won't teach them anything even if they are working. I won't hire NP's or CRNA's. I will hire PA's and AA's. Every physician out there needs to adopt this philosophy. Let's see how far NP's and CRNA's can get without physician training, support, and hiring.

You have to admit that PA's are a huge success story. NP's think that they have achieved so much but ironically PA's on average make more than NP's. That says a lot.

 

[Taurus]

With your pharmD degree you will be called doctor too. And?

Lots of pharmacists around my work go by Dr.__________ as they prefer it that way and that's the way its listed on their name tag.

What's the difference???

You're a doctor of Pharmacy
I'm a doctor of Nursing
We have Doctors of Social Work
We have Administrators with PhD in business, public health.....they are also Doctors
And we have Doctors of Occupational Therapy.

You're confusing the meaning of Doctor. Perhaps you should be called Physicians instead….??

We have pharmd's, dpt's, and odt's running around our hospital.

NONE of them introduce themselves by "Dr.". How much time have you even spent in a hospital since you're what a "pre-health" student?

 

[Hoody]

Is this the same Cali where the governor recently fired most of the nursing board for incompetence?

Maybe you should be more careful of your use of examples.

Maybe I should spend all day posting links about incompetent doctors. We both know there is plenty of that type of material out there. I guess I have better things to do than regurgitate links all day.

Maybe you should use a better example like Texas where they are cracking down on FNP's who have no inpatient training and yet are working in hospitals.

OR maybe I should use one of the thousands of examples of successful NP stories? You know they exist....and since your the link master, why don't you so some googling and hook us up.

Like I said, I don't care what NP's or CRNA's do.

Really? Coulda fooled me. You spend an awful lot of time proving otherwise.

I just refuse to support anything they do and that includes their training and hiring. So I won't precept any NP or CRNA students. I won't teach them anything even if they are working. I won't hire NP's or CRNA's. I will hire PA's and AA's. Every physician out there needs to adopt this philosophy. Let's see how far NP's and CRNA's can get

OH NO?!?!? WHAT WILL NPs EVER DO WITHOUT YOUR SUPPORT?!?!?! They'll do fine....considering they already are in states where they can practice independently. And why is that you think NPs and CRNAs want to be trained by you? A bit full of yourself aren't ya? All hail the all knowing resident Taurus.

You have to admit that PA's are a huge success story. NP's think that they have achieved so much but ironically PA's on average make more than NP's. That says a lot.

No, I cant say that PAs are a huge success because there is no study that says PA > NP. We've been over this how many times now? And since when does money determine a professions success? Are you really this dumb?

We have pharmd's, dpt's, and odt's running around our hospital.

NONE of them introduce themselves by "Dr.". How much time have you even spent in a hospital since you're what a "pre-health" student?

Good for your hospital. Key word is "yours" and unfortunately for you, yours is not applicable to every hospital. I find it highly unlikely that not one person other than an MD/DO at your hospital refers to themselves as doctor.....others might be so naive to believe your obvious BS, but not me. Also, I'm an RN with a few years of experience so I've spent plenty of time in the hospital. Keep trying.

 

[Taurus]

OH NO?!?!? WHAT WILL NPs EVER DO WITHOUT YOUR SUPPORT?!?!?! They'll do fine....considering they already are in states where they can practice independently.

I'm glad you think that way and I hope more and more physicians think that way too. However, I think that the NP's who can't find jobs and are working as floor nurses would beg to differ with you. Maybe you're one of them? If you think that 700 hours of training and getting your degree online prepares you to open up your own practice, I have a bridge to sell you too.

Physicians can't directly limit the scope of any group, but we can decide who we train and hire. That is the message I have been sending out to current and future physicians all of these years. The response has been very positive.

 

[Hoody]

I'm glad you think that way and I hope more and more physicians think that way too. However, I think that the NP's who can't find jobs and are working as floor nurses would beg to differ with you. Maybe you're one of them?

I know of none. Perhaps if there are so many as you insist, one will post here to corroborate your anecdote?

If you think that 700 hours of training and getting your degree online prepares you to open up your own practice, I have a bridge to sell you too.

Its too late....you already bought it! Again, your statement shows how really ignorant you are regarding NPs and DNPs. You don't need a DNP to run your own practice, only a NP....so your stab at 700hrs online is irrelevant (surprise!)

Physicians can't directly limit the scope of any group, but we can decide who we train and hire. That is the message I have been sending out to current and future physicians all of these years. The response has been very positive.

You really do think you're special huh? Anyone can regurgitate links. Anyone can skew information to favor certain beliefs. Its fine if you don't agree with NPs and nursing.....but why don't you be more productive and so some research or initiate some studies to back up your claims? Too hard for you? Or would it interfere with all the time you spend bashing NPs with information you only believe to be true while avoiding the real fact that incompetency exists within every field in medicine.


Like I said before, keep trying.

 

[tncekm]

Its too late....you already bought it! Again, your statement shows how really ignorant you are regarding NPs and DNPs. You don't need a DNP to run your own practice, only a NP....so your stab at 700hrs online is irrelevant (surprise!)

I hope you realized this example really, really, really sucks. He said that nurses are unqualified to open up their own medical practice as DNP's, and then you say "ha! we only have to be NP's! You're way off, stupid-head!" <-- NP's have less training than DNP's, that makes you even less qualified, and makes their opening practicing even more ridiculous by his estimate.

BTW, I for one will sign a "hire no NP/DNP pledge". Between RN's taking care of the nursing, and PA's taking care of the mid-level medicine (and understanding the limitation's of their education), there is no need for NP/DNP's in any practice as long as they're just looking to stir the pot and don't understand the limitations of their [lack] of education places on their ability to practice safe medicine. Let's get it started.

 

[KNC]

Yup....your gonna have to scan the flyer, Hoody, because I do not believe you.... I think u have made that up to make a point that is completely not working....

 

[Therapist4Chnge]

Yeah, but the consideration that has to be made is what do patients think "doctor" means in a clinical setting? They think "physician".

I personally avoid the term doctor when referring to a physician or professor unless I'm addressing someone. "Doctor" is becoming a meaningless word, IMHO.

It is up to the professional to be specific in their title. "Dr. So and So, your Cardiologist", "Dr. So and So, your Psychologist", etc.

 

[bradt9881]

Yet in most states practice under physician supervision (definitely in the early days), so how does that affect outcome data ? Also, a point I have made in the past, in group practices most mid-level providers get the "cake" patients, i.e. i have a sore throat, rather than the more complex cases.

Actually, in my internal medicine job as a PA I have my fair share of complicated cases AND I see most of the walk-ins. We can do a lot more than "sore throats". Last month, I found a 3 cm LLL mass. This month, it was a 2.5 cm agressive brain tumor that was absent on CT 4 months ago. And there are enough cases of diabetic vasculopaths to keep you on your toes every day you show up for work.

The point is, I have my own panel of patients, same as my supervising physician.....

 

[poresofkohn]

With your pharmD degree you will be called doctor too. And?

Lots of pharmacists around my work go by Dr.__________ as they prefer it that way and that's the way its listed on their name tag.

What's the difference???

You're a doctor of Pharmacy
I'm a doctor of Nursing
We have Doctors of Social Work
We have Administrators with PhD in business, public health.....they are also Doctors
And we have Doctors of Occupational Therapy.

You're confusing the meaning of Doctor. Perhaps you should be called Physicians instead….??

>
Either you need to update your profile, or you're full of crap. I'm going with the latter. Scan the flyer, post a link to affirm your claims....or your credibility is zero. At least Taurus backs up his argument with some data.

 

[poresofkohn]

Last week my mom came home from her appointment with IM. Apparently she saw Natalie, a PA. They sent home a little flyer that said, "Hi, my name is Natalie, I'm a PA. I went to medical school and have the same medical training as medical doctors." I **** you not. I should scan the flyer............

Do It!!!

It's a blatant lie clearly intended to mislead the public. In fact I don't care how good Natalie is, saying you went to medical school and have identical training as a doctor is a lie and that shoots all your credibility out of the door. I can't believe the MD was endorsing this?! (WHATS UP WITH THAT TAURUS!?!). How is that anymore misleading than a nurse with a DNP or a PhD calling herself a doctor? .........





Let's get real, those in the real world don't have time to care. And it makes no difference to the Patients....they barely listen to half the shizzz you say anyway.

There you have it ladies and gentlemen, the unbridled, pompous, militant nursing agenda........***"There is NO DIFFERENCE between an MD and NP"***..


And, again, for Taurus's sake, lets reiterate that there have been just as many wrongdoings by doctors and PAs as there have NPs.

Data please...oh wait...according to you, it doesn't exist.
Also, let it be known that there are no studies regarding the outcomes of Patients treated solely be MDs/PAs versus NPs.

In my state you can run your own NP practice completely independent of a physician.

And hows reimbursment without physician involvement? I'll assume you haven't seen "doctor" Karas website...LOL!

Yep. It's been this way for several years….so it's this whole "oh no Cali is letting NPs practice on their own" is OOOOOOLDDDD NEWSSSSSS. Get with the times. Perhaps if the Patient outcomes in these NP only run clinics were as awful as Taures and the like claim, you would hear about it and they would be shut down…..hmmmmm, makes you think eh?

Again...if no studies exist, how would we hear about it? If the nursing agenda is so sure of the safe outcomes and capabilities of NP's.....why no studies? Not that the nursing agenda would produce unbiased results. hmmmm, makes you think eh?

Maybe you guys should do some REAL research and not SDN research before you drown yourself in tears.

You would'nt know "real" research if it bit you on the nose. Read her MDapps for a good laugh.

 

[zenman]

Like I said, I don't care what NP's or CRNA's do. I just refuse to support anything they do and that includes their training and hiring. So I won't precept any NP or CRNA students. I won't teach them anything even if they are working. I won't hire NP's or CRNA's. I will hire PA's and AA's. Every physician out there needs to adopt this philosophy. Let's see how far NP's and CRNA's can get without physician training, support, and hiring.

Actually none of my psych NP training has been with physicians and my preceptors for my one remaining class (physical assessment) and my preceptorship are NPs, all with extensive experience. (However, I have no problem working with physicians nor having one as a preceptor.) I already have several independent practice states I'm looking at for practice after graduation. Your agenda is just not going to have much of an impact. Perhaps you need to fight a war you can win.

 

[tncekm]

Actually none of my psych NP training has been with physicians and my preceptors for my one remaining class (physical assessment) and my preceptorship are NPs

That makes things better

 

[tncekm]

It is up to the professional to be specific in their title. "Dr. So and So, your Cardiologist", "Dr. So and So, your Psychologist", etc.

Yeah, I understand that.

What I was saying is that if I were speaking of a physician, I wouldn't call him/her a "doctor". And, if I were speaking of one of my professors, I wouldn't refer to him/her as a "doctor" either. IMHO, the word doctor is becoming much more meaningless these days than the more specific alternative.

If I were addressing or "referring to" someone, I'd say "Dr. So and So". But, that's pretty much it.

 

[zenman]

That makes things better

Maybe, maybe not. I was pointing out the ineffective strategy of Taurus.

 

[Therapist4Chnge]

Yeah, I understand that.

What I was saying is that if I were speaking of a physician, I wouldn't call him/her a "doctor". And, if I were speaking of one of my professors, I wouldn't refer to him/her as a "doctor" either. IMHO, the word doctor is becoming much more meaningless these days than the more specific alternative.

If I were addressing or "referring to" someone, I'd say "Dr. So and So". But, that's pretty much it.

Fair enough.

I do this with my electronic notes, as it provides more information to be John Smith, Staff Physician. It also simplifies things when people list a bunch of degrees and licensures after their name.

 

[Therapist4Chnge]

Actually none of my psych NP training has been with physicians and my preceptors for my one remaining class (physical assessment) and my preceptorship are NPs, all with extensive experience.

We had mostly research pharmacists teach in my pharmacology program, so it was interesting to later take classes with an MD and a DO, as they tended to be much more "practical" about things. The research pharmacists were really into the nitty gritty (which I appreciated), while the MD, DO, and PharmD (practice, not research) were into patient impact/clinical relevancy. I can't say which was "better" training, but I appreciated having a wider range of approaches because there were distinct differences in the classes.

 

[Hoody]

>
Either you need to update your profile, or you're full of crap. I'm going with the latter. Scan the flyer, post a link to affirm your claims....or your credibility is zero. At least Taurus backs up his argument with some data.

Sorry for the confusion, I didn't mean that I personally am a doctor of nursing (I've stated several times that I am an RN). I will scan the flyer (If I can figure out how)....If I were an MD, I would be insulted by the flyer and I promise you, I'm not making it up. I persosnally have no problems with PAs. If I weren't already a RN, maybe I would consider becoming a PA. What I have a problem with is NP bashing and people claiming that NPs are incompetent and inferior in regards to PAs and training/education. Taurus has no data to support the theory that PAs >> NPs, and s/he has openly admitted that.

 

[Hoody]

I hope you realized this example really, really, really sucks. He said that nurses are unqualified to open up their own medical practice as DNP's, and then you say "ha! we only have to be NP's! You're way off, stupid-head!" <-- NP's have less training than DNP's, that makes you even less qualified, and makes their opening practicing even more ridiculous by his estimate.

Again, I think my wording has caused some confusion. NPs have been practicing on their own in some states (especially rural ones) way before the DNP came along. Taurus said that you "take 700 hours online and you get to open your own practice." Thats incorrect but it has nothing to do with the qualifications (or lack of qualifications) of the NP. Sorta having a hard time trying to articulate my thoughts here....
B

TW, I for one will sign a "hire no NP/DNP pledge". Between RN's taking care of the nursing, and PA's taking care of the mid-level medicine (and understanding the limitation's of their education), there is no need for NP/DNP's in any practice as long as they're just looking to stir the pot and don't understand the limitations of their [lack] of education places on their ability to practice safe medicine. Let's get it started.

How do you know that NPs/DNPs are "looking to stir the pot and don't understand the limitations of their [lack]of education?." I hope you realize that your opinions are your opinions, not facts.

 

[deleted6669]

Duke University has well regarded programs for both physician assistants and nurse practitioners.

Compare the programs via the links below:
Family nurse practitioner program: http://www.nursing.duke.edu
Physician assistant program: http://paprogram.mc.duke.edu/PA-Program/Curriculum/

 

[jbar]

Duke University has well regarded programs for both physician assistants and nurse practitioners.

/[/url]

I think the real concern isn't the "well regarded programs" but the ones that you can take mainly online with little clinical time and then push to be practicing independently. Right now it seems that there are a lot more NP/DNP programs that fit this bill. I haven't really heard of people getting their PA online.

 

[Therapist4Chnge]

I think the real concern isn't the "well regarded programs" but the ones that you can take mainly online with little clinical time and then push to be practicing independently. Right now it seems that there are a lot more NP/DNP programs that fit this bill. I haven't really heard of people getting their PA online.

emedpa (or anyone else) can correct me if I'm wrong, but I don't believe there is an option to receive a PA online.

 

[deleted6669]

emedpa (or anyone else) can correct me if I'm wrong, but I don't believe there is an option to receive a PA online.

there is not. a few programs( 2 or 3 out of 150 or so) allow a few didactic courses online but the vast majority are 100% on campus.
my reason for posting the links to duke's programs was so that folks could check out the difference in structure and clinical hrs between typical pa and np programs and make their own opinions.

 

[womp]

There are now two-year accelerated NP programs that require no clinical experience, no RN experience, only a BS/BA degree. These are the graduates touted as replacing family doctors. Scary, huh?

3 yrs minimum residency > 0 postgraduate clinical experience
4 yrs education > 2 yrs education

 

[deleted6669]

There are now two-year accelerated NP programs that require no clinical experience, no RN experience, only a BS/BA degree.

most of the "direct entry" np programs I have seen are 3 years after a prior nonmedical bs degree with appropriate prereqs.
yr 1 gets the rn/bsn
yr 2/3 gets the msn/np

 

[foreverLaur]

Taurus said that you "take 700 hours online and you get to open your own practice." Thats incorrect

How is that incorrect? A new grad RN can attend an online MSN program and be able to open up their own practice upon graduation. That's very true.

 

[Hoody]

How is that incorrect? A new grad RN can attend an online MSN program and be able to open up their own practice upon graduation. That's very true.

Taurus was referencing DNPs, not MSNs. Yes there are also online programs for MSN's....basically you take the science classes online, and complete the clinical training with clinical preceptors in your area. You still have to complete the clinical (and no, you don't get to do that online, sorry) and you spend > 700 hours at actual clinical sites. Also, you do have to meet on campus like 2 or 3 times a semester.

There are lots and lots and lots of advance degrees that you can complete online these days. Are people with eMBAs any less prepared than those with traditional MBAs? We've been over this only about a billion times before.

 

[Hoody]

There are now two-year accelerated NP programs that require no clinical experience, no RN experience, only a BS/BA degree. These are the graduates touted as replacing family doctors. Scary, huh?

a BS/BA is all you need for 2 year PA school....whats the difference?

 

[psychbender]

a BS/BA is all you need for 2 year PA school....whats the difference?

The amount of clinical and didactic training in most PA programs.


700 hours is less than 3 months in most PA or medical schools.

 

[deleted6669]

The amount of clinical and didactic training in most PA programs.


700 hours is less than 3 months in most PA or medical schools.

yup, my trauma surgery rotation alone was close to that followed by rotations in internal medicine, emergency medicine( x 2), peds em, psych, family medicine, obgyn.
in total 54 weeks of rotations around 3000 hrs.....

 

[Hoody]

The amount of clinical and didactic training in most PA programs.


700 hours is less than 3 months in most PA or medical schools.

We aren't talking about medical school. And regardless of what many PAs will tell you around here, PA school is not equivalent to med school. I'm qualified to say that because I although Ive never been to PA school, I heard it on SDN, goggled it, and compared a few curriculum's.

We keep arguing the hours thing, yet there is no conclusive evidence that PAs >>>> NPs in regards to anything (something I have to reiterate in almost every post).

Also, womp, not all NPs are training to be family providers.

 

[jbar]

We keep arguing the hours thing, yet there is no conclusive evidence that PAs >>>> NPs in regards to anything (something I have to reiterate in almost every post).

There is no proof that attending surgeons are better at taking out a gallbladder than a fourth year medical student, there is no proof that a MD can manage chronic asthma better than an EMT. Lack of proof of a difference is not the same of proof of lack of difference.

What is this craziness where everyone is convinced "I'm smarter than most people in the world and therefore can do X in 3 months that takes someone else 10 months." The average person is of average intellect, but they think they are in the top 10%.

The argument of "if x kind of provider is so much worse everyone would be getting sued and they wouldn't work anymore" is a bad argument. The first reason is that people sue who they don't like, not who gives them bad care. You pretty much have to chop off the wrong leg to get sued by someone who likes you. So being liked/not sued doesn't = better care. Second point is that the outcomes that people are interested in don't hit you over the head. We're talking about 20 year mortality rates, HgA1Cs, smoking cessation rates. I have no idea who is better at that stuff, an NP or PA, but you'd have to do real research to sort it out. It's not the kind of thing where if NPs are worse at something than PAs everyone would automatically know.

Finally, this argument of "you can't prove that PA/MDs etc are better than NPs/DNPs, therefore we get to practice independently is flawed. If you want to have more autonomy, you want to be called doctor in the hospital, the burden is on you (the DNPs) to prove that their training is similar, that their outcomes are the same, that their knowledge base is the same.

Without such evidence most reasonable people are going to say "I'm going to trust the people with 7 years of training over those with 3." The same way I'd rather have the airline pilot with 10 years of experience than the one with 5, the researcher with the PhD over the MS etc etc etc

 

[Therapist4Chnge]

There are lots and lots and lots of advance degrees that you can complete online these days. Are people with eMBAs any less prepared than those with traditional MBAs? We've been over this only about a billion times before.

Absolutely, and the hiring trends support this. Look at any top MBA program, and then any eMBA program, and you'll see a completely different degree, training, and trajectory. As you work yourself down to the 2nd and 3rd tiers of traditional programs, you'll still see a difference.

Before going the psych route I had a consulting career, and I dealt with large companies and MBA-types on a daily basis. The skills learned while taking classes online are totally different, as many MBA programs are as much about networking as it is about learning how to structure a company.

The people coming out of traditional programs were not only better trained, but they had a better network of people and they were sought out....instead of having to hunt for a job. People can still do fine with an MBA, but there is a night and day difference between an MBA from a traditional upper-tier school, and an eMBA.

 

[Therapist4Chnge]

Finally, this argument of "you can't prove that PA/MDs etc are better than NPs/DNPs, therefore we get to practice independently is flawed. If you want to have more autonomy, you want to be called doctor in the hospital, the burden is on you (the DNPs) to prove that their training is similar, that their outcomes are the same, that their knowledge base is the same.

You are completely correct, yet it has been twisted so that MD/DOs need to refute statements of opinion, instead of being present with solid data that supports the proposed hypothesis (NP/DNP can provide care that is equitable to that of an MD/DO.)

Without such evidence most reasonable people are going to say "I'm going to trust the people with 7 years of training over those with 3." The same way I'd rather have the airline pilot with 10 years of experience than the one with 5, the researcher with the PhD over the MS etc etc etc

In the psychology world we are getting crushed on the political front, because one side is yelling louder than the other, and have no actual data to back up their claims. We've been taught to trust in good study design, research methods, sound data....but that is no match for half-truths and opinions that are paraded as fact. We are good scientists....but lousy lobbyists and politicians.

 

[deleted6669]

We keep arguing the hours thing, yet there is no conclusive evidence that PAs >>>> NPs in regards to anything (something I have to reiterate in almost every post).

avg pa CLINICAL program hrs>2000
avg np CLINICAL hrs 500-800 with a few outliers>1000 but<1500.
do a bit of research.
this is what everyone is talking about.
I'm not saying that there aren't some great np's out there. of course there are.
I'm talking about typical clinical preparation in the program itself. for that pa>np in the vast majority of instances.
compare the pa and np programs at drexel(both good programs) or at the university of wa(both good programs):
at u.wa the ms pa program is 162 credits. the dnp is 90 credits.
at drexel the ms pa program is 117 credits and the dnp is 48.
the difference in credits is clinical rotations.

 

[bradt9881]

a BS/BA is all you need for 2 year PA school....whats the difference?

The difference? I am not replacing the family doctor. I am working right in the same building he is, where he supervises my work, teaches where appropriate, and is available for consult on tough cases. I am a dependent practioner both by law, and by choice.....

 

[Paseo Del Norte]

The difference? I am not replacing the family doctor.

This is the crux of most of these DNP threads. I am a nurse, and I do not get it. From my AAS undereducated point of view, nursing just shot a 12 ga slug through it's foot by pushing such a concept onto the health care community.

 

[tncekm]

The difference? I am not replacing the family doctor. I am working right in the same building he is, where he supervises my work, teaches where appropriate, and is available for consult on tough cases. I am a dependent practioner both by law, and by choice.....

This is the crux of most of these DNP threads. I am a nurse, and I do not get it. From my AAS undereducated point of view, nursing just shot a 12 ga slug through it's foot by pushing such a concept onto the health care community.

 

[KNC]

Im still waiting for the scan of the flyier.....This all started off with a complete lie on Hoody's part....to argue something based on a lie, is moot....

 

[womp]

There is no proof that attending surgeons are better at taking out a gallbladder than a fourth year medical student, there is no proof that a MD can manage chronic asthma better than an EMT. Lack of proof of a difference is not the same of proof of lack of difference.

What is this craziness where everyone is convinced "I'm smarter than most people in the world and therefore can do X in 3 months that takes someone else 10 months." The average person is of average intellect, but they think they are in the top 10%.

David Brooks at the NYT just had an article about that. Apparently 94% of professors think they are above average in teaching.

 

[jbar]

Lake Woebegon effect, it's pretty well documented. In general its a good thing. If everyone aims for the average about half of people are selling themselves short, but still, a little perspective is good.

 

[fab4fan]

Taurus was referencing DNPs, not MSNs. Yes there are also online programs for MSN's....basically you take the science classes online, and complete the clinical training with clinical preceptors in your area. You still have to complete the clinical (and no, you don't get to do that online, sorry) and you spend > 700 hours at actual clinical sites. Also, you do have to meet on campus like 2 or 3 times a semester.

There are lots and lots and lots of advance degrees that you can complete online these days. Are people with eMBAs any less prepared than those with traditional MBAs? We've been over this only about a billion times before.

I would never feel comfortable with a direct entry NP/DNP. Then again, it's a moot subject since I would not go to an NP for medical care. But all the rationalizing in the world will never convince me that a lack of clinical experience really doesn't matter when it comes to being a practitioner.

 

[fab4fan]

This is the crux of most of these DNP threads. I am a nurse, and I do not get it. From my AAS undereducated point of view, nursing just shot a 12 ga slug through it's foot by pushing such a concept onto the health care community.

Indeed. We were better off when we did our job and did it well...period.

 

[Lokhtar]

It's also not merely about the number of hours. PA school is a mini-medical school (modeled after the medical model obviously), and is much harder than NP/DNP school.

 

[AlephB]

I came across this discussion a few days ago and posed a few questions to a colleague of mine at hospital. I'm still not particularly clear on the matter, however.

I am in PGY-2 of a general surgery residency here in America but was educated in Ireland at RCS. This is a somewhat new issue for me. It certainly was not a subject of discussion at university. Most of my personal with non-physician providers was last year during my internship. We had physician assistant students rotate in with us and I found them all to be very well-prepared. One of our attending surgeons has a physician assistant working with him as a first assistant and she is brilliant- a true asset. I also worked with a nurse practitioner briefly last year in the NICU and she seemed very competent That is the limit of my experience. I don't have any stories about how I see a nurse practitioner for my own medical care or anything like that. And given what I have read, there won't be any stories like that in the future for me either.

Yesterday a nurse practitioner approached me to countersign an order for an opiate for a patient on our service. The typical discussion of where I am from led to a discussion about my education. He actually suggested that because my training resulted in a baccalaureate, his education was superior as it resulted in a Masters degree.

I was mortified beyond belief. I have NEVER had my qualifications questioned by other doctors. Naturally I had to go do a bit of my own research and ran across this forum. How do my fellow medics feel about me using the post-nominal letters "M.D."? Please bear in mind that my degrees are MB, BCh, BAO as well as licentiates L & LM, RCSI..... etc., not M.D. or D.O.

Second, is it true that a nurse practitioner can be qualified through an online program or is this claim only made in jest?

This nonsense about a "nursing model" vs. "medical model" is absolute rubbish. The "nursing model" smacks of quackery and it is beyond me why any profession would develop a rationale for its existence that puts it more in league with reflexologists than any legitimate scientific discipline. We may as well reverse more than a hundred years of medical progress and return to the pre-scientific era of health care. I took the opportunity to look at some charts and repeatedly came across this genius "diagnosis": failure to thrive. If that is the type of "diagnosis" this nursing model comes up with, those who subscribe to the nursing model should only be able to prescribe bed baths and the contents of a 1500 calorie diet. The very idea assaults the senses.

Oh, and this "Dr. Kara" website is a real gem. I did notice that she claims to provide "medical supervision". Doesn't she mean "nursing supervision"? I don't think you can have it both ways.

 

[tncekm]

Yesterday a nurse practitioner approached me to countersign an order for an opiate for a patient on our service. The typical discussion of where I am from led to a discussion about my education. He actually suggested that because my training resulted in a baccalaureate, his education was superior as it resulted in a Masters degree.

I was mortified beyond belief. I have NEVER had my qualifications questioned by other doctors. Naturally I had to go do a bit of my own research and ran across this forum. How do my fellow medics feel about me using the post-nominal letters "M.D."? Please bear in mind that my degrees are MB, BCh, BAO as well as licentiates L & LM, RCSI..... etc., not M.D. or D.O.

Just shows how stupid he is. You're a "surgeon" in an American residency, it doesn't matter what initials are behind your name. I wouldn't be surprised if she disrespected professors because they had D.Phil's.

Second, is it true that a nurse practitioner can be qualified through an online program or is this claim only made in jest?

It's true. And, their highest level program, the Doctor of Nurse Practitioning, is also online. And, the "test" is a very watered down version of Step 3 (BY FAR THE EASIEST STEP) and they have a >50% fail rate.

This is the problem with giving undereducated people those damn white coats... they start feeling all special and powerful, and start saying stupid **** and believing it because they think so highly of themselves.

 

[AlephB]

It's true. And, their highest level program, the Doctor of Nurse Practitioning, is also online. And, the "test" is a very watered down version of Step 3 (BY FAR THE EASIEST STEP) and they have a >50% fail rate.

This is the problem with giving undereducated people those damn white coats... they start feeling all special and powerful, and start saying stupid **** and believing it because they think so highly of themselves.

Mother of God.