N.P vs MD/DO ?

[Dwindlin]

Mother of God.

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[RGMSU]

Basic FM I could see but some of the other areas I have been in not so much....

Btw, I used to go to a PA over a MD since I thought he was better in FM.

Here we go with the "family medicine is easy and basic" thing again, another common refrain on these forums. News flash - mid-levels are not just in primary care. And, how many people who disrespect primary care have actually practiced it for any significant length of time? How about none?

 

[zenman]

.

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.

He was just stupid, not only in not knowing about medical degrees from other countries, but in even making such a statement to you.

I was mortified beyond belief. I have NEVER had my qualifications questioned by other doctors.

They usually do it behind your back, sometimes with statements relating to where you got your degree from.

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

Most physicians are too busy to study about modern methods of educational delivery and how effective they are. It's called progress but also puts you in the category of the NP above who didn't know about your country's degree system, that is "ignorant" about some things.

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.

Most professions have models so why should nursing be any different? http://currentnursing.com/nursing_theory/nursing_theories_overview.htm

I used the Betty Newman model when working on my masters in nursing. She was also a clinical psychologist. Many of the nursing models were developed by holders of doctorates so they were probably smarter than you give them credit for.

I don't especially care for nursing diagnoses but I can see what the developers were trying to do.

Some of my raiding ancestors are from Ireland and I've visited there. Nice place. Welcome to SDN.

 

[bradt9881]

Here we go with the "family medicine is easy and basic" thing again, another common refrain on these forums. News flash - mid-levels are not just in primary care. And, how many people who disrespect primary care have actually practiced it for any significant length of time? How about none?

Actually, primary care requires you to keep on your toes. Its definitely not easy to have to know ob/gyn, peds, medicine, ortho, and surgery just to function every day. IMHO its a lot harder to learn a medium amount of everything than it is to learn one field in depth.

 

[jbar]

Most physicians are too busy to study about modern methods of educational delivery and how effective they are. It's called progress but also puts you in the category of the NP above who didn't know about your country's degree system, that is "ignorant" about some things.

"To study medicine without books is to sail an uncharted sea, while to study medicine only from books is not to go to sea at all." Sir William Osler

You can argue about how online learning compares with lecture, but the truth is that a good chunk of learning medicine (or nursing) is hands on, in the hospital. It doesn't matter how much you read about IV insertion, at some point you have to actually practice it and I'd rather that be while in school under supervision rather than after getting certified.

Also we all know people who are book smart but are total disasters in person. Online learning for how to fix your car is fine, in medicine it scares me a bit. Having people have to show up in person, interact with peers and faculty and not be totally crazy helps ensure that the people you are certifying are going to represent your field well.

I think a lot of people do these programs because they are easier and cheaper and fit into their lives. (Which is another argument against them. If you need online so it doesn't disrupt your life how can you possibly be studying as much as full time students?)

Let's be honest. Most online degree programs aren't being run by Harvard or Yale with top students who are being offered an alternative way to study. Some of the students are probably up there with traditional students. But I'm not worried about the middle of the pack, I'm worried about the bottom 10% who are in some basement downloading their answers off the internet and skimming through the powerpoints.

 

[RGMSU]

I'm not worried. Good luck getting hired anywhere decent with an on-line education in healthcare. I wouldn't accept the liability for such a grad. This is what we call a paper tiger threat. When patients find out their provider was trained online, the busiest part of the office will be the back door all the patients are sneaking out of.

 

[RGMSU]

"Most physicians are too busy to study about modern methods of educational delivery."

Yes, we went to school to study medicine, not educational theory. Personally, I would prefer my physician to be trained in the former rather than the latter.

 

[Therapist4Chnge]

I think a lot of people do these programs because they are easier and cheaper and fit into their lives. (Which is another argument against them. If you need online so it doesn't disrupt your life how can you possibly be studying as much as full time students?)

In the DNP thread I cited a couple of studies that looked at online performance compared to classroom learning, and one of the findings was a difference in the student's abilities to handle more complex concepts in the online environment. The particular study wasn't perfect, but it spoke to a few concerns that many people have with the differences in learning, average student, etc.

Let's be honest. Most online degree programs aren't being run by Harvard or Yale with top students who are being offered an alternative way to study. Some of the students are probably up there with traditional students. But I'm not worried about the middle of the pack, I'm worried about the bottom 10% who are in some basement downloading their answers off the internet and skimming through the powerpoints.

I've also read studies (non-healthcare) where as long as the online student learner did everything they were supposed to do, that they would fair adequately, though I'm most concerned with the online student learner that is not willing/able to put in the time necessary to adequately learn the material.

 

[RGMSU]

So when are we going to start up the online MD programs? I'll say it again for emphasis - When patients find out their provider was trained online, the busiest part of the office will be the back door all the patients are sneaking out of. Let's have a little common sense here people. I wouldn't mind having my life in the hands of a provider trained online though. Sounds like it could be fun.

 

[jbar]

In the DNP thread I cited a couple of studies that looked at online performance compared to classroom learning, and one of the findings was a difference in the student's abilities to handle more complex concepts in the online environment.

Again, the issue is less classroom v online and more hospital time v online. To learn to treat patients you have to treat patients. Also most education research is flawed because it is based on the paradigm of "we gave these two groups the same info in different ways and then tested them, and here's how many questions they could answer." What we really want to know is actual clinical performance, but that's really hard to measure so knowledge is used as a proxy. But it's a big leap to go from having online and lecture learners getting similar test scores to arguing that they provide the same patient care. Everyone knows people who are good on tests and bad in person and vice versa.

Let's be honest, these online places are offering this option because they can make a lot more money with a lot less overhead, not because it's been proven that online RN is the same as a traditional RN.

At the end of the day when the respectable programs give someone a degree they are putting trust that that person will reflect well on their program, will be smart and provide good care, and won't get arrested or be crazy. It's hard to feel secure in those things for someone who you've never met. That's the main reason why I don't think the big names will ever move to education that is mostly online. They want to have the day to day interaction so that when someone graduates from Dartmouth Medical School and goes out in the world DMS can say "yeah, they were here for four years and we trust that they aren't going to mess up our reputation." Not "yeah, they are this email address that seems to post smart things on our chat room."

 

[zenman]

"To study medicine without books is to sail an uncharted sea, while to study medicine only from books is not to go to sea at all." Sir William Osler

You can argue about how online learning compares with lecture, but the truth is that a good chunk of learning medicine (or nursing) is hands on, in the hospital. It doesn't matter how much you read about IV insertion, at some point you have to actually practice it and I'd rather that be while in school under supervision rather than after getting certified.

Clinical is not done online. I don't know why people can't get that. You don't get certified till you do your clinical, internship or preceptorship. The only difference is delivery of didactic material.

Also we all know people who are book smart but are total disasters in person. Online learning for how to fix your car is fine, in medicine it scares me a bit. Having people have to show up in person, interact with peers and faculty and not be totally crazy helps ensure that the people you are certifying are going to represent your field well.

Again, showing up live in clinical will weed out most of the crazy people...but they seem to slip through in any kind of program don't they?

I think a lot of people do these programs because they are easier and cheaper and fit into their lives. (Which is another argument against them. If you need online so it doesn't disrupt your life how can you possibly be studying as much as full time students?)

I'm at Rush university which is at almost $2,000 per 3hr course so it's not too cheap. I'm also sitting here in Bangkok and wouldn't be able to do a brick and mortar program. I've done two traditional grad programs and currently doing post-masters certification online, plus I've also been an assistant professor. Yes, it's easier and fits my lifestyle better but I would do it if I lived next door to the university. I spend the driving and looking for a parking space time studying. You can't sit in the back of the class in an online setting. You are forced to participate. There are also many students who can only attend school online due to no nearby university or work and family responsibilities. Online learning is time consuming but I'm able to spend that time pursuing knowledge, not driving down the highway. Unlike my earlier nursing grad program where I had to physically go to the library and look up references and write on note cards, I can access the Rush library and get any reference I want in a few minutes. In a few weeks I'll be starting a physical assessment course. I'll go over to the US Embassy health unit (US soil) where I'll do H&Ps and then will have to go to Chicago to do actual H&Ps, including pelvics, on faculty members. I'll bet your faculty didn't make you do pelvics on them to make sure you did it correctly! Then I head to Okinawa to the US Naval Hospital for my preceptorship. Do ya feel better now?

Let's be honest. Most online degree programs aren't being run by Harvard or Yale with top students who are being offered an alternative way to study. Some of the students are probably up there with traditional students. But I'm not worried about the middle of the pack, I'm worried about the bottom 10% who are in some basement downloading their answers off the internet and skimming through the powerpoints.

There's always the bottom 10% in any kind of program.

 

[zenman]

I'm not worried. Good luck getting hired anywhere decent with an on-line education in healthcare. I wouldn't accept the liability for such a grad. This is what we call a paper tiger threat. When patients find out their provider was trained online, the busiest part of the office will be the back door all the patients are sneaking out of.

It is really not an issue.

 

[zenman]

"Most physicians are too busy to study about modern methods of educational delivery."

Yes, we went to school to study medicine, not educational theory. Personally, I would prefer my physician to be trained in the former rather than the latter.

Of course, that's why you're not on an expert on education...and why I don't take your comments with any authority...sorry! Not only do I have a special ed teacher wife but I'm surrounded by her international teaching buddies and have to listen to their shop talk. Boring most of the time but I do perk up when they talk about creative teaching methods. Last night I was at a dinner with about 10 of them. I'd rather have been drinking beer with you.

 

[RGMSU]

It is really not an issue.

What isn't an issue? Getting hired? Depends on the clinic. There are qualified people from lots of educational backgrounds. I just think some backgrounds are associated with more skepticism than others. Makes for a larger hurdle to climb. And different patients have different expectations as well. No two patients are looking for the same thing. No two clinics offer the same thing, etc. At some point, we will wake up and realize that American medicine at least will never be a homogenous thing.

 

[RGMSU]

I'd rather have been drinking beer with you.

Nope, no education expert here. Just trying to find something to do in this economy (the US one) and make a living. I'd rather have been drinking beer with you than doing what I was doing last night, too - trying to get ready to flunk a med school test.

 

[J1515]

I'll bet your faculty didn't make you do pelvics on them to make sure you did it correctly! .

Actually most medical schools provide standardized patients to practice pelvic exams/genital exams/prostate exams on. Between that and the 500 hours of Ob/Gyn exposure we get on our required Ob/Gyn rotation, I'd say medical students without any controversial online classes are more than adequately prepared my friend.

You can try to rationalize it all you'd like, but the bottom line is I wouldn't want someone caring for my life who 'learned medicine' via online classes. Now if you want to work under a doctor's supervision that's a different story.

 

[zenman]

Actually most medical schools provide standardized patients to practice pelvic exams/genital exams/prostate exams on. Between that and the 500 hours of Ob/Gyn exposure we get on our required Ob/Gyn rotation, I'd say medical students without any controversial online classes are more than adequately prepared my friend.

You can try to rationalize it all you'd like, but the bottom line is I wouldn't want someone caring for my life who 'learned medicine' via online classes. Now if you want to work under a doctor's supervision that's a different story.

No rationalization. Certainly you're adequately prepared but I bet if you lined up a few female OB/GYNs to guide you with your first ones (on them) you'd be starting off better than with the same number of standardized patients who are already accustomed to the usual exam. Bet you'd get better feedback.

Same with my first patient interview, done with an actor versus a real patient. I received all kinds of great feedback from her...things I never thought of...and would certainly never get from a real patient.

 

[lawguil]

Of course, that's why you're not on an expert on education...and why I don't take your comments with any authority...sorry! Not only do I have a special ed teacher wife but I'm surrounded by her international teaching buddies and have to listen to their shop talk. Boring most of the time but I do perk up when they talk about creative teaching methods. Last night I was at a dinner with about 10 of them. I'd rather have been drinking beer with you.

I believe your arguing something that is difficult to argue intuitively and based on your own experiential bias. Critical pedagogy studies relationships between teaching and learning. It is a continuous process of unlearning, learning and relearning, evaluation and reflection, and the impact that these actions have on students. Recognizing that all students need engagement in multiple learning styles in order to achieve the first step of praxis, thus engaging in a cycle of theory, application, evaluation, reflection, and then back to theory.

There have been no papers written that show online education does anything more than to engage students beyond the surface meaning or..,first impressions, leaving a great deal of variability in which each student takes away from the lesson. This is simply "recall" education at best.

My thought: Let MBA's do their online programs, but don't dehumanize education for healthcare workers. Medical education needs critical practitioners with little variation in student outcomes. Medical education must be taught, (as it traditionally has been) with engagement and application during the didactic phase of edcuation.

I sometimes have to laugh at how the nursing profession, whom advocate the importance of nursing theory, also advocate electronic learning venues.

 

[Rorympb]

I joined this forum as I thought it would be interesting but all I can
say is, wow, the hate for nurses. I never realized in my almost 25 years
in nursing, how much we were detested. And,
no I'm not an NP, just a
plain ol' garden-variety RN. But I have a question
about the clinical hours everyone keeps talking
about in the NP programs.
Maybe not a really a question but any of the RN's I knew
who were in my hospital's NP program (major metro ivy-league institution) actually worked a full-time clinical job as well as were "students"
in their program. It wasn't a situation where they went to class
and then went home. Don't know, maybe it's different in other programs, etc. I was never really interested in the programs etc
but the same went for anyone I knew who was in a
Masters program for other nursing disciplines
(education, administration, etc). You worked
your shifts and you went to school, not one
or the other. Maybe that doesn't count?

I always got along well with residents, med students, attendings, pa's (our institution doesnt have many) and
have worked with a surgeon in his private practice for twenty years (who is very pro-RN).
Of course, there is always the prick or two but that is life and every job/situation. I'm just still taken aback by
the disdain in which some of you hold nurses.
Again, WOW, is all I can say! Good to know, I guess? But sad too.

 

[poresofkohn]

I joined this forum as I thought it would be interesting but all I can
say is, wow, the hate for nurses. I never realized in my almost 25 years
in nursing, how much we were detested. And,
no I'm not an NP, just a
plain ol' garden-variety RN. But I have a question
about the clinical hours everyone keeps talking
about in the NP programs.
Maybe not a really a question but any of the RN's I knew
who were in my hospital's NP program (major metro ivy-league institution) actually worked a full-time clinical job as well as were "students"
in their program. It wasn't a situation where they went to class
and then went home. Don't know, maybe it's different in other programs, etc. I was never really interested in the programs etc
but the same went for anyone I knew who was in a
Masters program for other nursing disciplines
(education, administration, etc). You worked
your shifts and you went to school, not one
or the other. Maybe that doesn't count?

I always got along well with residents, med students, attendings, pa's (our institution doesnt have many) and
have worked with a surgeon in his private practice for twenty years (who is very pro-RN).
Of course, there is always the prick or two but that is life and every job/situation. I'm just still taken aback by
the disdain in which some of you hold nurses.
Again, WOW, is all I can say! Good to know, I guess? But sad too.

It's notindividual nurses that are detested, it's the nursing agenda.

 

[Rorympb]

It's notindividual nurses that are detested, it's the nursing agenda.

nah, some of you don't like nurses. The snide little comments
on education, an RN couldnt pass this test, blah blah blah...
that's dislike, has nothing to do with nursing agenda of which
I know nothing about. It's their chance to get their little
infantile digs in, nice professionalism btw lol! Remind me
where you practice so I can avoid that area lol!
In my formative years lol, I had all
plans on going to med school (pediatrics ) but nursing
was a better fit for what I wanted to do. And it wasnt
because I was "stupid", I was always a good student.
Nursing and
medicine are two different philosophies (?) and scopes of practice
but I always felt they were the two halves that made a whole.
They worked together to benefit the patient. One wasnt better
than the other, ya know?

 

[Paseo Del Norte]

nah, some of you don't like nurses. The snide little comments
on education, an RN couldnt pass this test, blah blah blah...
that's dislike, has nothing to do with nursing agenda of which
I know nothing about. It's their chance to get their little
infantile digs in, nice professionalism btw lol! Remind me
where you practice so I can avoid that area lol!
In my formative years lol, I had all
plans on going to med school (pediatrics ) but nursing
was a better fit for what I wanted to do. And it wasnt
because I was "stupid", I was always a good student.
Nursing and
medicine are two different philosophies (?) and scopes of practice
but I always felt they were the two halves that made a whole.
They worked together to benefit the patient. One wasnt better
than the other, ya know?

However, this is a public form where people can pretty much say anything from the anonymity of their keyboard. You have to take comments with this context in mind.

Unfortunately, what is said has some truth. You as a nurse cannot tell me you do not see the massive push for independent practice among national nursing leaders and organizations? Come on now, be honest with Uncle Ruckus Nurse Del Norte. I see it as a registered nurse and the potential precedent it could set honestly scares me. The removal of the physician from the front lines of health care.

 

[zenman]

However, this is a public form where people can pretty much say anything from the anonymity of their keyboard. You have to take comments with this context in mind.

Unfortunately, what is said has some truth. You as a nurse cannot tell me you do not see the massive push for independent practice among national nursing leaders and organizations? Come on now, be honest with Uncle Ruckus Nurse Del Norte. I see it as a registered nurse and the potential precedent it could set honestly scares me. The removal of the physician from the front lines of health care.

But perhaps physicians are responsible for most everything that has happened to them.

Maybe most nurses, like physicians, also don't agree with the national leaders.

 

[zenman]

I believe your arguing something that is difficult to argue intuitively and based on your own experiential bias. Critical pedagogy studies relationships between teaching and learning. It is a continuous process of unlearning, learning and relearning, evaluation and reflection, and the impact that these actions have on students. Recognizing that all students need engagement in multiple learning styles in order to achieve the first step of praxis, thus engaging in a cycle of theory, application, evaluation, reflection, and then back to theory.

Well, my thoughts are based on my experience…that of an asst. professor and a grad student who has taken both traditional and distance ed courses. Most people have one or two learning styles. Auditory learners usually don't like to learn visually, etc. Don't know many who enjoy learning in multiple learning styles.

There have been no papers written that show online education does anything more than to engage students beyond the surface meaning or..,first impressions, leaving a great deal of variability in which each student takes away from the lesson. This is simply "recall" education at best.

Recall is probably the method of testing in most nursing and medical schools with those sorry multiple-choice exams, isn’t it. Research shows that distance ed is as effective as sitting in a classroom.

I know it probably hasn't been done yet but I'd love to see a study comparing my group who is doing distance ed with traditional students from the same school.

My thought: Let MBA's do their online programs, but don't dehumanize education for healthcare workers. Medical education needs critical practitioners with little variation in student outcomes. Medical education must be taught, (as it traditionally has been) with engagement and application during the didactic phase of edcuation.

Sounds like boot camp training to me, lol! So you think this can only be done face to face? What about the students who don’t engage? I’m required to respond in my distance ed class. I have to interact with my instructors and fellow students weekly or my grade goes south…and it has to be a quality response. Hell, I’m sitting over here in Bangkok interacting with fellow students all over the states. I can share with them “on the scene” experiences, especially with cultural aspects. I’ve met my fellow students once and already plan on projects with some when we finish. I’d say that’s some good interaction.

Some of the other advantages of distance ed over traditional is that I don’t have to wait for the slow learners or those who haven’t read ahead and slow the class down by asking questions they should already know the answers to. In most distance ed classes there are videos or power point presentations which I can view many times, vs once in a classroom setting. And I can do it when I’m rested and can absorb it. And I’m able to spend my time pursing knowledge rather than cruising down the road to class.

I’m not saying every course can be taught via distance ed but if you’re creative you can see that many of the ones you’ve taken could certainly be done that way. Plus some students have to have their hands held and given step-by-step directions, but those types shouldn’t be in healthcare. I’m basically saying there is no need for the ill-informed bias against distance ed, that’s all.

I’ve also heard medical students say they skip classes and just look at the videos of the instructors who post them. That’s distance ed isn’t it?

I sometimes have to laugh at how the nursing profession, whom advocate the importance of nursing theory, also advocate electronic learning venues.

Some probably did the same when the printing press came out. It’s called “progress.”

 

[Paseo Del Norte]

But perhaps physicians are responsible for most everything that has happened to them.

Perhaps. However, that does not mean separating the physician from the "front lines" is a good thing, IMHO.


Maybe most nurses, like physicians, also don't agree with the national leaders. Maybe. I am not really sure where most nurses are in this issue, and it still does not excuse what appears to be occurring. However, it seems there are at least few powerful groups that insist on cramming concepts and agendas down the throats of the medical community, like it or not. This does not sit well with me as the methodology taught to me as a student nurse revolved around teamwork.

I agree that some people on this site like to go after nurses for the sake of fun and to appease their sycophant cronies. However, I think most of the providers and students on this site are simply sick of having agendas crammed down their throats.

 

[RGMSU]

But perhaps physicians are responsible for most everything that has happened to them.

Maybe most nurses, like physicians, also don't agree with the national leaders.

You folks can spin your little web in your own heads that docs will be "removed from the front lines" and similar nonsense. The problem is that 99.9% of Americans still expect to see an MD. Good luck removing us from the front lines anytime soon. You nurses don't know what you're asking for anyway. The first time you practice independently, get in over your head, and get your britches sued off, you won't want to practice independently anymore.

So what exactly is the "nursing agenda" now? Hah, to take over the world? Sounds like a bunch of kids playing a battleship game. Take it to any major hospital in America and see how far you get with it. Just a bunch of fringe crap that only succeeds in being perpetuated on an internet forum.

 

[Paseo Del Norte]

You folks can spin your little web in your own heads that docs will be "removed from the front lines" and similar nonsense. The problem is that 99.9% of Americans still expect to see an MD. Good luck removing us from the front lines anytime soon. You nurses don't know what you're asking for anyway. The first time you practice independently, get in over your head, and get your britches sued off, you won't want to practice independently anymore.

Sweeping generalizations about all people of a profession are rather myopic IMHO. I know exactly what I am asking, and it has nothing to do with spinning a web or asking for independent practice. Feel free to review my posts and point out where I have ever advocated such concepts.

 

[RGMSU]

I'm referring to the NP movement. It's lke a bunch of teenagers revolting against their parents. Declaring mutiny on your boss never appears very mature. And, as far as I've seen, it isn't really working anywhere other than the Walmart minute clinic. Many of them are shutting down already - not profitable. There's a small segment of the population that prefers to have a nurse oversee their healthcare. The majority of people would rather see a physician. Hence, there is no future in this movement. All you'll wind up with are a bunch of NPs who are unemployed or underemployed.

 

[RGMSU]

But perhaps physicians are responsible for most everything that has happened to them.

Maybe most nurses, like physicians, also don't agree with the national leaders.

What has happened to physicians? Please update me, as I haven't heard. Should I be intensely worried about my future employability?

 

[zenman]

I'm referring to the NP movement. It's lke a bunch of teenagers revolting against their parents. Declaring mutiny on your boss never appears very mature. And, as far as I've seen, it isn't really working anywhere other than the Walmart minute clinic. Many of them are shutting down already - not profitable. There's a small segment of the population that prefers to have a nurse oversee their healthcare. The majority of people would rather see a physician. Hence, there is no future in this movement. All you'll wind up with are a bunch of NPs who are unemployed or underemployed.

Mulldingerhead was the only nursing leader (sic) who had her students take Step 3. No one else, as I've been told by someone who knows, went that route. I haven't checked other DNP programs but the one at my school goes like this:

"Doctor of Nursing Practice Degree - Leadership and the Business of Health Care

Rush University College of Nursing is one of the first colleges in the nation to award the practice doctorate. Building on the established role of the master's prepared nurse, the DNP program provides real world experience in strategic planning, communication to affect change, data management and the application of critical business concepts.

The DNP degree is designed to prepare a leader able to affect change through system redesign and evidence-based decision making in a variety of clinical, organizational and educational systems. Through coursework, clinical practicum and project implementation, the DNP graduate is prepared to influence health care outcomes for diverse populations in a variety of settings."

Looks like a combination of nursing and business to me, not taking over the clinical role of the physician.

 

[zenman]

What has happened to physicians? Please update me, as I haven't heard. Should I be intensely worried about my future employability?

No, I think you just need a little hydroxyzine and you'll be fine. I'm part of the reason nursing is in the shape it's in. I wasn't old enough in the 50's to fight the creation of the AD nurse. Frankly, other than for a couple years, I never joined the ANA. I guess I just felt like I was a p***y and couldn't affect change. Also the reason I'm not running for president. I'm just trying to fit in somewhere and fly under the radar.

I'm remember physicians being called on the carpet and being the reason for DRGs back in the 80's ...if I remember correctly. That also affected nurses and many hospital closed as a result. So I guess we're all responsible for what happens to us.

 

[Dr.Millisevert]

I am in PGY-2 of a general surgery residency here in America but was educated in Ireland at RCS.


Yesterday a nurse practitioner approached me.. 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.

A medical degree is a medical degree!
(MBBS = MD = MDCM = MBChB = BMed = DrMUD = DrMed)

If you have passed US national medical licensing exams and hold a US Medical license you are no different to any other US doctor.

Most American's are ignorant of any system outside of their own and blindly think their system is the best at all costs. (its pretty amazing actually)

I would recommend that nurse spend some time working as a nurse in Ireland. Maybe she could learn a thing or two.

 

[zenman]

I would recommend that nurse spend some time working as a nurse in Ireland. Maybe she could learn a thing or two.

Yea, like there are 11,000 pubs there so you can pub crawl without too much effort

 

[jbar]

nah, some of you don't like nurses. The snide little comments
on education, an RN couldnt pass this test, blah blah blah...
that's dislike, has nothing to do with nursing agenda of which

We wouldn't be having this discussion if people weren't saying "NPs/DNPs know as much and are as qualified as MDs." Looking at how many NPs/DNPs can pass a test that all MDs must pass isn't being mean, it's objectively trying to refute the claim that a DNP is clinically similar to the MD/DO.

I'd argue that anyone who has taken the DNP and insists on being called doctor, wears a long white coat and wants independent practice isn't practicing nursing, so how we feel about them really has nothing to do with how we feel about the average RN.

 

[deleted87716]

A medical degree is a medical degree!
(MBBS = MD = MDCM = MBChB = BMed = DrMUD = DrMed)

SRSLY...? There's a "DrMUD" degree? Wow, I'd hate to have those letters after my name.

 

[RGMSU]

Mulldingerhead was the only nursing leader (sic) who had her students take Step 3. No one else, as I've been told by someone who knows, went that route.

Hah, I can imagine not. So, if nursing students can't pass the step 3, they're not equal to MDs then. Thanks for proving my point.

 

[RGMSU]

No, I think you just need a little hydroxyzine and you'll be fine.

No anxiety on my part. That was sarcasm. The discussion was heading in the direction of "physicians have created the mess they're in - blah, blah - so nurse practitioners are able to step in - blah, blah." I'm still waiting to here what mess physicians are in. Haven't heard it yet. Second, nurse practitioners are not effectively stepping in for the majority of clinical settings to function as physicians. Third, the majority of patients are perfectly content to continue to see a physician. Only a small minority prefers care from a nurse practitioner.

 

[RGMSU]

The DNP degree is designed to prepare a leader able to affect change through system redesign and evidence-based decision making in a variety of clinical, organizational and educational systems. Through coursework, clinical practicum and project implementation, the DNP graduate is prepared to influence health care outcomes for diverse populations in a variety of settings.

The leadership that a DNP will be able to exercise clinically will also be limited, at least vis-a-vis physicians. You won't find too many physicians willing to work at a clinic where a DNP is in charge. They'll all go across the street where the MD is running the show. Look, nursing leaders can push for whatever they choose, but as long as medical school remains the superior educational route, physicians will be captains of the ship. Nursing leaders can get up behind a podium and say anything, just like anybody can write anything on this forum. Doesn't mean it translates into reality. If nursing leaders were really going to function as leaders, they would be trying to attract students to perform traditional nursing roles, since there are tremendous shortages looming in these noble roles. In the end, if they continue to push for nurses as "leaders" or pseudo-physicians rather than as nurses, the shortage of nurses to fill traditional roles will be exacerbated. And, those nursing leaders will wind up looking pretty silly when they discover that they're the pied piper minus the rats. American medicine, doctors, and patients aren't buying what they're trying to sell.

 

[Dr.Millisevert]

SRSLY...? There's a "DrMUD" degree? Wow, I'd hate to have those letters after my name.

Yeah.. I think that's the Polish med degree.

 

[dienekes88]

The leadership that a DNP will be able to exercise clinically will also be limited, at least vis-a-vis physicians. You won't find too many physicians willing to work at a clinic where a DNP is in charge. They'll all go across the street where the MD is running the show. Look, nursing leaders can push for whatever they choose, but as long as medical school remains the superior educational route, physicians will be captains of the ship. Nursing leaders can get up behind a podium and say anything, just like anybody can write anything on this forum. Doesn't mean it translates into reality. If nursing leaders were really going to function as leaders, they would be trying to attract students to perform traditional nursing roles, since there are tremendous shortages looming in these noble roles. In the end, if they continue to push for nurses as "leaders" or pseudo-physicians rather than as nurses, the shortage of nurses to fill traditional roles will be exacerbated. And, those nursing leaders will wind up looking pretty silly when they discover that they're the pied piper minus the rats. American medicine, doctors, and patients aren't buying what they're trying to sell.

Look. Everybody knows that NPs are smarter than MDs. That's why they can do an FNP in 3 years what an MD would need 8 years (MD + FM res) to do. Objectively, their intelligence clearly exceeds ours by 167%.

They're also the best advocate for the patient, and they treat the whole patient while we just treat disease. Heck, most of the time we don't even know the patient's hospital course or history. We're lucky if we even get the name right.

 

[RGMSU]

I don't buy that physician-led treatment is inherently impersonal. Depends on the physician. Who says that only nurses view the patient as a whole person?

 

[zenman]

Look. Everybody knows that NPs are smarter than MDs. That's why they can do an FNP in 3 years what an MD would need 8 years (MD + FM res) to do. Objectively, their intelligence clearly exceeds ours by 167%.

They're also the best advocate for the patient, and they treat the whole patient while we just treat disease. Heck, most of the time we don't even know the patient's hospital course or history. We're lucky if we even get the name right.

I would say that 167% is a low number. It's well known that, other than knowing medicine, physicians are basically worthless (they've told me that personally). You spend a lot of money to have facts crammed into your head so fast that you can't remember half of it and think that you've had a great education. You're so busy you don't know what's happening in the real world. Very inefficient; should have gone to business school for undergrad.

 

[zenman]

I don't buy that physician-led treatment is inherently impersonal. Depends on the physician. Who says that only nurses view the patient as a whole person?

Probably very few, but the medical profession focuses on curing, not healing. That's ok, it's your role, but that's not treating the whole person.

 

[zenman]

Another smart physician (leader) move:

"The AAFP today announced a corporate partnership with The Coca-Cola Co., in which the beverage giant will provide a grant for the Academy to develop consumer education content related to beverages and sweeteners for the AAFP's award-winning consumer health and wellness Web site, FamilyDoctor.org."

http://www.aafp.org/online/en/home/...s-now/inside-aafp/20091006cons-alli-coke.html

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[RGMSU]

I would say that 167% is a low number. It's well known that, other than knowing medicine, physicians are basically worthless (they've told me that personally). You spend a lot of money to have facts crammed into your head so fast that you can't remember half of it and think that you've had a great education. You're so busy you don't know what's happening in the real world. Very inefficient; should have gone to business school for undergrad.

Ooh, very nasty. And quite biased. When you encounter a disease that is anything other than benign, it helps that you have been exposed to all of those "worthless" facts. Recalling a "worthless" fact in time could be the difference between a patient living and dying, unless all you're treating is head colds.

 

[RGMSU]

Probably very few, but the medical profession focuses on curing, not healing. That's ok, it's your role, but that's not treating the whole person.

Again, there are quite a few of us in the medical profession who focus on healing and treating the whole person, particularly in primary care. Overgeneralization on your part. Biased misinformation again.

 

[RGMSU]

Another smart physician (leader) move:

"The AAFP today announced a corporate partnership with The Coca-Cola Co., in which the beverage giant will provide a grant for the Academy to develop consumer education content related to beverages and sweeteners for the AAFP's award-winning consumer health and wellness Web site, FamilyDoctor.org."

http://www.aafp.org/online/en/home/...s-now/inside-aafp/20091006cons-alli-coke.html

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This probably is a classic case of sleeping with the devil. Problem is the devil has a pointed tail, so you could find yourself getting poked. Not saying that's what's going on here necessarily, but...

 

[zenman]

Ooh, very nasty. And quite biased. When you encounter a disease that is anything other than benign, it helps that you have been exposed to all of those "worthless" facts. Recalling a "worthless" fact in time could be the difference between a patient living and dying, unless all you're treating is head colds.

Now I didn't say any of your facts are worthless. I said the way you are taught does not lead to optimal long-term storage of that valuable information. If you were doing part-time distance ed like me for example, you'd retain 98% of what you were taught (and have more time to post on SDN) and still have time to learn social skills. Much more value for the money, don't you think?

 

[zenman]

Again, there are quite a few of us in the medical profession who focus on healing and treating the whole person, particularly in primary care. Overgeneralization on your part. Biased misinformation again.

Please give me an example of how you heal a person.

 

[RGMSU]

you'd retain 98% of what you were taught (and have more time to post on SDN) and still have time to learn social skills.

I have no deficits in any of these areas. So, I seem to be getting plenty for my money. And, I wouldn't be a physician at the end of it, because there are no such programs to educate physicians, so no I wouldn't consider it more bang for the buck.