Nurse Practitioners (DNP) the new DO?

[NaOH]

Exactly. No change in coursework or rigor. There's much more to being a doctor than putting a D on your name

But we aren't doctors, we're pharmacists. And in my personal experience none of the pharmacists I know or have worked with have tried to represent themselves as such.

There's a lot of talk in the pharm world about 'provider status' - it sounds a lot like the NP/DNP crowd, trying to turn us into midlevels, physician extenders, etc. Sounds stupid for most of us, considering that it will just become more crap our corporate overlords will expect us to do while not giving us any additional tech help or paying us any more.

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[Psai]

The PharmD (6 years) is not only LONGER than the BS in Pharm (4 years) EVER was, many programsrequire a research/thesis type project for graduation.

Geez, the IGNORANCE is THICK in this one!

And the reason I KNOW this is because my sister is a PharmD and a cousin first finished with a BS in Pharm then went back to school to become a PharmD.

What does any of this have to do with knowledge and ability? My understanding is that the bachelor's used to be 5, and the pharm.d can be done in 6 but more typically 7-8 depending on how many prereqs the student does. Also, it's your sister that's a pharmacist? Not you? Well then, your opinion certainly holds a lot of weight.

But we aren't doctors, we're pharmacists. And in my personal experience none of the pharmacists I know or have worked with have tried to represent themselves as such.

There's a lot of talk in the pharm world about 'provider status' - it sounds a lot like the NP/DNP crowd, trying to turn us into midlevels, physician extenders, etc. Sounds stupid for most of us, considering that it will just become more crap our corporate overlords will expect us to do while not giving us any additional tech help or paying us any more.

I just don't like seeing the "doctorate" argument because so many useless nps go around waving that flag as if it's supposed to impress people. But your post is very true. I respect your field as well as your respect for ours. I'm seeing pharmacists giving out flu shots for free and I'm just like, why? People are supposed to be paid for that.

 

[Rajayray2019]

NP's and PA's are not physicians.

so no.

this is like saying will a potato become the new apple? not the same thing.

Ancillary providers have their place. As patient need grows and number of physicians shrink, they're being pushed to fill in the blanks. That doesn't mean they're physicians. It simply means that the system is trying to find ways to provide extended privileges to less qualified providers.

 

[chipwhitley]

NP's and PA's are not physicians.

so no.

this is like saying will a potato become the new apple? not the same thing.

Ancillary providers have their place. As patient need grows and number of physicians shrink, they're being pushed to fill in the blanks. That doesn't mean they're physicians. It simply means that the system is trying to find ways to provide extended privileges to less qualified providers.

Ancillary providers don't need to exist. The fact that we need more of them points to how messed up our system is. We have plenty of people who are capable of becoming doctors but don't get to, and we have even more people who are full-fledged doctors from other countries ready to train and work here but we don't give them the opportunity to do so. Instead we fill up the gap with "providers" who took a fast track to learning medicine and think that's good enough. All the while our own citizens go abroad to learn medicine because they can't find a spot in a school here.

 

[username456789]

As patient need grows and number of physicians shrink

Huh?

Is this seriously what the AMA is telling medical students now?

This is worse than I thought.

 

[Psai]

NP's and PA's are not physicians.

so no.

this is like saying will a potato become the new apple? not the same thing.

Ancillary providers have their place. As patient need grows and number of physicians shrink, they're being pushed to fill in the blanks. That doesn't mean they're physicians. It simply means that the system is trying to find ways to provide extended privileges to less qualified providers.

Where are you getting any of your information?

 

[Drew2128]

I agree with NP's being a joke. I was an RN before going to medical school. The only way I see an NP being as good as a DO is in a very small nitch where they do they same things everyday. The education isn't even close. I had to study on my own all of the time to become good. I did constantly hear nurses telling me they were as good as the doctors. I used to say to them tell me about your histology, patho class, biochem class, genetics, organic chemistry classes, and surgery. Their anatomy and physiology class is a joke as well. Their pharmacology class is a joke. I didn't learn meds well until I got out of school. The problem with many nurses is they memorize signs and symptoms, but cant tell you why. I cringe when a nurse tells me they know just as much as the doctor.

 

[mats7]

Devil's advocate here.

MD education is moving towards competency-based curriculum. You either know your stuff or you don't.

4 years is initially implemented when undergraduate education wasn't required. Some MD programs have moved to 3 years if you commit to family medicine.

Aside from simulated patients and workshops, which are important, many students watch recorded lectures at home.

ACA actually supports nursing residencies, but doesn't appropriate funds for them. There are still many available and I think it's a great thing if they're going to end up being people's primary care provider.

There are some clinics where NPs are the CMOs. It's surprising.

NPs might not be the next DO or MD, but they're going to be the next family practitioners or psychiatrists.

A stark difference I've noticed between NPs and MD/DOs is the quality of referrals. So if the primary care provider doesn't know something, the NP may refer out to a specialist for a consult citing, "abnormal CT." The MD will ask specific clinical questions regarding the patient and provide relevant information very specifically, like "CT shows X in this region with Z features, and patient has levels of Y at 459 ug/L."

 

[W19]

Devil's advocate here.

There are some clinics where NPs are the CMOs. It's surprising.

NPs might not be the next DO or MD, but they're going to be the next family practitioners or psychiatrists.

A stark difference I've noticed between NPs and MD/DOs is the quality of referrals. So if the primary care provider doesn't know something, the NP may refer out to a specialist for a consult citing, "abnormal CT." The MD will ask specific clinical questions regarding the patient and provide relevant information very specifically, like "CT shows X in this region with Z features, and patient has levels of Y at 459 ug/L."

What is left for me now? F... it! I am doing radiology...

 

[Psai]

Devil's advocate here.

MD education is moving towards competency-based curriculum. You either know your stuff or you don't.

4 years is initially implemented when undergraduate education wasn't required. Some MD programs have moved to 3 years if you commit to family medicine.

Aside from simulated patients and workshops, which are important, many students watch recorded lectures at home.

ACA actually supports nursing residencies, but doesn't appropriate funds for them. There are still many available and I think it's a great thing if they're going to end up being people's primary care provider.

There are some clinics where NPs are the CMOs. It's surprising.

NPs might not be the next DO or MD, but they're going to be the next family practitioners or psychiatrists.

A stark difference I've noticed between NPs and MD/DOs is the quality of referrals. So if the primary care provider doesn't know something, the NP may refer out to a specialist for a consult citing, "abnormal CT." The MD will ask specific clinical questions regarding the patient and provide relevant information very specifically, like "CT shows X in this region with Z features, and patient has levels of Y at 459 ug/L."

There's a huge difference between watching lectures at home and online courses. You have your classmates in real life who you meet with and are friends with. There is a lot to say about the hidden curriculum. You don't just learn facts in medical school.

Name the medical schools that are a three year program if you commit to family medicine.

Only physicians are psychiatrists. Nurses are psychiatry nurse practitioners.

 

[TheTao]

Name the medical schools that are a three year program if you commit to family medicine.

Your posts in this thread are the reason there should be a minimum age AND life experience requirement for med school, you put the capital "N" in naive!

 

[LChristmas]

Name the medical schools that are a three year program if you commit to family medicine.

I believe Texas Tech is one such program.

 

[Rajayray2019]

Where are you getting any of your information?

have you seen the landscape of medicine? there are chiropractors with prescription privileges in underserved areas. i.e. west texas, NM, AZ. There's not a specific source that says "Oh ya we're trying to rely on ancillary providers to fill in the gap" but talk to anyone in medicine and that's what's happening. Ancillary providers absolutely have a role, and are critical parts of a care team. However...there's a push to rely on ancillary providers to fill in the gaps in the system, because it's costly to train physicians. Take that as you will.

 

[Rajayray2019]

I believe Texas Tech is one such program.

yep. FMAT.

 

[Rajayray2019]

I agree with NP's being a joke. I was an RN before going to medical school. The only way I see an NP being as good as a DO is in a very small nitch where they do they same things everyday. The education isn't even close. I had to study on my own all of the time to become good. I did constantly hear nurses telling me they were as good as the doctors. I used to say to them tell me about your histology, patho class, biochem class, genetics, organic chemistry classes, and surgery. Their anatomy and physiology class is a joke as well. Their pharmacology class is a joke. I didn't learn meds well until I got out of school. The problem with many nurses is they memorize signs and symptoms, but cant tell you why. I cringe when a nurse tells me they know just as much as the doctor.

why are people considering DO's as less than MD's? Thats insane...it's the same freaking curriculum.

 

[NontradCA]

why are people considering DO's as less than MD's? Thats insane...it's the same freaking curriculum.

They aren't the same. They're better.

DO is better because of holistic philosophy. Then NPs come close because everyone knows nurses are the ones who really take care of the patients. MDs just talk down to everyone and count their dollars.

 

[NickNaylor]

They aren't the same. They're better.

DO is better because of holistic philosophy. Then NPs come close because everyone knows nurses are the ones who really take care of the patients. MDs just talk down to everyone and count their dollars.

I specifically took a "counting dollars" class as an elective in M4 (srs).

 

[NaOH]

I specifically took a "counting dollars" class as an elective in M4 (srs).

Good, everyone should do so.

 

[W19]

Ancillary providers don't need to exist. The fact that we need more of them points to how messed up our system is. We have plenty of people who are capable of becoming doctors but don't get to, and we have even more people who are full-fledged doctors from other countries ready to train and work here but we don't give them the opportunity to do so. Instead we fill up the gap with "providers" who took a fast track to learning medicine and think that's good enough. All the while our own citizens go abroad to learn medicine because they can't find a spot in a school here.

We are not going to devalue our product, but we will let someone else (ANA) devalue it... That is pretty much the attitude of AMA and a lot of med students... They were against the law that was passed in Missouri for no logical reason. You have NP that say they want to fill the primary care gap, but most go into specialties in their nice suburbia... Missouri passed a law that will let med students who pass step3 to have a restricted license after working for 1-year under a physician, and AMA/ANA were against the law... We are fighting NP battle for them! Why do people think ANA was against that law?

 

[deleted407021]

Name the medical schools that are a three year program if you commit to family medicine.

Mercer, for one. NYU has a 3 year program, as well.

 

[GypsyHummus]

Tell that to the podiatrists and the chiropractors

You don't think pods are physicians?

 

[W19]

You don't think pods are physicians?

Pods are physicians... chiropractors are not!

 

[GypsyHummus]

Pods are physicians... chiropractors are not!

sweet, now what about dentists?

 

[Psai]

You don't think pods are physicians?

I think podiatrists are podiatrists. I don't understand why people have to continually coopt our language. Is being called doctor not enough? They are not physicians. They just deal with the feet.

Do we really need Dr. podiatric physician and Dr. optometric physician and Dr. nursing physician? I really don't understand. If you didn't put in the work and don't have the knowledge, why do you want to continually give yourself a promotion?

 

[chipwhitley]

I think podiatrists are podiatrists. I don't understand why people have to continually coopt our language. Is being called doctor not enough? They are not physicians. They just deal with the feet.

Do we really need Dr. podiatric physician and Dr. optometric physician and Dr. nursing physician? I really don't understand. If you didn't put in the work and don't have the knowledge, why do you want to continually give yourself a promotion?

At my hospital they give podiatrists the "Attending Physician" badge. If podiatrists can have it, why can't DNPs? Neither is more of a physician than the other.

 

[W19]

I think podiatrists are podiatrists. I don't understand why people have to continually coopt our language. Is being called doctor not enough? They are not physicians. They just deal with the feet.

Do we really need Dr. podiatric physician and Dr. optometric physician and Dr. nursing physician? I really don't understand. If you didn't put in the work and don't have the knowledge, why do you want to continually give yourself a promotion?

I think pod put the work... with 4-year of school and 3-year surgical residency training.

 

[PhillyMed777]

I would say pod put the work... with 4-year of school and 3-year surgical residency training.

But putting in the work isn't the same thing as being a physician...it's a word with a proper definition. It's not fair to change it to whatever one pleases

And honestly I don't know much about their residency. So I can't decide how much they learn and know at the moment

 

[W19]

But putting in the work isn't the same thing as being a physician...it's a word with a proper definition. It's not fair to change it to whatever one pleases

And honestly I don't know much about their residency. So I can't decide how much they learn and know at the moment

I worked with them and it seems like they went thru rigorous residency training... In fact, I would have them operate on my feet before having an ortho surgeon...

 

[Psai]

I worked with them and it seems like they went thru rigorous residency training... In fact, I would have them operate on my feet before having an ortho surgeon...

Years are not the same years. The time matters, the amount of effort matters, the knowledge obtained matters, etc. Pods are not impressive in what they know. There's a huge difference between doing a bunch of bunionectomies and a ruptured triple a. How can you judge the rigor of residency programs as a first year medical student? I can't even judge the programs in my chosen field.

 

[apr27]

Nah. What do they know about Chapman's points and counter strain?

 

[W19]

Years are not the same years. The time matters, the amount of effort matters, the knowledge obtained matters, etc. Pods are not impressive in what they know. There's a huge difference between doing a bunch of bunionectomies and a ruptured triple a. How can you judge the rigor of residency programs as a first year medical student? I can't even judge the programs in my chosen field.

That is a ridiculous argument... I obviously don't know what they do in residency, but I actually did see what they do on the field--you know, working in the OR at a major trauma center where they take care all trauma pertaining to the feet..

 

[Psai]

That is a ridiculous argument... I obviously don't know what they do in residency, but I actually did see what they do on the field--you know, working in the OR at a major trauma center where they take care all trauma pertaining to the feet..

Wait so you don't know what they do in residency but you know that it is rigorous? Which part of that makes sense to you?

 

[W19]

Wait so you don't know what they do in residency but you know that it is rigorous? Which part of that makes sense to you?

If they are performing complex surgeries, one can make inferences... I don't know what happen in MIT classrooms, but I am pretty sure it's a rigorous school...

 

[samac]

Nah. What do they know about Chapman's points and counter strain?

No no no no no no no no.

 

[feeling-dizzy]

No no no no no no no no.

yeah, what do they know about OMM, right?

 

[67552931811]

Pods are physicians... chiropractors are not!

Wtf are you talking about.

The amount of bastardizing of medicine by medical students and practicing physicians never ceases to amaze me. Yet, we all wonder how the suits have taken us out to the woodshed.

 

[Psai]

If they are performing complex surgeries, one can make inferences... I don't know what happen in MIT classrooms, but I am pretty sure it's a rigorous school...

What is complicated about their surgeries? Have you seen them? Have you seen any surgeries at all? And all of this is moot because having rigorous training doesn't make you a physician. We don't call navy seals physicians despite their rigorous training

Please just accept the fact that you don't know what you're talking about

To be a physician means that you got into medical school, got an md or do, finished an accredited residency and treat patients. If you're missing any of those steps you are not a physician. It's not complicated at all

 

[Rajayray2019]

Pods are physicians... chiropractors are not!

Pods are not physicians.

Physician - that implies a baseline understanding of the physiology of the entire human body, and an understanding of treatment.

Podiatrists are more qualified than chiropractors (assuming we're not talking about joint manipulation -- in which case I would still go to an osteopath), but neither are as qualified as physicians.

That said. I would go to a podiatrists over an ortho for most foot problems. The key is understanding the limits of each field, and having the humility to admit that. At the end of the day this is about one thing only -- treating patients. The push by ancillary providers for recognition and extension of privileges is childish, akin to someone beating their chest on the playground, and likely to cause issues with patient care. In the same spirit, physicians need to focus on how to incorporate extenders into their care teams.

We have a physician shortage. Everyone sees that. The solution is long term. It means creating new physicians, incentivizing physicians to continue to practice, and drawing hard working and intelligent people to the field of medicine. In the mean time, extenders can help ameliorate some of the problems we're seeing, if deployed correctly.

I'm gonna go hide my soap box in the garage now.

 

[W19]

What is complicated about their surgeries? Have you seen them? Have you seen any surgeries at all? And all of this is moot because having rigorous training doesn't make you a physician. We don't call navy seals physicians despite their rigorous training

Please just accept the fact that you don't know what you're talking about

To be a physician means that you got into medical school, got an md or do, finished an accredited residency and treat patients. If you're missing any of those steps you are not a physician. It's not complicated at all

Putting shattered foot (feet) together is not easy.. Yes I have seen these surgeries. If you are a med student, you should know hand/foot musculoskeletal anatomy is complex... You do NOT need to finish residency to be a physician. You can get a medical license in most states after 1-year post grad training if you are an AMG... I think you are the one who doesn't know what you are talking about...

http://www.fsmb.org/policy/public-resources/state_specific

 

[username456789]

We have a physician shortage.

No we don't. Have a distribution problem.

 

[Mjolner]

No we don't. Have a distribution problem.

We have both.

 

[oncology2020]

No we don't. Have a distribution problem.

Exactly! its a distribution problem, we do NOT have a physician shortage problem--this is a myth being driven by hospital administrators to further acquire cheap labor to run their hospitals and completely destroy job markets by training too many individuals..people go look at the forums for radiology, pathology, rad onc, cardiology, anesthesiology, etc.--many of these residents in these fields which are already 4-5 yrs long are being forced to do MULTIPLE fellowships before they can even get a job in a decent area--despite these issues administrators continue to open up more spots saying there is a shortage, it's ridiculous. That's 6-7 years after 4 yrs of undergrad, 1-2 yr gap year, 4 yrs of medical school..16-17 years of rigorous training requiring the highest standards before getting an actual salary...there's a complete disregard for medical trainees because we are cheap labor

Compare that to NPs who are getting autonomy after minimizing their training via online degrees and 700 hrs of clinic hours. NPs are asking for autonomy saying they can fill the gap and need in primary care..it's all BS, they go after the money which is why they have "residencies" in all the profitable fields (derm, cards, GI..they're learning colonoscopies...)

Instead of giving NPs autonomy, they should make more medical school programs that specifically require a commitment to primary care, once a student enrolls in that program they can't specialize. I'm sure there are many many students who could not get into a US med school who would love this opportunity. These students would be 100x more qualified than NPs. Or allow us to do a 1 year residency pass usmle step 3 and be allowed to practice primary care (most insurance companies won't reimburse unless a physician is board certified which means need to complete at least a 3 yr residency--this needs to change). Dentists start practicing general dentistry immediately after dental school without any sort of residency requirement, and they do more invasive procedures than a primary care physician. Our degree after all that education and 3 licensing exams is essentially worthless without at least a 3 year residency...

 

[chipwhitley]

Instead of giving NPs autonomy, they should make more medical school programs that specifically require a commitment to primary care, once a student enrolls in that program they can't specialize. I'm sure there are many many students who could not get into a US med school who would love this opportunity. These students would be 100x more qualified than NPs. Or allow us to do a 1 year residency pass usmle step 3 and be allowed to practice primary care (most insurance companies won't reimburse unless a physician is board certified which means need to complete at least a 3 yr residency--this needs to change). Dentists start practicing general dentistry immediately after dental school without any sort of residency requirement, and they do more invasive procedures than a primary care physician.

Yes! This is absolutely the way to fix the problem.

 

[W19]

Instead of giving NPs autonomy, they should make more medical school programs that specifically require a commitment to primary care, once a student enrolls in that program they can't specialize. I'm sure there are many many students who could not get into a US med school who would love this opportunity. These students would be 100x more qualified than NPs. Or allow us to do a 1 year residency pass usmle step 3 and be allowed to practice primary care (most insurance companies won't reimburse unless a physician is board certified which means need to complete at least a 3 yr residency--this needs to change). Dentists start practicing general dentistry immediately after dental school without any sort of residency requirement, and they do more invasive procedures than a primary care physician.

I have argued that for months here, and many were against it because it will devalue their degree ... This profession really needs help.

 

[chipwhitley]

I have argued that for months here, and many were against it because it will devalue their degree ... This profession really needs help.

Doctors were historically allowed to practice after doing an intern year. A few of them are even still around. They were certainly better equipped to do primary care than a fast-track online DNP who has less clinical hours than the first few months of intern year.

 

[W19]

Doctors were historically allowed to practice after doing an intern year. A few of them are even still around. They were certainly better equipped to do primary care than a fast-track online DNP who has less clinical hours than the first few months of intern year.

Maybe I should have used the word 'profession' instead of 'degree'... Anyway, that was the essence of their argument.

 

[username456789]

We have both.

Nope.

 

[Mjolner]

Nope.

The patient populating is growing faster than the physician population. Especially with the ACA covering more people.

Those are facts. The eloquence of your well thought out rebuttal of "Nope" was astonishingly persuasive tho.

 

[username456789]

The patient populating is growing faster than the physician population. Especially with the ACA covering more people.

Those are facts. The eloquence of your well thought out rebuttal of "Nope" was astonishingly persuasive tho.

Oh god, you really have been drinking the AMA kool-aid haven't you?

 

[Psai]

The patient populating is growing faster than the physician population. Especially with the ACA covering more people.

Those are facts. The eloquence of your well thought out rebuttal of "Nope" was astonishingly persuasive tho.

That still doesn't mean you have a shortage.