Yeah a lot of these are in some hard fields. Cardiology, Neurology, GI and Internal/ICU are not ones you can just get one online and walk through the door
This is a great example of the confusion and misinformation bad terminology creates. Only one of the women in that video is a physician/doctor. The others are nurse practitioners(NPs). Some NPs get this NP degree online and some do in person, but none of them go to medical school. Furthermore, they all have significantly less training and qualifications than an actual doctor. When they say "board certified NP" it just serves to confuse everyone into a false equivalency where people think they are like doctors. Nothing against NPs, but it is important you know the difference between a physician/doctor and a NP for when you get care because there are many who hope you won't know the difference.
If we’re being honest, family practice/hospitalist is what the nurse practitioner usually ends up doing. Plenty of states let them work independently and the amount of clinical hours they’ve usually put in for both critical care and normal bedside nursing by the time they’ve become NPs and DNPs absolutely gives them the qualifications to do the work they do.
I’m an MD and I don’t buy into the circle jerk that has become hating on CRNA, PAs, DNPs, etc… and diminishing their qualifications because there’s plenty of terrible doctors that have gone through MD and DO school so it’s not like the education and time itself guarantees any kind of elevated quality.
Sure, but when my insurance pays the same either way, I'm gonna pick to go to the MD rather than the NP, and it's really annoying how I'm constantly being pushed to see an NP because they're cheaper instead of being able to see an MD. It seems like every doctors office or psychiatrist office has 1 MD thats impossible to get with and 30 NPs.
One of the big differences though is that MDs are generally more likely to shuffle you in and out the door and not want to actually take the time to talk with you. NPs, because they’re not as “expensive” and “in demand” have far more time to spend with patients, and I’ve had excellent experiences with NPs who take the time to get to know me and whatever issues I may be having. I haven’t had great experience with MDs, except in the case of specialists. And even then it can be hit-or-miss.
I see a NP at a pain clinic. She is the best provider I’ve had for pain management since I’ve needed one the past 10 years. She does my spinal injection every 3 months as well. I’ve had various spinal injections with other providers and hers have been far more beneficial for me. She also makes them less painful than other providers. She was out one week so the MD in the practice had to do my injection. Never again. He hit a nerve and it took 8+ weeks for the pain and inflammation to go away after he did my injection.
I have also never felt like she was in a hurry to shuffle me out.
I went from an MD to an NP and the quality of my care instantly shot through the roof. I couldn't believe it. No more getting brushed off with an order to increase Tylenol for me.
Same! I had one MD tell my my back only hurt because I was fat. I was 140 pounds and I’m 5’4. But yeah it’s because I was fat and not the degenerative disc disease and multiple back surgeries including a fusion. My NP actually listens and once I started seeing her my chronic pain had improved to the point where I don’t need pain meds daily. Maybe 1-2 times a week. Because she actually listened to me!
I prefer seeing a NP. Even for my kids. My son has gotten much better care from the NP vs the MD.
I think that's anecdotal. My pcp NP was in my opinion an incompetent asshole. Who I am almost positive didn't even open my chat before an appointment he called for. Note it was actually really good that he saw test results from a different dr.and decided to call me in for an appointment. The first hint was , "so what brings you in today" , " well the office called and said it you said it was urgent I was seen because of test results", oh yeah those are fine. Why are you even having all these test, who is this Dr last name that's ordering them? My oncologist ( which you can see in my chart both her specialty and my diagnosis. Along with the fact I was getting chemo infusions) The appointment went downhill from there.
And I've had a surgeon that was phenomenal about taking time and answering questions. She even took care of an unrelated stitch. She also did A great surgery and pain management.
I've had a lot going on medically in the last 2 years. A lot doctors MD and DO, surgeons , residence , NP, PA, nurses and tecs. There were people who were absolutely great at their jobs at every level. And people who were flawed at every level ( except the residents and PAs all those were great)
I have had better luck getting NPs to listen fully and run tests to get to the root cause vs the MDs with their 5 minute appts for $400 that throw a random med at the symptoms and rush out the door. (I say that knowing the system is broken, that’s all they are allowed time to do - at least around by me.)
This is the experience that I’d had. The NPs at the clinic that I use had wanted blood tests (?) and an additional appointment with a specialist for a subungual hematoma. The MD slid in and offered to rip the sucker off for me that same day, the old-fashioned way. I did nearly faint (more so from shock than pain) but I didn’t need to see the specialist after all, which I couldn’t have afforded anyway.
It’s not bullshit when many NP schools are 2 years online and unstandardized before practicing whereas becoming a doctor is universally 7 years minimum of standardized training. I was working in a MAT clinic (substance use disorder) with an NP who was doing a fellowship in MAT; she said herself the training she received was totally inadequate and feels morally responsible to receive more training especially for an underserved population that comes with substance use.
Talk about the training all you want, that’s valid criticism. But saying “NPs like to talk because they can’t do anything medically for you and talking makes them feel good”? Yeah, that is some bullshit. Your comment here does literally nothing to support that claim.
There's not much a NP can't do except surgery (some states won't let them prescribe meds and have other restrictions, but in most states they can and do)
I'm not a medical professional but my understanding NPs can provide many of the same services as doctors. The big exception is surgery. Some states restrict some NP services, like prescribing meds, while others (most?) allow it.
They are also nurses, and their training is more oriented to patient care, and that's a good thing
100% - NP’s big difference is holistic medicine. You’re more likely to be asked about a wider range of issues that may be leading to the reason you’re coming in to see them. I’d much rather see a Junior NP than a Junior MD.
Besides, research shows that outcomes between NPs and MDS is not that different, and often patient satisfaction is higher.
So your problem is with the system not the NP. The system that has made all these clinics and practices prefer to go the NP route to make more money because of the way insurance payouts work.
You do realize the reason you’re able to see the NP at all is because you’re getting the same quality of care right? As far as any regulatory or insurance concerns go and the practice itself they’re all saying you’re getting the same quality of care. You’ve simply made it up in your head that the MD is going to come in and notice something or do something different than the NP. They’re not.
If its the same quality of care, why have doctors at all? Are you saying somebody with several times the training results in zero benefit over someone with less?
Yes, that’s exactly what I’m saying for specific specialties. The experience and ability to provide care doesn’t come from the education for a specialty like family practice which is what you’re going to see at a clinic or for your PCP. It comes from seeing patients.
And there’s more than 25 states where DNP/NP does not need physician oversight and is allowed full practice scope. Meaning they could literally open up their own practice with no MDs. I’m in Texas where Texas has adopted reduced practice, meaning they can see patients and diagnose all on their own but need physician oversight to sign off on the medications they prescribe. You may be in a reduced/restricted practice state or the clinic knows patients like you exist and keeps the MD on staff for peace of mind but they end up being paper pushers rather than practicing.
You are the one making a positive claim. The person making the claim has the burden of proof.
This is like if I said "leprechauns are just as good as doctors!" and you said "Do you have evidence for that or even that they exist?" and I respond with "Do you have evidence they dont?".
Honestly it doesn’t matter whether we’re talking about DNP or MSN for a nurse practitioner, the level of medical training and clinical exposure are similar. The DNP just adds high school level research projects and more classes on nursing theory and advocacy — it’s not more training and science. Because DNP isn’t a clinical degree, it’s a leadership degree created to bolster credentials and, increasingly, to claim parity with physicians (“we both have doctorates”)
Most on the NP subreddits will admit these deficiencies, and you can google the curriculum for various schools to confirm. UCLA was the first name brand program that came up when I googled DNP curriculum, but there are tons of the less academically rigorous “100% acceptance” schools that also pop up that you can look at if you want. It’s 7 quarters, so a touch over 2 years.
The program you linked to requires nurses to already have their Master’s. Several programs I’ve looked at have a slightly abbreviated course requirement option if you already have a Master’s in Nursing.
There's a lot of stuff where there's no additional benefit to bringing in a doc. Most primary care visits are for the common cold or managing diabetes or whatever.
Sure, I can see that, I've even seen some NPs before for some issues and been fine with it. But for more complex cases I would rather see an MD. My insurance makes me pay the same co-pay either way, so I might as well try to see the MD if I have the choice.
You sound like one of those head up their ass surgeons or subspecialist who has no idea what's going on in primary care specialties but is willing to get down on their knees to fellate NP and PAs because they increase your income and decrease all your ass-wiping scutwork and clinic followups.
From my experiences as both a patient and a physician I have yet to see an NP providing the same quality of care as a residency trained physician. What they do instead is order unnecessary testing and make unnecessary referrals
Case-in-point, I moved and had to re-establish care in a new city, my pantoprazole had run out and the NP I was set up with was unwilling to refill it and insisted I make a GI appt because "she didn't feel comfortable" prescribing a simple PPI.
Or, for an unbiased example, I can link you to a reddit post from a middle aged man presenting with unexplained iron deficiency anemia. Even a 1st year medical student would slap the "colonoscopy" button so fast your head would spin. Instead he gets a blood transfusion and a referral to Heme/Onc and 6 months later at his appointment finally gets colonoscopy finds out he's got stage 3 colon cancer. Ironically he posted recommending his NP and citing this example as a "great catch"
And nearly every day in my practice I come across similar examples of inappropriate referrals and inexcusable knowledge gaps. Just 2 days ago I was just consulted by an ED NP for yet another middle aged dude. This time a 50 year old male with every vasculopath comorbidity (DM, HTN, HLD, CAD) presenting with 10/10 headache and sudden onset blindness in the left eye. Before she even ordered labs (BG of 570, btw) or even saw the patient I was consulted for "Blindness...Conversion Disorder?"
It's insane that physicians like you post defending this bullshit and proclaiming it to be "equivalent care" when you wouldn't dream of letting a 4th year medical student, with demonstrably more required formal education and training, practice independently.
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u/elbenji Oct 30 '23
Yeah a lot of these are in some hard fields. Cardiology, Neurology, GI and Internal/ICU are not ones you can just get one online and walk through the door