Tuesday, April 30, 2013

Nurse Practitioners are not Medical Doctors

There is a national bill in the House of Representative called "Truth in Healthcare Marketing Act of 2013," (HR 1427). This would clarify for patients’ who someone is in healthcare.

Even if they have a doctorate or PhD, a nurse practitioner, chiropractor, physician assistant or psychologists is not a medical doctor. If you are treating someone in my family I want to know your background. I am proud to be a nurse practitioner and we have a lot of power as NPs. We perform physical examinations, diagnose and treat illnesses, order and interpret tests, prescribe medications in most states, and plan and implement therapeutic interventions.

On the other hand, I am not foolish enough to put myself in a class with most medical doctors, and patients should not guess who is wearing the white coat. I have met only one NP who was narcissistic and insisted she be called doctor by staff. Beside setting herself up for a lawsuit, I won’t tell you what the staff called her behind her back.  

This is a relevant topic because to be blunt, many patients are not educated enough, and have no clue to know the difference between the people in white coats. I wear a white coat now, but even in my nursing scrubs with my RN badge on, patients regularly call me doctor, and probably only because I am a male. Talk about confused.

Truthfully, anyone with a PhD or doctorate can call themselves a doctor, but that does not make them a medical doctor. In fact there are a lot of people out there in the world with PhDs and doctorates who like to be called doctor, and that is fine. However, I would never have them touch or get close to a real human being.  Thousands of people have Honorary Doctorate degrees like Stephen Colbert or Bill Cosby and can call themselves doctors. Do you really want them, a psychologist like Dr. Phil or the guy at the gas station with a PhD diagnosing your intracranial bleeding or cardiovascular disease?  

Thank God I know some doctors well enough to ask them medical questions, and I do so often. I am not a fool and will not pretend that I have the same education as a medical doctor.
MD's learn the medical model and as medical students they spend 10-15 years in higher education, medical schools and residency, and if they specialize add more years to that.
A nurse practitioner learns the nursing model and may spend 6-8 years in school.

 However, nurse practitioners are better and more equipped to deal with patients in several ways. We were trained to treat people more holistically and not just in a narrow allopathic or western form of medicine. We communicate better with patients and their families. We see the big picture more often. In most hospitals I have worked and research papers I have read, nurse practitioners consistently have a higher overall patient satisfaction score.  

Most docs love us and as NPs and PAs we are part of the solution to the primary care shortage. But a few bad apples can ruin it for a lot of people when it comes to trust and working together.  


PediNP said...

Well said! I need my physician partners...our patients can be so complex, I am always happy to take advantage of their expertise. And they recognize my strengths with some of the more complicated psychosocial issues. It is a win-win situation.

NP Odyssey said...

PediNP, exactly can't beat their experience. I am lucky and love the docs I work with now. Good relationships go far in the clinic.

Anonymous said...

Point of parliamentary procedure, your honor!

Bill Cosby earned his doctorate (education) at UMASS Amherst in 1976. He does have like 25 honorary degrees but also the regular Ed.D.

NP Odyssey said...

Anonymous, true he has an Ed D. Would not trust him to touch a sick patient though.

MD ConferenceFinder said...

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Commented by:
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Anonymous said...

Interesting piece though I disagree with a couple points. First and foremost, the term Doctor is an academic title, not an indication of one's profession; in contrast the term physician (or nurse practitioner, or audiologist, or physical therapist) is applicable to a profession. Second, it is not ego or arrogance that leads to proper titling, it is the ongoing effort to stop discounting care provided by nurse practitioners (for example, I expect nurse practioners to be addressed as Mr./Ms. xxxx in any environment that their colleagues are addressed as Dr. yyyy, and upon earning a doctorate I will expect they should be addressed as Dr. xxxx; in contrast where everyone goes by first name, I have no issue with being addressed in that informal way); it is an issue of collegiality. Finally, the issue of using the term doctor by a nurse is problematic for physicians in a way that is not seen with chiropractors, psychologists, or optometrists - why? I submit that it is because physician ego is such that they believe nurses are, or should be, submissive to the whim of the physician in a way that other professionals are not. The issue is not patient confusion, it is an issue of physician ego and 'turf'. Nobody is claiming that a DNP is the same as an MD but then neither is a PsyD, EdD, PhD, DPT, or PharmD. There are differences in training, philosophy, expertise in each of these areas but that does not make one 'less than' another.

NP Odyssey said...

Anonymous, you can tell people to call you whatever you want.
However, do not fool patients and others into them thinking you are a medical doctor, if you are an NP. I have met different healthcare professionals who tell people they are a doctor and do not clarify. One NP was so arrogant she had the staff call her doctor, her terrible attitude had the opposite effect on her co-workers and they lost respect for her.

Anonymous said...

In my PCPs office there are several NPs, one calls herself a Dr. She actually wrote me an RX for something I am highly allergic to, I'm talking go to ER and be intubated for! What is it?...most RN,NPs I've seen have enough sense to read a chart. I'm retired from ICU and can't get thru to this woman...I think narcissistic is way beyond what I'd call her.She doesn't listen to the patient and she talks down to us, even those of us that are retired with the same RN background.
Dazed and confused to Dr A. S. FNP-C...

Anonymous said...

I am an NP and my PHd took almost 4 years. There is ultrasound tech with a PHd that everyone addresses as Dr. __ and of course is a male. I am female, and I am Mrs.

Anonymous said...

I can say many horror stories about physicians and surgeons but I am not going there. A doctor title given by any university is to be respected and used by the person who earned it.So a DNP should introduce herself and insist others to call her a doctor rightfully. I can tell you why nurse practitioners are equal or better providers:

1. Medical model has made this country to have most expensive and least effective healthcare system contributed by physician greed.

2. NPs do not prescribe controlled substances to increase revenue and patients

3. Take time to listen and provide optimal care with more health education and less prescriptions.

4. A nurse practitioner will take due care of you if you have insurance or not because of the nursing philosophy of caring for everyone.

So it is time to wake up to the reality and go to a nurse practitioner if you want to live a healthy long life.