Doctors Don’t Agree on the Role of NPs


I turns out that I am NOT the only one complaining about the role of NPs.  Just to reiterate, I do believe there is a collaborative role for them just NOT a competitive one.  They are less educated and less trained (LELT) and they cannot replace doctors.  In the May 16 issue of the New England Journal of Medicine, the authors of a study were surprised at how far apart doctors and nurse practitioners were in their opinions.  Nearly 1,000 doctors and nurse practitioners surveyed were most divided on the question of who gives the higher quality of care: Two-thirds of physicians said if a doctor and nurse practitioner provided the same service, the doctor would do it better. Only a few nurse practitioners agreed with that.   A few!   Also 82 percent of NPs felt nurse practitioners should lead their own practices but only 17 percent of doctors did.  This magnitude of difference is massive.  Here is the best one.  Sixty-four percent of NPs said they should receive the same pay as physician for the same care while only 4% of physicians agreed.  Same pay!  I thought NPs were the cheaper option?

Here are some other tidbits of crap from this Health Day article with my thoughts in parenthesis:

  • On paper, it makes sense to expand the role of nurse practitioners in primary care because their education and training is shorter — an average of six years versus 11 or 12 years for doctors, including residency training. By some estimates, anywhere from three to 12 nurse practitioners can be educated for the price of producing one doctor.  (Our 11 or 12 years is like 25 of theirs.  They don’t do the hours we do in training.   And because they are cheaper to educate means nothing).
  • Donelan said there also is evidence that nurse practitioners do just as well as doctors when it comes to primary care — and that patients needing urgent care actually give nurse practitioners better marks on communication. (The evidence is with simple things like sore throats.  A monkey can score high on some of those things.)
  • But what is not known, she said, is how well nurse practitioners measure up against doctors when things get more complicated, such as in cases in which a patient’s diagnosis is unclear or a patient has multiple chronic health conditions. In those cases, Blumenthal said, “there’s no literature as to the superiority of one profession over the other.” (Once again, I told you that evidence that docs do things better than NPs will be hidden.  Read this post here where family docs do better in diabetes care than NPs)

Doctors need to protect their turf and their role.  Doctors need to protect patients.  The training and experience is not the same.   It is not politically incorrect to fight back.  It is the right thing to do.   Remember, the NPs started as a way to be collaborative.  Now they want to be competitive.  Game on.

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