Answer This Simple Question by Pat Conrad MD

Before we move on…We all had an interesting exchange last week about the curious rise of “nurse doctors”, wherein one respondent referred to them as part of “your supporting and collaborative team.”  That rhetoric is in line with this “5 Reasons to Get a Doctorate Degree in Nursing,” which apparently include research, access to better faculty posts, leadership blah-blah, and improving “the reputation and image of nurses in every area of practice.”  That sounds to me like nurse-doctors proving their indispensability by implementing more quality measuring programs to further eradicate any free time for in-the-trenches nurses, but then again I don’t buy a lot of infomercial claims.

A really interesting reason given to become a nurse-doctor is – deeeep breath – this:

The nursing view is unique. People who enter the nursing field do so to practice nursing, not because the schooling is easier than being a medical doctor. However, a nurse holding a doctorate degree can help level the playing field among medical doctors, psychiatrists, and nurses involved in a team. That is, if you were part of a project team that consisted of a medical doctor, a psychiatrist and a nurse all aimed to improve the care of patients entrusted to them, having a doctorate would “elevate” the nursing perspective to that of the other team members.”  And there you have it.

We have sprayed a lot of electronic ink back and forth here over several years about the degradation, dilution, and diminution of the role and worth of the physician relative to all the other “team members.”  The government, the screwed up insurance “market”, popular media, gender politics, and an unrelenting sense of egalitarian entitlement have all contributed to this.  It is exhausting, depressing, and it will not stop.

So I have a simple question, one that I really hope the non-physician “team members” who follow this site will be forthright enough to answer:

Are there any roles, responsibilities, or activities that should only reside with, be reserved to, or be performed solely by actual physicians?

I await your answer.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  7 comments for “Answer This Simple Question by Pat Conrad MD

  1. Ricky D
    April 19, 2017 at 10:24 am

    i say there are things that should be done by physicians only. But it is different for every LELT out there. I am a PA and I know what I can do and what I can not. I know there are those LELTs out there that think they know more than the physicians, and I have seen that these are the ones who don’t last too long and are quickly asked to move on. So I think that any “DESCENT” LELT knows their limit and does not push it. I have worked with some very good LELTs that do a great job. I have also worked with several that don’t. I have seen physicians that are great and many that are not. So just because people call themselves “doctor” doesn’t guarantee anything anymore.

  2. Pat
    April 17, 2017 at 10:46 am

    All weekend, and still no responses from the nurse-doctors and other militant midlevels. I’m asking you one simple question and you answer … crickets.

    Why the reluctance?

  3. Steve O'
    April 14, 2017 at 9:26 pm

    And once nurse-doctors get all high and mighty, wait for Emergency Medical Technician-Doctors, who are trained to save lives left and right, yeah? Another six months of school, and they can park in the Doctor’s parking space.
    [Wait until they find out that Doctor’s Parking is gone with Wednesday afternoon golf and Dr. Kildare]

  4. April 14, 2017 at 12:01 pm

    I spoke to a new director of nursing once when I was employed as a clinical faculty family doc. This was about 5 years ago. I asked her, ‘So what is the new DNP about’ and after a few minutes of talking about quality and teams and improvement and so forth she said, “We are trying to get on board with the same terminology that chiropractors and physical therapist use, ‘Doctor.” I can’t find that anywhere in the nursing professional associations mission though.

  5. Hawgguy
    April 14, 2017 at 11:55 am

    Answer the phone at 2am & get out of bed.

    Save a life.

    Take the ultimate responsibility.

  6. RSW
    April 14, 2017 at 10:31 am

    “Are there any roles, responsibilities, or activities that should only reside with, be reserved to, or be performed solely by actual physicians?”

    Defendant in law suit.

  7. April 14, 2017 at 9:07 am

    From one patient’s point of view: Twice now I have been shunted to a nurse practitioner when I had an immediate need and my doctor was not available. Both times the NP was clearly following a script, ordered labs, and told me to follow up with my PCP. My problems were not treated in any way at those visits. The decisions were left to the PCP. One test had to be redone correctly. It was a complete waste of time and my copays. If I am bleeding or having a heart attack I’ll call 911. Otherwise I will wait to see a real doctor.

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