Let’s get Ready to Rumble………… Main Event: AMA, AAEM and AAEM/RSA vs AANP

On July 8th, 2019, the American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA), along with the the American Academy of Emergency Medicine (AAEM), sent an open letter (1) to the AMA: “Where is the Public Campaign Advocating for Physicians?”  The overarching concerns were:

  • (a) the recent advertising by nurse practitioners advocating for their independent practice
  • (b) public campaign challenging physician education and compassion
  • (c) that the American academy of Nurse Practitioners (AANP) is suggesting that nurse practitioner (NP) care is equivalent or better than that of a physician.

The notion put forth is “NPs and other midlevel providers do not have the training required to sufficiently care for patients independently, only trained and board certified physicians do.” The AAEM position statement (2) states“the role of nurse practitioners and other midlevel providers is one that should be supervised as members of the patient care team.” This open letter was requesting the American Medical Association (AMA) take up the cause and advocate for all physicians as the unified physician voice. They urge the AMA to lead a sizable public endeavor, including:

On July 10th 2019, the AANP wrote an “Open Letter to the AMA, AAEM and AAEM/RSA(3)” to retract the above mentioned open letter (1). The rational for the retraction request was listed as “riddled with blatant inaccuracies and self-serving statements that seek to undermine the NP profession and devalue the health care needs of patients nationwide.” It then goes on to describe these inaccuracies as

  • (a)their campaign did not challenge physician education
  • (b) they did not sponsor the slogan “brain of a doctor, heart of a nurse
  • (c) 50 years of research clearly demonstrate, the “brains” of NPs drive health care outcomes equivalent to physicians, year in and year out,
  • (d) collaboration with physician is an unnecessary bureaucratic burden on physicians, NPs and their patients, and barriers, needlessly driving up health care costs and inefficiencies.

It then goes on to describe:

A vast majority of health consumers — two out of three patients — support policies and legislation that remove barriers to NP practice.

I’m not going to argue a position here, but instead will ask readers to decide their opinion. Who is adversarial here? Who is being combative here? Who is attacking who? Who is factually dishonest here? The two exceptions I take to these open letters is I would like to ask the AANP to cite and show the “50 years of research,” and the data showing “the vast majority of health consumers…..”

I’ve seen too many times these words thrown around with little backing, or when the research is reviewed it is lacking, biased, or methodologically flawed. I’ve written about this research a number of times and it’s almost perfunctory to use these words with little backing. As a former NP, I really wish the AANP wouldn’t take such an adversarial position. As an MD, I wish the AMA would take up the issue and push back against what amounts a hijacking of roles and of a profession/discipline from another discipline. Have a great day.