How Low Can You Go? NURSE PRACTITIONERS VS. PHYSICIANS: THE STUDIES AND THEIR CONCLUSIONS

I don’t like lying about, misrepresenting, nor misinterpreting data. The referenced article reports: 

“A review of comparative research reveals that NPs provide exceptional quality of care that is equal to or better than that of physicians.” 

However what it doesn’t say is that when you look at the study, two parameters cite very low level of evidence, another two are low level, and three are listed as moderate. Thus conclusions based on very low, low, and moderate evidence cannot be credible. This is the 2nd blog on an article that references this study (2). The below image from the study is a bit blurry, but you get the point. This data is touted as ‘evidence’ in the article and justification for increased scope of practice. 

Another study touted as evidence (3) reports “in ambulatory care situations where patients were randomly assigned to physicians and NPs with the same authority, the patient outcomes were comparable.” First of all, this study is 20 years old! Then, the hypothesis of this article is not clear. And, holy null hypothesis, look at those ‘p’ values. Again, low-quality evidence for which is being used to justify the increased scope of practice. 

            This data misrepresentation needs to stop!!

References:

  1. https://onlinenursing.baylor.edu/news/nurse-practitioners-vs-physicians-studies-and-their-conclusions
  2. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001271.pub3/pdf/full
  3. https://www.ncbi.nlm.nih.gov/pubmed/10632281

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Robert Duprey MD

Robert P. Duprey Jr studied medicine as a 2nd career medical student who went to medical school in his 40’s after honorable discharge and ‘retirement’ from 25 years in the US Military (USCG & US Army). He was a registered nurse (RN) with specialty training as a psychiatric RN in the US Army for 15 years. During this time he also became a Master’s level psychotherapist in 2002. While on US Army active duty he also became a Psychiatric Nurse Practitioner while working full time in 2011. He served as a Psych NP on active duty, to include a combat tour in Iraq, until his ‘retirement’ in 2014 and moved to Philippines with his 3 children. At this time he started medical school overseas at Oceania University of Medicine based out of Samoa accredited by Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU). He continued to work as a Psych NP throughout medical school to support his children and to not have to take out loans for medical school tuition. Originally from Rhode Island, he completed medical school clerkship rotations throughout the USA with a graduation in May 2019 earning the esteemed credential of MD. He has successfully completed USMLE Steps 1, 2CS, and 2CK. He will take Step 3 this September as he applies for Psychiatry Residency. Having been and RN, NP and now MD, he is a believer of Physician led multidisciplinary healthcare teams 

  2 comments for “How Low Can You Go? NURSE PRACTITIONERS VS. PHYSICIANS: THE STUDIES AND THEIR CONCLUSIONS

  1. Aaron M. Levine
    March 4, 2020 at 3:26 pm

    I just commented upon what the neighborhood web site, Next Door said about the Walgreens and CVS PA and NPs. They were cheap and fast. And the perception of these engineers, Master and PhDs was that they were as good as MDs. Andthey were in network.

  2. D. Mittman
    March 4, 2020 at 9:51 am

    Funny, the Annals wrote the same conclusion in an article about the treatment of diabetes by NPs and PAs at the VA.
    Just want to know if Dr. Dupree wrote them and was the letter published? If so what was the editors reply?
    Understand you can think there is bias, but what do the people publishing say?

Comments are closed.