Ass Umptions: Nurse practitioners – A solution to America’s primary care crisis

            What is an “Ass Umption?” A neologism inferring a ridiculous notion. But as the old saying goes “making assumptions makes an ass out of you and me.” This is a follow up to a prior recent blog: https://authenticmedicine.com/2020/06/point-counterpoint-nurse-practitioners-a-solution-to-americas-primary-care-crisis/. This article is tedious to review, so I will review in small sections at a time. It seems fitting, as each sentence is filled with Ass Umptions. The article reports:

“it is unrealistic to rely on the physician workforce alone to provide the primary care Americans need,”

            Talking point with the Ass Umption that another discipline can solve this problem setting up the argument as to why they should. Nurse practitioners (NPs) have a valuable role on physician led health care teams in my opinion, however, are not a replacement for physicians. It is unrealistic to think another discipline educated in the field of nursing can fill the physician shortage. Physicians are educated in the field of medicine. Thus, the physician shortage is not a nursing problem. It is a physician problem. Every year thousands of MD’s qualified to license aren’t matched into residencies. This is the problem. The bottleneck that occurs after medical school. The solution is not more nurses, but more physicians. 

“even fewer physicians practicing in rural areas”

            Another Ass Umption that assumes that NPs only go to rural areas to fill the physician shortage. This has been proven to be false. I’ve written about this before. Truth be told, the talking point that NPs go to rural areas and physician don’t is just false. Believe me, I am not anti-NP, I’m just pro-truth. 

            Last Ass Umption for this blog is based off of the following from the article:

“the NP workforce has increased dramatically and is projected to continue growing while the physician workforce will grow minimally”

            Why is this an Ass Umption? Well, it assumes that since there are more NPs being trained than physicians that this justifies replacing physicians with NPs. Well if this is the argument, then there are more RNs than NPs, so maybe RN’s should replace NPs. Or since there are more CNAs, maybe they should replace RNs. Or since there are more administrators being trained than physicians, why don’t we replace physicians with administrators. You can’t! Physicians are the only ones trained in the discipline of medicine and no other discipline can replace that.

Ass Umptions!!

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Robert Duprey MD

Robert is a 2nd career physician (MD); a combat Veteran with the US Army; a former psychiatric nurse practitioner; an independent researcher; a medical writer; and now having passed USMLE Steps 1, 2CK, 2CS, and 3, is a residency applicant.

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2 Responses

  1. Kurt says:

    Primary care sucks. Didn’t in the past. Spent 32.5 years in a rural practice, did office, hospital and call. Was doable until Obama forced the EHR thing upon us around 2007. I could do the above tasks, see enough patients to make ends meet and have time to myself. Now with EHR a doc has to pi$$ on everything whereas qualified staff could deal with routine stuff transparent to the doctor in the past. Oh, when I was on call, I only got paid for the admissions I actually went into the hospital and dictated. If nursing homes kept me up all night long on the phone, I didn’t get an effffing penny. It was just considered “part of the job”.
    Those days are over and I strongly suggest that a med student stay the he!! away from primary care. Yeah do nothing but office work, DPC and one still has too many hassles to deal with. Specialize and you too can say, “Bring that up with your primary care provider/Doctor!”. I’m so glad I’m done with this BS.

  2. Jesse L.Belville,PA-C says:

    Very True.
    But RN’s /NP’s have politics,strong lobbies in Every State. Every university,The VA system..
    Physicians are too busy building their own Kingdoms,fighting Hospital Admins and trying to make a living.Getting thru the BS for residencies, establish a practice or join a practice. Where are the Physician Leaders? Will primary care become NP care.?
    Good luck in this battle,cause I do not see a lot of leaders on this among Physicians..
    Before long MD’s/DO’s will be hired and fired by RN’sNP’s. That is their plan/goal..

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