Nurse Practitioners Practice “More Than Medicine”?

This article reports on a book written by Latonya Trotter, assistant professor of sociology Vanderbilt University. This blog is not about bashing or disparaging NPs. Nor is it about NPs practicing medicine. Although the title is misleading. It misleads to the notion that NPs practice medicine versus advance practice nursing. The first sentence of the article bothers me: “Nurse practitioners (NPs) are often thought of as stopgaps to mitigate the shortage of primary care physicians.”Unfortunately, the sentiment has a bit of truth in it, as NPs are often touted and promoted as means to fill the primary care physician shortage. Never mind that this is a physician problem to solve, now we have to compete with NPs for both our jobs, and the false notion of equality. In her book

What she realized was that NPs were not simply healthcare professionals capable of performing virtually all the same tasks as physicians, but they also worked to solve many other non-medical challenges their patients faced related to poverty

            Here this statement rationalizes that because NPs can do tasks, they must be equal. Never mind the extreme differences in depth and breadth of education. I can drive a car, but because I can, does that qualify to be equal to a race car driver? No, but how does this rhetoric become such commonplace? It disturbs me. It’s an agenda that seems to be taking hold pervading the health care world. But the article about the book is not about NPs practicing medicine, it’s about:

“Many of the problems health care organizations—and nurse practitioners especially—are tasked with solving aren’t just medical problems, but social ones,”

The article reports that much of the work NPs do, was once performed by social workers and many of the problems patients faced: transportation problems, affordable medication, good nutrition, safe living environments.

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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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6 Responses

  1. Bruce Bonanno says:

    I like your analogy of being able to drive a car but not being able to be a racecar driver. I have often used the one of having a small airplane pilot taking the controls of the 747 with people on it, or when I get really pissed compare it to the flight attendant taking over the controls since she has as many hours on the plane as the pilot!

  2. Jennifer Hollywood says:

    I now see articles on addressing the “social determinants” of health care put out by the AAFP and others. I agree that those are social worker’s responsibilities. When were these additional responsibilities foisted on us? And what are social workers doing?

    • Stewart says:

      “And what are social workers doing?”

      Is their professional society telling them they need to deliver babies and manage diabetics?

      Or do they, unlike the AAFP, have some sense of pride in their training and their profession, and not act out of a pathologic self-hating need to take on blame for all of society’s ills?

  3. Stewart says:

    “much of the work NPs do, was once performed by social workers and many of the problems patients faced: transportation problems, affordable medication, good nutrition, safe living environments”

    Interestingly the AAFP, in their on-going campaign to devalue and degrade those that they claim to represent, is now telling under-worked and over-paid family physicians that they are responsible for surveying and correcting all of their patients’ social needs:

    • Kurt says:

      Yeah right! Like we have the time, money and resources to do that! Just like they say “prejudice” is a public health problem, NOT! Prejudice is a social ill that is going to take education to correct and bottom line is people just have to be nicer to each other. I’m glad I retired July 1st.

    • Jeff Frederich says:

      In paragraph 2, line 2, did you mean ‘over-worked and under-paid’?

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