Delusion Commentary: Op-Ed: Practicing Medicine vs Practicing Advanced Nursing
A delusion is defined as “characterized by or holding idiosyncratic beliefs or impressions that are contradicted by reality or rational argument, typically as a symptom of mental disorder.” So, we’ve all seen the book Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, by Rebekah Bernard, MD, and Niran Al-Agba, MD. Lots of commentary going on about this book. On the Medpage Today online publication, a recent Op-Ed titled Practicing Medicine vs Practicing Advanced Nursing was written by the book author. However, I draw attention to the comments. Boy oh boy, there is a range interesting commentary ranging from support to downright denial and rottenness. See the link above and go see for yourself. Some really interesting comments, for example:
“I have attained clinical expertise equivalent to the level of my collaborative physicians.
Studies have found that after a 5 year period, MDs and NPs working alongside each other attain clinical equivalency. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367893/”
Ok, this is delusional! And this research presented as evidence for the delusional statement has been reviewed and reviewed and debunked as poor methodology with low level evidence and certainty. However, it keeps getting touted as ‘evidence’ supporting the delusion of equivalence and superiority of nurse practitioners over physicians. This is evident in the above statement in the comments, and this isn’t the only one:
Get over yourselves! Nurse practitioners have equal or better outcomes in primary care than physicians.
This mantra is being repeated over and over again and is quite simply not true. It’s the talking point rhetoric being promoted in the profession as a whole. Look at the certainty rating for outcomes in this so called ‘evidence’ research and judge for yourself:
No they don’t. I worked for years with some excellent NPs and some not so excellent. While a good NP can bring much benefit to the clinical team they are not and were never intended to replace physicians. “One of these things is not like the other, one of these things just isn’t the same”
While I agree with you, (and use every opportunity to try to educate patients on the issue), we are fighting a losing battle. The common patient doesn’t want to hear the difference, you can’t fight economics, and like it or not, too many physicians are complete asshats and arrogant to their patients. I practice DPC so I have time to relate to patients. Most physicians don’t. Proving ourselves to be better practitioners will be a long road but it will start by not only being competent, but relatable as well.
Doesn’t matter though. Health care institutions and insurance plans will use this and studies like it to prove “evidence” of NP equivalency and will continue to systematically replace physicians with NPs to pad their bottom line.