“Egotistical”. The most overused trope over the last year by non-physician practitioners(NPPs) towards physicians. The implication seems to be that having an ego is a bad thing. There is nothing wrong with possessing a sense of self-worth and self-esteem. It’s healthy. But NPPs, administrators, and the C-suite won’t be happy unless they crush ours. Everything that I have accomplished is a testament to my parents and ancestors who did not have the opportunities I did; they created a stepping stone so that I might achieve what they could not. I will not forget on whose shoulders I stand. I uphold the title “Dr.” in their honor. I’m not apologizing for a f***ing thing. Privileged my a**. There are plenty of physicians from backgrounds that did not entitle them to become physicians–they were prevented based on race, gender, sex, religion, and whatever bias was popular at the moment. Many sacrificed so that others like myself could pursue an education, unencumbered by discrimination. How quickly we forget. I maintain that those who insist on criticizing physicians for asking to be referred by their correct title are individuals who are resentful of our accomplishments. I have no intention of prostrating myself, FOR ANYONE, so that they feel better about their lot in life. F**k that noise. I’m supposed to be empathetic to individuals who expect me to deny my professional title because they feel less than–through no fault of mine? Not a damn thing holding them back from accomplishing whatever goals they set for themselves. Get some self-confidence. Don’t ask me to lower mine to accommodate you or to prove a point. There is something to be said about those who will perform extreme contortions, simply to avoid respecting a professional’s title (https://www.charlotteobserver.com/news/state/north-carolina/article250836964.html). Yet, there are NPs who haughtily demand to be called “Dr.” in a clinical setting, because they possess a sham s**t, NON-MEDICAL, online, DNP degree. Is that not pompous? Is that not egotistical? Is that not fraudulent? Their desire to practice medicine without a medical license is achieved through legislation–not education. Is that not the height of pretentious arrogance? And when physicians refuse to participate in their prevarication, we are deemed to be egotistical? GTFO with that mess.
The nurse practitioner(NP) scope creep issue began with the Institute of Medicine’s White Paper on the “Future of Nursing”, in 2010. That campaign initiated the transformation of physician-led medicine to nursing-led. The American Association of Nurse Practitioners(AANP) and other nursing organizations then DECLARED, audaciously I might add, that they could practice as well as physicians, despite having zero formal medical education or training. THIS IS WHERE THE S**T BEGAN. The fact that nursing and medicine are distinctly separate disciplines with separate duties, roles, schools, degrees and licensing boards didn’t matter one whit–a minor infraction as far as they were concerned. Who cares about details? Despite the absurdity of the entire matter, they nevertheless managed to convince highly educated nimrods in legislation, medicine and nursing that it all somehow made sense, even though it didn’t. And if it didn’t make sense, it should not have happened. But it did. So in 23-plus states, NPs can now practice medicine without a medical license.
No one asked what was going to happen to nursing as a profession–they didn’t give a s**t about that either. Wasn’t even on the radar. The RN shortage is worse than ever. NPs, in their eagerness to perpetrate doctors, proceeded without a clear, organized plan down the road to deception. First, for them to be respected as “doctors” they had to have a doctorate. With that, the abbreviated sham s**t Doctor of Nursing Practice(DNP) degree was born. No one cares that this doctorate is not remotely equivalent to any other doctorate in the universe(ie: MD/DO, PhD, DVM, DDS, OD, etc.). NPs simply SAID it was equivalent and voíla, equivalence by proclamation. During this journey, the Affordable Care Act(ACA) entered the picture and enabled nurse practitioners to continue their skulduggery by committing millions of dollars to their “education”. Predatory degree mills, anticipating a financial boon, multiplied like rabbits. Accreditations were granted like Jesus’ blessing of the loaves and fishes. Accreditations for everyone, who cares about quality? It wasn’t germane to the business and by golly, this was business. There was revenue to be made by these carnivorous cash-guzzlers who set about collecting tuition from naive NPs seeking a short-cut to prestige and financial fortune.
Speaking of financial fortune, enter the universally-hated corporate medicine folks. Private equity-backed contract medical groups(CMGs), for-profit hospitals and non-profit medical institutions seeking financial gain, slithered their way into the storyline. Scope creep was right up their slimy alley; they slobbered like Pavlov’s Dog at the potential riches awaiting them. These pimps could pay less with no physicians and make more off the backs of NPPs–it was almost too good to be true. However, success could only be attained as long as the public believed that NPPs and physicians were, well…”basically” the same. De-identifying members on the team became imperative, the lines had to be blurred. So everyone became “providers(prostitutes)”. NPPs, who benefited from this misrepresentation, became opportunists in this abominable game. In doing so, they also became unwitting allies of corporate medicine. By accepting the de-identification and dehumanization of their roles, they voluntarily degraded themselves in this travesty. The patients? Welp, they were screwed by the pimps and the prostitutes in this godforsaken system, without the benefit of enjoyment. And paid for the privilege.
The next step in the stratagem was to have pesky state laws, designed to protect the public against people practicing medicine without a medical license, removed. The exceptional nurse practitioner lobby cozied up to legislators who, flush and rosy with newly donated campaign funds, were ready, willing and receptive to manipulation. They subsequently passed the laws that permitted NPs to practice medicine without a medical license.
Unfortunately, Physician Assistants(PAs) are now taking their cues from the NPs, following the same reprehensible course as FPA with their own version, called Optimal Team Practice(OTP). PAs, who for years have worked well with physicians and were actually trained in the medical model, were pushed out of the medical landscape by NPs for one reason only–they required supervision. To save their profession and their jobs, the American Academy of Physician Assistants(AAPA)began to promote OTP which gifted PAs with more autonomy. The protective state regulations presented an impediment to them also. OTP conveniently removes those safety measures that were put in place for the public’s benefit. Great for PAs but unfortunate for patients as well as physicians, who are expected to sit in the background, ready to be used as a liability safety net when necessary. PAs no longer want to be referred to as Physician Assistants. Instead, they prefer “PAs” or “Physician Associates”. Some PAs also claim to practice medicine and therefore consider themselves equivalent to physicians. They created their own sham s**t doctorate, the Doctor of Medical Science(DMSc) degree. Eerily similar to Doctor of Medicine(MD)….Is this not also egotistical? And deceitful? Then they have the unmitigated gall to expect physicians to support them in this duping of the public while they throw us under the bus. I do not believe the majority of PAs support this nonsense, but the majority remain silent. And in their silence, they are duplicitous.
Where were the physicians while all this subterfuge was occurring? Working. Oblivious. Blind as bats and deaf as doorknobs. As usual. Laser-focused on patients, completely unaware of how the medical landscape was changing around them. A few were “woke”–the sycophantic, traitorous, whoremonger doctors who support corporate medicine. They knew of this devious transformation and didn’t give a s**t since they were making big bucks. Their oath was flushed into the sewer, along with their ethics. Then something no one expected occurred. Physicians awakened from their deep, duty-induced, patient-focused slumber. Their groggy, brooding eyes became witness to unethical s**t on a grand scale. Docs always knew the corporate practice of medicine was illegal; however, they were getting pushed more and more to engage in immoral practices, pressured from above. One pet peeve of docs is that we really dislike anyone telling us how to practice medicine, particularly non-medical people. We also don’t like patients being harmed, especially when it is avoidable. We began to stand up…and speak up. And were promptly fired. The COVID pandemic exposed these tremendous failings in medicine, which preceded the pandemic. It also exposed something else. It revealed that not only were physicians NOT interchangeable with NPPs, they were irreplaceable. The powers that be didn’t care–they have made a financial killing(pun intended) during this national disaster. Now these vultures with unseemly agendas are doubling down on the misrepresentation of NPPs being equivalent to physicians because the enormous financial rewards gained as a result of COVID must be maintained…at all costs. I’ve stated this before…When repeated enough, fiction often becomes fact. Keep reiterating that NPPs and physicians are “basically the same”, then reinforce that bald-faced lie by refusing to address physicians by their professional title; using instead that abhorrent term, “provider”.
Bottom line: Because we are impeding their treacherous progress towards immense prosperity, these gluttons want physicians to STFU so everyone else can make a buck by misappropriating our titles and usurping our positions. They want us to become unidentifiable. Invisible. Preferably obsolete. De-identification–the ultimate objective for the metamorphosis of physician-led to nursing-led medicine to be complete.
I for one refuse to feed into the gaslighting bulls**t from the peanut gallery that is simultaneously intended to disrespect physicians, diminish our roles, demean our profession and disenfranchise our person(all the while deceiving the public). Invisibility is not an option. I decide how I wish to be addressed–no one else. Their only job is to respect my wishes.
“I should not have to remain invisible so you can be comfortable.”–Dr. Yv Newman