I was reading a Facebook post the other day discussing a program for M.D.s to become nurse practitioners and I was like, “What the heck” is this? My immediate guttural reaction was this is crazy, this is ridiculous, this is insane. Why would someone who has dedicated now 8 years of undergraduate education and medical school, who holds an M.D. medical degree, spend more time and money to become a nurse practitioner. It actually boggled my mind since I had done the exact opposite and transitioned from an NP to an M.D in the early 2000’s. For those who can’t believe this, it is actually happening with several programs including http://www.clinicalclerkship.org/md-to-np-program/.
As I read the reactions it became clear. Just as our healthcare system is broken, so it our medical education system. Medical students accrue more debt that any other profession, upwards of 200K-300K. Then when they graduate from medical school there is no guarantee they will secure a residency program that is required for a physician to obtain licensure.
Congress determines the funding for the available residency slots, and I recall hearing something about physician organizations encouraging restrictions many years ago to keep demand high, but I was not around at that time and will not accept responsibility for the shortage of residency slots being shouldered on today’s physicians. With the recent Hahnemann Hospital fiasco and hundreds of residents and fellow physicians futures put in limbo it further shows how screwed up our medical education training system is in the United States. International medical graduates and from what I understand our own US trained medical graduates are unable to secure residency spots to complete their required training. With a public outcry about the impending physician shortage and the need to place less qualified PAs and NPs to filled these spots and government money encouraging this nonsense the problem gets worse and worse. I hear stories of medical school graduates working as waiters/waitresses and Uber drivers and it breaks my heart. The talent that is being wasted is sickening.
Then comes a possible solution. An M.D. to NP program to help these unfortunate folks to be able to bridge to become an NP and provide clinical services. Another quick fix which is what our country is all about. Instead of fixing this perversely incentivized culture, we put a bandage on the problem and make these new, but unemployable M.D.s jump through more hoops, acquire more debt just so they can make a living to pay off an immeasurable amount of medical school debt.
At first glance, I was abhorred to see this happening, but upon further thought I realize this at least lets them utilized their knowledge and practice is some field where they can do good and help people. I wonder how they will be addressed, they do have an M.D. degree and deserve the title of “Doctor”, but will they need to provide a disclaimer that they are actually licensed as an NP. The public is already confused the multitude of medical providers and the purposeful deception set by corporate entities to educate DNP and push them the use the “Doctor” title to further confuse the unsuspecting public. But these M.D’s in limbo deserve a chance to earn a livelihood, and I have mixed feelings about these M.D. to NP programs. If this is the only way for them to be able to secure employment and provide services to the public, I will support; but I implore anyone who will listen or who is in a position to make a change, to fix the problem and open up the number of residency slots to get more fully trained physicians in the workforce to prevent the impending crisis. The push for unsupervised midlevel providers is not the answer to the impending physician shortage. Legislative changes and incentives to encourage more students to go into primary care medicine is.