Race Car Model: Nurse Practitioners Fight for More Freedom

“It’s like having a driver’s license but then making it illegal for you to drive unless you have a permission slip from someone in your neighborhood,” she said. (1)”

            But drawing reference to this driver’s license comparison, we could say also that having a license doesn’t automatically mean you’re qualified to operate a race car. I.e., the Race-Car-Model I will call it. There are drivers, there are professional drivers, and there are racecar drivers. Let’s face it, it’s a fact that no one needs feel scorn over that physician’s have the most education and training and are the only one’s licensed to practice medicine. Physicians are the racecar drivers in the race-car-model, and the act of driving a racecar is analogous to practicing medicine. As a former RN, a former NP, and now MD, I think I can speak to this with credibility. My former profession will undoubtedly scorn me for saying as much. But this is in reference to the dishonesty and propaganda being put forth by my former profession. As evidenced in the referenced article here:

“It is true physicians go to more school, have more training, and bring a different perspective, but the evidence suggests nurse practitioners are able to provide care that is the same, if not better, quality,(1)”

            This statement keeps repeating itself in many sources, and it is simply not true and it motivates me to speak up. Stop the lie!! This statement isn’t cited here and is not cited often in articles that quote it.  This statement is not in fact supported in evidence, and has been disputed with both critical reads of this so called evidence (2) and evidence to the contrary (3). 

            Another item of propaganda is being put forth for full practice authority is also a farce and strawman argument (4):

“If they are allowed to operate on their own, they say, they can help reduce healthcare spending, improve access to medical care, and address the doctor shortage at a time when the U.S. population is aging and demand for healthcare is growing (1).”

This is simply not true and this lie has been refuted (4). I’m proud of my days as an NP, and I believe there is value on physician led multi-disciplinary healthcare teams. I’ll likely be attacked and scorned by the militant members of my former profession, but we need to be honest: Under the race-car-model, physicians are the racecar drivers, and having a license doesn’t automatically qualify you to drive a racecar. 

REFERENCES

  1. https://www.washingtonexaminer.com/policy/healthcare/nurse-practitioners-fight-for-more-freedom
  2. Laurant MReeves DHermens RBraspenning JGrol RSibbald B. (2005). Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001271.
  3. Lohr, Robert H. et al. (2013) Comparison of the Quality of Patient Referrals From Physicians, Physician Assistants, and Nurse Practitioners.” Mayo Clinic Proceedings , Volume 88 , Issue 11 , 1266 – 1271
  4. https://authenticmedicine.com/straw-man-the-dishonesty-needs-to-stop/

Robert Duprey MD

Robert P. Duprey Jr studied medicine as a 2nd career medical student who went to medical school in his 40’s after honorable discharge and ‘retirement’ from 25 years in the US Military (USCG & US Army). He was a registered nurse (RN) with specialty training as a psychiatric RN in the US Army for 15 years. During this time he also became a Master’s level psychotherapist in 2002. While on US Army active duty he also became a Psychiatric Nurse Practitioner while working full time in 2011. He served as a Psych NP on active duty, to include a combat tour in Iraq, until his ‘retirement’ in 2014 and moved to Philippines with his 3 children. At this time he started medical school overseas at Oceania University of Medicine based out of Samoa accredited by Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU). He continued to work as a Psych NP throughout medical school to support his children and to not have to take out loans for medical school tuition. Originally from Rhode Island, he completed medical school clerkship rotations throughout the USA with a graduation in May 2019 earning the esteemed credential of MD. He has successfully completed USMLE Steps 1, 2CS, and 2CK. He will take Step 3 this September as he applies for Psychiatry Residency. Having been and RN, NP and now MD, he is a believer of Physician led multidisciplinary healthcare teams 

  3 comments for “Race Car Model: Nurse Practitioners Fight for More Freedom

  1. Joe Smegma, DO
    August 31, 2019 at 9:07 pm

    Thanks Robert, for your service to your country. The training does matter,simply… it separates those of us without training. More training and importantly, experience backed by training, makes a seasoned clinician. Those in the medical profession for decades have made many mistakes. Hopefully, we learn from the experience. For any of us whether they be MD, DO, NP, PA, or other training, experience will guide us. There is no shortcut to clinical competency. I often thought during my training that ” I don’t know…. what I don’t know”.

  2. Jesse Lee Belville,PA-C
    August 30, 2019 at 7:37 pm

    I am a PA-C. My fearless Leaders want parity with Physicians too. PAs follow the medical model of physicians in our training. We were designed to compliment , enhance, and improve access to care while under the Supervision of a Physician. I have been a PA-C in primary care for 43 years. I believe if NPs or PAs want PARITY, Go to MED SCHOOL and become a PHYSICIAN.

  3. Sheryl Neely
    August 30, 2019 at 1:11 pm

    I have my NP license. I know exactly what car I should be driving, how fast I should be going and what lane I should be in….I shouldn’t be anywhere near a racecar! I don’t have near the training to operate a race car and recognize this fact. I love driving my car and will ride with my doctor, wherever he needs me.

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