Turf Wars

The doctors are angry.

Let me rephrase that.

The medical doctors are angry. Not all of them, a couple of groups have been very vocal about nurses earning their doctorates, and using the title of “Doctor” in their practice.

Why, the public might be confused!

I tend to give the public a little more credit than that, and I absolutely give nurses credit for never passing themselves off as physicians.

Did you catch the article in The New York Times,When the Nurse Wants to Be Called ‘Doctor’”? It opens with a nurse practitioner introducing herself , saying, “Hi, I’m Dr. Patti McCarver, and I’m your nurse.” (Emphasis mine.)

Dr./Nurse McCarver has her DNP, and she identified herself as a nurse immediately. She is fully within her rights to use the title of “Doctor”, just as anybody with a doctorate in any field has the right to use the title.

Nurses are obtaining advanced degrees, including the Doctor of Nursing Practice, because the level of care that registered nurses are capable of providing as advanced practice nurses requires this level of knowledge. They are capable of being primary care practitioners, and they are capable of doing this without a physician standing over their shoulders.

They are neither replacing, nor supplementing physicians.

Some in the medical community are fighting. The arguments against nurses (and other health professionals) practicing independently with advanced degrees are many and run deep.  It’s more than loss of control over the title “Doctor”. Per the NYT article, it’s a loss of control over prescribing authority and loss of income, as other professions with higher degrees demand more money.

Demand more money?  These days? You can demand all the money you want, no one is going to get paid any more than the system doles out. It poses an interesting idea, though. Nurses who practice independently have tended to gravitate to areas that are underserved (aka: lower income) where physicians don’t/won’t go.  Will that change as more DNPs incur student loans/need higher incomes?

Loss of prescriptive authority?  What does the medical profession lose if a nurse practitioner is able to independently order blood pressure, cholesterol, reflux or NSAID medications, for example?  Other than a need to see a physician to get the medication, leading to loss of income.

Just answered my own question.

Medical and nursing education are different, but they have their similarities, too. Nursing is also a science-based profession and advanced practice nurses study pathophysiology and disease. Most DNPs have worked for years with patient populations before going back for their doctorate. But nurses also study health and wellness and the human response to it all…

And when you walk into their office they see you as a whole human being and they take time to actually talk to you.

Then again, so does my own physician.

Both the nurse practitioner and the family physician can provide primary care, manage your illnesses, help you stay healthy and both of them will refer you to specialists when something needs attention.

There is a place for both medical doctors and doctorally prepared nurses in primary care and lord knows there aren’t enough of either to care for the millions in this country who need primary care.

Stop the turf war long enough and you’ll see that the presence of the DNP in primary care does not diminish the prestige, or the “power”, of the MD in the least.

How can the elevation of education in any profession in healthcare, diminish anybody?


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