...maybe we should work together......I think u may be my brother from previous life...

Most of the NP I know would probabaly opt out of beign called Doctor. For nurses that use a wholistic patient centered approach to their delievey of caring calling themselves a doctor would be equivalent to calling themselves a lawyer....GROSS!

It's all semantics. The best "HEALTH" advice I've received lately came from a non titled healer with a big heart and a brilliant mind.

The last treatment I received was an adjustment from a chiropractor, and boy did I feel great. I have NO DESIRE to see a big pharma sell out physician anytime soon!

True healers no matter what their discpline or specialty don't get hung up on titles, only the confused masses and the insurance companies and lawyers.

Medicare is the one you need to complaining to. They are the ones who pay resident salaries. Since they won't ante up for more resident position, none are opening.
This is the reason some 5000 people didn't match and for no other reason.
I think they should have come up with a different name. We were using doctor first so find something else to use, at least in the hospital/clinic setting. I understand calling someone doctor in the academic setting if they hold a phd, I have not problem with that. If you have earned your right to hold a PhD degree, you have earned the right to be acknowledged by that title. How about primary care nurse or nurse of primary care.
I don't really know how much more they will be able to do that a NP doesn't already do. I am still confused on what this extra "training" will actually let them do other than be administrators in hospitals and tell real doctors how they should or shouldn't be treating their patients. I think that's the real motivation these people have. Stick it to the ones who have been sticking to them for all of these years.
Ohh and sorry for reposting this article. I wouldn't have if I would have seen it.

Basically medicare is ditching the poor americans into the hands of nurse-doctorates......like in 3rd world countries, when docs are absent, quacks move in.

Very well said. What exactly can students and physicians do about this?... ideas?

You also must realize that patients are going to other providers either because of the physician shortage, or because they feel like these other providers have something to offer them that modern-day physicians don't. One of the main issues is lack of time with each patient. People often prefer sitting down to talk about their health issues with a nurse or naturopath who can spend time talking with them, than the typical physician who is out the door in 5 minutes. Another issue that appears to be lacking in many physicians I've encountered is lack of knowledge about lifestyle issues, nutrition, and even supplements. I know many med students would cringe at reading this, but the reality is that people are experimenting with supplements and herbs, and unfortunately clinicians aren't adequately trained in the topic. I have considered the idea of going to naturopathic school someday myself in the future (long after I complete med school and residency)... it's like a 2 year program for those with previous medical degrees, and I've even heard of a school who will be having night classes. Obviously at this stage, I can't even consider further education as I have so many years ahead... but maybe in 10-15 years I will be craving further studies. I know there are physicians with MD,ND degrees, and I think it's great that they have the foundation in clinical science, with additional training on herbs and supplements added in... I'd hope they'd be best able to evaluate the junk from the good stuff.

Here's what I think needs to happen (these are just my thoughts):

1. Open up more residencies for physicians and increase medical student enrollment

2. Increase incentives (higher pay, loan deferments) and reduce workload of those going into primary care

3. Change insurance reimbursement policy to allow physicians to spend more time with each patient

4. Encourage more government funding of complementary/alternative medicine and preventive medicine research and clinical trials so that physicians know about which treatments work (and can be incorporated into practice) and which are just bunk

5. Increase further educational opportunities/training/CME for physicians on topics related to lifestyle and preventive medicine, public health issues, evidence-based natural/holistic medicine

Obviously these things require to varying degrees a major change in the system... so no small deal here. But it's critical that something is done about it, as the problems will only escalate otherwise. Any ideas? Solutions?

Disclaimer: I'm not a current medical student yet, as I plan to start in '09. However, I am somewhat versed in the topic as I come from a family of physicians (and thus have spent my life hearing of their frustrations with medicine) and also I've done some study of health care issues during my MPH coursework. I'm also someone who has gone to non-MD and alternative providers to see what they had to offer.

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Formerly known as "rkaz".

My humble opinion is that since the chance to implement a socialized healthcare is slim, they are doing this "through the back door " or backward. By having this bunch of nurses acting as doctors, you will have more supply than demand and the goverment finally can have a system where the cost of healthcare will be lower since they certainly will not pay the nurse the same fee they will pay a doctor and the insurance companies will encourage their clients to go a see a doctor nurse instead. In this whole mess, the affected ones are going to be us, the medical students or current doctors.

Personally, I think the NBME getting involved in validating DNP knowledge by offering them a basic exam has the potential to worsen the cause of allopathic medicine and potentially the doctor-nurse profession as well. Why? If the DNP's pass the exam, US regulated allopathic medicine is in essence saying the Doctor -Nurse Practice (DNP) is equivelant to the general practitioner medical doctor.

On the other hand, if the doctor nurse practitioner fails the exam, the DNP loses some credibility as well. The answer is for the AMA/NBME and the powers to be in the allopathic medicine circles, is to clean their own house. Its amazing to me that the USA has lost the "General Practitioner" (GP) to numerous specialties. It is apparent insurance companies and law suits have been the catalyst to the demise of the GP in the USA.
However, in most of the rest of the world, the GP is still King!

I think the answer is the return of the "general practice" 1 year residency. Unfortunately, most states require FMG's to have 3 years of residencies anyway. It is amazing that a doctor of nurse practitioner can practice autonomously in many US states but a MD with 1 pgy year is for all intensive purposes worthless.

From what I've heard, they won't get any increased abilities, just a different title. They are already about as independent (too independent) as they can be without being physicians. However, whatever their motivation, I'm pretty sure that no "doctor nurse" will be telling a real doctor what to do. No matter what they call themselves, nursing school + 1 year extra class time and 1 year extra clinical time does not make them anywhere close to the level of a physician.

Unfortunately, it will probably lead to a growth in the nurses who think that they know as much or more than physicians...a category of nurses of which there are already far too many.

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AUC 2nd Semester
Rectouterine pouch!!
http://slevit1.blogspot.com

Give a man a fish and he will eat for a day; teach a man to fish and he will eat for a lifetime; give a man religion and he will die praying for a fish. --Unknown

I think you'd be surprised how hospital administrators work. They are there to turn as much of a profit as possible while the physicians are trying to treat their patients with the best, most appropriate care possible. These two views often mix and the administrators usually win and nurses do sit on these boards. The nurses I am talking about are the old, crabby ones who have been a nurse for 30 - 40 years and thinks (usually) she has seen it all and heard it all and knows what the patient needs.

Thank you AMA for not stepping up to the plate. The good ole boys club does it again. Now will you please open enough medical schools to supply the need?

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SMU SOM: 3rd year
Cores: IM, Peds, Psych, OB/GYN, Surgery (now), FM (Jul?)
Electives: EM (Oct)