Blog | Friday, October 4, 2013

MD vs NP


Some friends and I have a piece posted on the Health Affairs Blog.

One co-author is a doctor, the other is a nurse practitioner (NP). He runs the student health center at a university.

Our piece reflects on the vitriol between physicians and nurse practitioners in online forums, and ideas for restoring civility to the conversation.

NPs are nurses who get extra training in clinical medicine, such that they are able to diagnose and treat most illnesses and provide outstanding patient care. By now, if you haven’t been cared for at least once in some capacity by a nurse practitioner, then you haven’t really “used” the health care system.

Licensure in health care fields is state specific. Historically, when NP certification came into being, NPs were uniformly expected to have “supervisory” relationships with physicians. The docs were supposed to oversee their practice, from case review to monitoring prescriptions, hence, the origin of the term “physician extender.”

It was only a matter of time until NPs existed in sufficient numbers and had enough experience to amass data proving they can in fact practice medicine well without supervision. Many states, facing shortages of able-bodied health care professionals, have changed their licensure requirements to allow NPs to practice fully and independently.

Other states are considering the move. People feel very strongly on both sides of the issue. Medical societies have weighed in. Strong feelings are fine, but name calling and vilification of the other parties do nothing to advance progress, solve problems, or of course take care of patients.

I’ve worked with many nurse practitioners over my career. There are many standouts I’d choose to be my own caregiver.

What about you?

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.