Thank you.

Exactly my thought

Exactly

@@mursetalk Additional info. To be a physician you must do well on your MCAT to get it, take Step 1, Step 2, previous step 2 cs, step 3, and your specialty boards. Several of these exams have been about 8 hours long. Step 3 was a TWO DAY exam. The questions on them are far more difficult that the ones for nursing boards. I helped my aunt with studying for hers and I can attest to that. So a low pass from a doctor beats a high pass from a nursing degree any day. Nurses can do a few step 1 practice questions and see for themselves. In residency while studying for boards, the NP working the NP equivalent of my job could not for questions I had to know cold. My question to np who want to practice independently is, why not go to med school and complete a residency? I have friends who did that who say this very telling statement; “After going to medical school, I realize I didn’t know what I didn’t know”. Dunning Krueger effect. Also, there are science and social science classes required for med school entry. And that’s 4 rigorous years of medical school where you learn a college semesters worth each WEEK, you get your exposure to science and patients. Anecdotal, but all the PAs I know were my classmates in college who wanted to go to med school but didn’t cut it. They’re great people who I would love to work with on a team. But, to lead the team? There’s just too much of a difference in our training.

What's wrong with a Plastic Surgeon speaking on this subject?

Not true.

She’s in need of a psych consult.

Education is what makes a BSN. Education is what makes an NP. Education is what makes a PA and an MD. Education includes clinical experience, it's not separate from it entirely. Experience can also be obtained concurrently during an education (working during the 2-3 years of education from BSN to MSN). I listened to nurses like you and got my "experience" before getting my masters and ended up waiting for 4 years after becoming an RN to get my NP. I mostly plateaued in skill after the first 8-16 months of experience and had to continually switch lanes from med surg to hospice to pcu, ER to skilled nursing etc to continually improve. On the flip side I have worked in hospitals and snf with LPNs and ADNs and the knowledge gap is extremely evident, even with 20+ year LPNs. They just don't have the education to operate at a RN BSN level, the same way a 20+ year BSN knows little compared to a 1-2 year experienced physician. With that in mind, a PA and NP is considered a mid-level, as in not replacing a doctor where high level or high acuity of care is required, and they don't function in the same manner as an RN. Excluding low experience nurses from bettering their education just limits growth in extremely underserved population sections where an NP is suitable and a physician is unavailable.

@@chrisgotto4295 So you are : complaining you had to be a nurse for 4 years before becoming a NP ? Wow so much for “ caring “ . Experience takes “ time “ . “ Education does NOT replace it . “ excluding low education nurses from bettering themselves “ ? This isn’t about EGO , this is about giving the sick quality medical care . No one is stopping anyone from getting an advanced degree. That doesn’t give anyone the right to “ force “ people to be treated by NP ‘s . “ Limiting growth in underserved communities where a NP is adequate “ So it should be decided FOR underserved communities what their needs are ? Why are “ no doctors available “ ? How about recruiting doctors ? Why are we taking peoples right to choice in healthcare away ? I have great respect for NP, and PA’s . However patients should be able to decide what’s in their best interests, not have it decided for them .

​@chrisgotto4295 Just to expand on what kazoolibra said... the 2 years should be in intensive care.. nothing less than that should count...I am an ICU nurse and found that NPs that do not have an intensive care background are too timid and operate in fear when we request orders or present patient issues...I have 25 years of experience fiy.

@@georgehouston2310 The problem with that is that today's healthcare model is insanely fast-paced. ICU nurses lose their minds on med-surg floors with 5-6 patients as RNs. Even the experienced ones with PCU experience cry like babies when they get floated and have 4 patients I've seen that at every single hospital I've worked at. There's no way they can hack 15 patients with 4 admits and 3 discharges on a regular hospital floor. If you're saying an NP should have ICU experience prior to working with a pulmonologist or intensivist then I'd agree. But good luck filling that slot if that's the case. If an RN had that kind (2 years of ICU) experience and wanted to move up they may as well just become a CRNA. Much more money and autonomy. NPs by definition shouldn't be in the ICU anyway unless they're operating directly under a physician. An NP is a mid-level, not ideal for high acuity care. That's where the physicians shine. That's really at the crux of the argument that nurses should have to have more credentials and NPs should have to have more training. The problem is the physician shortage creating massive needs for more mid-levels to fill the gaps.

​@@OptimosTrollnice name.

Lack of family care. It takes people months to get appointments, it leads to increased hospitalizations, ER visits, and urgent care visits. These are all more expensive than seeing an established family provider both in money and health. I'm not sure sure if independence is the answer but it is an answer

She was probably an above average student as well. I'm sure shes very passionate about psychiatry as well, and not just chasing the money and telehealth opportunities.

So what you’re saying is the collaborative physician that agreed to partner with her is the scary part-not the NP, right?? If not, the argument isn’t effectively communicating that a physician is a better decision maker than a NP, as you’re showing that’s not the case.

she knew nothing because she was a student and needed guidance. 40 hours learning can be valuable if you teach her probably, and tell her what she need to study after this 40 hours clinic learning.

You dont talk crap about your student sir, that's bad. Yeah she did not know a lot at that point that is why you were the mentor/preceptor.Educational outcomes relies at least 50% on the educator. Some even says that there is no bad student but there are bad teachers. You , sir are a bad teacher. Please do not precept any more students!

@@TheShocktraumaby time someone gets to their clinical hours they have to have some knowledge already. This is where they put to practice what they’ve been learning in school. It is not the preceptors job or responsibility to teach them everything. The preceptor is there to make sure the diagnosis and plan of care are correct and to fill in knowledge gaps and direct the student where they are weak. I don’t know the dynamics between the student and OP, but if the student was wrong all the time or wasn’t actively engaging in learning opportunities and picking the preceptors brain then something is wrong.

Sometimes NP will give more in depth care than your MD. NP

@@auroraautumn8764 Do you have an example? I find that some NPs can provide better “holistic care,” often due to having more time, but I have never seen an NP outperform a physician with respect to medical management.

@@auroraautumn8764 They sure do! Nurse Practitioners are more personal and one-one-one with the patients than physicians. Every experience I've had with a nurse practitioner has always been phenomenal! I love NPs!

Sometimes NPs guide new doctors when they are inexperienced, some patients prefer NPs because they dedicate more time to them, and finally I guess pushing NPs on you wouldn't be necessary if there were enough doctors out there. Reality is that everybody has value, of course it is not to take any merit from doctors who had to go through so much in order to get their degree, but there's nothing better and real life experience which is what nurses often times have been exposed to. So let's not hate on NPs, if they weren't willing to further their education to serve you, many people wouldn't even receive any treatment.

@@asdfasdfasdfasdf297 this totally sounds like one of those narcissistic physicians that hate on NPs. If you went into the profession to care for patients, you should be happy to have more providers that care about doing the same. This is not about out performing, I could speak of many experiences where I worked with physicians that were terrible, treating patients and nurses very rudely, prescribing ridiculous amounts of medication where even pharmacy had to get involved due to how unsafe this was. The point is that you want somebody that cares about your well being, not just the degree that this person has.

You sounds so let me not say

We were never " designed " to work under a physician. I'm not sure where you go that information. We "collaborate", it's a money thing. I have never met or spoken to any other my collaborators, they just pull a paycheck.

Its not true..You misunderstood the concept. Nurse practioner role is not designed to be under a doctor. It is true for physician's assistants. Nurse practitioners actually study medicine and mostly they have been in one to one patient care for years. This tops all the residency or clinical hours, however NP is a new role and and still developing. There could be modifications to pre-requisites and/or some changes can be made in education/training part to close the gap with phycisians. At this time, NP's are paid a fraction of what doctors gets paid so it is true that industry want to use more NP's for the cost and that understandably concerns the physicians. Now, some physicians sees NP's as a threat and targets them and lobby against them which is wrong. I am also advocating for NP's to protect themsleves against industry and the doctors and get paid like a medical provider.

@@TheShocktrauma you drank the NP kool aid. They’re nurses who can prescribe and do nothing remotely close to the training of a physician

@@visionsbydean You should report those “collaborators” for not doing their job

Exactly.

These comments are ridiculous. People are still oblivious to the practice of NPs

Clearly these folks don't get but they will

NP/ PA are NOT qualified to work independently . We have become a society that has decided to change the names of things we don’t like . Physicians ASSISTANT, is not a doctor , NURSE practitioner is not a doctor . So you are saying let’s just change 200 + years of what a doctor is ? Let’s just decrease the amount of schooling , the training ? Hope you are never in a car accident where you need to be seen by an doctor who specializes in Emergency medicine or trauma . Just ask for someone who’s watched pimple popping videos on YT to help you . I’m sure you will have a great outcome .

Good point

Facts

Three years of training isn’t enough for many specialties….and honestly isn’t enough for the programs that are three years. And, btw, it’s not 80 hours per week….it’s an average. Some weeks are 120 hours, some are 60 or 80 something. We come out of training as physicians wondering if we trained enough….midlevels come out with entitlement thinking they deserve more pay and independence…..is that the mindset you want of someone taking care of you without supervision? No. If someone wants more pay and independence, go to medical school and pay your dues.

@@Chels-fz5uq Exactly we have the knowledge and are insecure because we KNOW how much there is to know. Midlevels come out, with only a fraction of the knowledge feeling FULLY COMPETENT.

Honey, if she has continued her education and has become a DNP, she will earn the title as doctor. And by the way, every NP does not attend an online college and even if she did, not all NPs are created equal just like not all MDs are. The ignorance about the practice of NPs is crinchworthy,

Facts, entering the match this cycle, so stressful

@@StepTwoCK-xo6lz good luck. Match sucks

@@ebf1003 thanks

Scary.

Same story everywhere.

@@lincolnallen1913 Greed

False. You be suprised how stupid some of these doctors are

@@uneyedentified2017 I know firsthand how stupid some of them are. That's why I am very selective and I refuse to see a np in place of a properly trained and qualified MD. However, you should do whatever feels right for you.

Doctors aren’t trained and paid to simply believe someone…..they’re trained to find the actual issue and treat it appropriately.

@@Chels-fz5uq 🎯

When you have a life threatening illness. Make sure you go to that NP, keep the same energy.

NPs are the best!!

@@jeanpierre9539 Many are wonderful , but you are missing the point .

Nearly every time I've seen them they've misdiagnosed or mis prescribed. When you look at the quality of outcome for np/PA vs MD visits, it makes sense. Np/pa treated patients fared far worse than MD treated. ""Hi, I'm nurse Lacy. I'll be performing your open heart surgery today."

Always see a doctor! Doctors have to work hard to get their license and spend years and years before they can practice. NPs don't and they have such a poor outcome for patient care

Yeah I've worked at medical offices before and seen many PA's who worked at my office misdiagnose@@ebf1003

Definitely agree, 2 years to learn the entire body system and treatment is way too short@@NoCreativeNameGirl

@@ebf1003You’re talking BS. NPs and PAs are not allowed to perform surgeries. PAs can be only the surgeons’ first assist. That’s it. Also for PAs, physicians have the last call. They work under the supervision of a physician by law. NPs need specialized credential training to be first assist RN, and/or further education in a masters of Surgical Nursing. And even like that, they can only be first assist. Surgeons are here to stay.

Yesssss!! I just had to express this in a prior comment. A PA can get their degree in two years, and start working, (SCARY).We have to attend school for over several years, and attend multiple labs and clinicals . It’s NOT EASY, and only those who attend a NP program will know this! I’m not shading any PAs, but this is facts..

The vast majority of PA programs require full-time attendance, and are so rigorous they don't even allow their students to work, plus they still must work under a physician. PA programs have a similar pace to medical school, they are just half the time. I have witnessed NPs completing their clinical rotations at a CVS minute clinic inside Target...and these clinicians should be able to practice independently? It's asinine....

@@kjmoran Not all PA programs are full time/ no work 🤣 I’ve seen some get their degree from online programs. The level of education between a PA & NP are not equivalent. Now, we have PAs begging for autonomy… I would not want a two year degree holding mid level taking care of me. Get me a nurse practitioner, PLEASE!

@@jeanpierre9539 I believe you misread my first sentence. If you go back and slow down you'll see the words "vast majority." But you're right, the education of a PA compared to a NP is not equivalent.. PA rotations make *some* NP rotations look like a joke (as I noted in my first comment). A large number of NP schools have 100% acceptance and require zero hours of bedside nursing experience prior to matriculation. The PA degree is two years and in that short time, they obtain more medical knowledge than any NP who went straight from BS to NP school. So take those 6 years, condense it down into 2 years and that's the difference. The average PA graduates with about 2000 hours in a provider role, whereas the average NP graduates with about 500. In reality, if you compare the average PA school to the average NP school, the average PA school is wildly more rigorous in coursework load. Additionally, way more competitive to receive acceptance. However, No PA or NP should be caring for really sick patients unless under the supervision of a physician.

@@OptimosTroll Username checks out lol

If someone is relying on memorization, they’re not doing it correctly. It’s about clinical experience and gestalt. You don’t get that from memorizing anything.

Nurses generally depends on memorization. They are inflexible.

And it’s not enough. If you can get that degree online, it’s not fit for independent practice.

It’s terrifying really. These online NP schools should be outlawed. Same for those that require zero patient care experience prior to joining a medical specialty school. I can’t believe this is legal!

We do clinical

@@IslemTav PLEASE stop creating fake scenarios in your head. It takes several years to become a nurse practitioner, and that’s from start to finish. Whether you’re attending a brick and mortar, or online, you will still have to take part in “IN PERSON” labs and secure clinical preceptorship to graduate. If we are talking about those who do not obtain any experience prior to applying to a healthcare program, you would be referencing that towards a PA program, which takes only 2 years to complete.

@@jeanpierre9539 You have no idea what you’re talking about. PAs need about 2000+ hours of patient care experience in order to apply to PA school, plus PA/MD/DO shadowing hours, plus volunteer work (often in the healthcare community), in addition to pre-med prereq courses. Without it, they cannot even apply. Stop gaslighting yourself that NP school is anything competitive. Everyone with an RN license with and WITHOUT real patient care experience can apply and get in without ever setting foot in a healthcare facility besides their RN/BSN school clinicals. Furthermore, to graduate NP school, you need only 500 hours of clinicals during the program. It’s 3 years, BUT on a part-time basis and mostly online nursing philosophy leadership courses. While PA schools is 24-28 months of full-time commitment only, must complete at least 2000 hours of clinicals to graduate (it’s one year of didactic and the rest of clinicals), plus their 2000+ hours of prior direct patient care experience. But I’m the one creating fake scenarios, right?! Do your research! The majority of NPs can disappointedly attest that NP school is a joke, far less rigorous than nursing school itself, and a waste of their time, if only to place more letters behind their name. It is unfair to RNs who really want to be remarkably-prepared providers, and, in general, unfair to the patients NPs care for as providers after graduation.

@@jeanpierre9539 To fathom that merely 500 hours (THREE MONTHS) of clinicals is enough to prepare anyone to practice medicine as a FULLY independent medical professional is insanity.

Physician Assistants was created during 1960's to address this.

​@@aznfriedrice415and did it work? 😒

@@aznfriedrice415 What i'm hearing is that for 63 years the pa profession has existed to deal with a shortage but there's still a huge shortage. So what's your solution removing nurse practitioners and adding to that?

There is NO shortage of doctors, just like there is NO shortage of Nurses . A lot of Doctors are leaving the profession , or not entering because of how they are treated . So let’s just make it worse , shall we ?

Not true. Most do NOT now adays. RN experience does not equal medical school and residency. If it did, they'd just make RNs DO/MDs after a certain amount of time. That makes no sense.

4 years of nursing experience cannot equate with 4 years of medical school where the sciences are learned.

No it really dosent. They're not similar whasoever. I learned about the heart in 1 week of medical school what I learned in 4 years.@@lincolnallen1913

It's not at all equal to medical school. People go straight from rn to np without ever working.

NPs never receive training on diagnosis at any point in their career. Experience in nursing makes them great nurses, not great physicians.

More compassionate? Do you want someone who tells you nice things, or an expert?

@@eib275 why not get someone who does both? A NURSE PRACTITIONER!

LOL do you even have any idea what a nurse practitioner goes through in terms of education and board certifications? Clearly not.

Retired RN here . Big Mistake !! Let’s just keep lowering standards right ? Now they want to take away our doctor ? I respect the practitioners , however they already have enough authority working at an advanced level . With all due respect to them , let’s not pretend they are the same as a doctor . I have a four year college degree in Nursing . If I had chosen to be a Practitioner, I would have needed just two more years of college . In no way does that make some one a “ doctor “ Currently they work under MD, see patients , write prescriptions . How much more are we going to do ? Take away years of training that a doctor has ? DON’T DO IT .

@@ZzXZ636 Sure you’re an RN. If you were, you’d know that this isn’t taking away anything - it’s enabling people to do what they already know what to do without ridiculous hoops to jump through. Right now the biggest issue with health care is the limited time you get with care providers. By re-evaluating who can do what and broadening that reach within sensible parameters, you increase the effectiveness of care delivered and decrease overwhelming workload and bottlenecks. You know how you maybe see your doctor for five minutes, if that? Apparently you’d rather it get worse.

Happens all the time . I will probably die early from #Akathisia, wrong dx because of this

@@BlownMacTruck not even close, the outcomes are worse consistently for those seen by np/PA vs MD.

are you serious? There is a HUGE difference in hours of training between doctors and NPs... that 100% has an effect on skill. And doctors have been trained in a greater scope of things. Would you let a taxi driver fly a plane after a quick course? Or would you rather have an actual pilot?

@@gingergardenwhat type of analogy is that. Taxi drivers and pilots don’t even work in the same industry?!?

@@jcbonner5044 Okay... then flight attendants vs pilots.

@@gingergarden If you think that a NP or PA is like a flight attendant to a pilot you clearly don’t work in medicine. Copilot and pilot would be a better analogy. Flight attendants cannot and are not trained to fly a plane. Doctors, NPs, and PAs are all trained to treat, diagnose, and prescribe. The only difference being that the doctor out ranks the pa and np due to their additional experience. Same thing can be said for a pilot and copilot.

@@jcbonner5044 So you agree with my original point, but just dislike my analogy...?

Residency and fellowship for midlevels?! LOL. Same name, completely different program. You're kidding yourself if you think they're even remotely the same. They're not. I speak from experience .

No one said they were. It simply highlights that there are structured opportunities for additional training. You do know that those terms aren’t restricted to or within the medical field right? Are you ok? lol

@@fjbrown92 when people hear residency/fellowship they assume physician. I’m not gonna listen to the gaslighting that they don’t.

So true!

Exactly!

In Quebec, they found patient outcomes improved by an average 30% when they required all hospital wards be supervised by physicians instead of senior nurses.

Please! Track malpractice cases among physicians, it’s been UP! 😂

Can you show your evidence?Research shows similar, and in some measures better, outcomes between NPs and primary care physicians (in the US).

They all take the exact same boards. Your point is moot. Go to medical school if you have the answers.

Going to a Caribbean medical school is not cutting corners. It's usually an admission problem. The US medical schools limit how many students the schools can take and only admit the top 5% undergrad. The Caribbean schools teach the very same sciences as

I'll do yours free of charge. Apply to AUC and let me know how easy it is.

I've had an ER physician ask me what a "flush" (pre-filled NS syringe) was lol.

Thank you!! Could not have been said better. But the people who need to hear this have never read the book and are blinded by the title MD

MSM have an answer to that?

Or maybe if you want to practice on your own, get the MD. Mortality rates don't lie. Patient outcomes from np/pa are well reported.

@@ebf1003Really? What references are you using? Cite your sources please.

@@BlownMacTruck med school insiders, journal of Mississippi medical association. Patient outcomes were worse, it cost more, antibiotics were over prescribed, excess imaging was ordered. Comics are no longer showing mid level caregivers to be primary caregivers and without oversight. It comes down to a lack of training and expertise.

@@BlownMacTruck and then there is this from a study. In terms of patient outcomes, physicians outperformed mid-levels on nine out of ten quality metrics including cancer screenings and management of chronic diseases such as high blood pressure and diabetes. Physicians were also found to have higher patient satisfaction scores compared to mid-levels.

@@BlownMacTruck but hey, let's not let competency get in the way of a money grab.

NP student here. This is a completely untrue statement. Yes, there have been programs in the past that have handed out fake nursing degrees in the thick of the pandemic however, the reality is that the majority of NP programs are incredibly rigorous and competitive. In my specific program (which is in Florida), we need an 85% in each class to pass. We take benchmark exams in every class along with many other exams, each student is responsible for their own research thesis, and every student completes up to 2,000 clinical hours (this is only master's level, the doctoral level is even harder) and at the end of every program, NPs must pass the board exam to be a registered, practicing NP. The requirements to even get into a NP program require an RN license and a bachelor of science in nursing in most programs along with a competitive GPA and a lengthy resume. Programs are online for core classes however, once hands-on training is required students go to campus/clinical sites to learn. It is unfair for a plastic surgeon who provides zero primary care to speak on the comparisons of primary care healthcare providers. Many physicians dislike the idea of NPs and PAs because we are "stealing their jobs at a lesser cost". As a result, they often preach that these personnel are unfit to provide quality patient care, specifically NPs due to the fact that they are able to open their own practices. Unfortunately, healthcare is a business at the end of the day and many physicians are only concerned with the amount of money they can make. They see NPs as a threat to this.

Same with MD degrees. I got mine in two weeks, and now I work in an LA hospital. 😊