Dr. Al Power writes…
Here’s my take on Bill’s March 5th post, “Doctor, Doctor, Give Me the News”:
The advancement of the nurse practitioner profession has caused a great deal of controversy in the medical community. From where I sit, it appears that the majority of doctors are happy with NPs in a subservient role, but get nervous when they “strike out on their own”, or expand their realm of practice.
There is no doubt that MDs have a great deal of specialized training and skills. However, most of them are using this training to go into specialized fields, and there are few who are willing to provide general care for the population at large, especially for older adults in nursing homes or other communities.
There are many things that doctors do that can be done as well by nurse practitioners. To me, there is something amiss with doctors being so territorial about this. Are they really concerned about quality of care? Or is it more of a “turf war”, or a fear of loss of income to someone that a patient might prefer seeing?
A basic premise of the advancement of knowledge should be that it is shared freely with all who wish to attain it. To jealously guard a realm of practice from others who wish to make a contribution will only hurt the community as a whole, and reduce access to care. There is a parallel here with doctors of past decades, who objected to their patients having access to medical information that made them want to be more active partners in their care.
Wake up, folks! There are many excellent NPs out there, providing excellent care. As an internist and geriatrician, if I have a patient that is complex, I often engage the help of a specialist. There’s no reason why an NP cannot do the same. If MDs were more pro-active in working with NPs in this manner, we would have a much better, more efficient system of health care.
I work with two geriatric NPs at my nursing home. I think they understand geriatric medicine better than many, if not most docs in town.
Finally, let’s stop guarding our titles so fiercely. A “doctor” may be one of various kinds of healers, or one who has obtained advanced knowledge in a variety of fields. No one complains about saying “Dr. Martin Luther King”, or addressing their dentist, veterinarian or school superintendent that way. So why get so bent out of shape if an NP was referred to as “doctor”? What are we afraid of?
Al Power, MD