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A person who graduates medical school with the letters MD at the end of their name has a ton of biology and chemistry knowledge but barely any clinical knowledge. How many residents including 4th year refer to the bedside rn to help treat and diagnose their patent! Nurses are the front line of medicine. They collect the data and have sharp assessment skills because they are at the bedside not mds. Mds take the info from the rn and write orders many times not even looking at the patient. RNs gain residency experience while working for years at the bedside and colaborating their input with mds. Nursings responsibilities have dramatically increased over the years. They should have the option to further their knowledge base and treat as an md does because thats whbecause they do that already as a beside rn. Mds have 8years of schooling plus residency...nps have 6 years of schooling plus however many years of experience at the bedside. Which is usually far more then 4!
A person who graduates medical school with the letters MD at the end of their name has a ton of biology and chemistry knowledge but barely any clinical knowledge. How many residents including 4th year refer to the bedside rn to help treat and diagnose their patent! Nurses are the front line of medicine. They collect the data and have sharp assessment skills because they are at the bedside not mds. Mds take the info from the rn and write orders many times not even looking at the patient. RNs gain residency experience while working for years at the bedside and colaborating their input with mds. Nursings responsibilities have dramatically increased over the years. They should have the option to further their knowledge base and treat as an md does because thats whbecause they do that already as a beside rn. Mds have 8years of schooling plus residency...nps have 6 years of schooling plus however many years of experience at the bedside. Which is usually far more then 4!
I am afraid you totally misunderstand the educational requirements to be a physician.
First there is four years of college, then four years of medical school. There are programs that offer a combined bachelor's degree and doctor of medicine that allow you to shave a year off the undergraduate degree, but most people do not do that. The last two years of medical school are traditionally clinical, but some schools now are incorporating clinical instruction throughout the four years of medical school. Following medical school, residencies require usually three or four years. Physicians who sub-specialize then do a fellowship, which adds another two or three years, sometimes more. The entire residency and fellowship are spent taking care of patients.
Nurses may attend a nursing school, have an associate's degree, or have a bachelor's degree. Advanced practice nurses have the equivalent of a master's degree, not a doctorate.
The content of medical school basic science courses is more rigorous than the courses taken by RNs and the clinical courses in medical school and the experience in a physician's residency are also taught more in depth than a PA or NP will receive.
MDs do indeed examine patients. They also interpret the tests they order and determine the treatment plan. Nurses help to implement the plan.
Advanced practice nurses do best taking care of well patients and following patients with established medical problems who are stable on their current treatment.
The educations are totally different. And physicians do gain experience as they practice, so you really cannot count the work experience of a nurse as being equivalent to a physician's residency.
These days, be very careful, and there is absolutely nothing wrong with inquiring about the qualifications of the practioners. I know of a case, at a clinic, where technicians were doing surigical work...not even a nurse...
At my kid's pediatrician, we almost always get seen by the PA. She has the ability to call in the Dr. anytime she needs to, but has only done this once with us. I feel just as comfortable with her taking care of my sons, and am grateful, in the case of emergency sick appts., that they can get them in so quickly.
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Last week I made an appointment to see my doc (internal medicine). When I got there, I was seen by a NP. Now, I wouldn't have been upset if they had TOLD me I wouldn't see my doc, but they didn't. I was only getting a few prescriptions refilled and had to go in for the annual face to face, but I expected to see my doc. Next time I make an appointment, I will definitely say I ONLY want to see the doc. I am more comfortable with her and I have more confidence in her. Plus I had a few medical issues I wanted to discuss with a physician.
For several years my primary physician had either PAs or NPs on staff and once one of them caused me a lot of trouble that could have been avoided had she remembered to follow through, but I never told the doctor. Later on, a new NP was condescending in her attitude and I called her on it. We argued and I told her I wanted to see the doctor, which I did. After she left the room he was there very soon. Nothing was said about it. She told me anytime I preferred seeing the doctor all I had to do is put it on the sign in sheet.
She is no longer there and he no longer has any NPs. I don't know what happened, but I'm not seeing one again. I think they don't know enough about complicated situations and when they come out with a platitude or two, I don't want to hear it. This doctor doesn't overbook and sees patients very close to the appointment time. He's not in a hurry, either. I'm not sure why he ever had the others there.
Maybe you do need an "expert" NP practising at "adavnced" level to assess a suspected stroke patient for thrombolysis, rather than a "junior" MD who is jack of all trades and master of none.
In the UK you wouldn't need an NP to suture a minor laceration or prescribe amoxil for strep throat.
A senior RN who had been trained could do it following "protocols" and "patient group directions"
Having said that, RNs in the UK have a LOT more autonomy and responsibility than US RNs.
I do not think the comment was patronising at all.
Personally, I have seen a NP several times for different issues when the doctor was not available. In several cases, I requested the NP instead of the doctor. The NP was experienced and very capable.
When I lived in NJ it seemed a little more difficult to see an MD/DO, especially in specialty clinics, but not impossible. Where I live now, NPs/PAs are common but it's generally not difficult to see the MD/DO.
I have worked with (both professionally, and as a patient) a LOT of terrific NPs and PAs. I have absolutely no problem seeing an NP or a PA for most issues. This is a broad generalization, but in my experience, they almost always have outstanding bedside manner, and seem to take more time to listen to my concerns and explain things than many physicians. Having said that, there are times that I not only prefer but insist on the overseeing physician. For example, as an oncology patient, for management of the side effects of the chemotherapy I had, I actually preferred seeing my oncologist's PA or NP. They seemed to have a lot more tricks in their bags on how to counteract those unpleasant side effects. But when I had (what I felt were) complicated questions about my diagnosis, treatment, or prognosis, I specifically asked to see my oncologist, and it was never a problem.
I would never use a clinic where they would not allow me to see the physician if I requested it. I do understand if perhaps the physician is out, and I need to make a different appointment to see him or her. But I would be very annoyed if they gave me a hard time about it.
Finally, a good NP/PA should always know when they need to have the patient be seen by a physician, and will arrange for this. I have had that happen as well. For example, I generally have my annual women's exam done by my ob/gyn's nurse practitioner, and she's awesome! I love her! But twice I have ended up with issues that required her to arrange a separate appointment for me to see the ob/gyn.
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