There is a perceived physician shortage in underserved areas in America. Many solutions have been explored. In an attempt to fill the gap, non-physician healthcare providers, such as nurse practitioners, have been placed in areas to act in place of physicians. Today, many states are passing legislation to normalize this practice. Non-physicians cannot fill the role of a physician because our training is fundamentally different. There are medical school gradates that go matched in graduate training due to a lack of funding. These physicians are unable to practice without completing a formal residency.
Educational and Professional Differences: Highly selective application process, rigorous national standardized entrance exam (MCAT). Applicants take basic science prerequisite courses more advanced than the required nursing school prerequisite courses. Medical school courses are of advanced sciences and are not offered online. Physicians complete upwards of 20,000 hours of clinical training before practicing independently. There are strict requirements and standardized education for this training.
Practicing physicians have a Doctor of Medicine or Doctor of Osteopathy, taking 7-11 years to achieve after undergraduate education. Physicians must complete post graduate specialty specific education, 3-7 years. Physicians are highly regulated, including by the Sunshine Act, preventing kickbacks. Accountable to very high, evidence based standard of care in court, with peer testimony.
Nurse Practitioners (NPs)
Many NP programs do not require an applicant to have nursing experience or even a prior nursing degree. Several programs advertise 100% acceptance with no required entrance exam. A large percentage of the NP school curriculum involves coursework on nursing theory and can be completed 100% online. Some NP programs only require 500 hours of clinical training and often rely on the honor system for meeting requirements. Clinical training programs are not standardized. NPs have a Master’s or Doctorate of Nursing (DNP); each option takes 12-18 months to complete, after undergraduate education. No post graduate requirement, and can switch area of specialty with NO further formal education. NPs are exempt from Sunshine Act and Stark Law regulation. NPs in states with unsupervised practice are NOT held to same standard in a court of law.
Please support training our medical school graduates with asking for increased residency funding here.
Fixing the doctor shortage requires a multi-pronged approach, including increased federal support for GME, which has remained frozen since 1997. The AAMC supports the Resident Physician Shortage Reduction Act of 2017 (H.R. 2267; S. 1301), which would add 15,000 residency slots over 5 years.
The Resident Physician Shortage Reduction Act of 2017 (S. 1301)[/vc_column_text][vc_empty_space][/vc_column_inner][/vc_row_inner][vc_row_inner row_type=”row” type=”full_width” text_align=”left” css_animation=””][vc_column_inner][vc_column_text]Who Do Patients Really Need?
Physicians! The profession of nurse practitioner was meant to be for experienced nurses to work with supervising physicians. It was never intended for the independent practice of individuals who has never worked as nurses.
There is a vital role for NPs on the healthcare team, but it is essential for patient safety that the position they fulfill is consistent with their education and training. NP education is not adequate to allow them to practice medicine without supervision safely. We support team based, physician led care.
NPs tell state legislators that passing laws which allow them to practice medicine without physician supervision will help improve access to healthcare in underserved areas of their state. However, the AMA has found no improvement in the access to health care in underserved areas in the 23 states where NPs have gained the right to unsupervised practice of medicine.
The evidence accrued shows states with unsupervised practice of NPs have higher costs of health care due to missed diagnoses, inappropriate specialist referrals, and more expensive and inappropriate testing.
We must keep the standard high, with physician-led care. Our current medical education system is the product of decades of development- the rapid recent evolution of online NP education is not equivalent. #knowthedifference