The Illogic of MD thinking toward NPs

As a nurse practitioner, I just don’t understand the AMA’s resistance to the role.  The research certainly shows people are not dying at the hands of NPs and that quality of care and safety is not an issue.  The most recent major evidence based document verified the research on nurse practitioners. The AMA repeatedly and with much venom disputes the role.

What is the fear of the AMA?  Currently, primary care providers are at a premium.  It is hard to find a practice that is accepting new clients especially if you have medicaid.  Some practices are also interviewing potential patients and refusing to care if the case is too complicated.  This is especially noticeable in the older population. New medical graduates are not going into primary care but opting for specialties.  This problem is especially acute in rural and suburban areas.

Why not embrace nurse practitioners as being primary care providers?  Why not work with the NP schools and credentialing centers to establish a collegial relationship?  Instead, there is an adversarial relationship.

The AMA puts forth two areas that are most disturbing to them.  One is the level of school and training.  It is the AMA’s contention that NPs do not have the hours of clinical training that a two to three year resident has nor do they have the four years of medical school.  There of course is truth in this.  However, I had ten years of being a nurse, working in hospitals, homecare and overseas before deciding to move into NP training.  I do not support fast track NP programs.  I think an NP should have a BSN and a two year MSN with increased clinical training hours.  I also think a year of clinical apprenticeship/residency would be an asset.

The other reason is if an NP has a doctorate (more schooling) and uses the title, then patients will be confused.  They also contend that NPs try to act like doctors, again confusing patients. What if they make a mistake or a medication error? I believe this is laughable if it didn’t have so much traction. To me, it is purposeful misinformation.  From my personal experience, I never think of myself  or introduce myself as a doctor.  I go out of my way to clarify the role.  I also know the difference in our roles.  I ask questions when I need to whether it is from another NP or MD.

The AMA is holding  primary care hostage.  It is causing many rural area in states with controlled NP roles from not having the necessary healthcare resources.  It has to be about money.  Will NPs take away potential dollars?  Only if there are too many practices which there aren’t at this time.  Who is going to fill the role in 2014 when everyone has to have insurance and more people will need primary care?

It is time for the AMA to stop this rhetoric, accept the research and work to create a viable healthcare primary care system.