Will Physician Education Be Valued In The Future?
The future of American healthcare will not value physician education. Perhaps it’s time to abandon the medical school model and train millions of nurses instead at a fraction of the cost. This comment was left on my blog over at NP=MD:
I don’t even compare NPs and MDs. Their models differ. One is not better than the other. The schooling — minus the residency — is nearly equivalent in terms of time spent. The problem is that NPs don’t get a long enough residency. If you take a NP and a MD, both with 20 years clinical experience, the MD does not know more than the NP. Sure, he had a few extra classes 20 years ago — which he doesn’t remember — but that’s about it.
NPs aren’t trying to steal MDs’ meal tickets, they’re attempting to better serve patients.
Research has shown irrefutable proof that patient satisfaction and outcomes are just as high, if not higher in certain cases, when being treated by a NP rather than a MD. Some of this data is no doubt skewed because many MDs are so overwhelmed with patient loads that they simply cannot spend the time to provide competent care, but I see that as the fault of the MD for taking on too much.
Finally, I laughed when I read that comment about “once there was a gold standard — the physician.” That was no doubt true. Unfortunately, it’s not NPs that tarnished that reputation. It’s the fact that nearly 60 percent of practicing MDs got their degrees in unknown schools in Pakistan or India or China. Then they did residency in the U.S. Then you have the American MDs who went to some Caribbean university. MDs straight out of reputable schools like Duke or Harvard or Wash U are rare.
Very soon, the idea that NPs are somehow “less” than MDs will change. A doctor is a learned person, and MDs are simply doctors of medicine. Eventually, when the Board of Healing Arts collapses in its ridiculous battles to slow NP progress, only patients will benefit. And NPs will no longer be asked: “Damn, you spent more time in school than a doctor. Why didn’t you go to med school?”
I just want to know where I can sign up for NP recertification boards instead of my internal medicine boards which I must take in just a few short years. Since we’re equal, I figure I could take the NP recertification boards instead. Probably a lot cheaper, too. On second thought, is there such a thing as NP recertification?
*This blog post was originally published at The Happy Hospitalist*
Probably true, overall. The only question is whether or not NP’s will be willing to take all the accountability for error and are willing to be available at 3 am, both for patients who are truly sick and for those who don’t have anything wrong but a need for Percocet refill.
Malpractice won’t go away just because other types of providers ‘really care about people,’ and courts won’t accept ‘I just want to help…is that a crime?’ as an excuse for negligence.
Finally, if this works out for NP’s and PA’s and all the rest, they can’t use the MD in the local ER as the constant fail-safe. They have to make decisions and live with the consequences.
MD’s and DO’s probably make more money mainly because they’re willing to be the final word and put their signature on the chart in question, because yep, I’ve forgotten a lot of my medical school information.
So welcome to the ball! The word is, everyone likes NP’s better than docs anyway. Fine by me.
Edwin