2234leej

That's really sad, considering that the NP/PA students do the vast majority of their classes together at that institution? I would think it would a great place for PAs. That's a shame.

As someone with a doctorate, I actually don't mind when pharmacists, dentists, optometrists, etc. use the term "doctor." Particularly in an appropriate setting. If anything, I am MORE bothered when chiropractors call themselves physicians. As others have stated on this board, the term doctor was never copyrighted or patented by physicians. The term physician should exclusively be held by MD/DOs. I have patients who refer to their providers as physicians, only for me to see the credentials and realize that they're seeing a chiropractor. How the MD/DOs let this happen is beyond me.

I have to meet some of these DPT/DNP people you guys encounter who call themselves “doctor.” I have my doctorate in physical therapy and did my residency in orthopedics; I am proud of my credentials and I have never called myself that in a clinical setting. It’s frankly embarrassing. On a side note, I know a few PT-DO and PT-MDs who received a bachelor’s in PT back in the early 90s. I have gotten the impression that they’re threatened by the DPT; they’ll argue that the curriculum is the same when that couldn’t be further from the case. They’re still a PT but the training is not the same.

I've always thought physician associate made the most sense. It keeps the PA title. Medical practitioner just sounds so vague and broad to me. It makes me think of medical assistant.

Yeah that will never happen. That's all hearsay as far as I'm concerned. No bloody NP with an ounce of intelligence would believe that they should supervise a PA (if they did, they deserve to be flipped upside down).

Only the rural states (for the most part) have true independence for NPs. Granted, I'm not complaining. Illinois was also one of the strictest states for PTs; thank goodness the governor finally passed a bill this year that allows PTs direct access to see their patients (just need to send a plan of care to their provider within ~10ish days). It was extremely frustrating to need a prescription for PT even though we are the ones evaluating, diagnosing and treating the MSK conditions. So glad Illinois is turning a new leaf.

Hoping for the best for you guys. Illinois, one of the strictest states for NPs, recently passed legislation that will allow for independent practice after collaborating with a physician for 4000 hours and 250 hours of CEU (we'll still have to have collaboration for certain drugs like BZDs, etc.). I feel like that'd be reasonable for you guys; unfortunately, many physicians are about self-preservation and not what's best for the patients. Rootin for ya'll.

agreed. I don't see this as an issue at all.

PTs have been prescribing basic musculoskeletal medications for a long time in the military (basic NSAIDs, stronger dose NSAIDs, muscle relaxers, etc.). They can also order imaging and order labs. It makes sense, as they see patients often for a variety of different orthopedic issues. Civilian PTs cannot. The ones in the military have to be board-certified and take a military course to prescribe.

My wife is a clinical pharmacist at a hospital. I do believe that pharmacists are more than adequately trained to prescribe certain medications. There already are advanced practice pharmacists in California. I do believe PAs and NPs have training that is superior when it comes to the diagnosis, management and treatment of medical conditions. Though, I think there is a place for pharmacists to provide certain medications in the retail clinics (what medications is a point of discussion). Even PTs prescribe basic musculoskeletal medications in the military and they have been doing so for the past 50 years as physician extenders. I don't see how pharmacy is different.

Couple thoughts on your post: 1. Not all NPs get their degrees from 100% online, for-profit schools. 2. I am not sure which hospital/geographic location you are in, but I have not seen one FNP in the ER who was unable to suture. I work as an ER nurse (getting my FNP) and all the NPs and PAs can suture at the hospital. I do think PAs are better suited for the ER than NPs, but some of your comments are inaccurate.

That is an atrocity. Your level of experience surpasses the vast majority of us. I know you (and others) are more than qualified to be independent practitioners. It is unfortunate that the profession is hitched to physicians when it shouldn't be.

I agree and disagree. It really depends on what field you enter. PAs are thriving and are still much preferred over NPs in cardiothoracic and orthopedics (which is unfortunate for me, because my specialty is orthopedics/sports medicine). NPs are usually preferred in psych and women's health from what I have seen. Primary care is still split 50/50 in my opinion. As I said earlier, in regards to curriculum and training, PAs have it better than NPs. No question. However, from what I have seen, the vast majority of PA students now do not have a significant amount of healthcare experience. Many do the minimal patient experience requirement to get their clinical hours (ex. PT tech) and go straight to PA school. How is that better than someone who is an RN for 2-3 years and then becomes an NP? Even with the superior PA training, it'd probably balance out (or be in favor of the NP). Again, this isn't even a fair comparison because their previous experience is apples to oranges. Do I believe they should raise the standards for NP school? ABSOLUTELY. Unfortunately for the profession, it is money driven. I HOPE that bad patient outcomes are shown in research for under qualified NPs. Maybe then the credentialing institutions will take notice (I don't want anyone getting hurt of course). How have NPs pushed their power too far? Isn't it the profession's responsibility to practice to their maximum capability? Wouldn't you do the same thing? The advanced practice nursing profession has proven through research (albeit, it isn't flawless research) that they can effectively and efficiently practice in primary care comparable to that of physicians for common medical conditions (Hughes et al., 2015; Mafi et al., 2016; Salmdone, 2015). It's not like the numbers are showing that primary care physicians are vastly superior in these research articles in regards to safe care, cost effectiveness, patient satisfaction. I feel for you guys. I was accepted to PA school at Rosalind but chose not to go for these very reasons. I figured that my PT background would help offset the inferior NP training (and it has). I still enjoy coming to this forum because these professions fight very similar battles in different states.

I get your frustration. But c’mon man. I know plenty of NPs who are solid clinicians and have skills identical to PAs. Do PAs have better schooling? Yes. Are most who come out of school better prepared? Yes. However, I know plenty of PAs with little real life medical experience and nurses who go to NP school with lots of RN experience. When I finish NP school I will be fighting for PAs. If you become a DO, you should be fighting for PAs, not tearing down/fighting NPs. If you choose to do the latter you won’t get far. The wheel is already in motion and there won’t be much that can be done to reverse these independent policies.

Yeah associate is higher than assistant/adjunct.