PArunner Posted October 5, 2011 Share Posted October 5, 2011 http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=1&_r=2&ref=health Read that article in the new york times, seems to be very interesting. Debate on whether nurses and other health professionals benefit towards a doctoral degree. If nurses continue to progress towards getting doctorates, where will that lead PAs? Do you think physicians are truly discouraging nurses from going beyond a masters degree because "they can do it just as well" and always "want to be on the front lines diagnosing"? Thoughts? Opinions? Link to comment Share on other sites More sharing options...
jmj11 Posted October 5, 2011 Share Posted October 5, 2011 http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=1&_r=2&ref=health Read that article in the new york times, seems to be very interesting. Debate on whether nurses and other health professionals benefit towards a doctoral degree. If nurses continue to progress towards getting doctorates, where will that lead PAs? Do you think physicians are truly discouraging nurses from going beyond a masters degree because "they can do it just as well" and always "want to be on the front lines diagnosing"? Thoughts? Opinions? I attended a meeting last week of the NP/PA section of the American Headache Society. I was the only PA and there were 4 DNPs there. I've been seeing this coming, but clearly, in my humble opinion, they were trying to create a lot of daylight between PAs and DNP. If that is the way society is going, then there should be easily accessible clinical doctorates for PAs. My impression, these clinical doctorates are are cheap "Drs", however, I confess I don't know a lot about the work that's involved. I do know that my DNP friends got their 'doctorates" in about a year part time. I have two sons working on PhDs right now, and they are on campus for 4-5 years (post grad) getting their PhDs. So, that's why I call it the cheap "Doc." Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 5, 2011 Moderator Share Posted October 5, 2011 http://www.nytimes.com/2011/10/02/health/policy/02docs.html?pagewanted=1&_r=2&ref=health Read that article in the new york times, seems to be very interesting. Debate on whether nurses and other health professionals benefit towards a doctoral degree. If nurses continue to progress towards getting doctorates, where will that lead PAs? Do you think physicians are truly discouraging nurses from going beyond a masters degree because "they can do it just as well" and always "want to be on the front lines diagnosing"? Thoughts? Opinions? rather we think it is right or not we have to come upwith some type of answer to this...... We are going to get left behind and then have to spend years trying to catch upif we do not address this quickly. I agree with "cheap doctorate" but I am on board with it. There no longer is this "a doctor is only a physician" in thiscountry - nurse, PT, OT, SLP, Phd, Chiro's, counselors and even yourhomeopathic doctor are all "doctors" We have allied ourselves with the MD/DO's of this country as we needed to earlyin our careers but now we need to come out from underneath them and develop ourown profession that protects our future... Maybe AMA can patent or trademark ""physician" but"doctor" is simply now a descriptor of having reached a terminaldegree..... And this is about a 180 degree change of heart for me----- but I have 25 yr oldnew grad PT's asking me to call them doctor, nurses asking me to call themdoctor - and yet I am "just the PA" in spite of the fact I am givingthe orders for treatment, directing the patient care, coordinating all theservices....... Maybe the Nurses can develop a special program for MS PA's to go back and get aDNP in 1yr of online courses...... (I am not kidding....) Link to comment Share on other sites More sharing options...
physasst Posted October 5, 2011 Share Posted October 5, 2011 POC, A DNP is NOT a clinical doctorate...no matter how they try to spin it. No change in clinical hours from the Master's course. Just like the DSc degree being offered to the Baylor/Army PA EM Residency graduates is NOT a clinical doctorate. The problem with the DNP is, it isn't a clinical doctorate..it isn't a research doctorate...and it isn't an educational doctorate....basically, it doesn't really fit anywhere. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 5, 2011 Moderator Share Posted October 5, 2011 The problem with the DNP is, it isn't a clinical doctorate..it isn't a research doctorate...and it isn't an educational doctorate....basically, it doesn't really fit anywhere. how about calling it an "administrative doctorate"....:) ...it's basically a doctorate in administration and management with a few epi, public health, and stats courses thrown in. FWIW when I am done with my doctorate I will not be putting Dr. Emedpa on my name tags or asking to be called Dr. at work.....it will be on there but like this: Emedpa, PA-C, DHSc. Link to comment Share on other sites More sharing options...
Dan Kemp Posted October 5, 2011 Share Posted October 5, 2011 Personally I don't think any of these other clinical professions should be moving towards Dr. in the way they are, but they are and that's no going to stop or change. So therefore I think the PA profession is in the position to be left behind unless they move the same way. As incorrect as it is, we will be perceived as subservient to DNP, PT, etc. by patients as well as those practitioners themselves. Link to comment Share on other sites More sharing options...
physasst Posted October 5, 2011 Share Posted October 5, 2011 how about calling it an "administrative doctorate"....:)...it's basically a doctorate in administration and management with a few epi, public health, and stats courses thrown in. FWIW when I am done with my doctorate I will not be putting Dr. Emedpa on my name tags or asking to be called Dr. at work.....it will be on there but like this: Emedpa, PA-C, DHSc. Agreed, it probably fits best in there, but misses a lot of leadership stuff too.....Anyway, never had cared about the title. I will only use mine after I graduate next June for certain professional situations.....Congress, Capitol Hill, testifying, or when being interviewed in health policy topics....otherwise...not so much. There's a physician I know that I was on a trip with...actually there were 2 PA's, and about 6 MD's......he actually reserved his hotel room under the title "Doctor".....I made fun of him for the rest of the trip. What was even worse was, at the airport on the same trip, another physician I know reserved his ticket under "Dr. So and So".... I made fun of him too, and remarked about the pretentiousness of that. The other MD's agreed. As far as my work, I cannot put it on my nametag (unless I get a formal research appointment-which is in discussion) or use the title anywhere in the institution... Neither can DNP's. I have a good friend with her DNP, and she can't even have it on her nametag, and definitely cannot use the title. Link to comment Share on other sites More sharing options...
CAdamsPAC Posted October 6, 2011 Share Posted October 6, 2011 POC, A DNP is NOT a clinical doctorate...no matter how they try to spin it. No change in clinical hours from the Master's course. Just like the DSc degree being offered to the Baylor/Army PA EM Residency graduates is NOT a clinical doctorate. The problem with the DNP is, it isn't a clinical doctorate..it isn't a research doctorate...and it isn't an educational doctorate....basically, it doesn't really fit anywhere. Could misinformation or degree mastrubation or manipulation be applicable????? Just the musings of a "Grunt PA" in the trenches of clinical medicine without "Jedi mind tricks" and no fancy book learnin degrees! Joking aside it's a marketing ploy and a path reflecting the chronic need for nursing to challenge physicians and ease their insecurity!! Just my take on it!!!!!!!!!!!!!!!!! Link to comment Share on other sites More sharing options...
medman2007 Posted October 6, 2011 Share Posted October 6, 2011 It's all poppycock and many, many NPs and RNs feel the same way. The movement of PTs, Pharm Ds, OTs or whatever has not changed the public's opinion of them (for better or worse) one bit. it will be the same for DNPs. There are no valid studies showing a positive correlation of increased clinical skills, pay, or "public" prestige to the above mentioned professions moving toward "doctorate" degrees. However, I do understand the policymakers potentially regarding a "doctorate" level education as more worthy when it comes to scope of practice, etc. But that is purely superior political acumen, and the NPs were winning that war long before DNP came into the picture. For PAs to "keep up" or not be "subservient" as some fear, why not just add a couple of h.care adminstrative classes to all the PA programs and award a "doctorate"? According to some logic, it doesn't matter whether others consider it fluff or not, just as long as the "doctorate" is awarded to be on level with the DNPs? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 6, 2011 Moderator Share Posted October 6, 2011 my long term hope is to not have to compete with np's, (dnp's or otherwise) or physicians. I am hoping to teach at a pa program, work overseas longterm, and spend a greater portion of my time working with underserved populations both here and abroad. since most of this won't be about making big bucks, competition for these positions will not be steep, however having a doctorate will certainly smooth the transition into these areas. Link to comment Share on other sites More sharing options...
wanwan Posted October 10, 2011 Share Posted October 10, 2011 I have two big concerns with the whole doctor-NP thing: 1-It gives NPs more of a reason to push for full independence. Is NP training really enough to practice independently? We, as PAs, get quite a bit more training and clinical time than NPs--and we can always chat w/ a physician if we want/need to. 2-Confusing to patients. Clinically when I hear "doctor" I think MD/DO--and there is a certain minimum level of training that I associate with the word doctor. I agree w/ EMED that doctorates for academic reasons make sense, but not clinically. Check out this facebook site for a breakdown of NP education: https://www.facebook.com/pages/Stop-NP-Independent-Practice/223088457751915?ref=ts#!/pages/Stop-NP-Independent-Practice/223088457751915?sk=wall Am I just crazy for being against the NP doctorate and NPs being independent? Link to comment Share on other sites More sharing options...
andersenpa Posted October 10, 2011 Share Posted October 10, 2011 I have two big concerns with the whole doctor-NP thing: 1-It gives NPs more of a reason to push for full independence. Is NP training really enough to practice independently? We, as PAs, get quite a bit more training and clinical time than NPs--and we can always chat w/ a physician if we want/need to. So can independent NPs, in consultation, no? 2-Confusing to patients. Clinically when I hear "doctor" I think MD/DO--and there is a certain minimum level of training that I associate with the word doctor. I agree w/ EMED that doctorates for academic reasons make sense, but not clinically. I guess it depends on how you view ownership of a title. If we are so dedicated to a paradigm shift in how NPs and PAs deliver care, we should let go of previous notions as the workforce changes. Check out this facebook site for a breakdown of NP education: https://www.facebook.com/pages/Stop-NP-Independent-Practice/223088457751915?ref=ts#!/pages/Stop-NP-Independent-Practice/223088457751915?sk=wall Am I just crazy for being against the NP doctorate and NPs being independent? Only if you believe that 4+4+3 is the ONLY way to train a competent, autonomous PCP. Link to comment Share on other sites More sharing options...
andersenpa Posted October 10, 2011 Share Posted October 10, 2011 Re the facebook page -I agree with #3. -The statement that the majority of NP programs are online- I'm curious to see a reference on that. -there certainly ARE PAs that desire independent practice. No pus for it that I know of other than scaling back restrictive supervision laws Link to comment Share on other sites More sharing options...
Contrarian Posted October 11, 2011 Share Posted October 11, 2011 "Don't Hate the Playa... Hate the game"... "Don't Hate... Congratulate"... "Stop Playa Hatin"... NO ONE PROFESSION OWNS A WORD. Especially when you consider that the degree they are granting themselves... are "Bachelors" degrees elsewhere on this globe. Link to comment Share on other sites More sharing options...
wanwan Posted October 17, 2011 Share Posted October 17, 2011 Re the facebook page -I agree with #3. -The statement that the majority of NP programs are online- I'm curious to see a reference on that. -there certainly ARE PAs that desire independent practice. No pus for it that I know of other than scaling back restrictive supervision laws If you have a little free time, look into a few NP programs--it's pretty interesting. Many are almost completely online (aside from a few on-campus experiences and the clinical rotations that NP students often setup on their own). Drexel's program even has a "residency" which consists of two 5-day on-campus "residency" weeks (and the Drexel NP students I've met actually refer to it as "doing my residency".) The training in many NP programs does not seem very standardized--an objective review (like Flexner) would be appropriate. PA programs are pretty standardized and we get more didactic and clinical training. I was amazed (and frightened) when I actually figured out how little training they get--and want to practice independently right after school. Here are some links for a few programs, for you to get a flavor of the training (online, clinical, etc): -Family NP: Drexel: http://drexel.edu/gradnursing/msn/nursePractitioner/familyPractice/curriculum/ GWU: http://nursing.gwumc.edu/academicsadmissions/mastersprograms/msnfamilynursepractitioner/welcome -Acute Care NP: Drexel: http://drexel.edu/gradnursing/msn/nursePractitioner/acuteCare/ Georgetown: http://nhs.georgetown.edu/nursing/masters/acnp/ Univ of MD (Trauma+CC+EM): http://nursing.umaryland.edu/academic-programs/grad/masters-degree/ms-academic-program/trauma -DNP: http://nursing.gwumc.edu/staticfile/SON/Academics/Brochures/DNP.pdf -Other info: http://www.facebook.com/pages/Stop-NP-Independent-Practice/223088457751915 I've met and worked with some great, experienced, NPs over the years. My problem isn't with the experienced NP, it's with the current training and push to become independent right after NP school graduation. I can't imagine coming right out of PA school with the ability to open my own practice and have no oversight--not that many NPs will do that, but it is legally allowed in a growing number of states. Ok, I'll stop ranting now:) Link to comment Share on other sites More sharing options...
wanwan Posted October 17, 2011 Share Posted October 17, 2011 Re the facebook page -I agree with #3. -The statement that the majority of NP programs are online- I'm curious to see a reference on that. -there certainly ARE PAs that desire independent practice. No pus for it that I know of other than scaling back restrictive supervision laws If you have a little free time, look into a few NP programs--it's pretty interesting. Many are almost completely online (aside from a few on-campus experiences and the clinical rotations that NP students often setup on their own). Drexel's program even has a "residency" which consists of two 5-day on-campus "residency" weeks (and the Drexel NP students I've met actually refer to it as "doing my residency".) The training in many NP programs does not seem very standardized--an objective review (like Flexner) would be appropriate. PA programs are pretty standardized and we get more didactic and clinical training. I was amazed (and frightened) when I actually figured out how little training they get--and want to practice independently right after school. Here are some links for a few programs, for you to get a flavor of the training (online, clinical, etc): -Family NP: Drexel: http://drexel.edu/gradnursing/msn/nursePractitioner/familyPractice/curriculum/ GWU: http://nursing.gwumc.edu/academicsadmissions/mastersprograms/msnfamilynursepractitioner/welcome -Acute Care NP: Drexel: http://drexel.edu/gradnursing/msn/nursePractitioner/acuteCare/ Georgetown: http://nhs.georgetown.edu/nursing/masters/acnp/ Univ of MD (Trauma+CC+EM): http://nursing.umaryland.edu/academic-programs/grad/masters-degree/ms-academic-program/trauma -DNP: http://nursing.gwumc.edu/staticfile/SON/Academics/Brochures/DNP.pdf -Other info: http://www.facebook.com/pages/Stop-NP-Independent-Practice/223088457751915 I've met and worked with some great, experienced, NPs over the years. My problem isn't with the experienced NP, it's with the current training and push to become independent right after NP school graduation. I can't imagine coming right out of PA school with the ability to open my own practice and have no oversight--not that many NPs will do that, but it is legally allowed in a growing number of states. Ok, I'll stop ranting now:) Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 18, 2011 Moderator Share Posted October 18, 2011 maybe all the NP students at those places shake thier heads at the PA schools that are admitting students with token or no hce. after all, previous high quality hce is essential/extremely helpful for PA awesomeness, right? lots of pa's shake their heads at this as well.... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 18, 2011 Moderator Share Posted October 18, 2011 maybe all the NP students at those places shake thier heads at the PA schools that are admitting students with token or no hce. after all, previous high quality hce is essential/extremely helpful for PA awesomeness, right? lots of pa's shake their heads at this as well.... Link to comment Share on other sites More sharing options...
andersenpa Posted October 18, 2011 Share Posted October 18, 2011 If you have a little free time, look into a few NP programs.......etc..... I'm aware that distance education is growing; I was not aware that "most" NP programs (to me meaning >50%) are as such. Link to comment Share on other sites More sharing options...
andersenpa Posted October 18, 2011 Share Posted October 18, 2011 If you have a little free time, look into a few NP programs.......etc..... I'm aware that distance education is growing; I was not aware that "most" NP programs (to me meaning >50%) are as such. Link to comment Share on other sites More sharing options...
andersenpa Posted October 18, 2011 Share Posted October 18, 2011 maybe all the NP students at those places shake thier heads at the PA schools that are admitting students with token or no hce. after all, previous high quality hce is essential/extremely helpful for PA awesomeness, right? RNs generally have pretty good bonifides as far as hce, correct? Given that we have no data on the quality of practitioners (PAs or NPs) in terms of outcomes, liability cases etc and how that correlates to previous HCE, I don't see how we can say anythgin with certainty. We have lots of anecdotal evidence that HCE makes students "easier to teach" but how it measures out in the long run, who knows. Right now we have PA and NP programs admitting students with the full gamut of HCE, from zero to >10,000 hrs. DE NP programs count nursing experience gained while in NP school. There is no standard and thus no universal statement can be made. Link to comment Share on other sites More sharing options...
andersenpa Posted October 18, 2011 Share Posted October 18, 2011 maybe all the NP students at those places shake thier heads at the PA schools that are admitting students with token or no hce. after all, previous high quality hce is essential/extremely helpful for PA awesomeness, right? RNs generally have pretty good bonifides as far as hce, correct? Given that we have no data on the quality of practitioners (PAs or NPs) in terms of outcomes, liability cases etc and how that correlates to previous HCE, I don't see how we can say anythgin with certainty. We have lots of anecdotal evidence that HCE makes students "easier to teach" but how it measures out in the long run, who knows. Right now we have PA and NP programs admitting students with the full gamut of HCE, from zero to >10,000 hrs. DE NP programs count nursing experience gained while in NP school. There is no standard and thus no universal statement can be made. Link to comment Share on other sites More sharing options...
Hear My Silence Posted October 18, 2011 Share Posted October 18, 2011 Actually, the DNP is a professional doctorate. The phrase "clinical doctorate" is not a recognized term for any current educational degree.This debate of who qualifies as a doctor goes way back to when MD's were stepping on the toes of PhD professors. In the society we live in now, there are many types of doctorate educational degrees. Professional, research, educational, administrative and so on. Whether or not you agree with the current system is irrelevant. If a person earns a doctorate degree accredited by the department of education then that person is henceforth a doctor and may use the title of Dr. ethically so long as they acknowledge the type of doctor they are and do not misrepresent themselves.A PA doctorate seems to contradict the very roots of what a PA was intended to be: former healthcare professionals who sought higher education in order to practice medicine in collaboration with physicians. The whole point of becoming a PA is to practice medicine WITHOUT becoming a doctor. A PA doctorate would basically be a medical doctor without a residency. That goes back to my belief that MD's and DO's should be allowed to test for a PA license if they do not wish to go through a residency.But that's another can of worms I'm sure no one here agrees with. Link to comment Share on other sites More sharing options...
Hear My Silence Posted October 18, 2011 Share Posted October 18, 2011 Actually, the DNP is a professional doctorate. The phrase "clinical doctorate" is not a recognized term for any current educational degree.This debate of who qualifies as a doctor goes way back to when MD's were stepping on the toes of PhD professors. In the society we live in now, there are many types of doctorate educational degrees. Professional, research, educational, administrative and so on. Whether or not you agree with the current system is irrelevant. If a person earns a doctorate degree accredited by the department of education then that person is henceforth a doctor and may use the title of Dr. ethically so long as they acknowledge the type of doctor they are and do not misrepresent themselves.A PA doctorate seems to contradict the very roots of what a PA was intended to be: former healthcare professionals who sought higher education in order to practice medicine in collaboration with physicians. The whole point of becoming a PA is to practice medicine WITHOUT becoming a doctor. A PA doctorate would basically be a medical doctor without a residency. That goes back to my belief that MD's and DO's should be allowed to test for a PA license if they do not wish to go through a residency.But that's another can of worms I'm sure no one here agrees with. Link to comment Share on other sites More sharing options...
kelbeth Posted October 18, 2011 Share Posted October 18, 2011 If you have a little free time, look into a few NP programs--it's pretty interesting. Many are almost completely online (aside from a few on-campus experiences and the clinical rotations that NP students often setup on their own). Drexel's program even has a "residency" which consists of two 5-day on-campus "residency" weeks (and the Drexel NP students I've met actually refer to it as "doing my residency".) The training in many NP programs does not seem very standardized--an objective review (like Flexner) would be appropriate. PA programs are pretty standardized and we get more didactic and clinical training. I was amazed (and frightened) when I actually figured out how little training they get--and want to practice independently right after school. Here are some links for a few programs, for you to get a flavor of the training (online, clinical, etc): -Family NP: Drexel: http://drexel.edu/gradnursing/msn/nursePractitioner/familyPractice/curriculum/ GWU: http://nursing.gwumc.edu/academicsadmissions/mastersprograms/msnfamilynursepractitioner/welcome -Acute Care NP: Drexel: http://drexel.edu/gradnursing/msn/nursePractitioner/acuteCare/ Georgetown: http://nhs.georgetown.edu/nursing/masters/acnp/ Univ of MD (Trauma+CC+EM): http://nursing.umaryland.edu/academic-programs/grad/masters-degree/ms-academic-program/trauma -DNP: http://nursing.gwumc.edu/staticfile/SON/Academics/Brochures/DNP.pdf -Other info: http://www.facebook.com/pages/Stop-NP-Independent-Practice/223088457751915 I've met and worked with some great, experienced, NPs over the years. My problem isn't with the experienced NP, it's with the current training and push to become independent right after NP school graduation. I can't imagine coming right out of PA school with the ability to open my own practice and have no oversight--not that many NPs will do that, but it is legally allowed in a growing number of states. Ok, I'll stop ranting now:) I have a question about PA/NP, and it looks like this is the best place to ask, even though it isn't about NP being called "Dr." My apologies if this has been discussed elsewhere. I am not a PA yet, but am in the process of applying to a couple of schools. My question is one regarding prescription authority. In my state, Kentucky, which is not PA friendly, PAs cannot prescribe scheduled drugs, yet after one year of practice, NPs can, provided they have a DEA license. Can someone explain the logic in that? How is it that a PA who has had 2 semesters of general chemistry, 2 semesters of organic chemistry, and probably upper level biology courses, and has gone through a PA program that mirrors a medical school curriculum (albeit not quite as long) not write a prescription for scheduled drugs, yet a nurse practioner, with maybe two lower-level chemistry courses can? Link to comment Share on other sites More sharing options...
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