Nurse Practitioners in Texas

[Kaepora]

Fine.  That's a reasonable point of disagreement.  But here's the deal.  Summarize "academic clinical training" of each profession in say, family practice, side-by-side:

 

PA's:  2,000 hours in PA school, 2,000 hours in prior healthcare experience:  4,000 hours (FP is only 600 hours in PA school, but I'm crediting your other rotations).

NP's:  800 hours in NP school, 2,000 hours as an RN: 2800 hours

MD's: 2,000 hours in MD school, 9,000 hours in residency: 11,000 hours

 

Difference: 25% vs. 33% with NPs vs. PAs compared to an MD or DO.  You ain't winnin' no arguments with that (to use my native vernacular.).

 

Let's not debate PA vs. NP and whatever prior experience this PA had vs. this NP, and RN training vs. PT, OT, EMT, CNA, RT, yada, yada, just for the sake of this discussion.  The PA's argument that he/she is better qualified than an NP means NOTHING in light of the "academic clinical experience" of an MD/DO.  NOTHING.  Our academic clinical training pales in comparison (me being an NP and this board being PAs).  Yet all research shows (OK, maybe it is somewhat limited) that PA's and NP's still offer excellent care, perhaps care equivalent to or even exceeding that of an MD/DO, especially with the experienced NP/PA.

 

When you go after NP's, arguing that your training is superior to NP's, you are talking about a rough difference of 1,200 hours in academic clinical training.  How relevant is that 1, 2, 3, 5 years out?  But that is not even my point.  How relevant is it in light of the fact that the average MD/DO vs. PA has 8,000+ hours more clinical training than you?! 

 

SO THINK ABOUT IT.  You PAs have (maybe have) 1,200 hours more relevant (maybe) training experience vs. the NP, yet the MD/DO has 8,000 hours more academic clinical training than you!

 

When you bash an NP for not having enough clinical training, you are bashing YOURSELVES. 

 

Purely anecdotal, but in my short NP career, I have now had 3 physicians tell me that their academic residency experience (supervised) as opposed to real world practice (non-academic, unsupervised) was night and day.  In other words, it certainly helps but it strongly highlights the fact that supervised clinical experience vs. actual clinical experience cannot be compared.  But I digress.

 

When you, or your groups, are fighting for more rights (as you absolutely should), you will never win arguing that you are better than NP's.  You must argue that your experience, training, etc. yields equal (better?) results to that of NP/MD/DOs.  There are NP studies (yeah, they can be questioned, but they're actually fairly decent and rigorous) that show that NP care is as good or perhaps even better than MD/DO care.  PA's could then point to those studies to legislators, and then note that not only do NP's provide equivalent care, but PA's have even more training (academic training of course) than NP's!

 

Obviously, I'm not talking about PA's and NP's in true specialties and sub-specialties.  And there's a bazillion arguments that can stem from this post in all sorts of ways (my math, "equivalent" training, these hours vs. those hours, this vs. that, etc.).  Maybe we hash those out in another thread.  But my point is simple:  You go after NP's for their supposed lack of training, and medical boards will use your arguments against NP's against you as PA's.  

 

You can choose to believe that or not.

 

 

THIS.  Look, I am not supporter of NP education (in general) and I think we should incorporate many more clinical hours (I'm personally doing this).  But UpRegulated is absolutely right here.  You are only arguing against yourselves with this argument.  It's like saying you're a better runner than your friend because you can run 2 miles to his 1 mile, meanwhile your other friend is running a marathon.  You just look silly.

[KMD16]

Are you kidding? NPs are taking jobs nationwide that could go to PAs. We congratulate ourselves for being better trained, but they have better politics. Which do you think is winning: training or politics?

So sick n tired of how we are better trained! We are been overrun. It's sad but true. It's silently scary to say the least. They are dominating primary care and extending their footing into other specialties.

[GetMeOuttaThisMess]

Updated story: http://www.wfaa.com/mb/news/health/nurse-practitioners-ask-lawmakers-to-loosen-law-on-practice/424481506

[Mainer]

Wrong about that.......I believe it is a valid argument, even if only part of the case PA's make for independence. 

 

NP in family practice training = 800 hours max 

PA's will do 600 to 800 in just family practice, but then they do internal medicine, and pediatrics for another 600 plus hours. 

Further, what completes your clinical training for family medicine is more your time in general surgery, emergency medicine, psychiatry, gyn/women's health ect. 

As an example, you'll see more breast masses, acute abdomens, colon cancer, rectal pathology, so forth, in a 6 week general surgery rotation than you will an entire career in family medicine.....How can you be a family practitioner if you've never done a psychiatry rotation?  

 

The point being that an NP would be better prepared for family medicine if they spent 400 hours family medicine and 400 in general surgery than spending 800 in family medicine.  Not to mention all the other clinical deficiencies. 

 

Nursing is poor preparation for success in medical/PA school.   Most RN's lack the science and math education to prepare them for successful matriculation into these programs. 

 

The whole point is that NP's are underprepared, lacking in breadth and depth.  NP's have the least amount of training and education of all health care providers by as much as 1/2 or more (compare optometrist, PT's/OT's, Pharmacy, PA's, so forth) 

 

Also agreed, PA's need to develop a plan for independence....name change, change degree awarded from masters to doctorate (it's already more credit hours than every other clinical doctorate other than MD/DO, Maybe DMD), and agenda for 50 state independent practice.