NPs are killing us

[sk732]

The thing with degree creep is it only impresses people that don't understand the difference between a PhD and MD/DO/DDS/DVM or whatever.  We had a PhD NP in my health region that put Dr in front of their name on their LinkedIn profile - it wasn't up there all that long, as it's misleading when attached to a health care worker...and it was a PhD(Ed), not even nursing practice.  Most MD's don't put Dr on their profiles - it's usually "Joe/Jane Bloggins MD"  There is an argument to be said walking around calling yourself "Dr Nursing Sister/Brother/PA" is in fact deliberately misleading, much like false advertising, especially with a white coat on (like "Dr Nurse" Poole on the short lived TV series "MD's").  IMO, if you're that insecure in yourself and your credentials, go to medical or voodoopathic school; otherwise, take a long look in the mirror and own who you are and what you do, whether you're an NP, a PA or some management geek medical or nursing wannabe/never was.  My mother is a "Dr"...of Canadian History, which rather pedantically comes out whenever she feels threatened by something/one. 

For perspective, someone trained under a British medical training system is called "Doctor" with the degrees  Bachelor of Medicine and Bachelor of Surgery (+/-Obstetrics depending on country trained in).  They then become "Mr" or "Ms" after completing their consultants' training.  They become "Doctor" again if they do their MD - which is like a PhD in medicine.

Just remember, most of these degrees, unless they're attached to a residency as a clinical degree, are in fact fluff and LCF (Look Cool Factor)  and more than likely, bank account vacuums.  Want to be management - take a health management/admin geek track.  Want to be clinical - do a clinical degree.  Feel you need to be a "Doctor" - well, you've heard my $0.02 on that.

Let the flames begin...

SK

[ProSpectre]

16 minutes ago, sk732 said:

The thing with degree creep is it only impresses people that don't understand the difference between a PhD and MD/DO/DDS/DVM or whatever.  We had a PhD NP in my health region that put Dr in front of their name on their LinkedIn profile - it wasn't up there all that long, as it's misleading when attached to a health care worker...and it was a PhD(Ed), not even nursing practice.  Most MD's don't put Dr on their profiles - it's usually "Joe/Jane Bloggins MD"  There is an argument to be said walking around calling yourself "Dr Nursing Sister/Brother/PA" is in fact deliberately misleading, much like false advertising, especially with a white coat on (like "Dr Nurse" Poole on the short lived TV series "MD's").  IMO, if you're that insecure in yourself and your credentials, go to medical or voodoopathic school; otherwise, take a long look in the mirror and own who you are and what you do, whether you're an NP, a PA or some management geek medical or nursing wannabe/never was.  My mother is a "Dr"...of Canadian History, which rather pedantically comes out whenever she feels threatened by something/one. 

For perspective, someone trained under a British medical training system is called "Doctor" with the degrees  Bachelor of Medicine and Bachelor of Surgery (+/-Obstetrics depending on country trained in).  They then become "Mr" or "Ms" after completing their consultants' training.  They become "Doctor" again if they do their MD - which is like a PhD in medicine.

Just remember, most of these degrees, unless they're attached to a residency as a clinical degree, are in fact fluff and LCF (Look Cool Factor)  and more than likely, bank account vacuums.  Want to be management - take a health management/admin geek track.  Want to be clinical - do a clinical degree.  Feel you need to be a "Doctor" - well, you've heard my $0.02 on that.

Let the flames begin...

SK

I agree one hundred percent. Unfortunately, degree creep is real, and is happening across the healthcare field (last year the professional organization for occupational therapists decided to transition to the doctorate as the standard for their profession, despite saying they didn't recommend the switch only two years prior).  I think a name change and OTP are more important for the PA profession than a doctoral degree, and I think the residency model is a better option for postgraduate training. However, my guess is that doctorates for PAs will become more common, and may eventually become the norm; I only hope that if they do, there is some residency component to the education, rather than additional "fluff" courses that don't help with clinical practice.

[pursuitofPA]

I agree one hundred percent. Unfortunately, degree creep is real, and is happening across the healthcare field (last year the professional organization for occupational therapists decided to transition to the doctorate as the standard for their profession, despite saying they didn't recommend the switch only two years prior).  I think a name change and OTP are more important for the PA profession than a doctoral degree, and I think the residency model is a better option for postgraduate training. However, my guess is that doctorates for PAs will become more common, and may eventually become the norm; I only hope that if they do, there is some residency component to the education, rather than the "fluff" many doctorates contain.   

Im an OT. I completely disagree with the change. They should’ve addressed compensation before requiring future students to get enormous debt that they will struggle to pay off for the rest of their lives.


Sent from my iPhone using Tapatalk

[GetMeOuttaThisMess]

I’m looking at adding GMOTM, PA-C Emeritus

[DizzyJ]

59 minutes ago, sk732 said:

The thing with degree creep is it only impresses people that don't understand the difference between a PhD and MD/DO/DDS/DVM or whatever.  We had a PhD NP in my health region that put Dr in front of their name on their LinkedIn profile - it wasn't up there all that long, as it's misleading when attached to a health care worker...and it was a PhD(Ed), not even nursing practice.  Most MD's don't put Dr on their profiles - it's usually "Joe/Jane Bloggins MD"  There is an argument to be said walking around calling yourself "Dr Nursing Sister/Brother/PA" is in fact deliberately misleading, much like false advertising, especially with a white coat on (like "Dr Nurse" Poole on the short lived TV series "MD's").  IMO, if you're that insecure in yourself and your credentials, go to medical or voodoopathic school; otherwise, take a long look in the mirror and own who you are and what you do, whether you're an NP, a PA or some management geek medical or nursing wannabe/never was.  My mother is a "Dr"...of Canadian History, which rather pedantically comes out whenever she feels threatened by something/one. 

Let the flames begin...

SK

LinkedIn is a professional networking site.  It is all about credentials and experience.  There is nothing misleading about it.  The profile is not meant for general public advertisement.  Her profile should have clearly listed what her doctorate was in.  I do agree though that if you list PhD after your name, then do you really need to put the Dr. in front of it?  Not really.  I don’t agree with the statement that it is misleading when attached to a healthcare worker as a blanket statement.  It is misleading to not identify yourself as a PA/NP to a patient or fellow healthcare worker.  Everyone should introduce themselves to patients based on licensure and not degree.  

[sas5814]

"Everyone should introduce themselves to patients based on licensure and not degree."

 

In a sentence you articulated something I have spent paragraphs trying to explain (and poorly I might add). I'll be using this in future conversations.  

[lemurcatta]

I think it’s important to remember that “doctor” means teacher, not “physician.” I have made it a point in my everyday speech to call physicians by that title only. This is because 1) I’m currently a graduate student where the title “Dr.” tells you nothing about whether the person is a clinician or not, and 2) the medical profession has made a mistake by being so sloppy with their title: they are physicians, not just doctors. Doctor means a lot of different things depending on context. Physician only means one thing. Also, the original doctorate is the PhD. The title is really afforded to the MD as a courtesy, a fact which has been long forgotten.

For this reason, I’ve never cared much about other health professions using the title. We should really divorce the automatic association between “doctor” and “physician.” It would make everyone happier I think. 

 

[ProSpectre]

4 hours ago, lemurcatta said:

I think it’s important to remember that “doctor” means teacher, not “physician.” I have made it a point in my everyday speech to call physicians by that title only. This is because 1) I’m currently a graduate student where the title “Dr.” tells you nothing about whether the person is a clinician or not, and 2) the medical profession has made a mistake by being so sloppy with their title: they are physicians, not just doctors. Doctor means a lot of different things depending on context. Physician only means one thing. Also, the original doctorate is the PhD. The title is really afforded to the MD as a courtesy, a fact which has been long forgotten.

For this reason, I’ve never cared much about other health professions using the title. We should really divorce the automatic association between “doctor” and “physician.” It would make everyone happier I think. 

 

While your post is accurate, these subtleties are often lost on the general public. In the clinical setting when the public hears "doctor", most equate that with "physician". Most members of the general public couldn't tell you the differences between an MD, DO, PhD, PharmD, DNP, or an OD, which is why it can be disingenuous for clinicians who do know the difference to use the "doctor" title in clinical settings knowing full well that most people automatically associate the term with a residency-trained physician. When health illiteracy is so high in many parts of the country, this distinction matters. In an academic setting, however, it doesn't.

[lemurcatta]

Working in evolutionary biology has taught me to not care too much about what the public thinks about certain things. I bet if you polled Americans, many would think their OD holds an MD. Patients who actually care will probably be savvy enough to do a simple google search of their clinician’s credentials (also I am trying to stay away from the term “provider”). Those who don’t, well, that’s their problem. This all applies only if the clinician is accurately representing themselves in good faith based on their license. I do understand that some NPs appear to be purposefully trying to get themselves confused with physicians.

[ProSpectre]

36 minutes ago, lemurcatta said:

Working in evolutionary biology has taught me to not care too much about what the public thinks about certain things. I bet if you polled Americans, many would think their OD holds an MD. Patients who actually care will probably be savvy enough to do a simple google search of their clinician’s credentials (also I am trying to stay away from the term “provider”). Those who don’t, well, that’s their problem. This all applies only if the clinician is accurately representing themselves in good faith based on their license. I do understand that some NPs appear to be purposefully trying to get themselves confused with physicians.

Sure, but as a profession, we should care what policy makers and employers (who often have no medical background) think, since they will directly effect whether our profession continues to grow or whether the regulatory environment favors those we compete with jobs for (i.e. NPs). Since they are technically part of the public, this stuff matters. 

[sk732]

2 hours ago, DizzyJ said:

LinkedIn is a professional networking site.  It is all about credentials and experience.  There is nothing misleading about it.  The profile is not meant for general public advertisement.  Her profile should have clearly listed what her doctorate was in.  I do agree though that if you list PhD after your name, then do you really need to put the Dr. in front of it?  Not really.  I don’t agree with the statement that it is misleading when attached to a healthcare worker as a blanket statement.  It is misleading to not identify yourself as a PA/NP to a patient or fellow healthcare worker.  Everyone should introduce themselves to patients based on licensure and not degree.  

The issue at hand is the use of an academic pre-nominal on a professional site without the academic post-nominal(s)/titles in their name, then nurse practitioner in small print elsewhere.  It was changed to read "J Bloggins PhD(Ed), MSN(NP) BN, RN, etc ad nauseum".  The underlying question is whether or not they introduced themselves as "Dr Bloggins" without qualifying the NP bit in a public/professional setting.

The title Doctor for a PhD (be it History, Pharmacy, Nursing Practice, Health Science, Rehab, etc) is an academic title that comes with the degree level; when in front of someone's name that is an MD/DO/DDS/DVM/OD/VD/DC/ND or whatever, it's a professional title that is attached to that professional degree (except JD's - Law is, like medicine, technically an entry level, post-grad, professional degree - God forbid lawyers start calling themselves Doctor too).  

To Jack or Jane Farmer where I work, were I to walk into the exam room, wearing a white coat or scrubs and a stethoscope and introduce myself as "Dr Sean one of the Emerg physicians" or "Dr Sean, one of the NP's here" or "Dr Sean, one of the PA's here"  they'll just hear "Doctor" and assume what we assume about ducks.  The difference is thus - two of me used academic titles in a professional setting where those titles mean something else and despite qualifying what we were, the patients, unless really savvy about medical hierarchy, will only hear "Doctor" and assume we're MD's...which we aren't, which makes it misleading.  Not saying that you personally do that, but like it or not, there are those out there that are pretty insecure in themselves that would and in fact, do that.  It's just like when my mother was a patient where I worked and started saying "That's Dr K to you" - someone came up and said they didn't know she was a doctor...I said, "yeah, she is...but of History, so take that for what it's worth".

I just really hate people that hide behind titles and either deliberately or accidentally on purpose, misrepresent who they are...incidentally, that includes MD's who are scared of their own shadows and who might be SP/CP's to some of the global us.

And yes, I have Mommy issues.

SK

[Cideous]

The only people I have EVER met who list themselves as  "Dr. John Smith" on their lab jackets have been DO's.  I have never seen an MD do it.  Only DO's.  I admit to have chuckled a few times at it.  All those years and they are still feeling inadequate....ouch. 

[BruceBanner]

Nothing more pretentious than the casual dropping of a doctorate title. It's relevant on papers, maybe in interviews, but never in casual conversation. It's like "hey, respect me!!!" A very human impulse. 

I always hated it when profs in college insisted on being called "doctor so-and-so". Ironically people would respect them more if they were on a first-name basis.

[sas5814]

My boss says he knows when I'm mad because my emails are signed with my full name, degree, and title. usually I'm just a first name. :-)

[sas5814]

On 1/27/2018 at 8:32 AM, UGoLong said:

I think that there must be some similarities between PAs vs NPs as with MDs vs DOs in the old days. Hopefully it will work out as well, at least as I see around here.

For many years I was on the "us vs them" train against the NPs. You know all the arguments so I won't belabor them. I started shifting gears a few years ago for one simple reason.... staying tied to physicians was holding us back and the nurses had that figured out years and years ago.

My issue with this particular situation is 2 fold...the way these "leaders" were picked and appointed and the fact that they are all NPs when there are easily 10 PAs in our system with vastly more experience in leadership, policy, politics and none were even notified or considered.

I sent a rather lengthy email to the VP in charge of these divisions and decisions (a physician) after I realized nobody really gives a damn about this besides me. I attached my resume, again outlined the issue, and told him as soon as I found an organization that had some respect for the PA profession and knew how to pick actual leaders I'd be gone. So far there has only been the thundering sound of silence. I guess that is better than getting fired....

[DizzyJ]

On 1/31/2018 at 7:08 PM, sk732 said:

The issue at hand is the use of an academic pre-nominal on a professional site without the academic post-nominal(s)/titles in their name, then nurse practitioner in small print elsewhere.  It was changed to read "J Bloggins PhD(Ed), MSN(NP) BN, RN, etc ad nauseum".  The underlying question is whether or not they introduced themselves as "Dr Bloggins" without qualifying the NP bit in a public/professional setting.

The title Doctor for a PhD (be it History, Pharmacy, Nursing Practice, Health Science, Rehab, etc) is an academic title that comes with the degree level; when in front of someone's name that is an MD/DO/DDS/DVM/OD/VD/DC/ND or whatever, it's a professional title that is attached to that professional degree (except JD's - Law is, like medicine, technically an entry level, post-grad, professional degree - God forbid lawyers start calling themselves Doctor too).  

To Jack or Jane Farmer where I work, were I to walk into the exam room, wearing a white coat or scrubs and a stethoscope and introduce myself as "Dr Sean one of the Emerg physicians" or "Dr Sean, one of the NP's here" or "Dr Sean, one of the PA's here"  they'll just hear "Doctor" and assume what we assume about ducks.  The difference is thus - two of me used academic titles in a professional setting where those titles mean something else and despite qualifying what we were, the patients, unless really savvy about medical hierarchy, will only hear "Doctor" and assume we're MD's...which we aren't, which makes it misleading.  Not saying that you personally do that, but like it or not, there are those out there that are pretty insecure in themselves that would and in fact, do that.  It's just like when my mother was a patient where I worked and started saying "That's Dr K to you" - someone came up and said they didn't know she was a doctor...I said, "yeah, she is...but of History, so take that for what it's worth".

I just really hate people that hide behind titles and either deliberately or accidentally on purpose, misrepresent who they are...incidentally, that includes MD's who are scared of their own shadows and who might be SP/CP's to some of the global us.

And yes, I have Mommy issues.

SK

I don’t find it misleading if someone says “I’m Dr Sean and I’m an NP”....just because the patient stops listening at “Dr” doesn’t mean the provider mislead them if they specifically say they are an NP or PA.  We can’t be blamed for a patient’s assumption of MD if one is clear about their licensure.  I think it would be even bettter to identify “Dr. Sean and I’m an NP with a doctorate in NP”.  I have never used my Dr title in practice and don’t think I will in the future either.  

[camoman1234]

1 hour ago, DizzyJ said:

I don’t find it misleading if someone says “I’m Dr Sean and I’m an NP”....just because the patient stops listening at “Dr” doesn’t mean the provider mislead them if they specifically say they are an NP or PA.  We can’t be blamed for a patient’s assumption of MD if one is clear about their licensure.  I think it would be even bettter to identify “Dr. Sean and I’m an NP with a doctorate in NP”.  I have never used my Dr title in practice and don’t think I will in the future either.  

I agree, WE (PAs/NPs) ARE NOT PHYSICIANS. I do not understand this mentality that we are equal to a MD/DO. We are NOT and will never be as we did NOT go to medical school. I am so tired of everyone whining about how we can make ourselves equal a MD/DO and we CANNOT. I don't care if you got a PhD in molecular genetics from Harvard, you are STILL not a MD/DO. If one wants to become a MD/DO then go to medical school and quit trying to find a "quick/easier" route to get to that goal. Do I consider myself just as good or better than some MDs/DOs, YES I do in some areas of medicine and from my past HCE, but that still does not get me to the point of calling myself Dr. Camoman1234 with my health science doctorate or PhD in biochemistry. Let's move forward on moving OUR profession (PA-C) forward and not comparing ourselves to NPs or MD/DOs. That is why we are getting ran over by NPs, like it or not that is a fact. (Disclaimer: my wife is a FNP so I learn a lot from her).    

[PACrankset]

24 minutes ago, camoman1234 said:

I agree, WE (PAs/NPs) ARE NOT PHYSICIANS. I do not understand this mentality that we are equal to a MD/DO. We are NOT and will never be as we did NOT go to medical school. I am so tired of everyone whining about how we can make ourselves equal a MD/DO and we CANNOT. I don't care if you got a PhD in molecular genetics from Harvard, you are STILL not a MD/DO. If one wants to become a MD/DO then go to medical school and quit trying to find a "quick/easier" route to get to that goal. Do I consider myself just as good or better than some MDs/DOs, YES I do in some areas of medicine and from my past HCE, but that still does not get me to the point of calling myself Dr. Camoman1234 with my health science doctorate or PhD in biochemistry. Let's move forward on moving OUR profession (PA-C) forward and not comparing ourselves to NPs or MD/DOs. That is why we are getting ran over by NPs, like it or not that is a fact. (Disclaimer: my wife is a FNP so I learn a lot from her).    

I think you make some really great points. We need to stop comparing ourselves and worrying about what other professions are doing. We need to focus on advancing our profession not trying to tear down others.

[Cideous]

Our name sucks.  The end.

[sk732]

DJ, we can agree to disagree - wonderful thing about the two countries we live in.

10 hours ago, PACrankset said:

I think you make some really great points. We need to stop comparing ourselves and worrying about what other professions are doing. We need to focus on advancing our profession not trying to tear down others.

What this guy said - it's been said many times that there needs to be a bit of upheaval of the status quo and the profession needs drop a hammer on the public and the medical community about what we do and what we bring to the table...and in a big way.  Do the public affairs folks at AAPA (do they actually have any?) do it for a living or is it their sideline?  Would people be willing to pay more membership dues if they hired some proper public affairs folks to aggressively market PA's the way the Sister/Brotherhood does for themselves?  CAPA, the Canadian Association of PA's, hired some full time public relations folks and an ex political staffer to ramrod some of this for us - things are picking up somewhat in the past year since the one dude came on line.  For the most part, out of necessity, a lot of advocacy was/still is done by ourselves in person at political get togethers, on social media, at conferences, etc. With the amount of people working in the US, I'd think you shouldn't have to do this yourselves - there are more than enough organizations people pay dues to (I'm also a SEMPA Member) that they should have full time, paid advocacy staff working for you all to make the public, medical hierarchy/bureaucrats and government see and know what you do and are capable off and be the loud voices for the busy quiet professionals we are (for the most part).

3 hours ago, Cideous said:

Our name sucks.  The end.

I wouldn't say it sucks...but it needs revamping to keep up with what we do.  English words are so easy to spin the wrong way...especially by the purveyors of evil...like the American College of Cathopathic Physicians, lol.

SK

[Boatswain2PA]

On 1/29/2018 at 11:36 PM, 2234leej said:

I will be obtaining board certification in family practice

More confusing lingo that conflates a nursing board to a medical board.

"Board certified" in a specialty should be a term reserved for physicians.  I would wager LARGE amounts of money that very very few FNPs could pass the family practice boards.

[DizzyJ]

On 2/2/2018 at 0:00 PM, camoman1234 said:

I agree, WE (PAs/NPs) ARE NOT PHYSICIANS. I do not understand this mentality that we are equal to a MD/DO. We are NOT and will never be as we did NOT go to medical school. I am so tired of everyone whining about how we can make ourselves equal a MD/DO and we CANNOT. I don't care if you got a PhD in molecular genetics from Harvard, you are STILL not a MD/DO. If one wants to become a MD/DO then go to medical school and quit trying to find a "quick/easier" route to get to that goal. Do I consider myself just as good or better than some MDs/DOs, YES I do in some areas of medicine and from my past HCE, but that still does not get me to the point of calling myself Dr. Camoman1234 with my health science doctorate or PhD in biochemistry. Let's move forward on moving OUR profession (PA-C) forward and not comparing ourselves to NPs or MD/DOs. That is why we are getting ran over by NPs, like it or not that is a fact. (Disclaimer: my wife is a FNP so I learn a lot from her).    

I’m trying to reread the posts to find where someone said we are equal to MD/DO.  I don’t see this.  This is an opinion of some that those PAs who have gone on to get a doctorate are doing so because they think it will make them equal.  This is not a fight about equality or comparison between PA vs MD/DO.  I think at our current level of training we should be viewed as being able to reach independent practice in certain specialties without obtaining any additional degree.  My personal opinion is that I will not call myself doctor in the clinical setting because it has nothing to do with my licensure.  If someone does choose to go by doctor they should make it clear what the doctorate is in and what their licensure is to practice.  

[CompassionateProvider]

Wow. I happened upon this site because I was comparing Epocrates to UpToDate for my clinical practice. I am a NP student. I'm reading these posts and it saddens me.  We each have a place, as a professional there are good and bad in EVERY field (how many MD's have you worked with that should have been run out of the practice!!!!)

   I have to say, I'm GLAD that NP's are being chosen over PA's. Look at it this way, I've been an RN (with a Master's degree) for 30 years. ANYONE can go to PA school, as long as they have a degree in something. Does that even make sense? You have no clinical background to draw on and come out to practice just based on your study. Now, I won't be a hater like many of you above, but please. Be professional. 

[CompassionateProvider]

Thank you 

[camoman1234]

1 hour ago, DizzyJ said:

I’m trying to reread the posts to find where someone said we are equal to MD/DO.  I don’t see this.  This is an opinion of some that those PAs who have gone on to get a doctorate are doing so because they think it will make them equal.  This is not a fight about equality or comparison between PA vs MD/DO.  I think at our current level of training we should be viewed as being able to reach independent practice in certain specialties without obtaining any additional degree.  My personal opinion is that I will not call myself doctor in the clinical setting because it has nothing to do with my licensure.  If someone does choose to go by doctor they should make it clear what the doctorate is in and what their licensure is to practice.  

 "I think at our current level of training we should be viewed as being able to reach independent practice in certain specialties without obtaining any additional degree." This is saying we are equal to an MD/DO. If you want independent practice then go to medical school. I disagree with NPs having independent practice even though their training is "nursing", but when you confront a NP about this then they tell you they practice medicine... We (PAs) are trained and practice medicine as MD/DOs are trained and do. So they is why I think we should have OTP, but not independence as we did NOT go to medical school.