Satori,
Respectfully, there is no confusion, or medical errors, or dissemination of incorrect information. I think that NPs generally get flack because there are some physicians and medical students still do the old turf war thing. I’m not sure where this is coming from or why people keep saying it, but there is simply no evidence to support these things. In fact, the 2010 report published by the Institute of Medicine about nurse practitioner practice proves exactly the opposite of this. Nurse practitioners do not make more errors or cause more harm to patients than physicians do. And patients do know the difference between a physician and a nurse practitioner. As far as I am aware, the state boards of nursing require that we legally identify ourselves with the ARNP, NP, or APRN title—even if we have a DNP degree. The rationale is simple: nurses with advanced training are still nurses, not physicians. I understand the desire of DNPs to proudly display and use their DNP title, but I don’t believe that any of us nurse practitioners who have DNP degrees would intentionally try to make a patient think that we are physicians. That would be unnecessary because we are practitioners in our own right.
I am a dude who wears a white lab coat to work every day, and a lot of patients call me ‘doctor’. I don’t have a DNP degree, but patients still call me doctor all the time—even when I was a bedside RN. I’ve never had a problem with telling them that I am the nurse or the nurse practitioner. But even though they know, most of the time they still continue to call me ‘doctor’ anyway. Its a sexist thing, I know. But I don’t care. I don’t think that the hospital systems or private practitioner offices that employ nurse practitioners care either. My goal is to educate patients and give them what they need. That’s all. But until I actually do med school I would never misdirect anyone to believe that I am a physician. I can’t tell you how many physicians are discouraging me from going to med school right now. Almost all the ones I work with are telling me not to do it. Many have said that they would have avoided the student loans and the stress if they had thought about nurse practitioner school, but I seriously doubt it. As everyone on this forum knows, there are limitations to being a nurse practitioner, and I want to be able to go whole hog in determining medical care plans for my patients. That’s why I’m here.
I don’t think that it will ever be necessary for physicians to call themselves “physicians” or “surgeons”. Everybody knows who and what they are. In acute care, every practitioner is required to wear an ID with their name and title on it. Nurse practitioners are primarily and very clearly identified as ARNP, or APRN, or NP. If they are DNP, then that may be displayed on their ID as a secondary title. Physicians are clearly identified as MD or DO. As an NP, what one can do is determined by the board of nursing. Even in states that grant independent practice rights to NPs, the NPs are fully cognizant of their limitations within the framework of the laws that guide their practice. Yes, like physicians, we can get sued for the simplest of things, but we know better than to set ourselves up for such lawsuits. And one of the biggest ways to get sued is to lead our patients into thinking that we are physicians.
My NP specialty is family practice, and one of the things that my clinical instructors told us over and over again when I was in school is to always be forthcoming and ethical in practice. So that, even if you make a little mistake your patient will respect your candor enough to forgive you. Another thing I was taught repeatedly is to know my limitations and know when to refer my patient to a collaborating or specialist physician who can better provide the needed care. Obviously, physicians receive more training and are better able to manage certain patients than nurse practitioners. I think its ridiculous that we are even having these discussions. But, for many issues in medicine, an NP or a PA can get the job done just as well, and many physicians employ us to save them some time and stress. NPs are colleagues, not enemies. And after I become a physician my opinion of this won’t change.