There seems to be a growing prevalent attitude that out patient comprehensive care is a scope of practice that is capable of being managed independently by those with out MD degrees. There appears to be a growing belief that nurse practitioners, those who have completed a nursing degree and have gone on to do masters level training in as little as a year, are capable of taking on the reigns of independent practice across the same scope of practice as internists and family medicine physicians.
So I say, great. Let's let the cards fall where they may. With less than 2% of medical students entering a comprehensive care field, I say it's time to disband the teaching and training of outpatient internal medicine (and family medicine and pediatrics) to focus on the inpatient aspects. If we as a nation believe that NPs are capable of practicing their scope as equals in terms of diagnosis and management of acute or chronic or acute on chronic medical illness, with no decrease in quality or increase in cost, then it's time that us MDs bow to the will of the nation.
For a peak on where we are heading, continue reading here.
Your argument is a straw man. I happen to agree with your sentiment, but you take other readers' positions to an extreme, to a point where what you are saying in this post isn't what they actually mean, and I think you know that. You do it solely to have an easy opponent to pick apart so you can assert some sort of authority or expertise.
ReplyDeleteNurses don't want to take on the role of PCP - because the hours are long, the pay is low (compared to shift work in the ICU for example), and the liability is high (plus they have to incur more school debt to become NPs). Primary care doesn't appeal to nurses for the same reason it doesn't appeal to many docs. ;-)
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