Turf Wars Aside, How Do NPs and MDs Really Differ?April 20, 2010
By Christine Moffa, MS, RN, AJN clinical editor
There’s been a lot of talk lately about turf wars between NP’s and physicians, especially when it comes to the much discussed U.S. shortage of primary care providers. Before going back to school and getting a master’s in nursing education, I batted around the idea of becoming a nurse practitioner. It seemed like the ideal next step for someone who was happy being a clinician but wanted to take on an advanced role.
However, there was something that didn’t sit right with me about becoming an NP—namely, my fear of public perception. I’m not sure most people know exactly what the role of an NP is and how it differs from that of a physician, particularly in primary care. I’ve seen patients call their primary care NP “doctor [insert first name here],” which to me illustrates the confusion.
When people ask me the difference, I myself have a hard time articulating it. How do I respond when someone says something like this: “if entry to medical school and residency is typically more competitive than for advanced degree nursing programs, and if physicians spend a longer time attending tougher programs, how do you justify their doing the same work as NPs?” (For instance, when I was in school we, along with the NP candidates, were only required to take two semesters of pathophysiology!)
Now, I’ve been to an NP as a patient, and I was happy with the care I received. She certainly spent more time with me than any medical doctor ever did. And people often point out that NPs work in poor and/or rural areas that have a tough time recruiting physicians. But by promoting ourselves as a cheaper, less busy alternative, are we doing ourselves a favor or confirming the suspicions of those who—despite the available research to the contrary—say we’re less qualified than physicians to provide effective primary care? I’m still looking to go back to a post–master’s certificate program to become an NP because I’d like to work in that capacity one day. I’d like to hear from any NPs or DNPs about how they handle these kinds of questions. How are you like physicians, and how do you differ?