Physician vs Nurse Practitioner?

Physicians and nurse practitioners work together in almost all clinical settings to help patients! In my GI office, I work with 3 awesome NPs who evaluate and treat patients. This allows me to see more people, allows my patients to have shorter follow up time if needed, and lets me do more procedures for patients who urgently need them! Thanks to Courtnery from @nursesofinstagram for joining me in this collab!

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[ANSNify]

If you have dosing questions, please ask pharmacists rather than APPs. They are the experts and always superhelpful.

[lin]

When I was in college, a nurse practitioner prescribed me ativan daily as a sleep aid for YEARS. I was young and naive so I just trusted how she practiced medicine. I begged her for ambien when I realized couldn't fall asleep without the ativan and she refused, I would try 3-4 benadryl and not fall asleep. She tried to switch me to gabapentin and trazodone "to help me sleep better" (no mention of risks of benzo withdrawal). Getting off of the ativan was one of the hardest things I've ever done, I thought I'd never feel normal again.

[emilybelle]

I'm pro team, and experience is great, but arguing a nurse practitioner is equivalent to a physician is false. We can respect physician extenders without doing a discourtesy to other physicians and the patients who want them by perpetuating falsehoods of equivalency.

[joy]

Do not forget, it was the PATIENT who requested a doctor ---the person/people upon your livelihood depends!

[TusharSingh-zhtq]

He got through IM residency and GI fellowship just to not know Entecavir dosing? He wasn’t capable of looking up that information on his own to build a personal decision that is evidence based to treat? And didn’t know his cirrhosis patient was decompensated?

The example this sets is that highly trained physicians can’t look up even an UpToDate article’s worth of information and just accept a dosing recommendation blindly. If you aren’t vetting information on an hourly basis, that is negligent.

[nengin]

A specialty and subspecialty trained physician and a board certified GI specialist can not do a simple Entecavir dosing. Interesting!

[forestrackes]

You need to rely on nurses to get your dosage right? They don't teach that to the GI fellows at Loyola? Honest question.

[scootiemcpootie]

Im a CT/ Rad tech. My experience is mid levels have very little training regarding radiology. Its takes a few years working experience before they even know what exams to order and how to order them correctly.

[xboxfullauto]

First thing I genuinely disagree with you on, and this is coming from a nurse. We both know that the educational background from nursing school and medical school is vastly different. Sure an experienced NP could be a good provider, but not when it comes to complex cases/patients (even in this case, they are more familiar with algorithms rather than why, mostly due to education [not going to med school]). Making it seem as if an NP and physician are similar is very misleading and honestly a little dangerous. A physician with a DO or MD degree are the same, an NP is still a nurse (despite higher education).

Tell me, if your child was incredibly sick, would you rather have them see a physician with 10 years of experience, or a nurse practitioner with 10 years of experience. We both know the answer to that lol.

[victoriaanderson]

When I moved to a new area no doctors who accepted my insurance were accepting new patients. I went with a nurse practitioner and I could not be happier. Come to find out that for years she was the nurse practitioner at my orthopedic surgeon's office so they all know her and speak very very highly of her. She's around my age and is very easy to talk to. I really like her and I am so glad I decided to try a nurse practitioner. She's not a doctor and does not pretend to be. But she is a highly trained skilled professional and I would recommend her to anyone.

[QueenParity]

My experience with nurse practitioners has been okay at best. I took my partner to PP to get switch to the depo shot from minipill, they saw two NPs. First one said you couldn’t take the minipill until the depo kicks in (completely false), second said we could for a week. They ended up seeing an endocrinologist a week later who immediately said it was perfectly okay to even take the minipill alongside the depo shot when spotting occurs to stop it. Way better experience with her. Not saying all NPs are bad, just not happy to get 2 completely different answers from NPs at the same practice, who should have birth control as their bread and butter since it’s PP! Endo was way more helpful.

[michaelelliott]

Love this idealized presentation, ignoring the hordes of unsupervised midlevels

[Vivienne]

What a sellout. This is obviously untrue. It’s funny how many doctors will decide mid-levels are amazing once they’re attendings in a field where having NPs see their patients increases their income.

[razakhan]

The AANP and the AAPA (the organizations for NPs and PAs respectively) have been lobbying to have NPs and PAs working independently despite their lower level of training. As mid-level providers, they are invaluable in helping address the common diseases, but when a case is more uncommon or complex, their training doesn't cover it. This is a patient safety problem if they are able to practice independently. A video like this may apply a false equivalence, and to paraphrase Dr. Jabbar of Med School Insiders from his Doctor vs NP vs PA video, the current climate prioritizing emotions over facts is a problem, as while humans are equal, we are not all equally trained nor equally capable. The scope of practice creep must be stopped.

[doctorm]

Midlevels, especially NP, are persons with extremely limited training (compared to doctors) who are employed by a healthcare system because they are cheaper than doctors. Initially, they were to work under the close supervision of doctors, but that has changed, and they have pushed for and won independent practice, leading to worse patient outcomes.

Making the danger worse is that instead of being trained in one specialty, they are allowed to after their minimal training switch specialties on a whim and get a job in a different field. Some are great and stay in a field for their whole careers and stay in their scope, but that GI NP coulda been a psych NP last week and just decided to switch jobs and now dabble in GI because it looks fun.

Him asking for info from someone else isn't the problem. Its his incomplete and false explanation as to what an NP is and is not.

[farazr]

The point of the degree is to guarantee a level of training and board certification at minimum. All MD/DO's have passed USMLE step 1/2/3, as well as ABIM or ACG boards. There's a guarantee that they will have been exposed to, and are required to continue updating their medical knowledge for the patients. The same is not true for NP's who can simply transfer fields, at which point this is built simply on trust rather than oversight.

[justshanestuff]

This to me is like saying a line cook is just as capable as a chef in the food industry. Maybe here and there, but as a whole it's just not true.

[blessed_one_]

Some of the comments here have been harsh, but the truth is that the job of making a diagnosis and prescribing medications should be for a physician, not a nurse.
Interestingly, the same people who make laws allowing non-physicians to practice medicine, would NEVER allow a paralegal to practice law for any reason.

[rwskiller]

No wonder his co fellows at SLU spoke poorly of him.

[TheClonetruper]

I love how a direct phone call turned into “I ran into them out there”