Nurse Practitioners Want Less Doctor Oversight
Prudie Orr is a licensed psychiatric nurse practitioner, but these days she feels more like an aspiring indentured servant. Since moving to the Central Texas town of Georgetown in December, she’s been unable to open a practice and see patients — because she can’t find a doctor who will allow it. “I’ve gone up and down the telephone book, calling every psychiatrist in town,” she says. “I have to go hat in hand to these folks to see if they will grant me the privilege of making a living.”
In Texas, nurse practitioners’ livelihoods are tied to physicians ...
Comments (10)
Sharon Arnoult via Texas Tribune on Facebook
As it should be -- with all due respect to nurse-practitioners, they have not gone to medical school, done internships and residencies, etc. In other words, they aren't doctors!
Gary Packwood
When applying for their degree did the nurse practitioners not know their livelihoods will be tied to physicians and that by law they can't treat patients or prescribe medicine without having a doctor's permission?
And just how many mental health professional do they need in Georgetown, Texas? As of the census of 2000, there were 28,339 people in Georgetown, Texas.
Only in Texas would a group of people attempt to intentionally violate the law and then claim victim status when they are stopped.
Not a good role model for our young people in Texas who are planning their lives as adults.
::
GP
Cynthia Casper Robertson via Texas Tribune on Facebook
@ Sharon, fyi yes they do internships and they have the educational equivalent of a Ph.D. So predicated on your commentary above, you would believe that someone who has a Ph.D. is Psychology is incapable of counseling because he/she doesn't have a M.D. in Psychiatry? Nurse practitioners have the capability of lessening the burden on physicians for the more mundane things, i.e. colds, flu shots, good hygiene, diabetes management, burning off warts, etc. It doesn't take an MD and residency at a teaching hospital to render medical assistance in those settings. They do much the same work as the Medi-Clinics for a lot less cost. And, because they can keep the cost of healthcare down, people are more like to frequent them to take better care of their overall well-being. You might want to do research on the actual functionality of a nurse practitioner before you diminish their abilities and expertise.
Evelyn White via Texas Tribune on Facebook
Why do we train them, if we aren't going to let them use the training to treat patients??? Makes no sense to me.
Scott Chase via Texas Tribune on Facebook
The turf wars are likely to get worse. Health care reform will incentivize the use of NPs and and primary care doctors and there aren't enough to fill the need.
Beverly Lynn via Texas Tribune on Facebook
well said Cynthia
Jaime Nelson via Texas Tribune on Facebook
Where did Ms. Ramshaw get the 20,000 hours figure from? I followed the link but can't find the AAFP analysis she referenced. If a physician attends 4 years of medical school followed by a 3 year residency in family practice, they would have to work 11 hours a day, 5 days a week without a break for 7 straight years to hit 20,000 hours.... no holidays, no breaks. That is being generous and including the residency years even though the language in the article suggests the residency is in addition to the 20,000 hours.
nancyfruge
There are positions for nurse practitioners in the Texas Health and Human Services System. See
https://rm.accesshr.hhsc.state.tx.us/ENG/careerportal/default.cfm
and
http://www.cms.gov/smdl/downloads/SMD10008.pdf
ladyblade
Jaime:
Let's see 20,000 hours ....
Classes 8 hours a day 5 days per week for 1.8 years in medical school = 3680 hours
(The summer between first and second year is a vacation. No vacation between second and third years.)
Clinical rotations (working in the hospital) for 1.9 years = 4000 hours
(One month vacation the last two years of medical school. Again this is a 40 hour work week.)
Family Practice Residency = 3 years.
With residency work hours limitations at 80 hours per week, and each resident receiving four weeks of vacation per year = 11520 hours
TOTAL= 19200 hours
That's pretty close to 20,000 hours.
And it doesn't count the 4 years of undergraduate study before medical school.
PhD Nurse Practicioner Training
Programs require 500 faculty supervised clinical hours
From the University of Denver School of Nursing Website:
http://nursing.ucdenver.edu/grad/dp.htm#3
(Scroll down about half way down the page)
(Students start with a BS RN, which is equal to the undergraduate work of a medical student so those hours are not counted.)
"Students are admitted directly into the PhD program; the pathway entails 30 semester credits to complete a MS degree, 42 credits of PhD coursework, and 30 credits dissertation."
So "... 2-3 years of post masters doctoral course work leads to the PhD dissertation and PhD degree. "
So giving the PhD Nurse the benefit of the doubt, and figuring they go to class 8 hours per day like a medical student. And that they get their summers off ...
3.1 years of classroom training with dissertation = 6400 hours
500 hours of clinical training
TOTAL = 6900
lyndawoolbert
Regarding the comment credited to me in the Texas Tribune article last week, I would like to make a couple of clarifications. My complete thought was that APRNs are able to spend more time teaching patients about their health and how to manage chronic conditions. Since APRNs have the education and necessary training to provide a range of services that approach 90 percent of the primary care most people need, allowing APRNs to provide primary care all over the state makes sense. As economist, Jeffrey C. Bauer recently stated, “nurse practitioners are available to fill many gaps in primary care at lower cost with impressive outcomes (quality).” Again, we just are asking that APRNs be able to provide all services they are completely qualified to perform as a result of their education and training, especially with the shortage of primary care physicians in the state, so that more Texans can receive health care services they need.