Thursday, April 03, 2008

Another Possible Healthcare Solution:The Dr. Nurse

WALL STREET JOURNAL--As the shortage of primary-care physicians mounts, the nursing profession is offering a possible solution: the "doctor nurse."

More than 200 nursing schools have established or plan to launch doctorate of nursing practice programs to equip graduates with skills the schools say are equivalent to primary-care physicians. The two-year programs, including a one-year residency, create a "hybrid practitioner" with more skills, knowledge and training than a nurse practitioner with a master's degree, says Mary Mundinger, dean of New York's Columbia University School of Nursing. She says DNPs are being trained to have more focus than doctors on coordinating care among many specialists and health-care settings.

(HT: Clover Aguayo)


At 4/03/2008 1:02 PM, Anonymous Anonymous said...

The AMA is likely already on the phone with their lawyers to block this

At 4/03/2008 1:36 PM, Anonymous Anonymous said...

kevin, maybe not if the DNPs are working under an M.D.'s supervision.

Think of it as a micro outsourcing program for M.D.'s. They get to offload a portion of their personal workload to a local DNP.

The DNP is of course paid less than the MD but the MD charges the full fee and pockets the difference.

DNPs could be a decent profit center for savy MDs.

On the other hand, it is only a matter of time however before DNPs will be able to set up shops independent of MDs.

At 4/03/2008 2:16 PM, Anonymous Anonymous said...

Keep in mind that there currently is no difference between a nurse practitioner with a masters and those with the "doctorate" in terms scope of practice. I tend to think of the DNP degree as just another example of degree inflation. It is essentially an arms race to see which ancillary staff can increase the number of letters behind their name the fastest with the least effort. None the less, I certainly can see a role for the NP/PA (physician's assistant...same thing) in cost containment in medicine.

Many cases are simple and and can be diagnosed and treated by rote, however, the catch lies in the complex or life threatening cases which present in a similar manner. Further, I find it discordant that while the complexity of medicine has increased drastically over the last couple of decades, the trend seems to be not only toward less schooling for clinicians but also away from education and toward what is generally termed "training".

At 4/03/2008 4:35 PM, Blogger Unknown said...

Wouldn't this be a natural consequence of increasing prices for health care and a dwindling supply of doctors. Is this a market reaction to the current situation? I know that I would have no problem going and seeing a nurse practitioner for my less serious concerns (colds, flus, minor infections, broken bones and so on). Why would I take my car to the master mechanic to have the wiper blades replaced, oil changed or headlamps replaced. After all, humans and cars are machines, just one is more complex than the other. I see no problem with differing levels of care at different prices. Today, how do you know how good of a doctor you have. In their office they might display their degree, but how many times have you seen your doctor's actual office or their degree, much less know if he or she was a C student or an A student. I guess my point is, you might be paying large amounts of money to a mediocre doctor who can charge the fee for a DOCTOR, when you could see a nurse practitioner who does just as good a job but charges a lesser fee.
And if the AMA is on the phone, ready to shoot this down, I think that helps illustrate the problems with our healthcare system. Its not just that it is expensive, but that the entrenched interests might be standing in the way of meaningful changes that could have an impact on the cost and distribution of healthcare.

At 6/07/2008 3:11 AM, Anonymous Anonymous said...

Good Job! :)

At 6/07/2008 3:12 AM, Anonymous Anonymous said...

Nice Work!


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