As more and more states get on board with expanding the scope of care offered by nurse practitioners, doctors and physician organizations are understandably opposed to the licensing changes in some of those states. The two sides in the debate offer valid points covering everything from meeting the demand for patient care to qualifications for providing that care. Yet we cannot help come to the conclusion that there is a critical difference between doctors and nurse practitioners, a difference that could put an end to the debate once and for all.
What is this critical difference between the doctor and nurse practitioner? Training. Not training in terms of the body of knowledge learned in university. When it comes to that body of knowledge, a nurse practitioner receives training that is nearly identical to the internist. The only difference is that the internist also undergoes a lengthy residency.
No, the training we are referring to is one of perspective. It has to do with how the care provider views his or her job in relation to the patient. Consider this: doctors are trained primarily to be problem solvers. Their job is to examine the patient, diagnose the problem, and prescribe a treatment plan for recovery. But nurse practitioners are not doctors; they are nurses. They are trained as nurses.
Care for and Treat Patients
The primary difference with nurse practitioners is that they are trained to take care of patients just as any other nurse is. Care is the primary function of the nurse. That’s not to say that their perspective is better or more important than that of the doctor – it is not. Both viewpoints are essential to achieving positive outcomes. Patients need to be cared for and treated. But the nurse practitioner’s training as a nurse gives him/her an advantage in things such as primary care and chronic illness.
Consider the doctor acting as a primary care physician in a local family practice. Day after day he/she sees the same kinds of routine cases that eventually stop being challenging. Furthermore, he/she is overloaded with paperwork and regulatory requirements that prevent his/her full attention from being on patients. As a problem solver, he/she is not likely to give patients the time and attention they really want in a family practice environment. Things are different for the nurse practitioner.
First and foremost, don’t forget that the nurse practitioner is trained (as a nurse first) to take care of people. Second, he/she doesn’t have nearly the same level of burdensome paperwork and administrative duties as a physician. He/she has more time and opportunity to sit and talk with patients. He/she can listen to their complaints, he/she can discuss their outlook, and he/she can get to know their expectations.
Plenty of Room for Both
The point here is not to say that nurse practitioners are superior to doctors. It is also not to cast doctors in a negative light. The point here is to simply say that there is plenty of room for both nurse practitioners and doctors in the arena of primary and chronic care.
Both the doctor and nurse practitioner have valuable skills and assets necessary for providing adequate patient care. If we use those skills and assets to the greatest benefit, we can improve care across the board. All things being equal, the nurse practitioner is in a better position to provide primary and chronic care than a doctor. The benefit to doctors is that they are freed up to handle more complex cases that continually challenge them and take advantage of their problem-solving skills.