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 Provided by Clinician 1
For those of you that read my blogs, you now I am opinionated. I think long and hard about things before making the decision on what to think about some things and I am willing to change my views at any time. Rarely am I torn. I am now on two fronts. One is the doctorate for NPs and the other, one the first of what I expect to be many bridge programs for PAs to become physicians.
I’ll start with the recently announced PA to DO bridge program. I never wanted to be a physician, ever. Nor did many of my colleagues. Met a few wonderful PAs while I was an Air Force medic and my future was set. Most PAs I know feel the same way-they were inspired by the PAs they met, not settling because they wanted to be a physician but could not.
A DO Medical School will shortly announce a bridge program cutting out a year or more of study if you are a PA. I do not know the details but I am torn by that decision. Why? I would rather see the PA profession come up with a plan where a PA could become a fully autonomous/independent clinician on its own. Especially in primary care as we need to move that way. I know we are trained well enough. I would even agree to go back for a one year residency (after practicing primary care for 5 years or more) and then the PA or even NP could become a new type of clinician-an (MCP) Medical Care Practitioner. I doubt that most PAs who would choose to complete a bridge program would choose a primary care residency anyway. Why? We generally can fully practice primary care now. Once a DO, why not go for the gusto? Go into the more lucrative specialties and leave the primary care to the NPs and PAs. Why would that new graduate be any different than any other new med school graduate?
I want my MCP.
Still, I have bitched and moaned for years that organized medicine has failed to set up a fluid system where you start out as an orderly or nursing assistant and graduate to an EMT or nurse and can continue to go on to become an NP or PA and then if your soul desires a physician. That always sounded most logical to me and, I know, to many of you. This bridge program is not that, but it might be a start. For the first time ever, this program at least is an acknowledgement by organized medicine that PAs really learn and do medicine. But again there is another negative. I think if we make being a physician the highest level of “PA”, we lose our soul. We lose our profession. We send the wrong message. If everyone has a bridge program to enter, the PA profession stops evolving into what it can be. The NP profession has evolved, continues to and stays within their profession to do it. I want the same ability. So I guess I don’t like it, but want to publicly thank the people who started this program. A part of me would have liked more recognition. Yet, I am sure their hearts are in the right place.
Regarding doctorates, in my humble opinion, a parallel is happening to the NP profession; the introduction of the DNP. Yes, I know it is the same profession on paper. But is it really? NPs are clinical practitioners. What they need to keep evolving and growing as clinicians is heavy duty clinical experience. The DNP is not going to make you a better NP clinically. It will allow you to say you are a “doctor” but will you really do any more for a patient on a clinical basis because you spent $50,000 to become one? What it will say to the public is that there is now, and for many years to come will be two levels of NPs. The “doctors” and the non-doctors. I think NPs should do whatever makes their profession happy but I don’t like two types of NPs nor do I understand the move. Speaking to my NP friends, many of them do not either. If you want a doctorate, make it clinical and enter into a one year residency-60 hours a week, and raise your clinical expertise and call yourself a Doctor of Nurse Practitioner. Make it clinical.
I guess I am sad. Just when we PAs and NPs have finally and clearly proven that we were right all along when we said “you do not have to be a doctor to provide high quality, cost effective, empathetic wonderful healthcare”, NPs have said you do. PAs on the other hand are not there yet, but may be offered another option to also say you do.
This old PA would like to see both professions grow and evolve into the clinicians who are not “doctors” who take care of most of your ills. We are already on our way to becoming the primary care providers of the future, by virtue of our excellent clinical track record, not by virtue of having a doctorate.
Dave has been a PA, and later NP, leader for thirty years. He strongly believes that NPs and PAs must work together to insure a better future for both professions. Most recently Dave has been busy launching another dream; Clinician 1, the first internet community for PAs and NPs. In October 2008, Dave was honored by the New Jersey State society of PAs with its “Lifetime Achievement Award”.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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