What is a Nurse Practitioner?
I get this question a lot. What is a Nurse Practitioner? Or i’m called “Doc” and I have to clarify my degree and licensure. I often get the response “what is the difference?” The difference is primarily based on the educational model, the certification board, the state licensure, and the scope of practice law.
Let me provide some background information. Medical and nursing education developed independently of each other. Physicians were formally recognized in the 1500’s. Prior to this, health care would be provided by the medicine woman, medicine man, healer, herbalist, apothecarist, etc. depending on what the village had.
Nursing was established in the mid 1800’s by Florence Nightingale. Her theory on healing focused on changing the environment: fresh air, pure water, efficient drainage, cleanliness/sanitation, and light/direct sunlight to provide nature with the best conditions in which to act. Nursing is based upon the holistic and naturopathic ways of improving health. The nursing model focuses on the physical, mental, emotional and spiritual needs of the patient; the whole. In the 1930’s the first Nurse Practitioner program was created. In the 1960’s the role of the Nurse Practitioner was formally recognized so as to increase care to pediatric patients. Nurse Practitioners have continued to increase care to all patients and now have independent practice rights in 27 states!!! More than half of the United States recognize the importance of decreased barriers and increased access to healthcare. There is pending legislation in the other states and territories to recognize independent practice for Nurse Practitioners. There are more than 335,000 nurse practitioners in the U.S. Nurse practitioners assess, diagnose, and treat patients based on their “whole” needs as defined above. We can prescribe medications and also provide education/referrals for non-pharmacologic means of treatment.
Physicians are trained upon the principles of the medical model. They focus on the testing, diagnosis, and treatment needed for a specific disease/illness a patient has. During the civil war there was a need for additional medical providers. Physician Assistants (now Physician Associates) were developed to perform delegated tasks so that more care could be given to the soldiers. Today, Physician Associates are trained in the medical model to test, diagnose and treat an illness a patient has. They do not practice independently currently, they must have a collaborative agreement with a physician in order to practice. Physician Associates are currently lobbying to have the collaborative agreement removed and are seeking to change the law and become independent practitioners.
As time has passed, I have worked with many Physicians and Physician Associates who are adopting characteristics of the nursing model into their practices to provide for the “whole” patient. The Nursing model is evolving and developing specialty nurse practitioners to meet specific patient population needs. Overall there has been a blending and melding of health care providers that will only improve patient care. The medical shortage is anticipated to last for the next decade, the more providers we have, the healthier our nation will be.
The educational “Dr.” debacle… Physicians graduate with either a doctorate of medicine or a doctorate of osteopathic medicine. I will not get into the details, however what is important is physicians are commonly referred to as “Dr.” Nurse Practitioners and Physicians Associates graduate with a masters degree for entry level practice. BUT….Nurse Practitioners and Physicians Associates have the opportunity to obtain their doctorate degree. Therein lies the quandry. Physicians have filed legal suits against Nurse Practitioners who call themselves “Dr.” despite having the Doctorate of Nursing Degree. It seems to be splitting hairs as Educators are called Dr. so-and -so to reflect their educational degree. Chiropractors are called “Dr” due to having their doctorate degree. Our current First Lady is called Dr. to reflect her educational achievements. Please do not call your Nurse Practitioner or Physicians Associate “Dr.”until this litigation is sorted out. We don’t need a lawsuit for “misrepresentation” despite having a doctorate degree.
Now that I have you a bit confused, what does all of this mean? How do you get the healthcare you want? The first thing would be to research the providers available in your area. We all have different specialties, certifications, and skills. Also consider your insurance or lack of it. Each practice accepts different insurances and pay methods. Ultimately you need to consider what health care means to you, what you need, and how you would like to improve your health. We are all qualified to provide patients with the baseline necessary recommended care. The biggest question is what additional services do we provide that align with your needs and health goals.
On a personal note, just call me Jenn or Mrs. Resh. I have a Master of Science in Nursing and currently I am considering the idea of obtaining my Doctorate in Nursing. It is very costly and my scope of practice (what I’m legally allowed to do) isn’t changed by having a Doctorate. I currently practice in Maryland and I am licensed to practice in Maryland and West Virginia. I have several certifications that permit me to provide services that are not covered by insurance such as DOT exams and medical marijuana evaluations. I’m working on additional certifications and trainings to expand health care offerings at my practice in Grantsville, MD. Give me an email, text, or call to find out more!
Have a wonderful day!