PREMED.me is a utility that helps you organize and manage several aspects of your premedical life. This spring, the University of Rhode Island in Providence is starting the registration process for the state’s first Doctor of Nursing Practice (DNP) degree. As this degree is gaining ground, it continues to stir intense debate and conflict within the health care community. The Commission on Collegiate Nursing Education (CCNE), the leading accrediting agency for Bachelor’s and graduate degree nursing programs in the United States, began the process of accrediting DNP programs in 2008. AACN, the voice for the country’s nursing education programs, notes in its position statement that more doctoral-level nurses are needed to meet the changing demands of the nation’s health care system.
The idea is that DNPs would fill some of the gap left by the on-going shortage of primary care physicians needed to treat not only the newly insured, but also the growing aging population. These present and future trends and challenges have prompted the Institute of Medicine (IOM), the nonprofit arm of the National Academy of Sciences, to issue a report at the end of 2010 urging increased training and autonomy for nurses. But as increasing numbers of DNPs are being trained and getting ready to assume more responsibility for patient care, many physician groups are concerned about the implications of these measures. One of the main arguments advanced by organizations such as the American Academy of Family Physicians (AAFP) and American Medical Association (AMA) against giving DNPs autonomy to care for patients is the lower level of education and clinical experience as compared to training MDs and DOs receive. AAFP’s president Roland Goertz, MD, MBA, tells SDN that the educational requirements for DNPs “focus more on topics such as concepts in nursing, health policy, illness management, drug therapy, epidemiology, and health assessment.
By comparison, Goertz points out that family physicians spend nearly 6,000 hours in lectures, clinical study, lab and direct patient care as medical students. The table clearly demonstrates that not all “doctors” are created equal, at least as far as the level of their training is concerned. By the time MDs and DOs start family practice, they have completed about 11 years of rigorous training – both academic and residency, clocking in between 20,000 and just over 21,000 hours dedicated to the study and practice of medicine.
However, AACN’s spokesman Robert Rosseter points out to SDN that doctoral-level nurses play an important part in the evolving health care environment.
Another bone of contention between physicians and nurses is the confusion surrounding the use of the “Dr” title.  Organizations like AMA and AAFP claim that the proliferation of doctoral medical degrees is confusing to the lay public and therefore only board-certified physicians should identify themselves as “doctors” to their patients. For example, a survey conducted by AMA in 2010 found that 35 percent of Americans thought a DNP was a physician, and another 19 percent were not sure whether a DNP was a physician.


AAFP’s Goertz agrees that if the “doctor” title is used without clarification, it can be misunderstood by the patients.  “A significant number of Americans assume a doctor of nursing has the same clinical training and expertise as a medical doctor or doctor of osteopathy,” he says.
The same AMA survey also demonstrates that 83 percent of respondents prefer a physician to have primary responsibility of the diagnosis and management of their health care.
The resolution to this controversial issue may very well lie in the proposed federal legislation called the Healthcare Truth and Transparency Act, a bipartisan bill introduced in May 2010.
Additionally, the state chapters of the physician organizations are pushing for state laws requiring accurate advertising and information about the licenses of health care professionals. As patients navigate the increasingly complex health care system, “consumer education is the most important way to ensure that they understand the clinical expertise of the person who is providing their health care,” Goertz concludes. Embarking on an educational journey that explores all forms of communication sciences and disorders is a decision that typically involves an innate desire to help and serve individuals who have undergone a life changing health event, or who simply need specialized expertise regarding how to effectively utilize language. It might actually come as a surprise to many would-be medical students that gender is an issue that still affects those who are training for a career as a doctor.
Sister Helen Prejean is a well-known anti-death penalty advocate who has ministered to prisoners on death row. One of the most pressing issues facing prospective medical students today is the choice of how to prepare for the MCAT, a now 5+ hour test which factors largely into the highly competitive process of medical school admission and whose revised edition is more complex than ever. This past weekend, I had the opportunity to meet some of our incoming first years at a meet and greet event. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
Clipping is a handy way to collect and organize the most important slides from a presentation.
Scheduled to commence in the fall, it will join the ranks of 153 other DNP programs presently operating in the United States; some 106 new ones are currently under development. On the other side are the critics, claiming that the “doctor” prefix confuses and misleads patients into believing they are being treated by a Doctor of Medicine (MD) or a Doctor of Osteopathy (DO), the two professional doctoral degrees for physicians in the US.
An estimated 32 million additional Americans will gain coverage as of 2014 under the recent health care law, so a larger number of health providers will be needed to care for these patients.
The most contentious part of this report is a call for the so-called “scope of practice” – the authority nurses would have to order tests, prescribe drugs, as well as perform other medical services.


They then go on to three years of residency training, in which they complete an additional 9,000 to 10,000 hours of clinical training. Just as an example, medical students learn anatomy, biochemistry, physiology, pharmacology, psychology, microbiology, and pathology, among numerous other courses focusing on treatment and prevention of a wide array of diseases. Supported by AMA, AAFP, and several other physician organizations, including the American Osteopathic Association and the American Society of Anesthesiologists, it would require that health care professionals be truthful about their credentials and qualifications when advertising services.
After all, there are more women in medicine than ever before–and certain areas of practice have become largely female-dominated. She began her prison ministry in 1981 by becoming pen pals with Patrick Sonnier, a convicted murder who was sentenced to death by electrocution in Lousiana’s Angola State Prison. Myxedema, most commonly found on the lower legs, is a form of non-pitting edema caused by an accumulation of mucopolysaccharides and water. Richard Friedman is a professor of clinical psychiatry and a psychopharmacology clinic director at Weill Cornell Medical College, where he focuses on mood and anxiety disorders.
They came in with wide eyes and big smiles, just waiting to sink their teeth into medical school. It was an informative session which students found useful to help them plan their next steps as role models and leaders at Maltby Academy.
Just as importantly, many medical organizations say, is the quality of patient care provided, since DNPs receive far less training than MDs and DOs do.
For this reason, AACN has suggested moving the level of preparation necessary for advanced nursing practice from the master’s to the doctorate degree by 2015. Hypothyroidism can be treated medically, and in this case, the growth was surgically removed. Friedman has interests in mental health policy and psychiatric practice, and is a classical pianist and long-distance swimmer.



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