The dark underbelly of nursing schools
General-practicing physicians and family doctors (MDs and Dos) are the bulwark of the US’s health care system. They take on the brunt of the responsibility to fix ailing patients and make them whole again. But that effort comes at a cost: The highly-paid doctors eat up a chunk of the nation’s health care budget.
As a number of States try to grapple with taming soaring health care costs, there is a growing sense to gravitate towards an easy fix – just download most of the health care tasks to lesser-paid (compared to physicians) Nurse Practitioners (NPs) or Doctors of Nursing Practice (DNPs). But there’s a hidden cost associated with embracing that strategy. That price is paid by patients, but collected by nursing school owners and operators!
Even though all of the NPs and DNPs are no doubt highly capable, trained individuals, though DNP does have “doctor” associated with the title, a nursing degree doesn’t qualify NPs and DNPs to substitute as physicians. None of the Nurse Practitioner Program Guides published by the institutions dishing out these degrees will tell you that! But in adding “doctors” to the degree, many nursing schools could be accused of willful deception.
So, as governments (Federal and State) try to address runaway health care costs, degrees like Doctor of Nursing Practice (DNP), handed out by many nursing schools are misleading. They could potentially be fatal to unsuspecting patients!
More ailing the world of Nurse Practitioners
Typically, resident physicians must do 15,000 to 16,000 plus hours of clinical work to be able to practice independently. However, for NPs and DNPs, that requirement is less than 10% in some cases.
How then can nursing practitioner school administrators justify the addition of “doctor” to their degrees?
There is also a disparity in the amount of education time required for NPs and DNPs. A typical MD (doctor/physician) will need anywhere between 11-years or more to complete their formal education. In many cases, NPs and DNPs may take half that amount of time (6 to 8-years of post-secondary education) to complete formal education. It’s is therefore misleading (bordering on negligence) to say that DNPs can do “almost” everything that a physician does!
While nurse practitioners do undergo a lot of education, training and patient-contact experience, many Nursing regulatory bodies, from individual states, do not yet grant practitioners full practice authority (FPA).
I fact, a larger number of state have Reduced or Restricted practice designations to NPs – and for a very good reason. That’s because the degrees awarded by various nursing schools don’t qualify those practitioners for FPA recognition.
A huge degree of difference
While many NPs and DNPs might rightfully feel that the education and training exposure from their degree entitles them to be treated as equals to MDs and other practicing physicians, the truth is different. There is a huge degree of difference, compared to NPs and DNPs, in the skills and expertise that doctors bring to the table.
For example, not every state believes having a DNP degree enables degree holders to prescribe medication or recommend other medical interventions. Some states, recognizing the limitations of those degrees, grant such right to NPs and DNPs – but only under close supervision of doctors and physicians.
Similarly, there is a broad degree of difference between how States grant authority for ordering diagnostic examinations and tests – or for reviewing and interpreting the results of those tests, for that matter. Many states realize that the 8-year training/education timeframe, as enforced by practitioner degrees, might not be enough for performing such critical tasks. They therefore either do not grant NPs and DNPs the authority to perform those tasks, or they mandate strict physician/doctor oversight for doing so.
It's more than just about “health care”
The vast majority of NPs and DNPs will tell you that their primary motivation for joining the health care system is to serve their patients faithfully. And no one should doubt that! But institutions “selling” nurse practitioner degree programs know that it takes more than just “motivation” to survive. To them (the nursing schools and their re-seller agents) this is more than about “health care” – it’s about money!
Many nursing schools, and nursing-school degree “resellers” and promoters, looking to sell their programs, will entice prospective applicants with lofty pay expectations. Some bait their quarries with flashing headlines like “Median salary for Nurse Practitioners…$105,000”. However, that too may be a bit misleading!
Recruiting agencieswho are on the front-line of hiring and placing NPs across the USA, are constantly in touch with their market place. They know what the demand for NPs and DNPs is, and which institutions in which States are hiring. And they also know how much those employers are willing to pay. The recruiters paint a far different picture of pay expectations than the one displayed on nursing school websites.
Based on data actual salary averages for more than 31 states is much less than the $105K promised by the merchants of NP/DNP degrees. In fact, some states barely pay more than $81K for certified NPs! And the combined average of 50 states doesn’t even crack the $100K salary ceiling (stopping short at $98K).
No “virtual” fix to healthcare dilemma
Many NP/DNP degrees are awarded after completing significant amounts of studies online – in “virtual’ settings. And while there might be a case to be made for learning to care for patients virtually, from the comfort of one’s home, it’s not the same as doing it in the trenches. True, many nurse practitioner degrees mandate an in-class test before awarding that degree, that’s still not a panacea for our ailing health care problem.
So, what’s the solution? Well, for starters regulators could take a closer look at the curriculum and certification standards of “virtual” NPs and DNPs. Is appending the term “doctor” to a degree valid – especially if the education and training is no where comparable to that of a doctor or physician? The issue of false advertising of such degrees should also come under regulatory scrutiny. Then, and only then, can we begin healing our ailing nurse practitioner,