Report Abuse
You have chosen to report the following comment as abusive, offensive, or inappropriate.
One final addition to my last post. I read the Wall Street Journal article referenced below. It appears that either the journal or Clark (in the comment on the website misspoke). The Doctors of Nursing will not be taking the same exam as medical doctors. They will take an exam which is based on, but narrower than the test given to doctors. This raises the interesting question of whether or not a "narrower" education will be any problem to patients. The difficulty with studying this is that the major study to date (sited in the journal article) has been done in an academic center and has involved relatively healthy patients, who may show no statistically significant difference in outcomes, even if they don't see a healthcare provider at all. They have also involved only Ivy League trained elite practitioners. Finally the case sited in the Journal article referenced in one of the postings seems to discuss a case of temporal arteritis, a common cause of headaches. I believe that most patients with this common disorder would be diagnosed and treated by a primary care physician. The patient in the journal article was referred to and treated by a neurologist. Once again, don't get me wrong. The Doctor of Nursing may end up being a great boon. But again, the market will have to determine that. My suspicion, based on personal observation and some preliminary published data, will be that Doctors of Nursing will be highly satisfying providers to patients without measurable detriments in outcome, but may actually increase the cost of healthcare by seeing fewer patients per day (this may be beneficial to patients, especially if they have higher smoking quit rates, etc.), ordering more tests and subspecialty referrals and increasing the already critical nursing shortage and, thereby, salaries. I believe that the best solution would be to increase the reimbursement for cognitive (nonprocedural) medical services for docs and NP/Doctor of Nurses so that good docs don't abandon primary care.
By Marty
