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Is a nurse practitioner also a physician?

The idea that nurses can “take over” primary care is all dependent on how you define primary care, according to the blogger, A Happy Hospitalist. He says: “I would take a newly minted graduate of internal medicine, one week out of residency to be my primary care doctor over a 30 year practicing nurse practitioner every single time.”

The Happy Hospitalist is a board certified internist who works in the hospital and writes regularly on several blogs, including The Happy Hospitalist.

More from The Happy Hospitalist

Interesting collection of comments: “Virginia Henderson (nursing theorist) promotes the idea of nurses being the primary care provider. I only know this because of nursing theory this semester and she was the only theorist with whom I could even remotely understand!

“The reason I mention this is because it addresses the idea of nurses taking over (or one might argue back) the role of primary care provider.”

Says one reader over at allnurses.com. As I’ve said before, the idea that nurses can “take over” primary care is all dependent on how you define primary care. I have no doubt in my mind that how the NP agenda defines primary care is far different than how I define it. Primary care, the way I practice it in a hospital setting can’t be practiced by NPs independently. There are certain aspects of my job that a monkey could do. That a secretary could do. That a nurses aid could do. That a nurse could do. That a nurse practitioner could do. But none of them can do everything I do as an entire package. Just as I can practice cardiology form a hospitalist point of view, I would never claim to be a cardiologist in the same scope a cardiologist practices.

I know this because I have lived through the training necessary to practice hospitalist medicine independently. I have lived through the training required to practice outpatient comprehensive primary care independently. I have had NPs train through Happy’s Hospital rotation. I speak with NPs (and PA’s for that matter) at 3 am who transfer me patient after patient from rural America with terrible ED work ups, stabilization and management skills. Work ups that lack basic medicine skills.

And I can say categorically, without a doubt that primary care as practiced by myself is not the same as primary care practiced by those less trained.

So define primary care as you may. As a patient, many may never know how to differentiate the care they are receiving from the care they need. Many are happy not knowing otherwise. I can say only that knowing what I know about the training involved in both, I would take a newly minted graduate of internal medicine, one week out of residency to be my primary care doctor over a 30 year practicing nurse practitioner every single time. That’s not because nurse practitioners are bad. It’s just that my idea of primary care is far different than what the nursing profession has to offer.

And I can say that with a straight face, every single time.

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