Physicians vs. Advanced Practitioners: Where Do You Stand?


A battle has been brewing within the medical community for quite some time. As the physician workload has steadily multiplied due to physician shortages and increased documentation requirements, advanced practice nurses and physician assistants have upped their fight for full practice authority in an effort to boost productivity, lower health care costs, and increase access to care. This hot-button issue has split the physician community down the middle, into those who are glad for the assistance and those who greatly oppose non-doctors treating patients as if they are doctors. And, lately, for those who oppose APNs and PAs, the gloves have come off, so to speak.

Despite study after study after study after study finding that APNs and PAs provide care comparable to or even better than physicians, multiple doctors have taken to the internet to speak out against expanding their scope of practice.

“With all due respect to our healthcare team, I beg to differ that going through four years of college and completing an additional two years – sometimes online, no less – can truly be “just as effective”,” wrote Starla Fitch, MD, in an op-ed entitled NPs/PAs ‘Just as Effective’ as Physicians? I Don’t Think So.

In another posting, an open letter penned by the Presidents of the American Academy of Emergency Medicine Resident and Student Association directed at the American Medical Association Board of Directors called for the AMA to implement a public awareness campaign that “advocates for physician-led care and educates the public of the discrepancies in nurse practitioner care” and increase “resources on state-level legislative operations that combat independent practice bills introduced by midlevel providers.” The authors of the open letter went on to state, “These efforts should be a priority for the AMA. Waiting for the complete devaluation of our medical degrees and the resulting significant harm to our patients’ safety as they actively pursue less capable “providers” is not acceptable. We must work together to directly combat this pressing issue in order to protect our profession, our future physicians, and most importantly our patients.”

“There are absolutely patient safety concerns associated with NP and PA care. We don’t diminish the fact that physicians make mistakes, of course, but the type of mistake is often very different from those of non-physician practitioners. We have had many physicians and patients share stories with us of missed diagnoses and misdiagnoses by NPs and PAs, as well as excessive and inappropriate testing, prescribing, and treatment,” said another physician—Carmen Kavali, MD, who is also a board member of Physicians for Patient Protection.

There is no shortage of opposition. However, as Alison Moriarty Daley, MSN, APRN, PNP, put it as far back as 2011, “There are too many people who need high-quality, dedicated providers; we are such providers and deserve the appropriate respect, recognition, and support from the healthcare community.”

The physician shortage is not getting any better. The Association of American Medical Colleges predicts a shortage of between 21,100 and 55,200 primary care physicians by 2032, and physicians are burning out and, sadly, dying by suicide at an alarming rate. So, why the fight?

Where do you stand on the issue? Tell us in the comments below.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

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