Physicians are trained to lead, and the AMA stands in strong support of physician-led health care teams. More than 90% of patients say that a physician’s years of education and training are vital to optimal patient care, especially in the event of a complication or medical emergency. Patients also deserve to know who is providing their health care and the education and training of their health care professional.
To help set the record straight, the AMA is publishing a series of news articles outlining the key differences between various types of physician specialists and nonphysician providers.
Physicians and nurse practitioners.
a Nurse-practitioner (NP) programs generally last two to four years, however, some nurse practitioners can get their degree in as little as 18 months after becoming an RN. Online-only programs are allowed. Physicians, by contrast, must complete four years of medical school to earn a degree as an MD (a doctor of medicine) or a DO (doctor of osteopathic medicine). There are no online medical schools.
b. Meanwhile, nurse practitioners have no residency training requirement, whereas physicians must complete three to seven years of residency and fellowship training depending on which specialty they pursue. Nurse practitioners will tally just 500–750 patient-care hours in training. By comparison, physicians get between 12,000 and 16,000 hours of patient-care experience.
More to follow:
As a hospitalist in California, Donaldo Hernandez, MD, has frequently seen the confusion patients experience over who is coming into their hospital room to provide treatment.
Blogfinger comment: I was an inpatient at Jersey Shore and I was uncertain as to who was in charge of my case. A variety of
“white coats” came in, asked questions and examined me, but I had to ask them who they are.
If they say that they are “residents” then they are not full fledged doctors in a particular specialty even if it says “cardiology dept.” on their ID. And the same concern applies for medical students.
Some residencies can take 3-6 years or more, so a resident may have more or less experience.
In my case, I requested a consultation with a electrophysiologist (a cardiologist whose specialty is heart rhythm issues.) But the doctor who showed up was not what I asked for. They ignored my request.
Jersey Shore says that it is a “university hospital” but the resemblance to a real university hospital is superficial in my experience there. They say that they are one of the “best” hospitals in New Jersey, but they need to earn that title not be granted it by a team of Mad Men.
A good ID term to know about is “Attending Physician.” Even though your care may be by a “team” (an over-rated concept) there should be one doctor named on your chart as “attending.” All decisions should flow through that physician-in-charge to avoid confusion and errors.
In my case, the doctor who was named on my chart was a physician who never saw me in the hospital. His “involvement” may have only been answering the phone and talking to those who were actually seeing me. If such conversations did occur, no one told me.
Someone needs to be responsible for your total care on site, and you need to know who that is and you need to communicate with that physician every day, but don’t count on it.
We used to call it “making rounds” and we did that every morning before going to the office. (or a “covering doctor” would show up who was acquainted with your case.)
We will continue this AMA discussion of “scope.”
Paul Goldfinger, MD, FACC.
Blogfinger.net.