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Nurse Practitioner vs Doctor of Medicine

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  • Nurse Practitioner vs Doctor of Medicine

    Всем доброго времени суток! В связи с определенными трудностями попадания в резидентуру у меня в очередной раз возник вечный вопрос: что делать? И тут недавно услышал про такую специальность как nurse practitioner. Согласно имеющейся информации, функционал у NP практически на 95% совпадает с функционалом MD/DO, включая возможность выписывать рецепты и открывать частную практику. А сейчас появились варианты узкой специализации, типа кардиологии или гастроэнтерологии. Не вдаваясь пока в детали обучения, кто-нибудь может поделиться личным опытом такого пути и плюсами/минусами этой карьеры? Либо может быть уже состоявшиеся врачи могут поделиться своими впечатлениями от данной специальности и насколько, по их мнению как врачей, NP сравнимо с MD (internal/family medicine)?

  • #2
    Ne mogu sudit" s posizii practikuuschogo americanskogo vracha, I poka ayvlyauys" NP sudentom. No dvizhenie po zamene ili po krayney mere vytesneniyu primary care providers in the country ochevidno. V shtate Oregon naprimer prinyat zakon nedavno zapreschayuschiy strahovym private companies platit" NP men'she chem doctoram za odinakovie medical care. Mnogie dumayut cho eto mozhet byt" nachalom zameny Primary Medical Doctors by NPs and PAs. Ne bedet smysla prohodit" cheres Medical School to have similar practice scope and income with NPs.
    Last edited by Pod; 10-22-2016, 11:06 PM.

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    • #3
      это уже интересно, потому что я читал на каком-то сайте, что np от страховых получают меньше чем врачи, видимо поэтому эту программу обучения и стали так обширно внедрять. но если реально появилась тенденция по повышении зарплаты np и постепенной замене врачей ими, то при одинаковом функционале наверное действительно стоит серьезно рассмотреть этот вариант...

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      • #4

        I found one of my discussion posts. I hope it will help a bit.


        A board of nursing defines a Nurse Practitioner as follows: “ A Nurse Practitioner (NP) is an RN who has earned a separate license as an NP through additional education and experience in a distinct specialty area of practice. Nurse Practitioners may diagnose, treat, and prescribe for a patient's condition that falls within their specialty areas of practice. This is done in collaboration with a licensed physician qualified I the specialty involved and in accordance with an approved written practice agreement and protocols. Nurse Practitioners are autonomous and do not practice under the supervision of the collaborating physician.” (New York State Education Department, 2016). Nurse practitioner specialty areas include Acute Care; Adult Health; College Health; Community Health; Family Health; Gerontology; Holistic Nursing; Neonatology; Obstetrics and Gynecology; Oncology; Palliative Care; Pediatrics; Perinatology; Psychiatry; School Health; and Women's Health (NYSED, 2016).
        Though NP role was developed and established from the 1960s, NPs still struggling to prove their place in the American health care system. A significant stratum of medical doctors and bureaucrats does not understand the role and scope of practice of Nurse Practitioners and other Advanced Nursing Specialties. Even nowadays one can hear confusing names that describe NPs such as physician extender, mid-level practitioner, nonphysician practitioner, and advanced practice nurse. Most NPs have master’s degrees, and some have doctorates. Master’s degrees for NPs are required by law in 34 states. In 45 states, NPs are required by state law to take and pass a national certification exam (Buppert, 2015).
        From the mid-1970s, state legislators began to consider proposed laws regarding the prescriptive authority of NPs. By 2006, NPs had achieved some degree of prescriptive privileges in all states and the District of Columbia. After enrollment of the large percentage of the population into managed-care plans, NPs received authority to bill for services to patients covered by Medicare and Medicaid (Buppert, 2015). Many professional organizations of Nurse Practitioners monitor the legal situation regarding the scope of practice and reimbursement rate and consistency for NPs. One of the great example of advancing NP’s role in rural primary care happened in Oregon State. The Oregon House voted to require private insurers to pay independent nurse practitioners and physician assistants at the same rate they would pay doctors for the same services (The Lund Report, 2013).
        References
        Buppert, C. (2015). Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) Burlington, MA: Jones & Bartlett Leaning.
        New York State Educational Department. (2016). Nursing. Retrieved from http://www.op.nysed.gov/prof/nurse/
        The Lung Report. (2013). Nurse Practitioner Pay Equity Easily Passes House. Retrieved fromhttps://www.thelundreport.org/conten...y-passes-house



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        • #5
          погуглил сейчас немного и нашел еще такую интересную диаграмму http://www.bartonassociates.com/nurs...practice-laws/ . В принципе, звучит как неплохая альтернатива MD, если только нет привязки к какому-то сильно лимитирующему штату

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