The 'nurse doctors' are here

The NYT recently profiled a nurse practitioner with a doctorate who wanted to be called a Doctor. ( "NYT article" Reg required.)The article stated that nurses who obtained their doctorates were not doing it to gain more autonomy, money or prescriptive power. The AAFP Board President commented that patients would be confused about who the doctor really is. Let us look at some current workforce numbers: 276,000 PCP’s, 125,000 NP’s, 225,000 Pharmacists and 81,000 PA’s. Mid-level practitioners are getting larger in numbers and with the shortage advertised by physicians (myself included) the ANP’s and PA’s and Pharmacists have an opportunity to gain market share as the first healer to see patients. All they have to do is convince payers to reimburse them at the same rates as the physicians. The same physicians who were tutoring PA’s and ANP’s and promoting the teamwork concept are now crying foul. The numbers are important, too. “In 2008, there were 375,794 nurses with master’s degrees and 28,369 with doctorates.” Now, no one has proved that a nurse with a doctorate can deliver better care. But, there it is. 
Comment: Where the rubber will meet the road is when Congress will look at the budget deficits and ask: Can we replace one PCP with two of either an ANP or PA? (The compensation, on average, for an ANP /PA is half that of a PCP) As I have said before on this page, the PCP’s who are locked into their own battle with specialists over being under compensated, will need support from their specialist colleagues. Will it materialize? This battle is surely before us sooner rather than later.