Monday, October 4, 2010

On the doctoral degree for entry into either PA or NP practice.

A doctorate as an entry-level clinical degree is a bit much for either group. I'll admit that my knowledge of DNP programs is limited, but unless there is additional advanced training in clinical medicine...then it wouldn't enhance the care given and makes the degree pointless from a clinical standpoint. If the degree hinges on some type of research project, then it is essentially the same thing as a PhD degree in nursing and again, becomes pointless from a clinical standpoint. If the goal is simply to get the title of "Doctor," and makes you feel better about all the extra money you spent...great.

I've been acquainted with PA's and NP's for over 30 years. I've been a PA myself going on 15 years. The first NP I ever met was a diploma RN, who completed a certificate NP program. I dare say all the master's (and now doctorate) prepared NP's have nothing to offer above and beyond what she had. I believe the same is true for the varied degrees offered by PA program. In the end, we all take the same standardized national examination for licensing. "Degree creep," "credentialism," of whatever you want to call it for attaining an entry-level of practice only drives the cost without offering any tangible benefits to patients.

I do think an advanced clinical degree is appropriate if in imparts advanced clinical knowledge and skills. The Baylor EMPA program for example. But a doctorate for entry-level PA or NP isn't really reasonable or necessary.

Everyone wants to be a doctor today. Medical doctors, pharmacists, physicial and occupational therapists, audiologists, now nurses. In essence, like like the comedic "hello doctor, doctor, doctor" skit...the title actually become meaningless. Many licensed physicians I have worked with actually hold a bachelor of medicine and surgery from UK medical school. We call them "doctor" when they don't actually hold a doctoral degree. Should I be called "master" by the "doctor?" That would be a hoot. Regardless of degree... you are licensed as a 1) physician, 2) pharmacist, 3) physicial or occupational therapist, 4) audiologist, 5) registered nurse. I am licensed as a PA. That should be the focus...not getting caught up in a title.

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