You’re seeing a new kind of healthcare worker almost everywhere these days. They’re at your family doctor’s office, at urgent care, and in hospitals. But here’s what most people don’t realize: these workers are not trained nearly as well as real doctors. A doctor spends four years at medical school and then several more years in a residency program before treating patients on their own.
So who are these other providers?
A Nurse Practitioner (also called an NP or APRN) is a registered nurse who has earned a graduate degree in nursing. A Physician Assistant (PA) takes a different path. PAs don’t need a nursing license, but they must finish a PA program and pass a certification exam. Both NPs and PAs are part of what’s called the “treatment team,” and both are supposed to work under a doctor’s supervision. The one exception: an NP can work on their own after three years of experience. A PA cannot.
So why are we seeing so many of them?
Big healthcare companies will tell you that NPs and PAs are needed to “extend” a doctor’s reach and help fill the gap when there aren’t enough doctors to go around. Baloney. The real reason is money. Hospitals, large medical groups, and private equity firms can pay an NP or PA a small fraction of what they’d have to pay a fully trained, board-certified doctor. Fewer doctors on the payroll means bigger profits.
Does this hurt patients? I believe it does.
To be fair, NPs and PAs can do a fine job in routine situations that aren’t life-threatening. But if you have a serious medical problem, you don’t want to gamble your health on a “mid-level” provider. The Wall Street Journal recently ran an article called “Dr. Who? The Nurse Practitioner Will See You Now.” One of the best lines in the article was, “These days heading to the doctor’s office often doesn’t involve a doctor.”
My Take: If you have a serious medical issue and you are being pushed to a NP or PA…it’s time to find a new doctor.