Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

Ask a Nurse – or Do You Really Need a Doctor?

By ACEP Now | on November 1, 2012 | 0 Comment
Opinion
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

I am also aware that sometimes I need an internist to do more than follow guidelines and recommendations for my healthcare. Sometimes I need him to figure out what is wrong with me.

You Might Also Like
  • AAENP, AANPCP Partner to Develop Emergency Nurse Practitioner Certification Exam
  • Opinion: Connecting with Patients Can Help You Become a Better Doctor
  • Opinion: Nurse Practitioners, Physician Assistants Should Not Have Same Drug Prescribing Authority as Physicians
Explore This Issue
ACEP News: Vol 31 – No 11 – November 2012

And there is something else that comes into play here. Sometimes knowing more and having a deeper understanding leads to doing less. (Recall the simple example of the minor head injury.) Very often a smart doctor can figure out what is wrong with you by taking a focused history, asking all the right questions, and doing a careful physical examination for signs of disease. The doctor may be 93% sure about what is wrong with you without doing any tests. Imagine how much money could be saved if you trust his clinical judgment and give him permission to refrain from spending any of your money on tests to raise the diagnostic certainty from 93% to 99%.

I have worked side-by-side with nurse practitioners for nearly three decades, including some I’ve thought were very capable. I am still waiting to meet a nurse practitioner I might judge to be an astute diagnostician.

This is hardly surprising. One can become a nurse practitioner by starting as an RN/BSN and taking an online master’s degree program, while an internist has 4 years of medical school and 3 years of residency after the bachelor’s degree. To expect the two to have similar abilities in the aspects of practice that rely on a foundation of education in the sciences is quite unreasonable.

Let us begin with the assumption that, among bachelor’s-degree RNs, only the best and the brightest decide to go on to earn master’s (or doctoral) degrees and become nurse practitioners. Now I’m going to look at that population of students and ask a simple question. How many of them would do well in the year of organic chemistry required of pre-meds and commonly used as a “weeder” course? My daughter Rose is very bright and hard-working. I know this because I lived with her in the same household for nearly two decades. And I saw how hard she had to work to get grades in organic chemistry last year that would meet with the approval of a medical school admissions committee.

Do you have any children still in school? Think about the smartest kid in your child’s class. Maybe it’s your kid. That kid could go to medical school or law school or choose any other of a number of career paths. Now remember, she’s the smartest kid in the class. When you are older and sick, what do you want her to be? Do you want her to be the consultant other doctors call when they are trying to figure out how to keep a perplexing illness from killing or disabling you? Or do you want her to be the lawyer your family calls when things don’t go well and they want to find out whether your doctors are to blame?

Pages: 1 2 3 4 | Single Page

Topics: Care TeamCareer DevelopmentEducationEmergency MedicineEmergency PhysicianInternal MedicinePractice ManagementPrimary Care PhysicianProcedures and SkillsQualityThe Wisdom of Solomon

Related

  • How Emergency Physicians Can Thrive in Value-Based Care Landscapes

    June 24, 2025 - 0 Comment
  • 10 Essentials for Your Emergency Department Fanny Pack

    June 17, 2025 - 0 Comment
  • ACEP4U: Reinventing Research Education

    June 11, 2025 - 0 Comment

Current Issue

ACEP Now: June 2025 (Digital)

Read More

About the Author

ACEP Now

View this author's posts »

No Responses to “Ask a Nurse – or Do You Really Need a Doctor?”

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*

Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603