The New York Post Bashes Nurse Practitioners

Put up your dukes! The New York Post has picked a fight with nurse practitioners. Last week, the sensationalist newspaper published an article titled "When a nurse is your health-care provider, you're at risk". Did you read the story?

I'm generally not someone to get angry over news stories or to take offense at other's opinions. I'm pretty go-with-the-flow. But, I will say when I read the New York Post's (unfounded) opinion piece about nurse practitioners, I was pretty peeved. The one-sided article was incredibly flawed in it's assertions. Maybe that's OK, because author Betsy McCaughey's portrayal of nurse practitioners was so errant it came across as uneducated and ignorant. 

Last year, New York lawmakers passed the Nurse Practitioner Modernization Act making it possible for NPs with more than 3,600 hours of experience to practice free of physician supervision. Nurse practitioners must still maintain collaborative relationships with physicians but no formalized process is required. These collaborative relationships do not need to be filed with the state or meet specific metrics. The new legislation took effect on January 1st this year. 

As a result of this new legislation, the New York Post warns New Yorkers to "ask whether your health-care provider is a doctor" the next time they find themselves as patients. "Some nurses are playing doctor", the article urges. The piece contends that nurses have gained legal rights as a result of aggressive lobbying but don't actually have the know-how carry out these freedoms with sound medical practice.

My biggest beef with McCaughey's op-ed is her allegation that nurse practitioners are trained to treat symptoms, rather than practice based on "how organs and the body work". Really? She cites an arbitrary example about insulin resistance and a pancreatic duct obstruction as proof.

In the example, related to McCaughey by a physician, the doctor recalls treating a patient for insulin resistance. He determines the patient's problem is caused by a gallstone lodged in the pancreatic duct rather than the more common cause of insulin resistance, type 2 diabetes. The physician giving the example asserts that nurse practitioners would have assumed the patient with insulin resistance had adult onset diabetes and treated accordingly rather than identifying the actual cause of the patients problem. The story is presumptive, not an actual example of a nurse practitioner's diagnostic mistake. 

McCaughey's article in the New York Post cites other problems with less restrictive legislation surrounding NPs. She claims that nurse practitioners don't actually save precious healthcare dollars because they order too many diagnostic tests as a crutch for lack of competency. She assumes that industry funded studies concerning nurse practitioner practice safety records are flawed. Her assumptions aren't backed by data, but are simply speculation. 

 

What are your thoughts on the New York Post editorial?

 

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Comments

How about this for real example. My mother was recently seen by NP in hospital for possible pneumonia. NP ordered single view CXR no CBC and cleared her of no pneumonia. Few days later she was seen again this time by MD who was able to get appropriate labs and CXR; finally diagnosed her and started on antibiotics.

Years ago I was seen by pharmacist (in India) and given steroids for symptoms resembling Typhoid and I nearly died.
Family medicine is specialty that should have highest trained physicians not least trained.

karam

Doctors drive up costs by ordering lots of tests mainly because they are the ones that have to over protect themselves from litigation. They have the money that people are after. The evidence used against NPs competency is through a highly special circumstance: Diagnosing insulin resistance secondary to a pancreatic duct blockage is not common in family practice. I can confidently say most family MDs wouldn't have that high on their differential list just because there was insulin resistance in a patient. An endocrinologist or gastroenterologist would likely diagnose this, and NPs aren't trained for that in school, just as Family MDs aren't. The old saying if it has hooves, look for a horse, not a zebra. Unless NPs are in practice in these specialties, then yes it is likely this wouldn't be diagnosed by an NP. However, NPs do know when to refer patients to appropriate providers.
These articles do nothing but create distrust in the medical community. NPs are a solution not a problem to the growing demand for healthcare. The preventative, routine, and episodic care NPs can give can actually decrease costs in chronic disease management
This story is comparable to the lawyers that try to stand in the way of MDs practicing medicine by producing commercials that are inflammatory, causing patients to distrust the care their providers are trying to give to them. Unless the author can share a real personal experience where she received less than optimal care by an NP, they should have reflected on their story and taken responsibity in knowing that the article may negatively impact readers. Why? For what purpose? Poor taste on the NY post to publish an opinion of someone that had nothing relevant to add to society.

Jessica L. FNP