Noctors aka “Nurse doctors”
Did you know that there are currently 101 doctorate of nursing programs in the United States accepting patients???? ONE HUNDRED AND ONE! This is nearly as many as the number of allopathic medical schools in the entire United States. Here is the official list according to the American Association of Colleges of Nursing. There is no escaping NP’s. They have even managed to make headway as far up and away as the Yukon!
Yes, you too can enter the Texas Woman’s University (just make sure you were able to crack a whopping 960 on the GRE to qualify) and a mere 46 credits later (don’t worry you will never have to take more than 9 credits a semester) and you too can call yourself DOCTOR. If you fear that 46 credits maybe too much of an academic burden, then you can always apply to the Frontier School of Midwifery and Family Nursing as they only require 33 credits to achieve the doctorate! Or maybe you hate having to sit in class. Well thanks to the the University of Cincinnati you can do your entire doctorate online (plus no GRE needed)! I had to pull out my old med school transcript to calm myself down since I knew working my butt off for a doctorate certainly required more than the above. Guess what? I can safely say that I did not lose my mind- just shy of 160 credits it was.
Oh and it gets better. There are another ONE HUNDRED additional noctor programs in the planning stages. So if you had concerns that your credentials were not competitive enough, you could always wait a couple years since there will be nearly double the spots.
Between greater govt control of healthcare in this country and the explosion of allied professionals, primary care salaries are not going up anytime in the foreseeable future while inflation and compensations in other occupations will only increase. This is chimpanzee economics. To add insult to injury, while your recently graduated med student is working like a racehorse in residency barely able to pay the minimum (assuming he is not in deferment or forebearance) on his quarter of a million dollar student loan balance, your noctor zipped through a one week residency (at the end of the first paragraph in this article) and is humming away making just shy of your future attending salary with a fraction of the loans. Actually, while you were sitting in lecture all day racking up those loans, your future NP was busy at work full time bringing in a nice salary. I will leave it to one recent NP grad’s remarks about her noctor program over on allnurses.com, “University of Cincinnati (UC) is 100% on-line, it allows me to continue to work!” Someone tell me how it is even possible to learn all there is to know in medicine entirely online and while holding a job? Please tell me I am dying to know, as are your future patients whom many of you will be independently treating.
Medicinesux 
It really is sad. It makes me wonder why more doctors aren’t leaving the profession.
I must thank you, because some of your posts have helped me in deciding that medicine isn’t for me. I didn’t really understand the reality of the job until I started to read the residency forum on sdn. Medicine today just seems like a masochistic profession. I am just going to graduate school with the goal of becoming a professor. I am glad I didn’t make the plunge off the cliff.
I hope things work out well for you.
I appreciate your comment amikemd. Medicine is definitely changing for the worse and shows no signs of improving. I am amazed how fast it had gone downhill just in the ten years that I embarked on this arduous journey. Congrats on making an informed decision. Don’t ever think twice about what you are missing out on by not going down the road I did. It is a hell of a trip I tell you. One I would never recommend to even my worst enemy.
what kind of job prospects exist for these ‘noctors’? if i were a hospital CEO, i will still treat them as a nurse and not pay them any much more than a RN. in fact, some of the dedicated time they take to pursue a doctorate will decrease the no. of yrs of experience as a nurse.
unless they want to do research. then the appointment as nurse researcher or sth might warrant some additional monetary remuneration. they do have journal of nursing or midwifery. as a med student, i do not mean any disrespect, but the articles are just not my cup of tea (u gotta gimme some credit for actually picking them up for a cursory flip at the hospital library)
Jeff(y),the respect to others is directly proportional to the upheld self respect..treating individual based on profession/role, is a testament of your abilities and limitations.. acquire your big MD, work hard to hold your license at least a century while attending your fav specialty,then consider a postgraduate-master’s in business/management before dreaming to becoming a CEO..hopefully your vision will expand,maturity will be reached and nursing research articles will become quantifiable in the intake of number of tea cups served at the meetings. just wondered how many research articles have you published?
Brilliance. Best article summing up all the key points and chocked full of stunning information. 5 stars!
Thanks Coastie for stopping by and leaving a comment. I was equally “stunned” by the above information I dug up myself. I don’t think the general public….heck…your typical medical student, has a clue how wildly proliferative and barebones these programs indeed are. I believe that the noctor issue is unsettling and an emerging threat to healthcare in our nation.
Noctors really have increased the need for pharmacists. It is very scary the things I see them prescribe on a daily basis, I am constantly having to call to adjust therapy and ask them why they are trying to kill their patients. Communities with higher number of noctors most certainly have more antibiotic resistance. Noctors dispense antibiotics like they are candy and seem very confused about what ABX covers what. Is it really that hard to figure out?
noctor. are you ignorant? nurse practitioners have to endure hellish years of nursing school, graduate education, including clinicals that mirror the clinical experiences of mds. ridiculous. just to earn half what a md makes with less prestige.
Yes, it must be terrible. All those late night pillow fights must take a terrible toll on your body and mind. I can’t even imagine….
Did you just smoke some crack? Nursing clinicals mirror those of a medical student as much as an ugly frog who looks in a mirror and thinks he’s a prince.
http://well.blogs.nytimes.com/2010/02/11/when-the-nurse-is-a-bully/
nurses go through just as much hell, you wouldn’t know would you? would you know? have you ever been to nursing school? been a nurse? gotten your masters in nursing? have you done any of this? no. so you wouldn’t know. stfu.
You cannot compare clinicals between an NP and an MD. I don’t disagree that nursing is hellish in it’s own right. The hostility in nursing in the article you provided does not surprise me at all. Your demeanor from your prior post fits this characterization perfectly well may I add.
nurses have pillow fights with each other, late at night at each others’ apartments, where we fantasize over the hot doctors we yearn to service everyday
nurse practitioners have to go through a lot of hazing and bullshit to get their credentials trust me so die.
I apologize, I love your blog, you’re actually one of the brave, brilliant, souls in this fucked up profession who is willing to tell the truth about how dysfunctional healthcare is, it is the greedy hospital administrators and the clueless MBAs who i should be hating.
Did somebody say useless MBA?
My close friend is in nursing school. She considers 12 hour shifts to be “long.” She does this 3x per week.
She had NO idea how long our hours are sometimes (ie 24 +6) and thought that doctors get overtime.
There is absolutely no way that nursing clinical education mirrors medical student education. I would be smacked if I actually complained about having to work 12 hours in a row. And, I would be smacked again if I complained about a lack of breaks.
It’s not that nursing students don’t work hard- they do! They work a LOT harder than I thought they did before I met my friend. And they learn a LOT more than I thought they did. Nursing school is not a walk in the park.
But they do not work as hard as medical students. That’s an undeniable fact.
And you have the “media Leaders” showering glorious words of praise about their hand-holding, empathetic nice visit (covered by insurance payment) to the nurse practitioner.
http://www.fiercehealthcare.com/story/how-my-search-doctor-ended-visits-nurse-practitioners/2010-07-08
People get what they deserve. The third party payment system is the root cause of all this nonsense in this country.
You must be one of the many “know it all doctors” a scholar with limited research, poor math skills and common sense, that brags about his 160 credits on paper.If your your vision and thought process would have NOT been shadowed by your big inflated ego,you would have been at least more mindful of the credits and requirements needed by NP program(120 credits- bachelor in science + 3 years clinical experience)The program can be offered as a master’s degree that adds at least another 40 credits in science/research or as a postgraduate to the master’s in science. Feel sorry for you. Just a word of advise: do not call the student nurse your friend. You do not meet the core competency of friendship.
Dear Anonymous–I did go to nursing school. I worked for seven years as a critical care nurse. And then I went to medical school. So I do have the street cred to comment. And my comment is this: online training simply cannot replicate clinical, hands-on training and experience. And no, nursing experience in the hospital is not an adequate substitute for the critical thinking necessary for generating a differential diagnosis and treatment plan. I thought I knew a lot when I entered medical school, but had to eat major portions of crow. Because what I learned is that sometimes you do not know what you do not know. Malcolm Gladwell is correct: 10,000 hours. There are no short-cuts to mastery.
intransition: a sentiment echoed by EVERY nurse in my medical school class. Most nurses are very smart, and I rely on them daily to help with basic day to day care. But, not a day goes by that I am not frightened by a suggestion or action by a nurse that clearly demonstrates a lack of understanding of how each part of the body interacts with every other. Basic understanding of fluid dynamics and pressure gradients and basic organic chemistry is grossly lacking. In over 14 years, I can count on one hand how many very good nurses could figure out how to level a ventriculostomy or check if it is reading correctly. It is a simple fluid column. Nothing more. I’m sure there are good nursing schools and bad, just like there are good medical schools and bad, and good colleges and bad. But there is absolutely no way that an online course is going to prepare a Doctor of Nursing to see patients and make informed decisions about their disease processes. There is no substitute for a patient laying in front of you in the middle of the night, surrounded by a less than pleasant family, asking “So what are you going to do to save my dying loved one?” The really good NP’s I have worked with learned on the job from doctors who were willing to teach them, not from online courses or nursing clinicals. Just like good doctors learn by experience with other doctors in residency, not by reading books in medical school.
The Nurses are NOT required to take a University course
in college physics-let alone calculus- based University Physics.
They NEVER develop critical scientific quantitative analytic skills,
and thus never understand medical physiology as well as the
pre-meds that have gone to medical school.
Yet they believe, with incalculable arrogance, that they “understand”
medicine just like real doctors [=PHYSICIANS].
The Nurses know WHAT is ROUTINELY done in medicine, and they
routinely do NOT know anywhere near enough Science to know WHY it
is done: hence they never recognize the limitations of the techniques used
in medicine.
The DNP degree is pure fraud perpetrated on the American public
at a time of national bankruptcy and extremely high impending primary care
medical demands from baby boomers plus Obamacare.
The US government and its malignant socialist agenda WILL embrace the “DNP”
as the “new” doctors in the United States. The cheaper, quicker alternative.
American standards in the medical profession will sink to incredible lows in
the sense of academic and scientific scholarly discipline, utterly debased with the
obscenely pompous and hyper-inflated “DNP” titles wielded by Nurses.
The Nursing leadership brings itself into extreme disrepute with this exercise of
fraud, chicanery and deception on the American public. Yet, they will accuse the
physicians of being entirely ego-driven, and territorial.
The fantastic hypocrisy of this is that all the physicians have known very well
the intense territorial and title jealousy that have always existed among Nurses
in the hospital. And nowhere in the health professions are Nurses treated with
more brutality and contempt than by OTHER NURSES.
As a nurse, I don’t claim to know everything. No, I don’t understand ALL of the science; what I don’t know I try to research. I’m not an autobot who simply does as it is programed. I do use critical thinking skills. As another poster commented, yes, I do know the “routine dosages” and what we “normally do.” I also know that “normal” will not work for all patients. Nurses, doctors, pharmacists, etc. all work together, sharing their expertise. What is so wrong with that? I know you went to medical school for a reason. I value you and you should value your nurses. There are bad apples in every bunch.
Also, not a lot of nurses I know would say going to medical school is easily. Yes, nurse practitioners are hot right now as the new mid-level provider. Where is your outrage for the PA?
These doctorate programs you mention are not so nurse practitioners can be called “doctor.” These DNP programs are for advanced practice RNs, which include clinical nurse specialists, midwives, and CRNAs. This degree allows for advancement, especially in education and leadership, not so we can take your precious title. DNP is not a degree to open up a practice. At least do a little more than cursory research please. Do PhD programs bother you this much?
I’ve always thought of NP’s as much more nurse than doctor, even if they held a doctorate. They definitely don’t have the intense science background or years of in hospital training physicians have. The doctorate degree was never meant to indicate the knowledge of a physician. Remember that musicians and philosophers also have doctorates, and it in no way implies a knowledge of medicine. Medicine and nursing overlap somewhat…but even with a doctorate in medicine I would never expect a physician to jump in and do my job without going through some training too.
Parity of pay? Well, if I have a problem with my car and I go to a general mechanic he’s not going to be able to fix it as well as the dealer. So is the general public willing to pay as much hourly to the gas station on the corner as the dealer’s mechanic- NO. The guy on the corner might solve my problem, or take a look and Bandaid it until I can get to the dealer.
Interesting post and comments. I’m a 24 year old RN going back to Med school next year and have deliberated over this very issue for quite some time. Getting into NP school would be easy – write a couple of essays and send them a transcript. GPAs over 3.5 are basically a shoe-in. 3-4 years of school, tops, and no residency. But I always felt unsettled about being a provider with that education; it felt like trying to sneak in the back door. So instead I took pre-med pre-reqs and am going to med school.
Skeptical Internist has the best point – that nurses and NPs might know what is routinely done in medicine – but the knowledge of WHY just isn’t there. That’s scary, and a risk I’m not willing to take. NPs can certainly learn from MDs who are wiling to train them, but I’d rather put in a couple years of work on the school end of things and eventually practice with adequate knowledge and autonomy.
I heard a few days ago that by 2015 there will a physician shortage of 68,000 providers. If all the MDs are so worried about the NP invasion, why don’t we open up some more med schools?
Because with the expanded practice right of advanced practice nurses. Why should anyone go to medical school anymore?
biggest mistake I made was doing an NP masters plus a 5 yr PhD in the faculty of medicine – to earn what a nurse makes who never went beyond a bachelor’s degree. In retrospect, I should have done a medical program – it definitely would not have been harder and the salary etc much better
Wow. First of all, this idiot has a medical degree but writes like this? Second of all, I did 800 clinical hours, as did my fellow NPs, in my advanced nursing practice nursing degree. Where in the world are you getting information from? Possibly jealousy inspired as the research out there is showing better outcomes with NP care, improved patient care outcomes and so on and so forth. Your article inspires not much more than a laugh at the sheer stupidity! If you want to be taken seriously, DO YOUR RESEARCH! Or possibly you need to take an extra course in order to do that. To sum it up, all this article shows is that you are a jealous, ignorant fool who likely has some very dissatisfied patients as there is no possible way you are a well rounded up to date clinician. One who is would not stoop to your level and write such disgusting garbage.
These militant NPs are a cancer in the modern medical system….only a matter of time before the DNP frauds are exposed to the lay public for what they are. Easy fix would be to hold them accountable for all the material they claim to have mastered to warrant being seen as equals to physicians and if they can pass every exam/practical assessment/core compentency required to become a licensed and board certified physician they’ve earned it…if not strip these clowns of their licenses and make room for the people who aren’t absolutely f*cking insane.