Doctor-nurse line is blurring

By Gilbert M. Rogers, D.O. Published: August 8, 2008
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As president of the Oklahoma Osteopathic Association, I am alarmed by the increase in the number of colleges and universities offering the doctor of nursing practice (D.N.P.) degree. The D.N.P. program allows nurses who hold at least a master's degree to earn a clinical doctorate and treat patients in place of a physician. According to the American Association of Colleges of Nursing, there are more than 60 D.N.P. programs and more opening every year. In Texas, there are already four D.N.P. programs. Kansas has two and Missouri has one.

As additional programs open, the public needs to understand how expanding the scope of practice for D.N.P.s without appropriate expansion of their education, training and regulation may do more harm than good for patients. The program, which is typically two years, is not equivalent to the training of an osteopathic physician (D.O.) or an M.D., who are the only two fully licensed physicians in the United States. Both groups attend four-year medical schools followed by three to six years of internship and residency training in their chosen specialty area of medicine.

As a physician, I find it hard to imagine how only two years of schooling and a condensed clinical training program can prepare D.N.P.s for the many difficult scenarios they may face while treating a patient. A comprehensive medical residency program prepares physicians by exposing them to patients presenting various symptoms of illnesses and conditions, allowing them practice in diagnosis and treatment. D.N.P. training does not provide adequate diagnostic experience to prepare these nurses for complex cases.

I will not deny the important role that nurses play in the health care system. However, steps must be taken to increase access to health care without compromising quality of care and safety for patients.

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