A recent session presented at the 2018 Society for Hospital Medicine annual meeting offered some quick facts regarding physician assistants (PAs) and nurse practitioners (NPs), using the catchall phrase advanced practice providers (APPs). This led to lively and often contentious discussion in the comments section from APPs, physicians, and other healthcare providers.
An outspoken nurse practitioner stirred up controversy right away:
I do not see any difference between myself and an MD. I have the same responsibilities, authority and requirements. I can diagnose, prescribe and admit to the local hospital. [I could also] open my own clinic.
An emergency room physician shot back quickly:
You may not see any difference between yourself and an MD, but there is a substantial difference in terms of training and, generally, experience. No one expects you to be a physician, but not knowing what you don't know can be a significant limitation. You may feel that you have adequate training for eighty to ninety percent of what you see, but if you don't recognize the corners around which you don't see . . . you are doing a disservice to your patients.
An anesthesiologist made an unflattering comparison:
McDonald's perfected the idea that you don't need a trained chef in every retail outlet and teenagers and warm bodies off the street could be trained
