Nurse Practitioner Dr. Susan Apold on Fox & Friends Discussing NP-guided Care

[paintem2000]

Don't kid yourselves from the MD perspective this is strictly a money issue. NP's acting independently means that MD's dont get paid for chart checks and "colaboration" however loose the term. This is why ER physician groups block the hiring of NP's over and over again but will readily hire PA's. No chart check, no money!

[hcolfer]

that rocks, get the word out NP's/DNP's provide excellent quality for patients and improve patient access to care. I find it interesting that the AMA cannot justify their fears with ANY data yet NP care has a 40 year track record of data and safe outcomes....

[cwmillerrn]

This was awesome. The NP was really well spoken. NPs are the wave of the future.

[JoanBeitman]

Dr. Apold you were awesome. At least this interviewer was infinity more intelligent then the previous interviews by Fox and friends (Dee Swanson interview)

[rakrobn]

@JoanBeitman Um, no. He is actually one of their more liberal interviewers on Fox and Friends, that's why he didn't actually call her out as she doesn't even know that the words "autonomous" and "independent" mean the exact same thing.

[Jasonat6034]

@rakrobn ... he didn't call her out because there was nothing to call out. Her point was that NPs want autonomy-- to have the ability to make their own informed decisions without having to have a physician's approval... independence in this case not only implies autonomy but suggests that they cannot and will not collaborate with MDs. Which isn't what NPs are suggesting... IMO

[rakrobn]

@Jasonat6034 Um no, try again. Independence implies that they do not require someone else to look over them, hence autonomy. Go to any dictionary and you'll see the definitions of "independence" and "autonomy" are the same. They are synonyms of eachother, if you look in the thesaurus.

[Jasonat6034]

@JoanBeitman Right.. she was incredible.. she really knew her shit.

[jmm121884]

Actually a PHD is not a Professional Degree, its an ACADEMIC Degree.... under many state laws Nurse Practitioners may not be called doctor in a patient setting...

Honestly I believe they have weak training compared to physicians and physician assistants.

[Jasonat6034]

@jmm121884 weak training to compared to a Physician I agree... but to a PA Im not to sure...particularly DNPs who have more years of clinical training than PAs...

[Marieannie2]

@onlyseeadoctor I would not be against NPs being called DOCTORS if they go for Ph.D. Then spend time at least 2 years of pure "internship" doing clinical rotations. This should then equal a medical doctor's background. I have great respects for Ph.D. The only thing lacking with Ph.D, is the clinical rotations and I believe they are good to practice healthcare.

[Jasonat6034]

@Marieannie2 NPs can also obtain a Doctoral degree which, as a clinical degree, allows for more clinical rotations...

[jmm121884]

@Jasonat6034 Perhaps they will receive more clinical rotation but it is still far less than a physician or PA. mostly. the doctorate is research. NP programs are designed to take experiences a nurse has and use that toward their "clinical exposure" I'm currently in a PA masters program and my friends currently in NP school hate it because there is way too much research and barely any patient exposure.

[hcolfer]

@jmm121884 the DNP is clinical with an emphasis on evidence based practice, hence the 'research' requirements. Cumulative clinical requirements for NP's triples PA requirements. By definition PA's are not able to disentangle themselves from physician oversight.

[jmm121884]

@hcolfer you basically pulled "triple" out of no where. I dont know what other kinds of research you are thinking about... obviously evidence based research. "disentangle"? basically that makes no sense at all. You seem to think oversight is means we less of a provider than a NP. PGY4-5-6, fellows Physicians are supervised even with hellacious training. I'll just finish with saying that you have no idea what you are talking about.

[Marieannie2]

@onlyseeadoctor What needs to be done is to distinquish the differences and admit that they are two separate entities and that MDs are never comparable to NPs and that their roles are not mirror image of each other.

[mdaine01]

Why not just go back to the original title "barber". The arrogance displayed in your posts is exactly why docs are under fire..... boy I bet your caca smells like roses, especially to you. You have no idea what I do or where, all I know is anyone with your attitude feels threatened an must have serious self-esteem issues.

[Marieannie2]

@mdaine01 I do not think onlyseeadoctor is arrogant. I agree with most of his points and I agree also that there are great NPs practicing nowadays. I have to acknowledge, though, that those are the NPs who are seasoned and who have extensive experiences. My great concern are the new crop who have nothing behind their belt except their clinical rotation experiences.

[mdaine01]

Then write a book and stop hiding behind a blog pseudo. You are full of b.s. - and probably have never stepped into a hospital. All you want to do is bash another profession because the good-old-boy, cover-each-others ass doc paradigm is shifting. Guess what? You aren't gods or omnipotent. You know nothing of the reasoning behind the DNP degree, which is an earned practice doctorate.

[Marieannie2]

@mdaine01 Having an online screen does not have to reflect he is hiding behind a pseudonym. Just focus on what he is saying without attacking him. It's not about being gods or omnipotent. It is about the distinction of two roles that involve delivering healthcare.

[Marieannie2]

@mdaine01 One is a full spectrum, I should say and that's the MD. One is what I consider a different approach, like eating food, one is a full meal deal and the other is a light meal, but both nutritious; however, one has less calories than the other...

[Ineedtorest]

I am grateful that Dr Apold is my NP

I love the personalized care she gives me. Again I say Thank you Susan

[onlyseeadoctor]

The other thing I take issue with is this attitude that nurses have where they say "We keep the doctors from killing you." Horses**t. If nurses ran the floors the patients would be dead in a day. Doctors could write entire books on all the stupid and dangerous things nurses say and do. Sure, the first month an intern enters the ICU the ICU nurse knows more about the day to day routine. Give that intern 3 months to adapt and he/she will be light years ahead.

[Marieannie2]

@onlyseeadoctor

I have to agree. The interns may not have the experience when he/she sets foot in the ICU, but as you said, give that intern a few months and due to the background extensive learning that the intern had to go through before becoming an intern really set him/her light years ahead.

[mdaine01]

And what is wrong with striving for perfection? As for knowledge, I have been in a specialty 10 yrs, have a national reputation in my field, provide continuing ed for doctors and np's, and perform consultations for docs. I have earned the respect I have in this field by knowing my own specialty and not pretending to be something other what I am in my specialty. Too much liability trying to be everything to everyone. I don't need to brag - too old and hopefully wise for that.

[mdaine01]

You started the thank God for google b.s., not me. I don't feel the need to brag about how much I know, and yes I do perform procedures in a sub-specialty and have for 10 yrs.- do you?  Who is the monday morning quarterback? No the aorta wasn't anatomically abnormal, just gross incompetence--- on my doctor friend's wife. Routine LAP. There are bad ones on both sides, you just don't want to admit it. You must be a med student.

[reereern]

to thevillianoftheyear:

when you listed the clinical hours of NPs vs PAs, you failed to recognize that most NP programs require at least 2000 clinical hours worked before being admitted into their program. Couple that with the additional 500+ hours of clinical time in NP school and it equals to the same amount as PAs. If you count the clinical time spent in undergraduate school, and any other years spent working as a RN the number of clinical hours greatly surpasses PAs.

[mdaine01]

Doctors are paid well to make those correct hundreds of thousands of medical decisions. Gross errors are not acceptable. Are those injured by incompetence collateral damage? I wasn't trained that mistakes are ok as long as you get most of them right. Shit happens, but gross incompetence is not the same complications.

[mdaine01]

The point is you seem to think the docs are perfect... those are only two of hundreds of mistakes I have seen made in the last 16 yrs. Ordering Golytely for hypertension? That's not stupidity? Granted, it was a foreign school grad... but still called "doctor". There are bad ones on both sides of the fence. If you think docs are so perfect, I want some of whatever you are taking because it must be good stuff. Errors like I mentioned are totally unacceptable in medical practice,

[mdaine01]

onlyseeadoctor- are you the guy I watched push a chest tube THROUGH a patient's diaphragm? Or are you the one the put a trocar (look that one up) through the descending aorta of my friend's wife, leaving her in PEA (glad you have google, huh?) for 46 minutes which by some miracle she survived with only minor residual problems. Do not ever suffer a traumatic injury in July when the new docs graduate and start internship, your chances of dying increase dramatically.

[mdaine01]

onlyseeadoctor and THEVILLIANOFTHEYEAR - you don't have clue as to what you are talking about. A Masters degree is minimum entry level for a new NP at this time and it will be a practice doctorate by 2015. You two can take your GEDs and go home now.

[kokyka03]

Way to go Dr. Apold!! Thank you. You were wonderful!!

[sgrnbsn]

Dear THEVILLIANOFTHEYEAR.

Nurse Practitioners are first nurses and have clinical experience from that training. We are nurses who often teach residents how not to kill patients. We laern from the nursing experience and add on with the next level. MD's graduate and have to be taught not to kill. Nurse Practitioners often recieve that knowledge in school. I have heard it said "You are not a good doctor until you kill someone". I don't hear that about nurses.

[rakrobn]

@sgrnbsn ". I have heard it said "You are not a good doctor until you kill someone". --- Now you're just making up Bullshit. You probably heard that among your nursing friends. The first few months, the residents may need tips from you guys as you all have been working at that hospital for a lot longer, but once a month or two passes, the resident has the resources (bc of their education behind them) to understand why they are doing certain things from a pathophysiologic standpoint.

[scrabby811]

I loved it, loved it -LOVED IT! Poised, charismatic and professional!

[brittgrn]

Getting the word out there!! MDs shouldn't be worried that NPs are a threat to their practice. They should be thankful that NPs can give autonomous, independent care with collaborating physicians thereby taking some of the burden of more people needing health care with fewer physicians.

[rakrobn]

@brittgrn Bullshit. It's nurses trying to be physicians and you know it.

[saftah0305]

Dr. Apold you ROCKED!! That was excellent!

[rzakahri]

Last time I check human physiology does not change from state to state. The notion that NPs cannot practice autonomously because it would compromise patient safety is unsubstantiated by the research. Metro Medical Direct is a nurse practitioner practice in NYC that provides comprehensive primary care by way of medical house call for well below the cost of similar physician practices.

[Yanksin98]

You countered very well Dr. Apold and thank you for your support of your fellow NPs out here providing the care that we have been competently doing for all of these years. Hurrah!

[yakfishingfool]

Fantastic Dr Apold!