Yesterday, I talked common frustrations in the NP-MD relationship. Nurse practitioners across the country have shared with me their perceptions of the highs and lows of working with physicians. While most NP-MD interactions are positive, differences in and misunderstandings between the two professions can lead to a disconnect. Now, it’s time for you to weigh in. What do you wish physicians knew about nurse practitioners?

Working as a nurse practitioner in the emergency department, I feel that I am respected and well regarded by my MD colleagues. I have more than a few years of experience under my belt, pull my own weight on the job, and work hard for the entirety of my shift. My MD colleagues trust my clinical judgement and understand that when I do have questions or concerns, they are legitimate and must be addressed in the interest of providing the best possible patient care. When I express interest, the physicians I work with are happy to help with procedural training or to answer questions I might have to further my professional development. My experience, while overall positive, has had a few bumps in the road. 

There are two things that I personally believe physicians should take note of when it comes to working with nurse practitioners. 

1. NPs Add Value to a Medical Practice

I’ve overheard MDs complain about NP’s clinical capabilities, work load, requirement for on-the-job learning, etc. Some concerns are legitimate, others more of a reflection of a negative workplace culture. Before beating up on nurse practitioners for having less clinical education than physicians, MDs must consider the value NPs add to their practice. 

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Nurse practitioners earn lower salaries than physicians and, with experience, in many settings can function in an almost equivalent role. Practices stand to increase revenues substantially by hiring nurse practitioners – if they are willing to put time and energy into teaching the NP the skills required to meet the needs of patients in that setting. Lower salaries mean practices can hire a greater number of providers decreasing wait times and increasing patient satisfaction, also a win for the practice. Hiring nurse practitioners adds value to a medical practice but also requires leadership from the employer. 

2. Inexperienced Nurse Practitioners Require Mentoring

My first year as a nurse practitioner was difficult. The transition from clinical work in my NP program to autonomous patient care was a daily struggle. When I transitioned from urgent care to working in the emergency department, I was once again faced with a steep learning curve. Some MDs were helpful in my continued clinical development, others were not. 

Physicians who don’t feel they have the time, energy, or interest in training should not hire inexperienced nurse practitioners. Hiring a new grad NP can be a positive – the physician may train the NP to practice in a manner that best fits the practice. Doing so, however, requires time, energy, and coaching. 

The working relationship between physicians and nurse practitioners can be professionally rewarding, increase practice efficiency, and confer significant financial value to a practice. Some practices approach this set up in a positive, well managed process. Others struggle. Addressing misconceptions and challenges in the NP-MD relationship is the first step towards improvement. 

As a nurse practitioner, what do you wish physicians knew about working with nurse practitioners? 

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5 thoughts on “What Do You Wish Physicians Knew About Nurse Practitioners?”

  1. 1. We are not trying to take their job but to be an extension of them and provide a higher level of care to patients as well. They are not replaceable and very much needed as mentors.

    1. JoAnn Woodward WHNP-BC

      I’m not trying to be an extension of anyone. I know my limitations and proudly work to the highest level of my skill set for over 40 years. Proud to be an NP

  2. I wish physicians knew how little pathophysiology NPs have learned about, and wouldn’t ask us questions about that. NPs are demonstrably more caring for patients, spend more time, and make the patient feel better. This is far more important than knowing the mechanism of an antibiotic, a diabetic medication, or blood pressure treatment.

    1. Pamela Phares PhD, ARPN

      It is the NP’s responsibility to learn the mechanism of an antibiotic, a diabetic medication and BP treatment ALWAYS! We need this knowledge to explain to patients why their meds are necessary and how they work to improve their health. I am a professor in a DNP program for NPs. If you are taking on the responsibility of treating patients, then you need to necessary foundation of that which is knowing physiology, pathophysiology and pharmacology. If you didn’t get that in school, then you need to self learn. This is not an excuse for ignorance in these areas.

  3. The training part…. 3 jobs so far with no official orientation plan. It seems like they get mad when you don’t know as much as them in 8 weeks of an entirely new specialty. Unfortunately reading about stuff just isn’t the same as seeing and treating it. I feel like often the assumption was that I was not intelligent enough but really I am just trying to learn something I’ve never done before. There are many skills outside of the new specialty I know but this is new. I notice they do the same thing to residents though.

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