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Notes -
That AMA link gives such a laughably biased summary of the actual study, though. The paper itself suggests a far more nuanced picture than your metaphor about Juan the day laborer-- and that's a study led by an MD who presumably has his own professional axe to grind. (I'd be much more interested in seeing some adversarial MD-DNP research collaborations in this area.)
Notably,
- The study focused almost entirely on costs in an ED setting; on a skim, I can't find that it examined detailed health outcomes at all beyond 30-day mortality and "preventable hospitalization," the latter of which seems difficult to define in terms of patient welfare. They say NPs and MDs had no significant differences in 30-day patient mortality.
- The study did find that treatment by NPs cost the system more than treatment by MDs, owing to NPs calling for longer hospital stays and more tests. But the difference in costs diminished with more experienced NPs.
- The cost difference also diminished to a relatively trivial level for less complex cases, and the authors themselves suggest that this means NPs could be valuable substitutes for physicians in primary care.
- They found almost as much variability in productivity from clinician to clinician *within* professions as there was *across* professions. Money sentence from the abstract: "Importantly, even larger productivity variation
exists within each profession, leading to substantial overlap between the productivity distributions of the two professions; NPs perform better than physicians in 38 percent of random pairs."
I agree with you that NPs receive a disturbingly small amount of training before they're turned loose on patients. But I think the question we should be asking is what it suggests about doctors' care if MDs still realize such minor gains over DNPs.More options
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