Should nurses and PAs get doctorates?

I agree with you. I think I poorly communicated my opinion. They should get doctorates as they see fit, as long as they don't intend to throw around the "Dr." title in clinical settings.

 

Honestly, I'm far less concerned with the use of the title "Doctor" for PAs and NPs than I am with the degree inflation.

When I was in high school it was still possible to become a PA with an associates degree. Then bachelors degrees became more common. Then they were quickly overtaken by five year BS/MS combo programs. Now a doctorate?

One of the great values these positions offered was that you could be working in less time (and expense) than it would take to be an MD. Personally, I think the fact that an NP (in my state at least) can have their own practice and doctorate is proof that the medical training required of an MD/DO is more about gatekeeping than preparation. Rather than creating all of these different professions with different degrees that achieve the same end just create alternate pathways to physician licensing.

 

MDs have done their best to limit the practice of other healthcare professions. Nothing to do with the quality healthcare or what is best for patients, but only to make the barrier to entry high therefore allowing MDs to profit from the shortage of medical professionals

 

I hate to agree with you as my brother is a DO (ER Physician to be even more specific) but it is evident. They work to limit the scope of practice and so forth hence resulting in a shortage which in turn keeps their salaries very high.

 

They fight very hard to limit the scopes of practice of optometrists, psychologists, nurse practitioners, physician assistants and other healthcare providers. They haven't fought as hard to make medical school more affordable and accessible.

 

One thing that I hear about now and then is that old idea of Clinical Psychologists becoming psychiatric prescribers. In my area there's a lack of Psychiatrists and it would be a real service to the community if there were more prescribers. I would think that if you can create a program to train RNs to be Psychiatric prescribers then you should be able to create one for Psychologists. Maybe the MDs don't want the competition.

 

I'm sure that's the case.

Consider how few psychiatric nurse practitioners there are relative to psychologists. In my town I found around 4 nurse practitioners specializing in psychiatry. These are the nurses in private practice. I cannot account for any currently working for psychiatrists or in hospitals.

Psychologists? There are dozens of them.

Back in Pennsylvania when my wife was more actively seeing patients as a mental health counselor, it wasn't uncommon for a psychiatrist to basically be the prescriber for other mental health professionals. You saw your psychologist or your counselor and they had relationships with a psychiatrist for when they wanted to incorporate meds into the treatment plan. The only reason the psychiatrist was involved at all was because they had something the psychologist didn't have; a prescription pad.

Give the psychologist a prescription pad and you gut the psychiatry market. You'd still need psychiatrists, of course. But gone would be the self-employed psychiatrists who can sit in their home office writing off prescriptions for roughly three to five times the annual revenue of the psychologist who referred to them.

While we're on the subject, I always found it kind of silly that only one state allows Optometrists to be trained to perform surgery. Podiatrists can perform surgery. Dentists can perform surgery. But optometrists often get relegated to a function that is occupied by Opticians in many countries.

 

A handful of states allow psychologists to prescribe medication if they earn an MS in psychopharmacology on top of the five to seven years they spent in a PhD or PsyD program. They also have to complete another supervision period under a physician. I know that there needed to be a transition for current psychologists, but I expected PsyD and PhD programs to integrate sufficient pharmacology training into their curricula and internships.