Written By: Lauren Jacobson MS, RN, WHNP-BC
There can be a lot of confusion about the scope of practice for different health care providers. When you see a nurse practitioner prescribing your medication, diagnosing you, and doing procedures, you may wonder, "is a nurse practitioner a doctor?” The short answer is no. Here we will go into details clarifying the role of the nurse practitioner and explain the differences and similarities between them and doctors.
Education
One of the main initial differences between is education. Both length of schooling and the theoretical framework for schooling differs between nurse practitioner school and medical school. Nurse practitioners are required to have at minimum a master's degree in nursing that has prepared them to practice nursing at the advanced level. This means at a minimum they are usually required to have 6 years of school including their bachelor’s degree. Nurse practitioners choose their specialty when they apply for graduate school. In contrast, doctors need at minimum 8 years of schooling which accounts for their bachelor's degree and then medical school. After medical school, they do another 4 years of residency in their chosen specialty. Doctors do not choose their specialty until later in medical school. Residency is a training program where they practice as doctors and learn specific skills but with supervision and guidance from other experienced doctors. After residency doctors may go on to do a 2-year additional training program called a fellowship.
During their education, both nurse practitioners and doctors are learning how to assess, diagnose, and manage various medical conditions. Nurse practitioners are trained using a nursing model of education that utilizes nursing theory and provides a more holistic focus whereas doctors and physician’s assistants are trained using a medical model. Both models train clinicians on how to provide care to patients with a wide variety of conditions using evidence-based practice. Nurse practitioners are also trained in primary care and prevention. They may be taught how to do certain procedures depending on their specialty. For example, women's health nurse practitioners will be taught how to do IUD and nexplanon insertions and removals. Doctors receive extensive training in each and every-body system and then specialize during their residency. Doctors will also be trained to do surgery depending on their specialty whereas nurse practitioners will only be trained to do minor surgical procedures and assist in surgery depending on theirs. Medical school is also longer and therefore more expensive than a nurse practitioner school.
Scope of Practice
There are important differences between the scope of practice of nurse practitioners and doctors. You should familiarize yourself with these scopes before deciding what type of health care provider you want to be so that you make the right choice. Nurse practitioners can assess patients, diagnose conditions, and treat them just like doctors can. Doctors can also manage more complicated conditions and nurse practitioners are trained on when to refer a patient to a doctor. Doctors also perform surgery and nurse practitioners do not. Additionally, the regulation of practice for nurse practitioners varies by state. In some states such as Massachusetts, nurse practitioners must have a supervising physician and a collaborative agreement. This does not mean that the doctor has to review all your cases or directly supervise you while you see patients. It means that there needs to be a doctor available to consult and that they will be required to review some of your cases throughout the year. It means that you and your supervising physician have a written agreement on what types of cases you are seeing, what procedures you can do, and what types of medication you can prescribe. In other states such as Washington, you will not need a supervising physician as a nurse practitioner and can practice independently. This means that in some states you could even open your own practice as a nurse practitioner!
Can a Nurse Practitioner Become a Doctor?
Certainly! But before you do this make sure you have a very good reason for wanting to do so because that is a very long and expensive path to becoming a doctor. Being a nurse practitioner does not mean you can take short cuts on your road to being a doctor. After you become a nurse practitioner you will still need to go to four years of medical school and 4 years of residency if you want to be a doctor. If you are already a nurse practitioner and want to go through the process of becoming a doctor make sure that you are spending your time and money wisely. Nurse practitioners can provide a broad variety of care in many different clinical settings. If you have realized that your life will never be full without doing something that only doctors can do, like surgery, then it may make sense to become a doctor. If however, you want to work in a different setting or specialty look into recertifying in a different nurse practitioner specialty. This is a much cheaper, and quicker process than going to medical school and completing residency.
Is a Nurse Practitioner as good as a Doctor?
This is not a yes or no answer. Are nurse practitioners doctors? No, but analyzing the quality of care they provide is complex and there are many factors to consider. One type of provider may be better than another in certain situations. Many studies have shown that nurse practitioners provide patients with a similar quality of care as doctors do. The literature shows that patients who receive care from nurse practitioners have a higher patient satisfaction rate, are sent back to the hospital less, and utilize the emergency room less when compared to patients who are under the care of doctors. Another study also showed that the care provided by nurse practitioners is comparable to care provided by doctors and physician assistants. The American Journal of Managed Care discussed the growing body of literature documenting that nurse practitioners provide similar quality of care as doctors do. They also acknowledge that the long training of primary care doctors means that they can produce more differential diagnoses particularly with complex patients and may order fewer tests than nurse practitioners.
The Bottom Line
Making the comparison and asking “are nurse practitioners doctors?” is not fair as the roles and training are very different. Ultimately most research has shown that nurse practitioners provide a similar quality of care to doctors. This does not mean that nurse practitioners and doctors are the same though. Education and training are different and nurse practitioners are taught from a more holistic lens while doctors have more extensive training. As a nurse practitioner, you can become a doctor, but this is not the ideal way to get there. This is a long and expensive path to becoming a doctor and you can do many of the same routine things that doctors do as a nurse practitioner. Remember, one profession is not better than the other, they are simply different.
Lauren Jacobson MS, RN, WHNP-BC
Lauren Jacobson is a registered nurse and women’s health nurse practitioner who is passionate about global health and gender-based violence prevention. She is Editor and an Advisory Board Member for the Global Nursing Caucus and volunteers with Physicians for Human Rights as a medical evaluator for asylum seekers.
