Wednesday, October 25, 2017

Nurse practitioners are "dumber" than doctors?

For the record, I don't believe that to be the case.  I have many friends who are nurses and amazing at what they do.  Frankly, I find most of them more tolerable to be around, too.  I have also seen a few good physicians' assistants.

Today's post comes courtesy of a thread on RfM.  Someone posted a link to a news piece about Dr. David Glener, a faculty member at Florida State University.  On October 14th, a post that appeared on Doximity, a social networking site for clinicians, Glener apparently typed,

"Nurse practitioners are not, I repeat, not physicians. They lack the education, IQ, and clinical experience. There is no depth of understanding. They are useful but only as minions. Not politically correct, but true. Who would you want your family member seen by-- a nurse or a physician?"

The next day, Glener allegedly followed up with this:

“You can be competent Nurse Practitioners, but you are still not physicians. You are subordinates. If you are so proud of being NPs, why do you allow patients to call you ‘doctor’ and you don’t correct them. You think it’s cute to be “Dr. Susie” or “Dr. Brian.” Ever see a CRNA in an operating room when something goes wrong? They freak out and scream for the anesthesiologist, whenever something does not go according to plan. And before you claim I am “sexist,” my sister is a physician and so is my daughter and they both agree with me.”

Naturally, those posts inflamed a few people.  For his part, Glener claims that his account was hacked and he had asked Doximity to remove the posts.  Still, damage has been done and many nursing students were offended.  Judy McFetridge-Durdle, Florida State University's nursing school dean, has reached out to students and alumni and said that Florida State University is "immensely proud of our nursing students and alumni."  A nurse blogger named Danielle has written a pretty good rebuttal, too.

Just out of curiosity, I looked up Dr. Glener.  Apparently, he's really taking some heat for the comments attributed to him (and personally, I have a feeling he did post them).  Glener, who is an anesthesiologist and a faculty member on FSU's Fort Pierce campus, now has very low ratings on several doctor review sites.  I'm pretty sure those ratings appeared after the derogatory comments about nurses appeared on Doximity.

I don't condone the negative ratings people are leaving on the review sites because I don't think it's fair to rate a doctor you've never seen.  Although Glener's comments make him look like a pompous asshole, they are not necessarily a reflection of his clinical skills.  On the other hand, as someone who Googles, I probably would think twice about seeing him because he does come across as elitist, egotistical, and small-minded.  Nursing is a different profession than medicine is; therefore, nurses have skills that doctors don't necessarily have.  The reverse is also certainly true.  These are fields that should be complementing each other, not competing with each other.

I think a lot of people are pretty narrow minded and downright ignorant about certain subjects.  I, myself, was guilty of once being narrow minded about the value of studying fields that appeared to be similar.  When I was earning my MSW, I had a professor who had a MSW, a Ph.D. in social work, and was also a LPC (licensed professional counselor).  It seemed superfluous that this man would bother to get a master's degree in social work and another master's degree in counseling.  Many social workers work as counselors, after all.  Why spend the extra time in school to earn counseling credentials in two disciplines?  But the professor pointed out that while the disciplines share some similarities, they are, in fact, different and employ different philosophies and techniques.

Nurses can become nurse practitioners, which gives them the right to treat patients under the supervision of doctors.  Nurses can also earn doctoral degrees, which would mean they would have the right to be called "doctor".  Physicians' Assistants also treat patients under the supervision of doctors.  They may not spend as much time or money on their schooling, but sometimes they can come up with answers that doctors can't, simply because they look at solving problems in different ways.  Everybody's different, too.  A person doesn't have to be super educated to be very intelligent.  On the other hand, I have run across my fair share of idiots with MDs and Ph.Ds, too.

Personally, I believe that there's much more to excellent healthcare than seeing a doctor who is very well educated and has spent long hours in training.  A doctor could be the most intelligent person on the planet who doesn't actually care about people.  Doctors like that are pretty worthless, in my view.  I won't want to see a doctor who doesn't listen to me, take me seriously, or treats me with cold indifference.  If I don't see the doctor (and I pretty much never do) because he or she has an off putting personality, it really won't matter how smart and educated he or she is.

Bill often told me when he was still on active duty that the enlisted ranks of the military were the backbone of the entire operation.  Officers may typically (but not always) be more educated.  They also earn more money and outrank enlisted servicemembers.  However, an officer would be an idiot not to listen to an experienced non-commissioned officer.  I think the same applies to many doctors, especially the ones straight out of medical school.

A doctor may technically outrank a nurse, but it would be foolish for the doctor to discount the nurse's experiences and contributions to healthcare delivery.  I think it's a shame that so many people, especially those who claim to be educated and experienced physicians, don't seem to understand that.  And maybe that attitude does cast a negative reflection on the physician, because it means that he or she has a closed mind.  It's been my experience that people with closed minds are usually not very curious, which means they are typically not that intelligent.  That scenario often ends up being wasted time and money.  Give me a broad minded nurse practitioner any day over a doctor who can't get over his or herself.


  1. Nurses are nurses and doctors are doctors. If I had to have open heart surgery, I would want a board-certified cardiac surgeon. If I needed to have a bladder cather insterted, I'd much prefer a nurse -- male or female.

    The greatest evaluators of neonates that I've ever seen have been registered nurses. They spand more time with the newborns than do pediatricians and have better instincts for when something subtle isn't quite right with a given baby. It may be the doctor who treats whatever ails the baby, but often it is the nurse who first picks up on the problem. At the children's hospital affiliated with my medical school, two experienced neonatal nurses share charge of the [non-NICU] neonatal ward. Most of their jobs consist of administrative duties, but because one or the other of them is on duty every day, as they're going about their paperwork, they hold one infant at a time. They notice things about heart rhythms, subtle coloring aberrations, reflexes, breath patterns, odd smells, and all sorts of other things the rest of us don't catch. Only God knows how many babies those two nurses have saved. It's a skill that can''t be taught. Only great instincts and years of experience will get a person there. Our hospital doesn't like to discharge newborns before twenty-four hours because it's advantageous to each baby to be evaluated by at least one of these nurses.

    Nurse practitioners and PAs are in the middle. They perform some tasks of both doctors and nurses, but function more closely to doctors than to nurses. They're typically more approachable and spend more time with patients than doctors do. As long as PAs and nurse practitioners know their limits and know when to ask for consultation (and the same goes for doctors, for that matter) they are perfectly fit for what they are doing. In this age of doctor shortage, do we really need MDs diagnosing influenza, colds, and ingrown toenails?

    As far as IQs . . . I loked up Dr. Glener, too.If he entered med school at the age of 22 and if he finished in fur years, he should have been born in 1963 and should be arund 54. He looks older than that, though. I wouldn't be surprised if his soaring IQ didn't require him to take the MCAT multiple times and to apply to med school more than one year. Either way, he's pre-affirmative action, when the white mae was King of the World. In his era, if a white make from a prominent family applied to a mid-level med school, he was admitted regardless of his GPA and MCAT scores. He probably considers his IQ stellar because he took some online IQ test that said "90% of the people who take this test will score below 100" - the trests that are so easy a fourth gradr would max them.

    He doesn't seem to acknowledge that opportunity had a whole lot to do with who was a doctor and who had to settle for being a nurse. For those not blessed with wealthy parents and who must rely on student loans, back in the day, it was far more difficult for a female to secure a loan for medical school than it was for a male. Dr. Glener would like to just assume he and his progeny are superior, but his words belie his assertion.

    1. He seems to be a jackass. That being said, there's a need and room for both professions. I don't see what the point of berating nurses is... is he upset because of nurse anesthetists?

    2. Probably he is. Either he became angry at one of them or they're cutting into hi profit margin. And OF cOURSE they come to him when there's a problem. That's why he or one of his conterparts must be there.


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