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Did you know that nurse practitioners (NPs) are not "mini-doctors"? NPs can be primary care providers who have the education and preparation to be a practitioner rather than a medical doctor (MD). This is just one of the nurse practitioner vs. doctor myths we'll address.
Knowing what education your healthcare provider has and their scope of practice can go a long way toward easing any misconceptions or misinformation you may have. Keep reading to learn the role nurse practitioners play in healthcare and how you can use their unique skill set to maintain good health.
Should I See a Nurse Practitioner or Doctor?
NPs are often primary care providers. Primary care providers are healthcare professionals who are the first contact for an undiagnosed medical problem. They also provide continuity of care for chronic health conditions.
Whether you choose a nurse practitioner or doctor as a primary care provider is a personal choice. If you become a patient of a large practice, you may be able to see both.
Phyllis Morgan, Ph.D., FNP-BC, has more than 29 years of nursing experience and is the senior core faculty and academic coordinator for the family nurse practitioner (FNP) program at Walden University.
She says that a patient may choose an MD because they may not know about NPs, the patient care they can provide, or that they can be a primary care provider. According to Morgan, studies show that NPs are becoming the new primary care provider over MDs.
Some of the reasons people may choose an NP as their primary care provider include a shorter wait time for office visits, more time teaching patients about their conditions, and better preventive care.
Like doctors, NPs can:
What's the Difference Between an NP and a Doctor?
In a primary care setting, NPs are educated to provide the same care as doctors. An NP must first earn a bachelor's in nursing. An NP candidate must then complete a master of science in nursing (MSN) or doctor of nursing practice (DNP) degree in a specific field. Candidates may choose from several DNP or MSN degree specialties, including:
Doctors must earn a four-year degree before being accepted to a four-year medical school. After graduation, doctors narrow their focus and apply to a three-year (or more) residency program. After residency, a doctor may take a national board certification in their specialty. Some specialties require more years of training and residency, such as pediatric cardiology or surgery.
While it is more common for an NP's focus to be primary care in their specialty, doctors often choose specialties where they can provide acute care services beyond the scope of an NP. For example, doctors can be educated in subspecialties like medical genetics, diagnostic radiology, or interventional cardiology.
Tony Anno, a board-certified nurse practitioner, practices in cardiology/electrophysiology at the Kansas City VA Medical Center and volunteers as the sole provider for the Health Partnership Clinic.
Anno emphasizes differences in care provided by doctors and NPs, pointing out that neither is better than the other. It all comes down to what type of care patients are seeking.
"Not all physicians provide care in some areas, just as nurse practitioners do not," Anno explains. "Every provider needs to practice within the scope of their practice and expertise."
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Top Misconceptions About Seeing NPs vs. Doctors for Primary Care
There are several myths about the differences between an NP and a doctor. It is important to understand the differences and root out any misinformation.
Let's look at four common myths and how they may impact your choice of seeing a nurse practitioner versus a doctor.
Myth: Nurse Practitioners Are Lower Than Doctors
Morgan is quick to point out that NPs being "lower" than doctors is one of the more common myths about NPs.
"One myth is that NPs are little, or lesser, doctors," she says. "That is not the case. NPs are primary care providers who have received different training and preparation than medical doctors."
NPs undergo rigorous national certification, peer review, and evaluations, which promote quality care and positive clinical outcomes. A pediatric primary care NP is not qualified to diagnose and treat complex heart conditions, but neither is a pediatric primary care MD. The care provider you choose must meet your medical needs.
Nurse practitioners are fully qualified to be a primary care provider, and many have advanced education and nursing certifications in medical specialties. For example, Anno is certified by the International Board of Heart Rhythm Examiners as a certified cardiac device specialist and certified electrophysiology specialist. He is also a registered cardiac diagnostic sonographer.
Myth: Nurse Practitioners Cannot Practice Independently
Some NPs can practice independently, while some cannot. Whether an NP can practice independently or not is determined by each state. The American Association of Nurse Practitioners has a database of which states grant an NP full, reduced, or restricted practice authority. The number of states with full-practice authority is expanding as more states recognize the potential of utilizing NPs in primary care.
Currently, there are:
- 11 states with restricted practice
- 15 states with reduced practice
- 27 contiguous states plus Alaska and Hawaii with full-practice privileges
In full-practice states, NPs are permitted by law to practice independently, which is the model recommended by the National Academy of Medicine (formerly called the Institute of Medicine).
Myth: Doctors Have More Training Than NPs
While education and training are similar for doctors and NPs, physicians are taught under a medical model to assess, diagnose, and treat patients. NPs are educated under a nursing model to accomplish the same tasks, but with a focus on treating the whole patient, not just the symptoms. NPs also focus more on preventive care.
Doctors usually earn a bachelor's degree in one of the sciences, such as physiology or biology. The first four years provide a strong foundation in math and science, including laboratory requirements. Some schools offer a premed major to prepare students for medical school.
Once in medical school, students delve into anatomy, physiology, and genetics classes. They also get real-world experience through clinical practice. You may have met a medical student while seeing your doctor. After graduation, medical students go on to residency.
Nurse practitioners first complete registered nurse (RN) requirements before advancing to NP. This includes, like MDs, four years of undergraduate education in biology, physiology, anatomy, and genetics. They also complete clinicals as an RN student. After graduation, an aspiring NP must first pass the RN licensing exam. Most practice for 2-3 years as an RN before completing a two- or three-year MSN program or earning a DNP.
During the program, NP learners also have clinical experience, assessing and diagnosing patients with NP or physician supervision. After graduating from an NP program, NPs must pass a national certification examination to practice.
Myth: Doctors Provide Better Care Than NPs
More times than not, the quality of care you receive depends on the relationship you have with your provider. People who have good relationships and high communication are better able to effectively manage their health conditions.
"One myth is that NPs cannot provide quality care because we have a different background," Anno says. "Many studies that compare NP and physician primary care find very few differences."
In other words, the quality of your care depends in part on the provider (not their degree) and your relationship with them. Research has also shown that NPs can provide triage care in the emergency room that matches the skill level of physicians. This means that NPs can recognize emergency situations and make referrals as well as doctors.
Choosing a Primary Care Provider: NP or Doctor?
Morgan and Anno agree that one of the reasons people choose an NP over an MD is the amount of time they can spend with their patients.
Studies demonstrate that NPs spend more time with patients, listening to their concerns and treating them appropriately, according to Morgan.
In some cases, an NP has more availability so they can spend more time with patients. Because of the direct correlation between the quality of care and a patient's relationship with their healthcare provider, an NP's availability has a significant impact on care.
"There is one element of care that cannot be replaced and that is availability and time spent with a patient," Anno adds. "Even if you have the most talented provider in the world, it means little if you can't see them when you need to or if your visits with them are rushed."
Despite this, Anno notes that people may choose a doctor over an NP because they are not aware of what an NP does, how they function, how much education they have, or because seeing a doctor is what patients are used to doing.
Tips for Choosing a Primary Care Provider
One of the best ways to find a primary care provider is to ask your friends and relatives who live in the area. People will often tell you if they are satisfied with their healthcare. Take the time to "shop." Ask if you can meet the doctor or nurse practitioner before becoming a patient of their practice.
Before deciding on whether or not to choose a nurse practitioner as your primary care provider, learn how NPs work in their practice and the role they can play in your healthcare. It's important to find the right "match" with a provider who is interested in developing a relationship with you and whom you can trust.
"Educate yourself about the role of an NP," Morgan suggests. "Schedule an appointment with an NP and ask questions about their roles and responsibilities. Give an NP a try before assuming that they will not provide safe, competent, and quality care."
The Bottom Line: NPs vs. Doctors
Ultimately, it is the relationship with the primary care provider that will bring you the best care.
It is your choice whether you are comfortable with and can trust an NP over a doctor. However, it is crucial to make that decision based on facts and not myths. Nurse practitioners can often spend more time helping you understand your care plan so that you are more likely to follow it and have a better outcome.
NPs also focus on preventive measures that may help reduce your need for medications.
"Your care depends on the relationship you develop with your provider," Anno says. "The best models of care incorporate patient education and shared decision-making across all levels of care."
Meet Our Contributors
Tony Anno, APRN, ACNP-BC, DNP, CCDS, CEPS, RDCS, FHRS, is a core faculty member for Walden University's MSN program. Anno also practices in cardiology/electrophysiology at the Kansas City VA Medical Center and volunteers as the sole provider for the Health Partnership Clinic. He is certified by the International Board of Heart Rhythm Examiners as a certified cardiac device specialist and certified electrophysiology specialist. He is also a registered cardiac diagnostic sonographer.
Phyllis Morgan, Ph.D., FNP-BC, CNE, FAANP
Phyllis Morgan, Ph.D., FNP-BC, CNE, FAANP, a faculty member for Walden University's MSN program, holds more than 29 years of nursing experience. Morgan has been a certified family nurse practitioner for several years and is the senior core faculty and academic coordinator for the FNP specialty at Walden. She also works as an FNP for CVS Caremark Minute Clinic in northern Virginia. Morgan has published research articles and presented at national and international conferences on health disparity issues among African Americans.
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