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| “You Shoulda Been A Doctor.” |
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by Kimberly Spering, MSN, FNP-BC - July 11, 2011
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 Provided by Clinician 1
Previously I have blogged (“Roll With It, Baby”) about the frustration of having certain patients say, “shouldn’t you ask the DOCTOR?” when I am discussing their diagnosis or treatment for something. It may be due to the fact that the patient does not know me, or understand my role as a Nurse Practitioner, etc. I’ve worked in my current practice for almost three years now, so most patients have seen me personally...or their family and/or friends have. Thankfully, those comments are getting more infrequent.
Then...there is the flip side of the coin.
I’m sure YOU have heard it, too.
You see a patient...perhaps make a diagnosis that may be life-changing...or maybe you explain something in a way that the patient finally “gets it” when it comes to their diagnosis or management. Perhaps it’s something the patient has heard 100 times...but it “clicks” this time. Or you share a moment of laughter...or hold a hand during tears that are shed.
And then...the words are spoken.
The patient says the infamous words: “You know...you shoulda been a doctor.”
BAM. Heart skips a beat. Mentally, one puzzles over that comment for a microsecond.
How in the HECK do you answer that without either sounding disgruntled, too passive, dismissive, or NOT standing up for what we DO as advanced practice clinicians?
I’ve heard this comment over the years many, many times. I heard it as an RN, and as an NP. In over 20 years, I have yet to think of a great, polite, proactive comment that is short-and-sweet. So, please, if anyone has one, chime right in.
I suppose that society as a whole views the doctor as the pinnacle of medicine--the most elite degree of all. After all...look at the media and see how nurses are viewed. And, oh my...PAs are not even mentioned in TV shows for the most part. (Not that is necessarily bad, if all we nurses get is “bad” press and look like we either don’t DO anything, or are subservient slaves to medicine.)
Perhaps that’s why patients will say that...but what exactly does that mean for us as NPs, PAs, and nurses? What? If we seem to know what we’re doing, then we shouldn’t have “settled” for being “less” than a physician?
Truly, I think that virtually 100% of the time, people mean well when they drop the “shoulda been a doctor” bomb. However, I’d like to continue, as a collective whole, to point out what we APCs do so exceptionally well...whether or not we have MD/DO behind our names.
And so...I am quick to smile and respond to their comments.
I’ll joke that I don’t need yet another graduate degree...or seven MORE years of school and residency.
And the response I’ve finally settled on, imperfect as it may be?
“I LOVE being a Nurse Practitioner. I have the best of both worlds – nursing AND medicine. Isn’t it great? I don’t NEED to go to medical school to take care of YOU.”
So far, that seems to satisfy everyone.
Kim Spering is a family nurse practitioner who currently works at Brndjar Medical Associates, P.C., a family practice in Emmaus, PA. Her past experience includes the fields of medical/surgical ICU, open heart/trauma ICU, labor and delivery, nursing education, nursing supervision, and as a nurse practitioner in both family practice and OB/GYN settings. She currently serves as a NP preceptor for her graduate school alma mater, DeSales University, as well as for local baccalaureate programs. She is passionate about patient education and helping patients understand that they are ultimately responsible for their own health. She also firmly believes that the public needs to be educated on the value of NPs and PAs in meeting the health care needs of the next decade and beyond. In her free time, Kim enjoys family vacations with her optometrist husband, Mark, and her two sons, Matthew and Connor.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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| becky (Iowa/Nebraska929) |
on 22 Jul 2011 at 9:57 am |
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I like to be able to take the time to discuss a patient's health issues and guide them in prevention in order to better their health status. Key role for NP is education and prevention it is over the years we have added curative. I look as us working in a collaborative effort for the benefit of the patient.
Now that I have my DNP I state, "I am a docotor specializing in nursing and explain the collaborative aspect." Whether we work solo or with a physician this is true. |
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| PhD PA (California) |
on 22 Jul 2011 at 5:58 am |
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| I also don't understand why it is such a crime to have advanced degress, MPH and PhD in preventive medicine when you have a clinical PA license. It amazes me when I look for faculty or research positions that every interviewer kept treating me and speaking to me as if I were just a "PA". They totally ignored the fact that I have a clinical MPH and clinical PHD. One MD who interviewed me stated that she also had a PhD in English but chose not to list it and I snapped back that I have a PhD in Public Health and chose to list it. Also forget about the fact that I am a foreign trained MD with an ECFMG verified MD degree. I wish PA's and NP's would stand up to the professional bullying by OD's,DPM's,MD's,DO's and even PHD's. Why does having an NP or PA license all of a sudden negate your PHD degree? But having a PhD degree by itself make you a "Doctor" when you can't even perscribe medications?(Psychologist) |
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| Allan B. (DHSc., PA-C) (WV) |
on 19 Jul 2011 at 11:00 am |
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| This has never bothered me in my 20 years of practice. I pretty much say "Thank you" and whenever needed, explain what I do. I have also heard many times the patient say "I will like to see the PA instead of the doctor."I have also had my Chief introduce me to patients as "Dr. Allan B." which of course I promptly corrected as "I am Allan B. and I am a Physician Assistant. "Feel confident in yourself and demonstrate competence and expertise in what you do and your patients will trust you. |
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| Tom (NH) |
on 18 Jul 2011 at 4:50 pm |
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I am one of the "Old Guard" being a PA since 1971. I went through all the comments, and if you think they don't know what a PA is now, nobody knew what one was then.
Fortunately now I get more of the "Oh thank god it's not some kid" when I walk in the room rather than questions about my being a PA. Age does have some benefits! |
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| Ebonique (Georgia) |
on 18 Jul 2011 at 3:04 pm |
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Kim, I completely feel and understand your comment. I've been a practicing PA-C for almost 7 years now and it's amazing how many times I may get that comment, especially from new patients or they may say, "Why did you stop, you should've kept going."
Typically my response to them would be, "You know, Doctors have been around for many centuries as opposed to Physician Assistants who've only been around for less than 50 years. So, I completely understand if you may not be familiar with a PA. Have you heard of a Physician Assistant before?" This gives me a lead way into educating about a Physician Assistant/Mid-level.
Some are open and understand while others may be stuck in their ways. Either way, it gives me an opportunity to share and educate about Mid-level professionals.
In my eyes Mid-levels have a great and rewarding profession! |
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| Jay (Los Angeles) |
on 14 Jul 2011 at 1:20 pm |
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| Thanks Kim, I appreciate it. I also agree that the whole \"mid-level\" provider label doesn\'t fit. Not only does it presuppose a lower level but implies a higher level, I assume that of physician. I don\'t hear that in other professions. Is there a mid-level psychologist? Or maybe it\'s that anyone with a Master\'s is mid-level. I might be able to buy that, if looking at \"high level\" means anyone practicing with a terminal degree - PhD, DNP, MD, JD, etc, although as the DNP is so new, and I do the exact same thing as a psychiatrist, it\'s difficult to swallow. |
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| Kim Spering (Emmaus, PA) |
on 13 Jul 2011 at 7:25 pm |
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Thanks, everyone, for the great commments!
Jay, you certainly have my permission to link to my article or use it entirely with a link to me.
Linda, your granddaughters are precious! We need to clone them. LOL!
Kim, I used to watch ER in the days of Jeannie Boulet (I think that was her name)...sad that she was written off after contracting HIV.
However, I must add that I personally will not refer to us PAs or NPs as "mid-level" anything. Who, then, are the "low-level" providers? Nurses? Respiratory therapists? We all know that they aren't...but to suggest a tiered structure of care providers is (IMHO) a slippery slope that I'd rather not slide on. (smile)
Great comments, everyone -- thanks! |
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| Jay (Los Angeles, CA) |
on 13 Jul 2011 at 11:49 am |
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| Great article. I was recently blogging about nearly the same thing. I read your "Roll With It, Baby," too. A DDS recently went so far as to say, not only, "Why didn't you become a doctor?" but to finish with, "Too scared?" May I have permission to either link to your article or use it in its entirety with a link back to you? |
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| Linda (Iowa) |
on 12 Jul 2011 at 10:49 pm |
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| I don't have a good answer for this comment, which I have heard several times. But, I do have a story I once overheard my twin granddaughters tell their friend when he was climbing on the swingset that I told him not to climb on. " you need to listen to my Granner (which is what they call me) she used to be a doctor but now she is a nurse." In their eyes nursing is much more important, and I never was a doctor. |
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| Kim (MA) |
on 12 Jul 2011 at 8:05 pm |
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| I have been a PA now for 4 years. My father is an MD and my mother an RN. I say, I took the best of being an doctor and of being a nurse and use that as a mid-level. I explain that I love my job and I wouldn\'t want to change careers because I love what I am able to do for patients as a PA. It\'s also nice in my opinion, (not that I always tell the patients) but that we don\'t necessarily need to be involved in the business part of medicine. The comments like that will never stop! I try not to let it get to me. And there was a PA in the show ER!! |
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