Academic Medicine , journal of the
American Association of Medical
Colleges, has sent out a recent call for
articles addressing the 2013 question
of the year: “What is a doctor? What
is a nurse?” Thirty years ago this
would have been an absurd question.
Not only would it have been absurd
for doctors and nurses, but for
patients too. Roles were clearly
delineated within the disciplines, and
the white coat indicated a doctor and
the white uniform and cap identified
the nurse.
There are several reasons why we
have to ask the question posed by
Academic Medicine . A big reason is the
entry of women into the field of
medicine. Another is the development
of advanced degrees for nurses. The
computerization of medical records
has spurred increases the need for
physician extenders to support
practices. A huge reason recently has
been cost-containment considerations.
The erosion of the doctor as an
ultimate authority figure and the rise
of patient autonomy have leveled the
field as well. To some extent access to
education is in the mix also.
Educational level is usually part of the
definition of a doctor or nurse. This is
no longer a reliable indicator. A
doctor has an undergraduate degree
and an MD. But a doctor might be a
DO also, a doctor of osteopathic
medicine. A nurse has an
undergraduate degree in nursing.
Except that a nurse might have an
undergraduate degree in something
other than nursing, and get the
nursing training later in a master’s
degree program. Up until relatively
recently you didn’t have to have a BSN
to be a nurse, an associates degree
was enough. Now a nurse might have
a master’s degree or a PhD. A nurse
practitioner has a master’s degree. A
physicians assistant might also.
Authority used to be used to separate
doctors from nurses. Doctors can
prescribe medicines. But now so can
many advanced-practice nurses.
Doctors can write orders. So can nurse
practitioners. Doctors can examine
you and diagnose you. So does your
NP.
Nurses and doctors used to look
different. The physical appearance
and dress of nurses and doctors in
hospitals today is actually emblematic
of the blurring of the lines of identity
that have characterized medicine in
recent years. A doctor might wear
scrubs; a nurse practitioner might
wear a white coat; in the operating
room, everybody wears the same
thing. Clothing has long been a
tangible symbol of turbulent times.
The casting off of corsets was a signal
of relaxing social restrictions. The
shock of a woman wearing pants
coincided with women entering the
workforce. Burning bras were a way
of protesting gender inequality. It is
no accident that the shedding of the
nurses cap happened around the
same time nurses became college
educated.
Lifestyle and money? Nope. A primary
care doctor makes less than a nurse
anesthetist. Some doctors don’t take
call anymore, and many nurses do,
even those without advanced degrees.
Surely knowledge, skill, and ability
separate nurses from doctors? Of
course not. Your experienced floor
nurse knows way more about
medicine than your average intern.
Physicians assistants can sew up
wounds and assist in surgery. A
person who becomes a nurse is just as
smart as a person who becomes a
doctor, which has always been true
but not always acknowledged. An MD
is just a piece of paper that gives a
person permission to start learning
how to be an actual doctor. An RN is
much the same. Clinical experience
and training are the only things that
matter materially to patients. Some
argue that training level is also part of
the definitional differences between
doctors and nurses. Doctor’s clinical
training in a formal educational
system is usually longer. So you could
equivocally say that a doctor has
longer training.
I would suggest to my readers that the
only thing that truly separates doctors
from nurses is ultimate responsibility.
The editor of Academic Medicine says
in his introductory remarks
introducing the question that his
daughter was trying to decide
between medicine and nursing. This is
the decision she must make. Does she
want to live with the ultimate
responsibility for every patient under
her care? Because of our investment
of time and money, and presumably
because of the economic and social
standing granted to us, we doctors
bear this ultimate burden. This is not
to say that nurses don’t also have a
responsibility to their patients and
their field, or that they haven’t
invested just as much time and
money.
I have been both a nurse and a doctor,
and am a huge proponent of the
expanded role of nurse practitioners.
But the law and society have laid the
ultimate privilege and burden on the
person that people call “doctor.”
That’s the difference.


source ; forum.facmedicine.com/threads/the-only-thing-that-truly-separates-doctors-from-nurses.19294/

source ; forum.facmedicine.com/threads/the-only-thing-that-truly-separates-doctors-from-nurses.19294/

God punish inferiority complex.
For the fact that an experienced nurse can only be compared to an intern, medicine is way higher.
Try harder .