What’s really happening is that American physicians are over-trained for run-of-the-mill primary care. Of course nurses can do it. I sometimes joke that a properly motivated high-school student could do it with a smartphone and a checklist. The current standard of care is medicine-by-protocol. The work is ceaseless and routine to the point of tedium—and almost half of primary care physicians are burnt out. Nurses are probably quite justified in criticizing what they see. But that doesn’t help physicians accept them.
Especially since, generally speaking, a lot of doctors are still chafing from the treatment they received at the hands of these nurses during residency training.
The rancor between our two professions is heightened by an obvious bias towards nurses in the media. It makes a good story to portray nurses as victims of unfair, bloviating physicians. Doctors Doubt Nurses Skills, Survey Finds trumpeted one of many similar headlines reporting this NEJM study. But that headline could have also easily lamented: Nurses Doubt Doctors Abilities, Resent Salaries.
This media bias has a corrosive effect on our dialogue—and this doesn’t help us get to a much-needed solution—because in some ways nurses and doctors aren’t all that far apart. A closer look at the NEJM study shows a startling amount of agreement. Most doctors and nurses agree that nurse practitioners can improve access to care. Moreover, an astounding 20 percent to 25 percent of doctors actually agree that nurses will provide safer, better and more cost-effective care.