Is a MD higher rated than a FNP?

Answer 1

"Higher rated" is difficult question to answer, but there are differences in educational preparation, legal status, reimbursement, and quality of care.

Educational Preparation: Different Paths

Medical doctors and family nurse practitioners have different educational backgrounds. A medical doctor in the US completes a 4 year undergraduate degree in any subject, including prerequisite classes for admission into medical school. The medical students completes four years of medical study, typically starting patient care in the third year of medical school as an intern. Following medical school, the MD completes a residency, and then may complete further fellowship study for subspecialization. The physician may choose to pursue board certification or not.

A nurse practitioner, whether a family NP or one of another study, completes a four year degree in nursing, typically starting patient care in the first or second year of nursing school, depending on the student's path. Following The Bachelor of Science in Nursing and licensing as a registered nurse, the nurse practitioner typically works in nursing while pursuing a master of science in nursing or doctorate of nursing practice. Following completion of that program, including clinical preceptorship (practicing as a student NP under the supervision of a licensed clinician), the NP begins clinical practice. Board certification is typically required for the nurse practitioner in order to obtain the ability to bill insurance or, in some cases, to get licensed.

Legal Status: Varies from State to State

The physician may practice independently in all fifty states. The nurse practitioner may practice independently in 19 US states, and under statutory-required collaboration with physicians in most others. Updated scope-of-practice laws are under consideration in many of the remaining states. The 2011 Institute of Medicine Report (referenced in related links) calls on US lawmakers and regulators to eliminate artificial barriers that limit the practice of nurse practitioners by standardizing scope of practice regulations allowing NPs to practice to the full extent of their education and training, and by removing financial and reimbursement barriers to NP practice by states and insurers. The Robert Wood Johnson Foundation and Institute of Medicine see these reforms in playing an integral part in enhancing the quality and value of the US health care system.

Reimbursement: NPs paid 85% of MDs by insurance

Medicare reimburses nurse practitioners as they do physicians, but at a 15% discount for the same service provided. Many private insurers follow the same pattern, but some refuse to reimburse or empanel NPs, limiting access to NPs by patients.

Quality of Care: Equal or Better

For different types of care for health problems or health maintenance, a patient may prefer to see a nurse practitioner or a physician. Some aspects of health care, such as major surgery and certain types of specialty care, remain the purview of the physician. For primary care and some aspects of specialty care, the nurse practitioner provides equal or better outcomes. There are many studies that demonstrate quality of NP care as compared to MD care. (See related links for review article with bibliography).

Summary

Is an MD higher rated than an FNP?

• MDs and NPs have different educational paths
• MD has better-protected legal right to practice
• MD has better reimbursement
• MDs and NPs have comparable quality of care rating in areas in which both practice

In the real world, NPs and MDs enjoy a collaborative and collegial relationship in order to provide health care for patients.