The healthcare industry has radically changed in recent years.
There are new career options and scopes of practice for those wanting to go into clinical practice without going to medical school. With the torrent of new providers flooding the marketplace, there’s a need for better education and communication for consumers/patients to make informed choices about who will provide their medical and health care.
This article will briefly tackle some of the alphabet soup of physicians and providers currently providing clinical care.
MD and DO
People with an MD or DO after their name are physicians. These are the people whom most people think of when they use the word “doctor.”
MDs attend and graduate from medical school, which HealthLine describes as “modern or mainstream medicine.” I don't the description was meant it as a pejorative, but rather was intended to distinguish the more common allopathic medical schools from osteopathic medical schools.
DOs attend and graduate from osteopathic medical school. According to the American Association of Colleges of Osteopathic Medicine explains, osteopathic medicine is a distinct pathway to medical practice that includes training in osteopathic manipulative medicine, as well as an emphasis on wellness through health promotion and disease prevention.
Allopathic and osteopathic medical training is normally exclusively or substantially live and in-person. Most students who are admitted to either type of medical school already have an undergraduate degree.
After completion of four years of medical school or osteopathic medical school, physicians from both schools of training typically complete advanced clinical training through an internships and residency, and sometimes a fellowship before obtaining a medical license. They can then pursue careers as physicians and surgeons in office, clinical, and similar hospital settings.
As physicians, MDs and DOs are licensed to perform surgeries and prescribe medications.
DPM
The DPM designation refers to “Doctor of Podiatric Medicine.” People with this training are called podiatrists or podiatric physicians or surgeons.
The American Association of Colleges of Podiatric Medicine explains that podiatrists are specialists in the diagnosis and treatment of the feet, ankles, and related structures of the legs. If you need foot or ankle surgery at a hospital, it could be performed by an orthopedic surgeon or podiatric surgeon on the hospital’s medical staff.
Like allopathic and osteopathic medical schools, students in podiatric medical school must complete a four-year curriculum following undergraduate work. After graduation from podiatric medical school, podiatrists then typically complete a two or three-year clinical residency before going into independent practice and obtaining a license. Podiatrists may have staff privileges at the hospital or surgery center or may have an office-based practice.
Podiatrists are licensed to perform surgeries and prescribe medications.
DC
Providers with a DC designation are chiropractors. Chiropractors are licensed providers who focus on spinal manipulation to emphasize the body’s ability to heal itself.
Chiropractors attend a graduate-level program that typically takes four years to finish, following the completion of at least three years of undergraduate studies. Although some chiropractors complete additional clinical education after chiropractic school, it’s not required or the norm.
Chiropractors are not licensed to perform surgeries or prescribe medications.
APN, NP and DNP
Nurse practitioners are advanced practice nurses. For many years, nurse practitioners were referred to as mid-level providers, indicating that their scope of practice was somewhere between that of a registered nurse and that of a physician. That term has fallen out of favor in recent years.
According to the American Association of Nurse Practitioners, all nurse practitioners must complete a master’s or doctoral program, in addition to being a registered nurse (RN).
• APN means advanced practice nurse
• NP means nurse practitioner
• DNP means doctor of nursing practice
In many states, advanced practice nurses, including nurse practitioners, are allowed to practice independently, without medical direction or supervision by a physician. In other states, such as Texas, nurse practitioners must be supervised by a physician, with a written agreement.
A nurse practitioner with a DNP degree may introduce himself or herself as “Dr. Smith,” for example. That doesn’t mean, though, that the individual attended medical school or is a physician.
Additionally, it doesn’t mean that the individual completed graduate-level clinical training in a live hospital setting. Some advanced practice nursing graduate programs are online. DNP Programs lists the top entirely-online DNP programs currently offered.
Depending on the scope of practice allowed in each state, nurse practitioners may be able to prescribe medications. Many patients rely on nurse practitioners for primary care, and advanced practice nurses practice in medical specialties as well.
CRNA and DNP
Anesthesia care may be provided by residency-trained physicians or advanced practice nurses called certified registered nurse anesthetists (CRNAs).
According to the Cleveland Clinic, a CRNA is an advanced practice registered nurse with graduate-level training in the administration of anesthesia. CRNAs typically have a master’s in nursing degree (MSN), but there has been a movement in the industry to require a doctoral degree, the DNP (doctor of nursing practice).
A nurse anesthetist with a DNP degree or designation hasn’t attended medical school and is not a physician.
Depending on the scope of practice allowed in each state, CRNAs may be able to prescribe medications. CRNAs provide and manage anesthesia care in office practices and operating rooms in surgery centers and hospitals nationwide.
PA and PhD
The other health career described by the old moniker “mid-level provider” is the physician assistant. According to the American Academy of Physician Associates—which itself recently changed its name from the American Academy of Physician Assistants—PAs (physician associates/assistants) are licensed clinicians who practice medicine in every specialty setting.
Although PAs are frequently educated at medical schools, they’re not physicians. PA school is typically a two-year graduate program after undergraduate work has been completed. Some PA programs now offer PhD-level training, resulting in the award of a doctorate. Even with a PhD, though, a PA is not a physician.
In many states, physician assistants are allowed to practice independently, without medical direction or supervision by a physician. In other states, such as Texas, PAs remain subject to supervision by a physician.
Many patients rely on PAs for primary care, but PAs work in other specialties. In many hospital systems, PAs provide post-operative care for surgical patients.
Sorting the alphabet soup
As a former hospital administrator, it’s clear to me that all physicians, providers, and nurses are valuable parts of the healthcare team. As a medical malpractice lawyer, it’s equally clear to me that patients and consumers are often unclear on the educational preparation, background, and experience of the people taking care of them in medical and healthcare settings.
When researching or selecting a primary care provider (PCP) or specialist, a little research and asking questions can go a long way.
Some people may be comfortable with an experienced nurse practitioner as their PCP or specialist. Others may not be so keen on someone with entirely online graduate training being responsible for their care. Still, others may choose physician-only care. Regardless of the path to care a patient takes, it’s the patient’s right to have disclosure of the information necessary to make an informed choice.
If you’ve been seriously injured because of hospital, medical, or nursing care in Texas, then contact a top-rated and experienced Texas medical malpractice attorney for a free consultation about your potential case.
