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The “Not Quite Doctor” Dilemma

Steven E. North, Esq.
Shari James, Paralegal


An April 29, 2014 opinion post in The New York Times addressed the disparity in training between a medical doctor and a nurse practitioner and the recent bill passed by the New York State Legislature regarding the issue. The article, "Nurses are Not Doctors" commented on the bill passed in April, 2014 that now allows nurse practitioners to provide medical care without physician oversight.

The reason given for the implementation of this bill was that the former requirement of mandatory collaboration between a nurse practitioner and a physician "no longer serves a clinical purpose" claiming that the necessity of such collaboration reduces access to primary care. The Affordable Care Act increases the need for primary care physicians and seems to be the justification for allowing nurse practitioners to provide medical care on their own.

Primary care is among the most comprehensive fields of medicine. It requires the doctor to have a general understanding of a wide range of medical issues so that appropriate diagnoses and referrals can be made. A nurse practitioner has far less educational and clinical experience than a medical doctor, and generally cannot treat a patient with the same level of care. As the author of the article explained, "Primary care, though routine, is also about finding the extraordinary in what may appear to be routine." A trained physician is far more suited for such tasks.

Though the Affordable Care Act requires more medical practitioners to be available, the level of care that patients receive must not be subpar. Would the standard of care owed to a patient by a nurse practitioner be less rigorous than that of a medical doctor? If so are we condoning a system of second class medicine? Such a dichotomy in care might very well open the door to an onslaught of medical malpractice claims.