Ask an NP – Differences between MDs, DOs, PAs, and NPs

00:01 When I'm talking to my patients about nurse practitioner role, you got to remember it's different for each state.

00:08 Some states have the full practice authority, and unfortunately Oklahoma is not one of them yet.

00:15 We're hoping that'll get there.

00:17 Right now, all nurse practitioners have to have a supervising physician, and that has to be a DO or an MD.

00:28 Our job has to pay that supervising physician a monthly fee, or in private practice, such as myself, I pay a supervising physician a monthly fee just to be available for consults.

00:40 And the biggest thing, as a nurse practitioner, you cannot write Schedule II drugs on your own.

00:47 In psych, that's going to be mostly your ADHD medications, Adderall, Vyvanse, Ritalin, Folkland, all that stuff.

00:56 What I do is I write the prescription, and I pinned it for my supervising physician, and then he comes along and signs that.

01:04 Technically, right now, that's really the only reason I need him.

01:07 Now, when you're talking about the difference between physician assistants and nurse practitioners, physician assistants, they don't specialize the way nurse practitioners do.

01:17 We have to go into a specialty, whether it's family, acute, or psych.

01:23 Physician assistants, they go to a PA school, and they just get their general knowledge, and then they get that specialized training on the job, wherever they work, whether it's cardiology, psych, emergency medicine.

01:36 They get their training there, whereas nurse practitioners, we are board certified for whatever practice that we're doing.

01:43 Now, when you're talking about the difference between an MD, a DO, or a nurse practitioner, of course, they've had a few more years of school.

01:54 They do a rotation.

01:58 Nurse practitioners, I kind of wish we would do that a little bit.

02:01 I wish that we would go in and spend a little more time following a psychiatrist or even a psych nurse practitioner.

02:10 But in Oklahoma, that's not required.

02:11 But I think that most places require about 800 hours of clinical practice, which is very much needed, and then you're still going to learn stuff on the job.

02:23 The school can't teach you everything.

02:24 You have to eventually get in there and do it and learn how to do it.

02:30 Nurse practitioner, MD, and DO, they can write the Schedule II drugs.

02:35 We can't.

02:36 In a lot of the specialties, let's say if you're an acute care nurse practitioner and you work alongside a general surgeon, of course, you're not going to be performing surgeries.

02:45 You may be assisting.

02:47 But in psych, it's interesting because I can do everything a psychiatrist can do except for write the Schedule II drugs.

02:54 I can diagnose ADHD, autism.

02:58 I can treat schizophrenia, bipolar, anxiety, depression.

03:02 So with psych nurse practitioners and a psychiatrist, there's not that much of a difference between us.