Posted by: Witch Doctor | April 8, 2008

The Dr. Nurse – a conflict of interest?



There is a new kind of nurse practitioner emerging.

The DNP. The Doctor Nurse Practitioner.

Last week’s Wall Street Journal carried and article called “Making Room for the “Dr. Nurse.” It looks as if it is part of a series called “THE INFORMED PATIENT”

This seems to be the solution to the shortage of primary care physicians in the USA.

As the shortage of primary-care physicians mounts, the nursing profession is offering a possible solution: the “doctor nurse.”


Who in the nursing profession is helping out by offering this solution?

Mary Mundinger, Dean of New York’s Columbia University School of Nursing.

Mary Mundinger says:

“The two year programs, including a one year residency, create a “hybrid practitioner” with more skills, knowledge and training than a nurse practitioner with a master’s degree.

Mary Mundinger also says:

“DNP’s are being trained to have more focus than doctors on coordinating care among many specialists and health care settings.”

Mary Mundinger, who herself seems to be a Dr. Nurse reassures doctors:

“The primary aim of the DNP is not to usurp the role of the physician, but to deal with the fact that there simply won’t be enough of them to care for patients with increasingly complex care needs”

Do you think, that an alternative solution might be to train more doctors or at least make primary care in the USA more attractive to the medical profession?

You don’t think so, My Black Cat?

You smell a rat?

Do you suppose our CMO became aware of this new idea during one of his trips to Neverland?

Do you suppose it’s one of the reasons he consistently says “we need more doctors?”

Why do you suppose The Wall Street Journal thinks its a good idea to inform patients about Dr Nurses?

Is The Wall Street Journal not usually more concerned with big business than with patients?

Will you try to catch that rat soon, My Black Cat, and let me know what you’ve found.

Tomorrow maybe?

Or the next day?

© | Agency:
© Ijansempoi |


  1. Your clever Black Cat is ahead of the game and may soon flush out that Wall Street cat for all to see.

  2. Mary Mundinger, who recently resigned from her position as dean at Columbia School of Nursing where the doctoral program for nurses began, has arguably been the most aggressive advocate for replacing physicians with nurses.

    There is more to the story. Over the years, there have been a number of conflicts of interest. Mundinger is entwined with corporate interests in the healthcare industry. She is on the Board of Directors of UnitedHealth Group, Welch Allyn, Gentiva Health Systems (nationwide provider of home health and nursing services), and Cell Therapeutics.

    Mundinger has pushed for more power for advance practice nurses at the same time she has had a fiduciary duty to UnitedHealth Group and its stock-holders, and the similar duties to stock-holders of other companies.

    Mundinger, a Director of UnitedHealth since 1997, HAS RECEIVED OVER 1 MILLION DOLLARS IN COMPENSATION FROM UNITEDHEALTH SINCE 2006 alone. As of December 2007, Mundinger held 32,000 shares of UnitedHealth stock.

    How much of Mundinger’s aggressive advocacy to replace physicians with nurses is related to her duties to UnitedHealth insurance company and other healthcare corporations? Mundinger is a highly compensated director of organizations that could profit from her recommendations to replace physicians with less expensive (though not equivalently trained) nurses.

    This issue is especially relevant given the U.S. Institute of Medicine’s recent report on conflicts of interest in medicine with its recommendations to remove industry influence from medical education and the development of practice guidelines.

    Of concern is that Mundinger has not mentioned these important conflicts of interest in her academic articles and research reports. These reports have propelled the ‘nurse doctor’ movement. One wonders how much of Mundinger’s work reflects her professional and academic research and beliefs, and how much reflects her fiduciary responsibilities to commercial organizations.

    • Thanks for visiting and adding this important comment. Since it is well hidden in the depths of the blog I have brought it to the front in a new post.

  3. […] The original post is here. […]

Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s


%d bloggers like this: