A Response to Dr. David Glener from a Nurse with an Adequate IQ

Meet Dr. David Glener. If you were to read his bio, you might deduce that he is an experienced, board-certified, anesthesiologist with exceptional training. If you continue to dissect his life online, you’ll see that he is a Clinical Assistant Professor of Medicine at Florida State University amongst others, a consultant for the Department of Justice, and more. He is decorated to say the least. Personally, he is married and has three children who all following in their fathers footsteps. His Health Grade scores are subpar since his latest online commentary, but might have been better prior to the backlash. He is quoted to be an “old-fashioned physician” and takes his dog, Charlie, to work with him on a regular basis; he seems like a pretty great guy. But, most of us do not really know Dr. Glener.

On October 14th, Dr. Glener posted this on Doximity, a website for verified healthcare professionals:

“Nurse Practitioners are not, I repeat, not physicians. They lack the education, IQ, and clinical experience. There is no depth of understanding. They are useful, but only as minions. Not politically correct, but true. Who would you want your family member seen by – a nurse or a physician?”

On October 15th, Dr. Glener posted this:

“You can be competent Nurse Practitioners, but you are still not physicians. You are subordinates. If you are so proud of being NPs, why do you allow patients to call you ‘doctor’ and you don’t correct them. You think it’s cute to be “Dr. Susie” or “Dr. Brian.” Ever see a CRNA in an operating room when something goes wrong? They freak out and scream for the anesthesiologist, whenever something does not go according to plan. And before you claim I am “sexist,” my sister is a physician and so is my daughter and they both agree with me.”

Image from @NurseNacole

Pause to soak that all in. There was also a comment to follow by another physician (Dr. Wendell Perry, Emergency Medicine) stating:

“Hahahahaha. Took the words right out of my mouth. NPs follow algorithms and protocols. Very little creative thinking. If you think you could have been easily accepted to medical school, you should have put that theory to the test.”

These comments have since been removed. A statement was made the American Nurses Association and the Florida State University College of Nursing denouncing Dr. Glener’s commentary. So what can we learn from this? Let’s break down the key points.

Are Nurse Practitioner’s Doctors? Or do they believe they are physicians?

FACT: This is a common argument in the medical community. Nurse Practitioners can obtain doctoral degrees ­– a DNP or a PhD, just as pharmacists, physical therapists, and psychologists can.

OPINION: In most academic settings, Nurse Practitioners who earn doctoral degrees are referred to as “Doctor” like any other professor with a doctorate. While there are some Nurse Practitioners who want to be called “doctor,” in general, to avoid confusion, they do not refer to themselves as “doctor” in patient care settings. There are bad apples in every profession. Some Nurse Practitioners do attempt to assert themselves over physicians. Perhaps this is human nature. There are techs who want to be nurses, nurses who want to be doctors, vet techs who want to be veterinarians, family medicine doctors who want to be specialists, interventional cardiologists who want to be surgeons… the list could go on and on. Oppression is cyclical. When one profession is dominated, the underdog frequently and irrationally lashes back. Someone always wants to deem themselves to be more important, or claim their job or degree is/was more difficult. But we have to acknowledge our egos are the enemy. To defend oneself is to know oneself. If we were all satisfied and secure with ourselves, these arguments would cease to exist. But, insecurity in this day in age is the root of all evil. Do not let your insecurities drive your response to comments like Dr. Glener’s – all it does is perpetuate hate and discourse.

Do Nurse Practitioners lack education?

FACT: Requirements to become a physician are different from Nurse Practitioners. Physicians do have far more clinical hours and years of school than Nurse Practitioners. However, Nurse Practitioners frequently have experience as a Registered Nurse prior to Nurse Practitioner school, but it is not required.

OPINION: Once again, Nurse Practitioners are not trying to be physicians. We have different skill sets and different requirements, but we both are capable of providing exceptional patient care.

Is care by a Nurse Practitioner comparable to a Physician?

FACT: Yes. There are multiple research studies indicating comparable care, particularly in primary care. However, there have also been studies comparing the use of Nurse Practitioners in intensive care units. If one study is deemed bias, there are plenty more to counterbalance.

OPINION: I personally despise the NP vs. MD vs. PA games. We all serve a purpose in healthcare and you know what is even better for patients? Multidisciplinary care, meaning we all combine our talents and work together. However, the reality is, each specialty needs a way to measure and validate their worth, especially in healthcare today. Thus research has to be done. Also, this same research can also be used to lobby for full practice authority for Nurse Practitioners, which I firmly encourage.

Do Nurse Practitioners lack an adequate IQ? 

OPINION: I actually feel like I might lose IQ points answering this question. There is no doubt you have to maintain brain function to attend medical school and that there are some extremely intelligent physicians. But, there are exceptionally intelligent Nurse Practitioners as well. In no way will I engage in a battle about who has a higher IQ, however, what I will say is measuring intelligence is no substitute for having it and using it. You may have the highest IQ score in the world, but if you cannot translate it to patient care, it means nothing. Similarly, one may have an Ivy League education or work at the best hospital in the country, but it’s very easy to hide behind a nametag or a fancy degree. It is all about you – what you do, and the standard to which you raise yourself.

Some final comments…

I do not wish ill upon Dr. Glener, but I do hope someday his opinions change. I have made comments on social media that I regretted and subsequently removed. I have also written blog posts that I decided did not shine the best light upon the nursing profession and me. However, I continue to educate myself and grow. Healthcare is dynamic and ever changing. Technology is progressing, patients are living longer more complicated lives, and methods to care for them must evolve alongside the population. At one time, physicians were extremely respected and nearly god-like in society. Their opinion was the final opinion, but was also the only one. This hierarchal perspective of healthcare is being phased out in the best medical centers around the country because it hinders patient care.

The bottom line is, we are a team. Dr. Glener is a poor representation of his profession and most doctors are not like him. So, if this man makes you want to snap back and defend yourself in a flagrant, demeaning, way, remember why you are here in the first place. I am nearing the end of my doctorate of nursing practice degree and plan to work as a nurse practitioner in an ICU post-graduation. Upon graduation, I will have nearly twelve years of higher education for all of my degrees. I did not go to school for my DNP because I wanted the title. I went to be at the forefront of the profession that has shaped me, made me a better person, and provides me with any opportunity I choose to accept. Oh, and, I get to help people every single day, and that is what it is all about. I plan to seek learning opportunities from my patients, nurse practitioners, physicians, pharmacists, physical therapists, respiratory therapist, techs, environmental services, management, IT, secretaries – anyone who will take the time to teach me. My degree means nothing if I cannot fully, comprehensively, and professionally “be” it.

Dr. Glener may regret these comments some day, or he may not. The reality is, there will always be naysayers, in every profession and in general life. How we respond really represents who we are. Anyone can say anything they want to you. They can call you stupid, ugly, too emotional, or they can degrade your entire profession. The only reason people do this is because they are insecure and miserable in one respect or another. It is up to you to know yourself, be authentic and confident in your abilities and your importance, admit wrongdoing, hold on to your integrity, and through that, your response to people like this will be genuine and concrete every time.

I do not know Dr. Glener in real life, I only know him from these comments. What I do know, is that despite everything, if he were my patient, I would care for him the same way I would care for a nun, my mother, a criminal, the president, a VIP client, or a regular Joe – wholeheartedly and expertly, because that is my core and that is truly what nurses do.