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Last updated: May 10. 2014 9:41AM - 943 Views

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Remember when you would arrive at your appointment and a friendly receptionist would say, “The doctor will see you now?” Today so many types of skilled medical professionals are involved in direct patient care that in many practices a non-physician is likely to be involved.


Many people ask me about all abbreviations, initials and credentials they see. It’s tough to keep it all straight. D.O., M.D., PA-C, RN, LPN, CRNP, CNM, CRNA, DNP … What does it all mean? It’s actually fairly straightforward. This week, National Nurses’ Week, is a good time to decipher the credentials.


For starters, the tried-and-true medical doctor (M.D.) and doctor of osteopathy (D.O.) are physicians, four years of college, four years of medical school, eligible for license after a year of internship, often (but not always) with training in a residency program, perhaps an additional hospital fellowship and maybe even “Board Certified” by peers in a specialty based on all that post-medical school training.


Nurses are on the front lines of medicine, working hands on with patients, and no doctor — not a single one — can deliver the highest quality care without their collaboration. Your nurse is a major player in your care. He or she is the one checking up on you regularly, dressing wounds, administering medications, fielding your requests, playing a key role in assuring safe, effective care.


A licensed practical nurse (LPN) is trained, as are RNs, to perform many important nursing functions, and RNs add to this vital foundation a set of even more sophisticated skills focused on evaluating patients and creating and implementing strategies to “cure sometimes, improve often, comfort always.”


Career opportunities in health care abound, and nursing is often the starting point for other niches. A generic term often used for some of the non-physician professionals involved in patient care is “advanced practitioner.” These absolutely vital, highly trained medical professionals bring an important perspective to your medical team.


A physician assistant (PA) is licensed after obtaining a college degree and advanced medical training, often with a master’s degree or more. They can deal with a variety of patients and often are focused on surgical specialties. Other advanced practitioners include certified registered nurse practitioners (CRNP), certified nurse midwives (CNM) and certified registered nurse anesthetists (CRNA), all with specialized training.


While responsibilities are generally the same, the difference between CRNPs and PAs is the track they took. CRNPs are typically RNs before seeking advanced education whereas PAs need not be.


Certified nurse midwifery is another branch of advanced nursing. These pros work primarily with healthy mothers-to-be in preparing for childbirth and the transition to motherhood.


In Pennsylvania, advanced practitioners must work closely with physicians, though they can see patients independently in certain cases. They can conduct physical exams, diagnose and treat illnesses, order and interpret tests, prescribe medications and assist in operations. There are limitations on the particular scope of each of these responsibilities, but rest assured that in Pennsylvania, if you are visiting an advanced practitioner, you are seeing someone with tested expertise and a physician working in collaboration. Several states have even considered “liberating” some classes of advanced practitioners from this collaboration requirement.


Some people say you are defined by what initials are after the comma. So if someone with RN, LPN, CNM, CRNP or CRNA after the comma has touched your life, take a moment to say thanks. After all, it’s not just this week that nurses change lives.


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