[Kevin Kim]

As a resident of California, it was interesting to see how low we were in the rankings compared to the rest of the state. I am curious to see if the size of the state plays a major role in the overall score. I did notice that the top 3 states did have smaller land masses compared to the other states. I was attempting to identify a pattern such as higher costs resulting in better patient outcomes but that did not seem to be the case either. Although this article shows the research of the states I would like to see the results of the cities/counties with the best healthcare outcomes as well. Considering that New York, California, and other states have major cities I wonder if they would have better rankings than the overall state. The research utilized key factors such as cost, access, and outcomes. The U.S. healthcare system has always been seen in a negative light compared to other major global powers. Although these rankings of the the U.S. States provides important insight into our healthcare system, I feel we should also see how we stand globally to really get perspective on how efficient the system is.

[Kevin Kim]

Hello April!

Thank you for your take on the title of the Doctor for the role of the Nurse Practitioner. I agree with you that like many other professionals who have earned their Doctorate degree, NPs should also be able to utilize this title. The word Dr in context of title refers more to the education degree as you have mentioned. I understand that patients may get confused in a clinical setting but there are times when I feel this negative perspective seems targets towards the NP. As you have mentioned above, there are other healthcare professionals that utilize the term Doctor in a clinical setting but face less backlash. I think the term Dr should be up to each NP/ healthcare professional on what they prefer to be called. As long as it is clarified that the NP is not a Medical Doctor or MD and explains to the patient that they are a Nurse Practitioner I do not see a major issue. Outside of the healthcare field I have seen this debate as well. Recently First Lady Jill Biden or Doctor Biden was also the subject of scrutiny for utilizing the title Doctor. She has a Doctorate in education and has never stated that she was a medical doctor but was still under fire for referring to herself as doctor. Even within the educational community it is understood that term Doctor refers to the education of the individual not that they are a medical doctor. I agree with you that as long as an individual is not misrepresenting their occupation or level of practice that the title doctor should be up to the individual who has the Doctorate degree.

• This reply was modified 1 year, 9 months ago by Kevin Kim.

[Kevin Kim]

Hello Avery,
When mentioning the pursuit of a DNP degree I have been met with both positive and negative comments from my fellow nursing peers. More often than not it tends to be positive but I feel the role of APRNs and the idea of nurse obtaining their DNP is still fairly new within the nursing community. Nursing is consistently evolving, there are many avenues that can be taken within this one profession and I feel that as it grows the attitudes towards the different careers will change as well. I have often noticed many of the nurses who discourage the pursuit of higher education, tend to lack knowledge on what opportunities are available now. The scope of practice and amount of jobs available is also increasing for many APRN roles within institutions and even those not within the healthcare field are becoming more knowledgeable on the role of the Nurse Practitioner and other APRNs. I feel as these newer positions become more prominent the attitudes will also change. I have often noticed many of the nurses who discourage the pursuit of higher education, tend to lack knowledge on what opportunities are available now. Hopefully those negative comments do not discourage you from the important role you will be able to play as a provider. APRNs play an important role in closing gaps within the healthcare system and dedicating the time and resources to help fill these inequalities should be encouraged.

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