Nursing organizations including the ANA deny they are striving to expand their turf. What they are really spending much of their time on, they say, is defending the abilities they already have, which organized physician groups in many states keep trying to erode, says Summers.
"The sad truth is, we're very frustrated about the time we're spending on the defensive," she says. "Really, there have always been plenty of sick people to go around, and now there's really going to be enough sick people to go around."
Nursing organizations blame state medical societies for "restricting practice."
Jodi Hicks, vice president of government relations for the California Medical Association, says that doctors aren't saying nurses "are unsafe." But there have been several efforts over the years when nursing organizations in her state have pushed for expanded practice. For one thing, she says, they have expressed a desire to lead the medical home—in essence practice without physician supervision – something state regulations now prohibit.
And Hicks thinks those rules should remain. "Nurses don't go through 12 years of school," as many doctors do, she says.
"When people started taking courses (to become nurses), it was never the thought process that they would develop to replace physicians. No. Their appropriate role is to be an extended paraprofessional, a help to the physician and an integral part of the healthcare system."
Stephen Collier, director of the Office of Health Professions Education and Workforce Development at the University of Alabama at Birmingham, says that nurses are already working at many levels to obtain doctorate degrees as part of their continuing education.
By 2015, most nurse practitioners will reportedly hold doctorate degrees, which will be the standard for all graduating nurse practitioners, Polly Bednash, executive director of the American Association of Colleges of Nursing, told the Associated Press.
Financial reimbursement is starting to go up for RNs as well, and under health reform for example, nurse midwives will earn just what an obstetrician-gynecologist makes.
And therein may lie the rub. Patton, president of the ANA, advises one to "Follow the money," suggesting that somehow, physician groups are starting to get worried that giving nurses more purview, greater scope of practice, will affect the amount they are able to bill, and in turn affect their own earning potential.
How will this tug of war play out? Will we ever call a nurse, "Doctor?"
Only time will tell.