Patients often have questions about working with nurse practitioners (NPs) vs doctors. We asked Meagan Smoyer, a talented NP from our Hyannis Care Center, to share her insights and help demystify the process.
As with all content on our blog, the following is educational, not medical advice. Always consult your medical provider regarding your unique healthcare needs. 
Could you explain the educational background required to become a nurse practitioner vs a medical doctor?
MEAGAN SMOYER: Nurse practitioners have a master's degree in nursing. There are several different routes or specialty tracks for nurse practitioners, including family health, psychiatric nurse practitioner, women's health, acute care, pediatrics, neonatal, and adult gerontology.
Nurse practitioners must complete an undergraduate program, take a competency exam for nursing (NCLEX), and complete a two- to three-year master's program that includes clinical hours. Then, they must take and pass the national licensure examination.
Before becoming nurse practitioners, they will typically practice as registered nurses (RNs) for some time to gain nursing experience before attending a master's program. The total time is approximately six to seven years.
Medical doctors like urologists complete an undergraduate degree program, take an entrance exam (MCAT) for medical school, and complete a four-year doctoral program (MD or DO). They will do three to seven additional years of residency training. Then, they will need to take and pass the licensure examination. The total time is approximately ten to 15 years.
What is the scope of practice for an NP in urology, and how does it differ from the responsibilities of a urologist?
MEAGAN SMOYER: There are a few urology fellowship training programs for nurse practitioners in the United States. These programs provide urology-specific training for advanced practice providers. Enrolling in one of these fellowships isn't necessary to work in urology, however. But doing so certainly provides helpful urological-specific training.
Nurse practitioners can work in many different specialties. They will train with other NPs, physician assistants (PAs), and physicians on staff to learn standard evaluations and necessary skills and procedures that they can then perform in the office.
Nurse practitioners can follow specialty-specific guidelines from the American Urological Association (AUA) or American Urogynecologic Society (AUGS) to diagnose, order diagnostic testing, prescribe medications, and provide patient education regarding diagnosis.
Urologists have several years of urology-specific training and perform procedures and surgeries specific to urology. NPs do not perform surgeries, but with training, some can assist in the operating room and perform specific office procedures like cystoscopies, prostate biopsies, and percutaneous nerve evaluation.
What is it like to be an NP in a urology practice?
MEAGAN SMOYER: I have really enjoyed working in urology. A good mix of patient care and in-office procedures keeps things exciting. It gives me great pleasure to help patients navigate through different urological problems and concerns. These can be very sensitive topics for patients. Making them feel comfortable is one of my priorities.
I truly enjoy treating patients who suffer from overactive bladder and stress incontinence and providing them with ways to improve symptoms through dietary and lifestyle modifications and other available treatments.
Can you walk us through a typical day in your role as an NP in the Hyannis Care Center?
MEAGAN SMOYER: I typically start my day by reviewing my patient schedule and preparing charts to allow for better clinic flow. I will also address any laboratory results or imaging studies in my inbox. Then, I will see patients and perform procedures.
I usually make a few patient calls during the day and help staff with any questions that arise throughout the day. I end my day by making sure my documentation is complete and everything I needed to address for the day has been completed.
How do you connect with your patients? What's your approach to patient education?
MEAGAN SMOYER: I love connecting with patients and helping them understand a diagnosis, medication, or treatment plan. My goal is for patients to better understand their bodies, the reason behind the diagnosis, and our treatment recommendations.
I want to always facilitate open communication and have patients be open and honest with me. This allows me to understand their issues or limitations. From there, I can create a treatment plan that will work best for them, hopefully improving their quality of life.
When patients genuinely comprehend these things, they are more apt to follow treatment recommendations, improving overall outcomes. I appreciate improving the quality of life for my urology patients or making it so they enjoy coming to see me in the office.
What diagnostic tests and treatments are you authorized to perform or prescribe?
MEAGAN SMOYER: I am authorized to order laboratory tests, urodynamic testing, cystoscopy, CT scans, prostate biopsies, bladder Botox, testosterone replacement therapy, urethral bulking, indwelling Foley catheter placement, and chronic catheter management. I am also the one who performs urodynamic testing in our office.
How do you collaborate with GBU's urologists and urogynecologists, and what does that partnership look like?
MEAGAN SMOYER: I work closely with the urologists and urogynecologists in the Hyannis office. They provide me with the necessary support and are always available to help me address any concerns I may have with more complex patients.
I also help them manage their patients for any acute problems or follow-ups after in-office procedures. I provide their patients with further education on treatment plans and assist them and their patients with post-operative needs.
I help with patient navigation by seeing patients for initial visits to start any necessary workups so that once they see the urologist or urogynecologist, they have undergone some of the required initial testing that helps the physician with diagnosis or the treatment plan.
What common misconceptions do patients have about NPs, and how do you address them?
MEAGAN SMOYER: Patients sometimes do not understand our training and role within medicine. We are nurses who have completed additional training to become nurse practitioners. We are master's degree-trained nurses who can provide care by diagnosing medical conditions, ordering diagnostic tests, prescribing medications, and performing certain procedures. We are typically addressed by our first names.
What advantages do you feel NPs bring to patient care at GBU?
MEAGAN SMOYER: Nurse practitioners can offer improved access to patient care. Specialists can get very busy with referrals. NPs and PAs can see these patients to initiate necessary workups to evaluate certain concerns or diagnose, evaluate, and manage patients who may have less complex urological problems.
Patients can then see a urologist or urogynecologist if needed. The physician can review any of this diagnostic information and adjust the diagnosis and treatment plan accordingly (if needed).
Is there anything else you want to convey?
MEAGAN SMOYER: Nurse practitioners are healthcare providers who offer improved access to care for our patients. We thrive on providing excellent care and education, and we love treating patients.
At GBU, we work collaboratively with our physicians to effectively care for our patients and to support and be extensions to our physician counterparts to the best of our ability.
Read past articles featuring our talented physician assistants and nurse practitioners.
We have a team of talented physician assistants and nurse practitioners at GBU. Below are links to other articles: