Why is Change so Difficult? (Pure Speculation)

An Interesting Conversation between Abhi and Krish about Nurse Practitioner Education

We were taking a quick break a few days back from writing our NP Ultimate Guide To Finding Your Own Clinical Rotations, and Abhi asked me this super interesting question.

Abhi asked, “In Nurse Practitioner education that needs help finding rotations or needs help in the academic space, why is there so much pushback in not working together to make that happen?”

Check out my answer below!

We also included a transcription to follow along!


Krish: Hey, guys. We are taking a quick break. We’re actually putting together the Ultimate Guide and we’re sending it out so it can be turned into an e-book.

And, Abhi asked me a question, and I immediately said “We have to record this.”

The question was…

Abhi: Yeah, so he took me away from writing to record this…

So I guess the biggest challenge that I’ve had, right…so, we have gone through the meticulous task of reaching out to a bunch of bloggers, folks in the industry, influencers, and we’ve had a relatively “okay” response.

There’s some that kind of don’t understand what we’re doing, there are others that are inquisitive, they want to learn a little bit more. And my biggest question has been for those folks that are emailing back and saying, “Do you want to advertise on my website?”

And then, “Sure”, but I want take the conversation further. I want to understand data, I want to just understand who you’re serving, are you really only interested in advertising dollars?

Do you have good information on the website?

The response we get is like, “Why do you care? The numbers don’t matter. Just give me money so you can advertise on my website,” to which I say, “Excuse me.”

Krish: Right. I think…yeah, so the story, the back story on this one is…

Abhi: Pulling my hair out on this one.

Krish: We’re reaching out to influencers in the industry so we can get our name out there, and we wanted to put together some content, share information that we found and insights that we know.

One of the advertisers we reached out to, her response was, “Do you want to advertise?,” and which we said, “Maybe…”

“Do you get a lot of traffic to your website?” It’s a very normal question to ask because we’re trying to determine why does it make sense.

Abhi: Right. We need data.

Krish: “Do you get a lot of visits to your website? What are the types of visitors you get? Where are they from?” And her response was, “It’s a simple question. Do you want to advertise on our website, yes or no?”

Abhi: Yeah, she was like, “Numbers don’t matter. Really, the really big question is do you want to advertise?” to which I was going to write a really long email, and then you stopped me.

Krish: Yeah.

Abhi: I’m still salty about that. I still want to send that email. I mean, yeah, I still want to send that email. But I don’t know, I probably shouldn’t.

Krish: Yeah, it’s probably a good thing that we don’t!

Abhi: Yeah, but I think overall, our objective with this is:

  1. To see if we’re on the right track
  2. To be of service to as many Nurse Practitioner students as possible
  3. To see who else we can work with where we can add value to them and they can add value to us

Krish: So what was the big question that you had? You said, “Why…?” What was the question?

Abhi: Okay, okay. So I guess my biggest question is why, in an industry that needs help… NPs clearly need help, you guys clearly need help.

In an industry that needs help finding rotations or needs help in the academic space, why is there so much pushback in not working together to make that happen?

It’s totally mind-boggling to me.

Krish: I have a theory.

Abhi: Okay, what’s your theory? You have this, like, mad scientist hair thing going on.

Krish: I know, I didn’t put gel in it today. So I have this theory, and here it is. The healthcare industry is historically conservative, right? We’ve dealt with this for years before.

Abhi: Sure, sure.

Krish: We know they’re conservative. On the NP side, there’s no reason why it would different. You’re going to generally have people who’ve gone through a lot of nursing and then went back to school, have gone through their Master’s program, they’re going to come out and start doing…what?

Practicing what they’ve studied.


You don’t become a doctor and then go into another field. You don’t become a lawyer and go into another field.

We know from our research in entrepreneurship, when we were looking at new opportunities that the legal space and specifically the healthcare space need innovation, because you just don’t have a lot of people there. So when you’re coming in with this mindset of, “Okay, well…,”

Abhi: “We’re going to disrupt and we’re going to change, we’re going to help.”

Krish: You’re going to get pushback. But here’s the other thing, we also have to realize, guys, it’s not like these influences or older practitioners…it’s not their fault. They’re in an industry. They’re still subject in healthcare to increasing demands of insurance companies demanding them see additional patients per day. This is why hospitals have to be run by business people and not doctors, even though they need to be run by doctors and its run like a business.

Abhi: This is what we see on the MD side all the time, and it’s happening every single day.

Krish: I think because the way education has been done in the NP world… When we spoke in the last… So it’s April 2017. In the last year and a half we’ve spoken to about 35 different schools.

They’re all saying the same thing, “This is how it’s always been done,” in regards to their clinical rotations being scheduled by students independently, “This is how it’s been done.”

They haven’t adjusted yet for moving forward into this time period where you have online programs coming up, students are attracted to online programs because they have lives and they can’t go back to school full time.

Abhi: Totally.

Krish: And then they’re not addressing this gap of clinical preceptor availability. So my answer to you in one sentence is: It’s a more conservative industry. I think we have to continue just putting more effort in being transparent…

Abhi: And diligent and persistent.

Krish: …and sharing why we’re here. And it’s going to come with skepticism, right? I think for every 15 NP students we talk to who love that we’re doing this, we have 1 or 2 that are like, “Why are you doing this? Who are you guys?, “What are your credentials?”

You and I have been scheduling and setting clinical placements and rotations for a long time. You’ve been doing it for over a decade, 15 years almost.

Abhi: Yeah. It’s been awhile.

Krish: Fourteen. And I’ve been doing it for four years!

Abhi: Yeah. So get ready, it’s going to be disrupted, and I cannot wait to be the catalyst of change!