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re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187
Posted on 5/17/16 at 5:49 pm to Hopeful Doc
Posted on 5/17/16 at 5:49 pm to Hopeful Doc
The NPs have been calling in. If you care and you're a doctor call your rep. The vote is Thursday
0
Posted on 5/17/16 at 5:51 pm to Bleeding purple
quote:
It is not about the money it is about properly taking care of patients
Do you give away the vast majority of care that would be dealt with by NPs over the phone?
I ask you, but I think know the answer from your above posts. People seem to not understand that physicians typically give away somewhere around 15% of their services that could've come in and been seen by an and billed by an NP or charged a 99213 (~$60 visit) from the MD.
Posted on 5/17/16 at 5:55 pm to Hopeful Doc
quote:
Do you give away the vast majority of care that would be dealt with by NPs over the phone?
I used to, but now I have NP's and capture those visits. I think people fail to realized that more NP's will just increase the cost.
I'm not fighting it. Posted on 5/17/16 at 5:57 pm to Hopeful Doc
quote:
It is not about the money it is about properly taking care of patients
If anyone is doing it for the money, it's the NP's.
I now refuse to take any NP students that will not be employed by me. One way we can bite them in the arse is to quit training them for free.
Posted on 5/17/16 at 5:59 pm to Parallax
quote:
Medicine is incredibly vast and difficult; I'm challenged daily. If you think you could handle yourself in the wild with the quantity and quality of training NPs get, you're too dense to realize all of the things you don't know.
I completely agree and have a great respect for the vastness of medicine and the amount of training you docs receive. If you go back and look I agreed that this legislation was probably not the best course of action because of the amount of knowledge required to practice effectively and safely. I have been in the ER for 3 years now, and I am just now becominf fairly comfortable with my practice. I still collaborate and discuss cases with the MDs on a regular basis, because there is so much to learn. It makes me appreciative for you docs that like to teach and help an NP, rather than ignore them.
Posted on 5/17/16 at 6:00 pm to Scooby
quote:
Scooby
So you for it or against it?
Posted on 5/17/16 at 6:03 pm to SmackoverHawg
Against
Posted on 5/17/16 at 6:05 pm to SmackoverHawg
quote:
If anyone is doing it for the money, it's the NP's.
In a way, yes. If our collaborating doc decided to wake up one morning and say he didn't want to do it any more, business would come to a grinding halt, which would keep us from being paid.
Posted on 5/17/16 at 6:05 pm to Hopeful Doc
That is a difficult question to answer. Prior to the ACA I was able to substantially discount and or write off office visits for a large portion of my patients that are uninsured. Do to undercoding and over coding both being insurance fraud, at a much higher percentage of my patients having insurance even though they can't pay for the deductibles or the premiums, I am unable to provide such discounts to patients by federal law. Furthermore the decision to treat a patient over the phone demands a certain level of trust that the patient's intelligence level is sufficient for proper presentation of symptoms and prevention of poor outcomes. I do provide some telephone medicine and prescriptions dependent upon the above factors. However I also operate an open walk-in model at my clinic that is superimposed on top of my regular schedule. This means some days I see 25 patients and on others I may see 50. But I will see all sick patients on the same day as long as I am still physically in the building. Often I see families with multiple children we're only one of them was seen for the office visit and the other two children and parents need similar treatment, which is been prescribed without a charge. This of course equates to 1 office visit fee, in return for services and liability associated with five patients.
Posted on 5/17/16 at 6:06 pm to tigerpimpbot
From what I have read, it doesn't seem to address liability or malpractice.
Posted on 5/17/16 at 6:08 pm to SmackoverHawg
Our office recently made the same decision smack, no training of nurse practitioners unless they sign a non-compete clause to work for our office.
Posted on 5/17/16 at 6:10 pm to Scooby
Scooby if you ever want to move to Texas and need a job let me know you are the type of NP I would be interested in employing
Posted on 5/17/16 at 6:13 pm to Scooby
quote:
In a way, yes. If our collaborating doc decided to wake up one morning and say he didn't want to do it any more, business would come to a grinding halt, which would keep us from being paid.
That is a predicament, but no different from the RNs, LPNs and office staff. Doesn't mean they should be able to practice medicine without a license. And I agree that physicians charging for oversight should give oversight. But you get what you pay for most times. What I would charge for mine would be a shitload more than some half-arse quack that can't make a living would.
I can't believe it's even up for consideration. It's a total "frick you" to our entire training and profession. Hell, my RN can do 90% of what my NP's can do. Let's pass a bill allowing RN's to do NP work. How'd that be? RN training is closer to NP training that NP training is to MD.
ETA-this isn't an attack toward you Scooby. Just spouting off in general.
This post was edited on 5/17/16 at 6:15 pm
Posted on 5/17/16 at 6:16 pm to Bleeding purple
quote:
Our office recently made the same decision smack, no training of nurse practitioners unless they sign a non-compete clause to work for our office.
We need to all pull together and exert our collective authority. Until that happens, we are gonna keep getting screwed worse and worse. Of course, my arse will be long since retired by then. Just hate to see where it's headed.
Posted on 5/17/16 at 6:24 pm to SmackoverHawg
Sadly the idea of staying detached from the political and economic aspects of medicine and living by the mantra of "just take care of the patient and it will all work out" has placed us at this destination.
Posted on 5/17/16 at 6:28 pm to Bleeding purple
quote:
Scooby if you ever want to move to Texas and need a job let me know you are the type of NP I would be interested in employing
Appreciate it.
Posted on 5/17/16 at 6:31 pm to SmackoverHawg
quote:
I can't believe it's even up for consideration. It's a total "frick you" to our entire training and profession.
Head of Texas NP from the podium "The only difference between nurse practitioners and doctors is the salary".
If teaching that philosophy how can they be expected to understand their scope and limitations?
Posted on 5/17/16 at 6:32 pm to Bleeding purple
quote:
living by the mantra of "just take care of the patient and it will all work out" has placed us at this destination.
This. And it was all bullshite. That's why I'll never work for anyone but myself and I have no allegiances to any particular hospital. We have to go out and stake our claim. Take what we deserve and defend what we have. We hold 100% of the cards. We just choose as a group not to play them.
Posted on 5/17/16 at 6:35 pm to Bleeding purple
Same with the optometry lobby. They are taught in school to lobby for their field and they have convinced the politicians that their work is equivalent to an MD though they went to school/training for 1/2 the time
This post was edited on 5/17/16 at 6:36 pm
Posted on 5/17/16 at 6:39 pm to LATigerdoc
This is still ongoing?
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