| Posted by | Message |
mmtsanders 
LSU Fan
Member since Nov 2011
248 posts
| Is this the new norm in health care treatment?? (Posted on 11/18/12 at 10:52 pm)
Nurse practitioner versus doctor...
I took my daughter to the ER tonight for severe right-sided abdominal pain, fever and shaking chills.
A nurse practitioner was the treating clinician. We never saw a physician. Upon the nurse checking us out, I ask her why we were not seen by a physician. She said something like if the clinician felt the visit warranted the physician seeing the patient, she would have asked the doctor to see us. Then she asked would I like her to request the physician to see us.
I just found this odd since I never seen the doctor.
|
| Back to top | Share on  |
BamaDude06 
Alabama Fan
T-Town
Member since Jan 2007
707 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/18/12 at 11:05 pm to mmtsanders)
I would say yes. One of the Birmingham hospitals has been running a "30 min wait or less" campaign for their ER.....to see a doctor or PA.
|
| Back to top | |
buddhavista
Member since Jul 2012
3543 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/18/12 at 11:14 pm to mmtsanders)
yes, and its frankly a good thing IMHO. We need to get health care costs down, and ER care chews up a big chunk of the costs. I would be curious to see how much less a nurse practictioner makes, but I bet its a good bit less.
I am betting that 75% of what comes into an ER can be handled by a nurse praticioner.
And think of the benefit to you, if you really need to see a dr, it will be easier since there will be less of a queue.
This post was edited on 11/18 at 11:35 pm
|
| Back to top | |
Hammertime
LSU Fan
Hiding in your back seat
Member since Jan 2012
8875 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/18/12 at 11:33 pm to buddhavista)
quote:
I am betting that 75% of what comes into an ER can be handled by a nurse praticioner.
Sniffles
Cough
Headache
Overly ashy skin
Bumps and bruises
Scuffed knees
All of those conditions require the hospital to go through the whole gamut of tests. Huge waste of time and money
I have an ex that is a NP, and she used give me stitches most of the time. I only had to go to the hospital for overly broken bones, very deep cuts, and after having a seizure. You are right is assuming that 75% don't need to be seen by a doctor
|
| Back to top | |
mmcgrath
LSU Fan
New Jersey
Member since Feb 2010
2237 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/18/12 at 11:47 pm to buddhavista)
quote:
yes, and its frankly a good thing IMHO. We need to get health care costs down, and ER care chews up a big chunk of the costs. I would be curious to see how much less a nurse practictioner makes, but I bet its a good bit less.
ER's need to adapt to have a safety valve for less extreme cases. Something that has been in demand since family doctors work banker's hours with no house calls. Still need treatment, just don't need the typical battery of tests.
|
| Back to top | |
mmtsanders
LSU Fan
Member since Nov 2011
248 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 1:44 am to buddhavista)
quote:
yes, and its frankly a good thing IMHO. We need to get health care costs down, and ER care chews up a big chunk of the costs. I would be curious to see how much less a nurse practictioner makes, but I bet its a good bit less. I am betting that 75% of what comes into an ER can be handled by a nurse praticioner. And think of the benefit to you, if you really need to see a dr, it will be easier since there will be less of a queue.
I agree with everything you said.
I am conservative and would rather not pay $150 copayment for an ER visit for something that can be treated by our primary care or an urgent care facility. However, since it was a Sunday afternoon and neither was open, and she was doubled over in severe pain I was thinking it could be a kidney stone or acute appendicitis, I felt it was better to have her seen immediately.
Since it has been years since I have visited an ER, not seeing a doctor seemed stranged to me.
They did a urinalysis and diagnosed her with an acute pyelonephritis, gave her a shot for pain, a shot of Rocephin and wrote her a prescription for Bactrim.
The prescription was wrote by a physician and not the NP.
Now that I am being told that this is normal, and even though I have paid my $150 copayment, it will be interesting to see if the insurance is billed for a NP or a doctor.
|
| Back to top | |
RogerTheShrubber
LSU Fan
Juneau, AK
Member since Jan 2009
73754 posts
 Online
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 1:46 am to buddhavista)
quote:
I am betting that 75% of what comes into an ER can be handled by a nurse praticioner.
Probably is. Even if you are in the hospital your face time with an actual doctor is measured in minutes a day. Nurses or NP's have taken over it seems.
|
| Back to top | |
jeepfreak
LSU Fan
Back in the BR
Member since Oct 2003
18714 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 2:43 am to mmtsanders)
quote:
Is this the new norm in health care treatment??
Not just in the ER, but in your GP/FP's office. Truthfully, 90-95% of routine medical cases can be handled by NP's and/or PA's(Physician's Assistants). The laws governing how much they are allowed to handle vary from state to state, but it is by no means a lower standard of care for routine ailments.
|
| Back to top | |
Dark Tiger
LSU Fan
Member since Sep 2006
3914 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 3:34 am to Hammertime)
quote:
Overly ashy skin
|
| Back to top | |
totalqualitysafety
LSU Fan
Thibodaux, LA
Member since Jan 2012
136 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 5:22 am to Dark Tiger)
The Pedatician's office that we take our daughter to has a NP. The NP usually sees the patients who are on Medicade (i.e. LaCHIP, etc.). However, being a paying customer with insurance (self-employed with high deductible that usually has to pay the full amount up front), we are usually given a choice to see the NP or one of the Doctors. I guess this is good for all customers. With this practice, mostly all patients can get a same day appointment. Who can really complain with good medical service. With that being said, I am charged the same for a Dr. or NP. By seeing the NP, we are not saving any money
|
| Back to top | |
coondaddy21
LSU Fan
Louisiana
Member since Oct 2012
619 posts
Online
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 5:29 am to buddhavista)
quote:
I would be curious to see how much less a nurse practictioner makes, but I bet its a good bit less.
They typically make around 75k-100k per year and an emergency room physician will make 100K-200k, depending on where they work.
|
| Back to top | |
mmtsanders
LSU Fan
Member since Nov 2011
248 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 5:52 am to jeepfreak)
quote:
Truthfully, 90-95% of routine medical cases can be handled by NP's and/or PA's(Physician's Assistants).
I guess I'm too old to embrace such a change to health care as I grew up in an era where doctor's opinions and assesments really mattered.
I'm not knocking what a NP and PA does as I don't know what kind of education or training they receive, but if this is the norm, what is the role of the traditional doctor these days.
I'm all for cutting down on health care cost, so if this is a way to do it and still receive quality care then I'm all on board.
Like I stated earlier, I have paid my copayment and the rest will be billed to my insurance. It will be interesting to see how much is billed and how much my insurance covers for a NP visit instead of a doctor visit.
I am very conservative and that includes being conservative where health care is concerned as well. Just because I pay my required copayment, I still want to know that my insurance is going to cover what they agreed to cover while at the same time I want to make sure that a doctor, urgent care or hospital is billing my insurance only for the services provided.
|
| Back to top | |
mmtsanders
LSU Fan
Member since Nov 2011
248 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 5:55 am to totalqualitysafety)
quote:
I am charged the same for a Dr. or NP. By seeing the NP, we are not saving any money
So does a NP, PA and doctor receive the same education and training?
|
| Back to top | |
stat19 
USA Fan
Member since Feb 2011
8361 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 7:34 am to mmtsanders)
quote:
Then she asked would I like her to request the physician to see us.
Saying, yes increases your co-pay and insurance amount by several hundred dollars.
It sounds to me like she didn't whisper the fine print to you. You may therefore have a lawsuit against the ER in which you're entitled to wait an extra 3 hours on your next ER visit.
|
| Back to top | |
RCDfan1950
LSU Fan
United States
Member since Feb 2007
6903 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 8:06 am to mmtsanders)
Absolutely...and not necessarily a bad thing.
My Grandpa Gene was known as the community *veterinarian*; doubt that he graduated high school.
Stupid lawyers think the Progressives will protect their ability to sue/spread the wealth around. Once it all goes to single-payer...do they really think they'll be able to sue the government?
There will be some form of government 'certification', but the mere demands created by smart doctors bailing because it really was the MONEY that insprired them to get good at what they do...will leave a big hole in the demand/services equation. The government will have to fill that hole, obviously with less qualified/intelligent individuals.
Pray for good health...especially if you are old. Which is an oxymoron.
Sidenote...went fishing with a dear friend yesterday...Progressive/Green. Has a great private health policy through a well-know environmental advocacy group. Had no clue that he is going to lose that policy to Obamacare. And that Government single-payer will have egalatarian/'social justice' criteria where we'll all take a number in line with illegals, slackers, etc.
We both agreed that there needs to be programs to address the misery of poor immigrants and slackers who are - for all practical purposes - unemployable...but I don't think that he realizes that he'll be paying a personal price in that *program*.
Live and learn.
|
| Back to top | |
wavebreaker
LSU Fan
New Orleans
Member since Nov 2012
467 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 8:17 am to mmtsanders)
Solution to doctor shortage!
|
| Back to top | |
MSMHater
LSU Fan
Houston
Member since Oct 2008
10975 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 8:42 am to mmtsanders)
quote:
I'm not knocking what a NP and PA does as I don't know what kind of education or training they receive, but if this is the norm, what is the role of the traditional doctor these days.
Family practice? With todays demographics...diabetes, cholesterol, hypertension, fatty liver and other byproducts of obesity, a shit-ton of geriatric ailments, and OVERSIGHT of all the NP's and PA's they employ and insure. If the PA missing something, who do you think is liable?
Oh yea, they also have to try and turn a profit in the most difficult field of medicine to do so.
This post was edited on 11/19 at 8:44 am
|
| Back to top | |
MSMHater
LSU Fan
Houston
Member since Oct 2008
10975 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 8:45 am to wavebreaker)
quote:
Solution to doctor shortage!
No. Not even close. Help to supplement the shortage, maybe. But not a solution.
|
| Back to top | |
OlGrandad 
Auburn Fan
Member since Oct 2009
113 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 8:49 am to wavebreaker)
I went for an annual follow up for a heart condition and instead of my cardiologist I was seen by an NP. I paid my copay at the visit and later received a note from my insurance company that I had seen a provider not on their approved list and therefore no coverage. I called the office and fortunately was told it was their mistake. I owed nothing and was told I would only see the doctor from then on.
So, a good question to ask is whether the np or pa is included in your insurance plan.
|
| Back to top | |
MSMHater
LSU Fan
Houston
Member since Oct 2008
10975 posts
| re: Is this the new norm in health care treatment?? (Posted on 11/19/12 at 8:58 am to OlGrandad)
quote:
So, a good question to ask is whether the np or pa is included in your insurance plan.
Their manager or credentialing person should have been fired. The NP is supposed to be credentialed on all the same insurance plans as the doctor. So everytime that NP saw a patient with your insurance, their reimbursement was 100% denied.
Huge F Up!
|
| Back to top | |
