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Started By
Message
1
Posted on 5/25/16 at 12:10 am to Da Hammer
quote:
I will never say any profession is perfect but show me that Ophthalmologists are?
Who ever said anything about perfect?
It's about increasing quality care. I'm not saying the system is great right now, but passing legislation to give certain groups responsibilities they were never trained for is irresponsible. It's a shortcut that will result in poor results in the long run.
We need an increase in qualified professionals performing the tasks they were trained for.
- Increase the number of residency spots
- increase scholarships for new MDs practicing in rural areas
- stop price control by the government to allow competition between QUALIFIED individuals
- make patients have a stake in payments
- makes costs more transparent
These are all reasonable solutions. Optometry/NP legislation is about making more money for those professions, not about sloving healthcare problems. Even though yall are doing an incredible job trying to make it seem that way.
Posted on 5/25/16 at 12:11 am to LATigerdoc
Great but battery dead time for sleep for me.
Posted on 5/25/16 at 12:12 am to WaWaWeeWa
Congratulations you won a free eye exam and an unlimited license to practice medicine and surgery and whatever else you can think of.
I guess you've already got that so whatever but
Post #2000 still gets an NP white coat
I guess you've already got that so whatever but
Post #2000 still gets an NP white coat
Posted on 5/25/16 at 12:13 am to LATigerdoc
In short,
The bill is not good
Read the thread for details
The bill is not good
Read the thread for details
Posted on 5/25/16 at 12:19 am to PJ250R
quote:
Board
quote:
Reform how physicians oversee their PAs
How do you suggest we do this? If we are being honest the bottom line in anything is always money. I foresee the urgent care market soon becoming more saturated if these rights continue to expand. Essentially we train PA/NPs on the job so they can go out and under cut us and bill for 85%. But for the sake of pt care we continue to do this, and have no other option in the matter.
quote:
The Nps put on their white coat at the hospital and take it off when a pt threatens to sue.
Truer words have never been spoken.
Posted on 5/25/16 at 12:27 am to greenhead11
Who will get the #2000 independent midlevel doctor nurse white coat?
Posted on 5/25/16 at 12:35 am to LATigerdoc
Working our way there. Idk might could pull an intern coat switch-a-roo.
Posted on 5/25/16 at 12:43 am to greenhead11
quote:
How do you suggest we do this? If we are being honest the bottom line in anything is always money. I foresee the urgent care market soon becoming more saturated if these rights continue to expand. Essentially we train PA/NPs on the job so they can go out and under cut us and bill for 85%. But for the sake of pt care we continue to do this, and have no other option in the matter.
Urgent care has already taken over in Connecticut. It's a stop before the ED and they bill for it. We called the ED a problem, now we have a middle man of under educated "providers" making incompetent decisions to just send to the ED. The urgent care company is fine with it bc they billed. Meanwhile, the patient is left with another bill to finally see a doctor. None of our facilities are owned my M.D.s.
How do we oversee the NP/PAs? Many ways, but let's start by requiring they tell the patient who they are, what they are, when they see a patient so the patient can have informed consent. If you are a NP physician I can see how you a problem with this.
quote:
If this passes it will really handicap the training of future of NPs.
I feel sorry for the graduating NPs if this passes.
This post was edited on 5/25/16 at 12:52 am
Posted on 5/25/16 at 12:46 am to greenhead11
You do realize that not every NP feels this way right? We don't all go around wearing long white coats trying to act like MDs. I was required to get a white coat and place my credentials on it. If I had a choice, I wouldn't wear one.
Not every NP is for this, some of us understand our limitations.
Not every NP is for this, some of us understand our limitations.
Posted on 5/25/16 at 7:07 am to PJ250R
What in the world is a np physician ?
I believe you're confused
I believe you're confused
Posted on 5/25/16 at 7:08 am to WashRSkins
Please lobby against it. Thanks that's interesting to hear
Posted on 5/25/16 at 7:22 am to PJ250R
quote:
If you are a NP physician I can see how you a problem with this.
And they say the general public is able to tell the difference between the two professions.
Posted on 5/25/16 at 7:39 am to PJ250R
quote:
It's a stop before the ED and they bill for it. We called the ED a problem, now we have a middle man of under educated "providers" making incompetent decisions to just send to the ED.
This is a horrible model for pt care. Yet this problem is likely not going to be reflected in a "pay for performance" type system as long as Mid level providers provide perceived initial quality care.
I firmly believe the business of owning/operating urgent cares are underlies this movement. Expanding access to care is a bunch of bullshite. If a sensible government wanted to do this, they would further incentivize MDs going in to primary care. It's shame the majority of the top half of class wouldn't even entertain the idea of going in Primary care.
Posted on 5/25/16 at 7:42 am to LATigerdoc
Agreed. Interesting to hear. For the interest of patient, I believe it should be abundantly clear who exactly is providing care.
Nothing pisses me off more than to hear a CRNA (with a doctorate) introduce themselves in a CLINICAL setting as Doctor of Anesthesia. This should be criminal without further clarification.
And we might all have to go to blue coats.
Nothing pisses me off more than to hear a CRNA (with a doctorate) introduce themselves in a CLINICAL setting as Doctor of Anesthesia. This should be criminal without further clarification.
And we might all have to go to blue coats.
Posted on 5/25/16 at 7:50 am to greenhead11
quote:i don't think more govt involvement will help.
sensible government wanted to do this, they would further incentivize MDs
I also believe that if docs are truly scared that NPs are going to be missing critical diagnosis,and folks are going to suffer as a result, they should fire every NP this morning. But they keep employing them and i suspect the oversight is pretty sketchy at best.
I don't disagree that NPs are not sufficiently trained to act independently. I just see that in a lot of settings they basically are already. This makes it seem like it is more about who controls healthcare than it is about quality
Posted on 5/25/16 at 9:17 am to greenhead11
quote:
This is a horrible model for pt care. Yet this problem is likely not going to be reflected in a "pay for performance" type system as long as Mid level providers provide perceived initial quality care. I firmly believe the business of owning/operating urgent cares are underlies this movement. Expanding access to care is a bunch of bullshite. If a sensible government wanted to do this, they would further incentivize MDs going in to primary care. It's shame the majority of the top half of class wouldn't even entertain the idea of going in Primary care.
But the Louisiana model as is currently in place is superior? We are ranked 50th in heathcare. Anyone with common sense should look at these other states and attempt to mimic parts of what they are doing. They are doing it better than us.
Posted on 5/25/16 at 9:44 am to greenhead11
quote:
Expanding access to care is a bunch of bullshite. If a sensible government wanted to do this, they would further incentivize MDs going in to primary care. It's shame the majority of the top half of class wouldn't even entertain the idea of going in Primary care.
You just dismissed the legitimacy of a big problem, and validated it entirely in consecutive sentences.
But I'll let that go, I don't want to go back to that particular angle today.
quote:
they would further incentivize MDs going in to primary care.
How? And I should have asked SmackoverHawg this before in previous discussions, but what would incentivise new docs to follow primary care?
The easiest answer is better reimbursement for your E&M coding, with specific modifiers to identify the encounter as "primary care". But do you consider that primary care encounter equitable to a simple procedure or a complex examination of a chronically ill patient?
One element of the current system is that it is (supposedly) tiered reimbursement based on the complexity/difficulty of the encounter. I think most physicians I know would ideologically agree with that approach. But you have to turn that on its head if we're truly pushing people to primary care "for the greater good". Is that what we're ready to do? Is the medical community, as a whole, good with paying the PCP the same for his 99212 as we're paying the hepatologist for his 99214, if that is what it takes to expand access to care without independent med-levels?
This post was edited on 5/25/16 at 9:59 am
Posted on 5/25/16 at 10:46 am to MSMHater
quote:
One element of the current system is that it is (supposedly) tiered reimbursement based on the complexity/difficulty of the encounter. I think most physicians I know would ideologically agree with that approach. But you have to turn that on its head if we're truly pushing people to primary care
before I launch into a retort, would you do me a favor and explain your logic here?
Posted on 5/25/16 at 10:52 am to Bleeding purple
Holy frick, is this thread still going on? Anything new besides "everyone you love will get cancer without medical doctors"?
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