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re: SB 435 would allow advanced practice nurses to not work under a physician

Posted on 4/4/18 at 1:27 pm to
Posted by NoHoTiger
So many to kill, so little time
Member since Nov 2006
45757 posts
Posted on 4/4/18 at 1:27 pm to
quote:

Hopeful Doc


And all of this is why I defer to those with much more experience than I.
Posted by tgrbaitn08
Member since Dec 2007
146214 posts
Posted on 4/4/18 at 1:27 pm to
quote:

You would make a decision to go into a clinic to see a NP rather than seeing a MD?




If Im not mistaken I think this bill is for hospitals and nursing homes. I didnt see anything about clinics
Posted by TheWiz
Third World, LA
Member since Aug 2007
11690 posts
Posted on 4/4/18 at 1:28 pm to
quote:

If Im not mistaken I think this bill is for hospitals and nursing homes. I didnt see anything about clinics


Ahh, I should read more closely.
Posted by buffbraz
Member since Nov 2005
5678 posts
Posted on 4/4/18 at 1:28 pm to
This does not pertain to PAs. Nor should it.
Posted by Epic Cajun
Lafayette, LA
Member since Feb 2013
32840 posts
Posted on 4/4/18 at 1:29 pm to
quote:

You would make a decision to go into a clinic to see a NP rather than seeing a MD?

As someone said earlier in this thread, some mid-levels are good and some suck. The same applies to physicians. Some are good and some suck.

Also, I don't need a physician to prescribe a z-pak.
Posted by Golfer
Member since Nov 2005
75052 posts
Posted on 4/4/18 at 1:29 pm to
quote:

You would make a decision to go into a clinic to see a NP rather than seeing a MD?



Possibly. Hell, it already happens thousands of times each day.

But again, that's beside the point. I may not decide to see an NP over a MD, but I don't need a regulation telling me to do such. Let the consumer decide for themselves what is reasonable and prudent for their situation.
Posted by tgrbaitn08
Member since Dec 2007
146214 posts
Posted on 4/4/18 at 1:32 pm to
The amendment states:

quote:


AMENDMENT NO. 1
2 On page 1, line 14, after "who is" delete the remainder of the line and on line 15, delete
3 "nursing duties in a hospital" and insert "employed under contract or arrangement with
4 hospital systems"

Posted by TheWiz
Third World, LA
Member since Aug 2007
11690 posts
Posted on 4/4/18 at 1:34 pm to
quote:

Let the consumer decide for themselves what is reasonable and prudent for their situation.


The bad part is that I think the general public is ignorant to what medical professional they actually see. Overall, I personally think this is how the quality of healthcare becomes diluted. Imagine all of the wasted visits patients will make, IF the NP can't diagnose the issue and they have to refer to a MD. All of which may have been somewhat avoidable if the mid-level had physician oversight.

Now that being said, there are some bad physicians out there and sometimes they don't do a good job diagnosing the issue.
Posted by Golfer
Member since Nov 2005
75052 posts
Posted on 4/4/18 at 1:37 pm to
quote:

The bad part is that I think the general public is ignorant to what medical professional they actually see.


Then that's their own fault. I'm tired of regulating stupidity.
Posted by Hopeful Doc
Member since Sep 2010
15039 posts
Posted on 4/4/18 at 1:37 pm to
quote:

Also, I don't need a physician to prescribe a z-pak.



I'd argue it's also a problem that people come in with the notion of needing a Z-pack and won't stop seeing providers until they find someone who writes one, regardless of their actual need for one.
Posted by Epic Cajun
Lafayette, LA
Member since Feb 2013
32840 posts
Posted on 4/4/18 at 1:40 pm to
quote:

Imagine all of the wasted visits patients will make, IF the NP can't diagnose the issue and they have to refer to a MD. All of which may have been somewhat avoidable if the mid-level had physician oversight.

The physician isn't standing over the NP's shoulder anyway, he's basically just "reading" the NP's notes and co-signing them.

Also, this doesn't seem to be aimed at outpatient visits anyway.
Posted by 50_Tiger
Dallas TX
Member since Jan 2016
40282 posts
Posted on 4/4/18 at 1:41 pm to
quote:

I'd argue it's also a problem that people come in with the notion of needing a Z-pack and won't stop seeing providers until they find someone who writes one, regardless of their actual need for one.


From watching "My 600lb Life" I didn't realize how easy it is for someone to seek a certain medication, narcotic or not, many...MANY times!

I also did not know Texas has an actual system of tracking these prescriptions. It's something I hope every state has to track abuse and actual prescriptions given.

My SO helps facilitate clinical trials for new drugs and it's crazy how some clinics/Private Practices lie or forget what they prescribe.
Posted by Epic Cajun
Lafayette, LA
Member since Feb 2013
32840 posts
Posted on 4/4/18 at 1:41 pm to
quote:

I'd argue it's also a problem that people come in with the notion of needing a Z-pack and won't stop seeing providers until they find someone who writes one, regardless of their actual need for one.

I was just using that as an example of a visit that does not need physician intervention.
Posted by TheWiz
Third World, LA
Member since Aug 2007
11690 posts
Posted on 4/4/18 at 1:41 pm to
quote:

I'd argue it's also a problem that people come in with the notion of needing a Z-pack and won't stop seeing providers until they find someone who writes one, regardless of their actual need for one.


People always want the placebo. You can talk until you're blue in the face about viruses vs. bacterial, but it is a waste of time.
Posted by Epic Cajun
Lafayette, LA
Member since Feb 2013
32840 posts
Posted on 4/4/18 at 1:43 pm to
quote:

it's crazy how some clinics/Private Practices lie or forget what they prescribe.

Most of these probably have e-prescribing and can have reports run on which meds are ordered, and the frequency of the orders.
Posted by LZ83
La
Member since Sep 2016
17406 posts
Posted on 4/4/18 at 1:45 pm to
How does the public know which provider they need to see?

Posted by Golfer
Member since Nov 2005
75052 posts
Posted on 4/4/18 at 1:51 pm to
quote:

How does the public know which provider they need to see?



The same way they're currently seeking out medical care?
Posted by LSUFanHouston
NOLA
Member since Jul 2009
37202 posts
Posted on 4/4/18 at 1:53 pm to
quote:

The Government needs to stop assuming everyone is a moron and needs regulation to protect themselves from the boogeyman.


While I understand your thought and somewhat agree... you have to admit that many more people need the government to protect them from themselves, than those of us who can make a smart decision.

Pathetic as that is.
Posted by LZ83
La
Member since Sep 2016
17406 posts
Posted on 4/4/18 at 1:54 pm to
You should see the shite NPs can come up with. If you could you would change your mind or not.
Posted by LSUFanHouston
NOLA
Member since Jul 2009
37202 posts
Posted on 4/4/18 at 1:57 pm to
quote:

The physician isn't standing over the NP's shoulder anyway, he's basically just "reading" the NP's notes and co-signing them.


That's my issue.

If I go see an NP or an advanced nurse... many times they are working alone. I damn sure know that for my average cold/flu case, they are not running over to the doctor while I'm in the room and asking him for his advice/consent.

I feel like there should be a program, certification, something, that says if you meet the qualifications/tests, then you can do X without needing to work under a physician. And as long as you stick to X, then all is well. But X needs to be a pretty low thing.
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