re: LA legislature denies Independent nurse practice

Trained physicians don't like their professions being bastardized by nurses with a superiority complex, bad attitude and a chip on their shoulder. Who'd have thunk it?

What is the current rule on “physician oversight”, if I remember correctly it used to be the md had to be available by phone and review a handful of charts, that is bullshite to begin with and worthless

Either give it some teeth or remove it but just having the word oversight in the practice act does no good

There has to be a middle ground here. There's an obvious demand here as shown by the shortage of doctors especially in rural areas and skyrocketing medical care costs. When's the last time the AMA has opened a new medical school? I haven't heard of one in years and years despite a rise in population and an entire generation of baby boomers getting old.

Seems like straightforward enough issues could certainly be treated by NPs and PAs. Sutures, colds/flus, sinus infections, stomach bugs, ear infections...Basically let them take care of all the low hanging fruit which provides more access to care for more people. And frees up physician time for more involved, non percentage based medicine type things.

If there are any real red flags such that a high level decision needs to be made the mid levels could consult with an MD and have all of the salient facts ready to go.

Everyone wants to complain about healthcare costs, but then they support stupid shite like this.

An NP can handle 80% of what comes up at a doctor's visit. For anything else, they can send you to a specialist.

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Everyone wants to complain about healthcare costs, but then they support stupid shite like this.

An NP can handle 80% of what comes up at a doctor's visit. For anything else, they can send you to a specialist.

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its not as stupid as believing healthcare costs will be fixed by midlevel independence lol. healthcare isnt expensive because of physician salary. midlevels being independent will do nothing except allow hospital administrators to bloat their own salary at the expense of patient safety. gotta tackle problems with administration, insurance, patient satisfaction, and billing transparency for that.

its more like 80% of things that come up at a doctors visit wont kill or maim a patient so even if a midlevel mismanages the care there is no significant harm. they aren't trained well enough to recognize enough of the 20% they can't handle. they are fine in specific supervised roles but independent practice especially primary care is a hard no.

They are a doctor just not an MD

That said I wouldn’t introduce myself as that

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Yep. And I’d keep monitoring this and reach out to your legislator to let him or her know how important this is because as someone alluded to, the nurses are going to keep pushing for this. They will bring it back next year and the physicians need to be ready. It’s a dangerous idea.

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yup. this type of bill has nurse and big hospital groups lobbying interests while the physician lobby group is weak, and the public is largely ignorant/complacent of the problem. physician lobbying is hamstrung by the optics that the nurse groups are trying to solve problems and fill gaps despite the fact they aren't trained or qualified for the scope they are pushing for. And it makes physicians appear as defensive elitists to point out the dangers of that

unfortunately I think midlevels will eventually win out and gain independence for those reasons. unless we see legislation that beats them to the punch to fix the actual issues related which are related to administration, incentives, and residency availability.

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They are a doctor just not an MD

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Maybe in an academic setting, but in the context of this post they are not doctors like someone who graduated from medical school is a doctor. Not even close.

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Generally interested in people’s overall opinion on this matter. How many of you or your loved ones routinely see mid levels (nurse practitioners or physician assistants) instead of MDs or DOs? Are you happy with or ok entrusting your health and well being to someone with less training even though you pay the same amount for the “care?”

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Not everything requires a physician to treat. General family practice and pediatrics are a great example. If an NP can diagnose an ear infection or bronchitis and write a prescription. It is a great way to reduce the cost of delivering health care.

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CajunDoc

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I get the sense you spent $200K in med school to become a family practice doctor.

Now if I have cancer or a heart ailment, then absolutely it needs to be an MD or DO.