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Started By
Message
re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187
Posted on 5/25/16 at 8:33 pm to Tigerpaw123
Posted on 5/25/16 at 8:33 pm to Tigerpaw123
quote:
If true that it has been tabled, that would be the second time in as many weeks , which indicates that it is lacking support
Nope, not that. Some key votes had to leave because of the time of day.
2
Posted on 5/25/16 at 8:40 pm to chadg
Ain't going to happen without a lot of watering down amendments , if at all
Posted on 5/25/16 at 9:16 pm to Tigerpaw123
Nps saying its moved to May 31
Reportedly adding amendments
Sounds like it's lacking support
Keep the pressure up to stop this bad bill
Reportedly adding amendments
Sounds like it's lacking support
Keep the pressure up to stop this bad bill
Posted on 5/25/16 at 9:25 pm to LATigerdoc
Thanks to LA for disrespecting their docs and treating them like shite. 
I just added another of your best and brightest to my staff.
Hopefully, y'all will keep this from passing, but the attitude toward docs, especially primary care, in LA seems to be poor.
I just added another of your best and brightest to my staff.
Hopefully, y'all will keep this from passing, but the attitude toward docs, especially primary care, in LA seems to be poor.
Posted on 5/25/16 at 9:42 pm to chadg
quote:
Nope, not that. Some key votes had to leave because of the time of day.
That is what the NP leadership is telling their members, because they can't admit publicly that they Do Not Have The Votes.
Last week it was a "light house" excuse (which should affect both sides equally). I forget the excuse the week before that.
Early lesson on passing legislation: when you have the votes, run the bill. Corrollary: if you aren't sure of the votes, running the bill is risky, but sometimes works. If you know you don't have enough votes, table it and work your tic sheet until you are over your target number. Build in a few extra for liars.
6 more days of misery for leges and their aides, brought to you by nurses who think they can practice unsupervised medicine under an unqualified board.
This post was edited on 5/25/16 at 9:43 pm
Posted on 5/25/16 at 9:47 pm to LATigerdoc
quote:
Nps saying its moved to May 31 Reportedly adding amendments Sounds like it's lacking support
Yup
Adding amendments = not enough votes, trying to persuade swing votes with BS that will get stripped off in conference committee. Most of the leges know this already, so it is unlikely to work.
Posted on 5/25/16 at 10:07 pm to jat912
Good win for PTs. As for the question regarding what happens when a patient shows up without benefits that pay for PT.
1: cash only
2: pro bono
3: do not treat
Even if there are never changes to insurance there will always be a portion of the population willing to pay cash for services.
1: cash only
2: pro bono
3: do not treat
Even if there are never changes to insurance there will always be a portion of the population willing to pay cash for services.
Posted on 5/25/16 at 10:09 pm to The Eric
On 187, do not count your chickens til they hatch. No excuse to stop expressing opposition until it's done
Posted on 5/25/16 at 10:16 pm to LATigerdoc
Don't worry.
Already working on the next 6 days.
Already working on the next 6 days.
Posted on 5/26/16 at 11:33 pm to jat912
Sorry not reading all 103 pages but not sure if this was mentioned. Most of these doctors dont want the collaborative agreement to go away because its free money for them. I know 3 nurse practitioners that have their own clinic, and they pay 1500.00 to 2000.00 per month to these does to be their collaborator. And they never see these docs, nor these docs sign any charts. I know 1 np that doesnt pay anything to a doctor for the collaborative agreement however, she has to work his clinic every other saturday and sunday. Some of these doctors want the public to believe that its about patient care when it is truly about fattening their pockets. I think it is essential for a np to have the ability to collaborate with a doctor for complex issues. But I dont think any np is trying to be a doctor. I could be wrong but that is my take on it.
Posted on 5/26/16 at 11:39 pm to desitiger
Yep you're wrong
Posted on 5/27/16 at 12:29 am to desitiger
I recently heard a story about abuse of this collaborative practice agreement: We are pretty much in agreement about MD oversight of NPs, but some MDs are charging the NPs enormous amounts for this oversight. Some MDs are charging the NPs as much as 7k per month for this oversight. Hmmm. Makes you think.
Posted on 5/27/16 at 1:42 am to desitiger
Ok the thoughts from us is that there should be more oversight. We're not in approval of these people never talking or seeing each other. I don't think that's the way it should be at all. But it's hard to argue these nurses are not trying to practice medicine, when they are asking to run a clinic of sick patients on their own without supervision, prescribing meds, trying to diagnose stuff and ordering a bunch of tests and making all the decisions alone. If that is not practicing medicine or trying to be a doctor, please explain how it is not
And then I really don't think there's a way to deny that there is a financial benefit to the nurses if this thing were to pass. At a Minimum, they save the money you just discussed from no cpa. And it's possible that they stand to receive a significantly larger amount of money from the passing of this bill. Especially if they lobby to get paid the exact same per patient as an MD at some point.
And then I really don't think there's a way to deny that there is a financial benefit to the nurses if this thing were to pass. At a Minimum, they save the money you just discussed from no cpa. And it's possible that they stand to receive a significantly larger amount of money from the passing of this bill. Especially if they lobby to get paid the exact same per patient as an MD at some point.
This post was edited on 5/27/16 at 1:43 am
Posted on 5/27/16 at 1:48 am to LATigerdoc
I think a lot of the nurses who support it do so for the reason that they feel it is some goal of advancement of the standing, status, and the scope of their profession. Many of these mid level fields are encouraged in school to push their agenda legislatively in their field. That's really not taught much in medical school, but it needs to be because it's essential that doctors stand up in defense of patient safety. Sufficient Training before autonomy used to be a no-brainer/ widely accepted criteria by society. Nowadays people want to dissolve societal lines of responsibility without sufficient training or rational scientific proof and the public just stands by and watches without any attention or thought
This post was edited on 5/27/16 at 1:49 am
Posted on 5/27/16 at 1:59 am to desitiger
quote:
Sorry not reading all 103 pages but not sure if this was mentioned. Most of these doctors dont want the collaborative agreement to go away because its free money for them. I know 3 nurse practitioners that have their own clinic, and they pay 1500.00 to 2000.00 per month to these does to be their collaborator. And they never see these docs, nor these docs sign any charts. I know 1 np that doesnt pay anything to a doctor for the collaborative agreement however, she has to work his clinic every other saturday and sunday. Some of these doctors want the public to believe that its about patient care when it is truly about fattening their pockets. I think it is essential for a np to have the ability to collaborate with a doctor for complex issues. But I dont think any np is trying to be a doctor. I could be wrong but that is my take on it.
This. Exactly this.
Posted on 5/27/16 at 2:19 am to cmayLSU07
I'll just say the dumbest person I know is a NP. And a few more who may compete for the title. They simply don't have the training to properly diagonose. That's not to say that many nurses are probably smarter than the docs they work under, cuz I know some of those too. (The good ones normally become PAs or at least advance). In the end it's a numbers thing.
Soon NPs will be too booked. Then front desk and orderlies will be doing brain surgery
Soon NPs will be too booked. Then front desk and orderlies will be doing brain surgery
This post was edited on 5/27/16 at 2:24 am
Posted on 5/27/16 at 4:44 am to Celery
Which part of Louisiana are you in? I will try my best to not go there for my healthcare
Posted on 5/27/16 at 4:47 am to LATigerdoc
I'm no doctor but all this time spent responding in this thread cannot be good for your health
Posted on 5/27/16 at 8:02 am to LATigerdoc
So latigerdoc, not sure what type of doctor you are. But let say that you are in family practice and I know most of the family practice docs that still have clinics, see about 30 to 40 patients a day. So let's say u have supervision(collaborative agreement) of a np that has his/her clinic across town. This person sees the same amount of patients a day. How can you justify being at 2 places at once and seeing 80 patients a day.
And for the other guy that commented on the dumbest person being a np. Work in a hospital and you will come across dumb doctors, nps, nurses, etc. There are dumb people in every job. I know some doctors here locally that I wouldn't let them touch my family. The same way I feel for some nurses. But I do know the doctors I would want and would hope they would never retire.
And for the other guy that commented on the dumbest person being a np. Work in a hospital and you will come across dumb doctors, nps, nurses, etc. There are dumb people in every job. I know some doctors here locally that I wouldn't let them touch my family. The same way I feel for some nurses. But I do know the doctors I would want and would hope they would never retire.
This post was edited on 5/27/16 at 8:05 am
Posted on 5/27/16 at 8:17 am to desitiger
Latigerdoc, I am a nurse practitoner. I could honestly give a rats arse about this bill. I don't have a clinic nor do I want a clinic. I work for a hospitalist group that believe we are an asset not just a helper. I don't care to worry about reimbursement. All I am saying is that I do understand where you are coming from but this CPA is abused everywhere because there is minimal to no supervision in the clinic setting. You say that doctors have all this training. Why am I getting a patient from the emergency room with a creatinine of 1.25 and the er doctor consulted nephrology for acute renal failure. Why am I getting a septic shock patient from the er doctor on a dopamine drip for hypotension but the heart rate is in the 180s and the er doctor gave labetalol to the pt to slow the heart rate down. Not all doctors are like that. But just examples there are bad in every profession. As far as clinic, I never cared to work in clinic. I have about 20 doctors I have a CPA with. One doctor is on call with me every night I work. If something is over my head, I can call them at 3 am to discuss with no problem. But from my earlier post with friends having clinics, the CPA and the fees are widely abused believe it or not.
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