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Message
re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187
Posted on 4/9/16 at 12:42 pm to nolatiger711
Posted on 4/9/16 at 12:42 pm to nolatiger711
quote:
The mechanic (Doctor) can change the oil on my Honda, but I will have to drop it off for a couple hours and it will cost a bit. However, I trust 5 minute oil change (NP) to do it when all I need is an oil change. They are less trained, but fully capable to handle a simple issue. Sometimes, I even feel daring enough to let them top off my fluids.
The problem is you think you know what you need. Maybe you haven't seen simple issues go wrong.
Theoretically if you can guarantee that NPs saw URIs all day and "simple" issues. That would be fantastic. I would be 100% for them being fully autonomous in those situations. But when you completely open the door to them managing every issue some of them will think they can, and some of you will pay for it.
0
Posted on 4/9/16 at 12:42 pm to WaWaWeeWa
quote:
Mandeville is the only example you can give where that would seem desirable
Lafayette is full of small towns surrounding it. So is Baton Rouge. Lake Charles doesn't qualify, but the rest of Calcasieu Parish does. It's all tied to about a 15m commute.
And in terms of better incentive- they don't need more primary care in Uptown. But the incentive is tied to committing early. You owe what you took if you change your mind during school. It would be nice if the state looked and took a retroactive approach- you've paid on your loans and served an underserved area for 5 years, so put the rest on our tab.
From the two posts above though, it seems that the committing isn't as big an issue as the working in a rural area. If that's the case, I don't really have an answer, because there's nothing that's going to address that problem.
Posted on 4/9/16 at 12:45 pm to WaWaWeeWa
Well said. At that point you would be better off subspecializing and going with the 10 year loan forgiveness route.
Posted on 4/9/16 at 12:49 pm to lsunurse
quote:
I know that type, work with some of them Working in a teaching hospital though...there have been times that us RNs had to stand our ground on crazy orders an intern may try to write. I hate going over them and calling the senior, but sometimes we don't have a choice.
I mean, I guess I just want to thank you. You just confirmed everything I have been arguing in this thread.
You know maverick nurses who would over step their boundaries.
And the intern doesn't know what he is doing, but the senior does. Reinforcing what everyone is arguing, that on the job training is what prepares you for the real world of Medicine. That intern needs to finish his residency before he is autonomous. Just like an NP should have to complete something similar to a residency before they are autonomous.
That's all I'm saying
Posted on 4/9/16 at 12:49 pm to double d
(no message)
This post was edited on 4/9/16 at 11:22 pm
Posted on 4/9/16 at 12:50 pm to Hopeful Doc
quote:
Alaska is doing it right. They have a PCP shortage and a strong state economy,
Alasksa's economy is cratering due to the oil bust. That program will go away with a quickness.
Posted on 4/9/16 at 12:53 pm to WaWaWeeWa
quote:
Maybe the question should be how do you get a professional to live next to a cornfield in Iowa or the ninth ward?
The easiest way is to find someone who already has family ties to the area. All the young doctors in my town are either originally from here or their spouse is from here.
Posted on 4/9/16 at 1:07 pm to SmackoverHawg
quote:
Paralegals become lawyers
I know some paralegals that are way better than many lawyers. The degree doesn't make you good at what you do. There are several lawyers that I can't figure out how they ever passed the Bar exam.
Docs just don't want the competition. Unlike lawyers, your profession is not overpopulated, and needs more professionals.
Posted on 4/9/16 at 1:07 pm to Jim Rockford
Agreed. Tell that to LSU medschool
Posted on 4/9/16 at 1:10 pm to WaWaWeeWa
I don't think making med school free would have an affect on students going into primary care.
The only people I know going into rural primary care are people from rural places that want to go back (and these tend to be excellent doctors) or shitty doctors with limited opportunities.
The only people I know going into rural primary care are people from rural places that want to go back (and these tend to be excellent doctors) or shitty doctors with limited opportunities.
Posted on 4/9/16 at 1:11 pm to WaWaWeeWa
There is a similar battle going on in LA between the orthopods/podiatrists and the PT/chiropractors.
PTs and chiropractors are trying to expand their scope to become primary providers for a variety of orthopedic conditions. It's literally crazy talk.
PTs and chiropractors are trying to expand their scope to become primary providers for a variety of orthopedic conditions. It's literally crazy talk.
Posted on 4/9/16 at 1:14 pm to Parallax
quote:
The only people I know going into rural primary care are people from rural places that want to go back (and these tend to be excellent doctors) or shitty doctors with limited opportunities.
It's unusually bimodal, and I've noticed this too. I mean the same thing when I say, "there are two kinds of people who go into primary care- those that want to do everything, and those that want to do nothing."
Posted on 4/9/16 at 1:16 pm to nolatiger711
quote:Are the exams done online as well? I'm almost positive they are.
My point was becoming a NP is not as easy as 18 months of online courses. It's a 3 year program
It is still part time for 3 years (most nurses work through school) with anywhere from 500-1000 clinical hours. That is like 4 months of clinicals, which is kind of a joke.
Posted on 4/9/16 at 1:23 pm to Mung
quote:
Docs just don't want the competition. Unlike lawyers, your profession is not overpopulated, and needs more professionals
Do you think this would reduce costs?
Healthcare is more complicated that that. Doctor salaries are 10% of the total cost. Make them work for free and you are still in a completely unsustainable system
Posted on 4/9/16 at 1:31 pm to WaWaWeeWa
quote:
Healthcare is more complicated that that. Doctor salaries are 10% of the total cost. Make them work for free and you are still in a completely unsustainable system
Physician reimbursements are basically the ONLY thing that is routinely trimmed down to cut costs, yet costs don't decrease at all. Funny how that works.
Posted on 4/9/16 at 1:32 pm to WaWaWeeWa
So just to summarize. We have already decided that this bill
1. Will not decrease costs.
2. Access to care?
NPs can see as many patients as they want, just with a MD supervision. How will allowing them to work autonomously increase the number of patients seen?
Your only argument would have to be rural areas. Can you show me that NPs are more likely to practice in rural areas? Doubtful
3. Quality of care? Who knows, but I doubt it goes up
These types of bills will do nothing to address the problems in our healthcare system, but will only serve to empower a few daredevil NPs who want to be called "doctor". The smart NPs will know their limits and stay away.
1. Will not decrease costs.
2. Access to care?
NPs can see as many patients as they want, just with a MD supervision. How will allowing them to work autonomously increase the number of patients seen?
Your only argument would have to be rural areas. Can you show me that NPs are more likely to practice in rural areas? Doubtful
3. Quality of care? Who knows, but I doubt it goes up
These types of bills will do nothing to address the problems in our healthcare system, but will only serve to empower a few daredevil NPs who want to be called "doctor". The smart NPs will know their limits and stay away.
This post was edited on 4/9/16 at 1:36 pm
Posted on 4/9/16 at 1:46 pm to lsunurse
Attending in NICU ordered tap water flushes to neonate's chest tubes to unblock them. That went over real well!!!
Posted on 4/9/16 at 1:54 pm to Scooby
In reality everyone involved in patient care are only human and not all perfect. It's good to work with docs, nurses, therapists, aides, etc and know we all have each others back in most cases. It does take a village to care for patients. When one part of the village wants to be autonomous there will be break downs.
Doctors are autonomous, but comparing APRNs to MDs is ridiculous.
Doctors are autonomous, but comparing APRNs to MDs is ridiculous.
This post was edited on 4/9/16 at 1:56 pm
Posted on 4/9/16 at 2:55 pm to LATigerdoc
This is allowed in almost every other state, I've never seen a group of rich bratty crybabies bigger than Louisiana doctors. This one doctor who sits behind me in the stadium club and has 8 seats was bitching at me when she casually found out I was a registered democrat over how she's so poor because of Obama care. All while wearing the most fashionable clothes and with her 8 seats in the club section that cost what for the TAF fee? Assclowns
Posted on 4/9/16 at 2:56 pm to Isabelle81
quote:
Attending in NICU ordered tap water flushes to neonate's chest tubes to unblock them. That went over real well!!!
You are talking about an individual who has had thousands upon thousands of hours of training. And probably by all standard measures of intelligence smarter than 99% of the population. And he still made a mistake like this.
And this is your argument for allowing mid level providers autonomy without further training?
Got it
Eta: sorry didn't read your second post lol
This post was edited on 4/9/16 at 3:08 pm
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