re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187

When you "screw" the docs, you are "screwing" thousands of hours of reading/study, clinical experience, previous patient experiences, and clinical judgement, but I guess if that's what you want maybe that's your preference. It is, though, the moral obligation of physicians as guardians of patient well-being in society to speak up when they find something dangerous being suggested to overhaul society's medical care system

I haven't read the entirety of the thread, so take my post with a grain of salt. While I agree with aspects of the OP's argument, I do question the fact that a specialist who does not work with midlevel providers is the vociferous advocate against expansion of midlevel provider freedom of practice. I'm not entirely sure that MD supervision of midlevel providers is as extensive in most cases as claimed, and I also think that the ability of midlevel providers to refer more complex cases to a higher level of care is discounted.

It is a fact. Thanks for the compliment. Primary care is the center of healthcare and should be advocated for. If the specialist doesn't look out for patients and their primary Doctor, then the specialist will inherit much more complicated more difficult patients and also it's just the appropriate thing to do when you feel something is unsettling to speak up before it's too late

Sorry, I'm not buying this is all about pt advocacy. I work side by side with you guys and this feigned concern doesn't seem genuine. So many docs don't even assess pts anymore when they round much less take the time to advocate for them. I think this outrage is more likely about power, respect and money.

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But all of us eventually get replaced by automation or a more efficient less expensive alternative....and MDs are not immune. Find a way to make yourself irreplaceable.

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jennBN back at it again with the hard truths!

I call BS on so much of this thread. I too am an RN and see things on a daily basis. Point in case, and not associated with my job: I went to see THREE MD's about an issue I was having with an elevated creatinine level. None could find out the problem. Next time I went the doc wasn't in and they hurried me over to the NP. Guess who figured it out, after asking me three questions, of which the highly educated MD's didn't ask. I see things like this quite often and I do agree that the MD's have much more classroom ed than the NP's but most NP's have years of practical experience as RN's before they move up to become NP's. You hang around an auto shop long enough, you know how to change a spark plug.

What I see in this whole issue is territorial. The MD's have had the AMA on their side who have a frigging monopoly on healthcare and they don't want to give up anything, and I get that, especially with the time and expense spent for their credentials. But there just aren't enough MD's to go around, so let the NP's do the fill in work. Just like a previous poster said, it makes more sense to have an NP write a script for $30 for strep throat than an MD write one for $100 when he/she could be seeing patients with much more complicated issues.

Just my two cents. Have a great day.....

I'm not talking costs, more about availability. It's super hard to get any American physician to go work in a rural area, which is why they end up with foreigners and NPs. Heck, when o go to my physician I typically wait 30-45 minutes past my appointment, and he is working non-stop the whole time. This is an effort to resolve that issue.

I agree with you on the issue of autonomy for APRNs...but I also don't think physicians should practice with autonomy. Peer review should be required for all areas of practice and there should be oversight with frequent audits of care. There is a mindset that many of us fall into where we think we know best and the pt knows less. With autonomy all care suffers. If you know another brilliant Doctor is randomly checking your work you would perform at a higher standard.

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And the nephron is quite more complicated than a spark plug I'm sorry

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Apparently not complicated enough for the dumb undereducated NP to figure out.