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re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187
Posted on 4/9/16 at 8:13 pm to jennBN
Posted on 4/9/16 at 8:13 pm to jennBN
I'm using my first post give you an e-fist bump.
If this fool of an OP actually gave a shite about patient care/coverage then where are his posts re: the almost 20% of residents who don't have the coverage to see anyone regardless of degree. Not to mention he is apparently steeped in evidence-based practice yet has presented no evidence at all to support his claim that APRN autonomous practice results in worse health outcomes and/or higher insurance rates (and we all know that's not because he didn't look). Almost half the states in this country (21) allow autonomous APRN practice, and all the evidence shows exactly the opposite of what the OP wishes it would show.
Fact of the matter is that the vast majority of docs are going into specialized care - and that's fine - but the vast majority of any of our issues are of the general sort. Yall ain't doing that anymore so let someone else do it. You can't have it both ways.
And finally - this bill is a free market one. You can still go see an MD if that's what you want.
Oh and PS: you're not the only one who knows what they're talking about re: this particular issue area anymore so I fricking dare you to repeat the lie that MDs currently supervise APRNs. They're required to "review" 10% of the APRN charts and that's it. So as far as Im concerned you're done pretending that the current structure is anything other than a government mandated kickback program for doctors.
frick off.
If this fool of an OP actually gave a shite about patient care/coverage then where are his posts re: the almost 20% of residents who don't have the coverage to see anyone regardless of degree. Not to mention he is apparently steeped in evidence-based practice yet has presented no evidence at all to support his claim that APRN autonomous practice results in worse health outcomes and/or higher insurance rates (and we all know that's not because he didn't look). Almost half the states in this country (21) allow autonomous APRN practice, and all the evidence shows exactly the opposite of what the OP wishes it would show.
Fact of the matter is that the vast majority of docs are going into specialized care - and that's fine - but the vast majority of any of our issues are of the general sort. Yall ain't doing that anymore so let someone else do it. You can't have it both ways.
And finally - this bill is a free market one. You can still go see an MD if that's what you want.
Oh and PS: you're not the only one who knows what they're talking about re: this particular issue area anymore so I fricking dare you to repeat the lie that MDs currently supervise APRNs. They're required to "review" 10% of the APRN charts and that's it. So as far as Im concerned you're done pretending that the current structure is anything other than a government mandated kickback program for doctors.
frick off.
This post was edited on 4/9/16 at 8:17 pm
2
Posted on 4/9/16 at 8:18 pm to CoolKat
NP's are grossly undereducated and grossly incapable of developing a differential diagnosis, Developing a treatment plan, or explaining why any of it matters or the pathophysiology or the pharmacology or the potential complications of disease, etc. Because they lack the basic knowledge base. If the general public makes the choice of an NP, I feel sorry for them - they are completely ignorant. And ignorance is bliss...Furthermore, this is not a legislative issue. It should be handled by the LSBME and LA Board of Nursing, but the nurses can't handle the idea that they need the oversight. No way the Legislators should even be involved in the discussion
Posted on 4/9/16 at 8:19 pm to Cold Drink
Cold drink with the mic drop
Posted on 4/9/16 at 8:20 pm to uway
Sounds like an angry murse.
Posted on 4/9/16 at 8:25 pm to Parallax
quote:
Sounds like an angry murse.
...who seems to think that it's very very bad when doctors try to maintain the amount of physician oversight that they have because, well, they get paid for it.
But at the same time seems to think that it's honest, pure, and noble for someone who trained to practice with oversight to circumvent the state board of medicine and go directly to the legislature to try to have that oversight removed in attempt to make more money. It could easily be said that this is just a move by NP's to attempt to make more money.
Posted on 4/9/16 at 8:30 pm to Yellerhammer5
quote:
When I was in medical school, we occasionally had NP students in the same ED. Several of them were weeks from graduation and still couldn't even write a passable H and P or come up with a plan besides giving fluids. At least med students with that level of incompetence are going to get fixed during residency. Those NP's were probably just unleashed on the world.
I think this post is the real mic drop and sums up what the physicians have been saying in this thread.
Posted on 4/9/16 at 8:30 pm to Parallax
Just out of curiosity why is the go to to be insulting to nurses I'm not being insulting to physicians I'm just simply stating that their motivation is not patient care. I've read nurses called stupid undereducated negligent and now a murse? Is this what our nations highest educated population has to offer ? Shame on you, shame on all of you.
Posted on 4/9/16 at 8:32 pm to jennBN
You just finished saying physicians don't actually care about patients but now you're playing that card? 
Posted on 4/9/16 at 8:37 pm to LATigerdoc
Thank god state politicians are here to overhaul the practice of medicine.
Louisiana patients deserve what they get for not moving out of that third world craphole.
quote:
Louisiana patients deserve to have the primary care of a Medical Doctor.
Louisiana patients deserve what they get for not moving out of that third world craphole.
Posted on 4/9/16 at 8:38 pm to Parallax
Ask an NP to give you the top 3 bacterial causes of acute otitis media, the antibiotics used to treat the condition, why the middle ear effusion should be followed until resolved. Wait for the answer. There will be silence. I know. I've asked those questions trying to teach the students. This is simple stuff. Only touching the surface people. NP'S have no business being independent. This is entirely a patient safety issue - and I know some pretty competent NP'S who are still grossly incapable of answering these questions. They over refer, undertreat, over treat, the list goes on.
Posted on 4/9/16 at 8:39 pm to Hopeful Doc
quote:
It could easily be said that this is just a move by NP's to attempt to make more money.
Maybe, but really I'd assume insurance companies were behind this. Perhaps to save money by cutting out the doctor altogether.
Posted on 4/9/16 at 8:55 pm to jennBN
quote:
I guess my question would be "where is the outrage" about pt care, lack of adequate staffing, ratios, unavailable supplies or resources...I rarely see a doc go to bat for acute care issues but worrying about the NP scope of practice gets you up in arms? Can you really say that part of this opposition is not because you feel jilted? If there was such a plethora of problems with NPs in practice the media would be all over it....hell Michael Moore would have done a documentary or two.
How many times you given free medical care? How often you go to work for nothing? We do it all the time. We don't get paid shite for call. It's a mandate. I'll bet your arse does. How many times have you bought a patients medicines? I'll bet mf'ing zero to all. And there is a problem with independent NP's and I don't give two shits if they can practice solo or not. They're not gonna cut into my business. I just want their asses held to the same standards. They damn well better provide 24/7 call and have an admitting hospital in order to be someone's PCP. They damn well better be obligated by law to that pt for at least 30 days after the receipt of a letter of dismissal. And they damn well ought to have to retake their boards periodically like we do. You people haven't a clue what all goes into what we do or have to put up with. Give these dumbasses the ball and stand back. We're just warning you.
For the most part, it won't be an issue. Most NP's know that they don't know shite and love to have us backing them up. The average America thinks on the level of a 10 yo.
They need protection. But politicians love to give healthcare in name only. Cut the bullshite we have to deal with and you'll see an abundance of good, caring, well trained PCP's. You think giving out some shitty, half arse degree with inadequate training to people that would never sniff the bottom of their med school class is an answer? Then you're asking the wrong damn question. Pass that mf'er.
And I hope and pray all the doctor haters seek 100% of their care from NP's. Don't be hypocrites either. When that shite gets bad and someone's is dying, by all means cry out for the "NP in the house". Posted on 4/9/16 at 8:56 pm to biglego
quote:
Maybe, but really I'd assume insurance companies were behind this. Perhaps to save money by cutting out the doctor altogether.
Insurances and big hospital groups. But NP's "care" so much more. They can heal you with rainbows and unicorn shite. Or REFER YOU TO A DOCTOR!!!
Posted on 4/9/16 at 8:56 pm to jennBN
quote:
just simply stating that their motivation is not patient care.
...which is insulting
Posted on 4/9/16 at 8:57 pm to Hopeful Doc
quote:
...which is insulting
Yes. This dumbshit has not got a clue. I want her arse to come follow me for a bit and then give an opinion.
Posted on 4/9/16 at 8:59 pm to Cold Drink
quote:
you're not the only one who knows what they're talking about re: this particular issue area anymore so I fricking dare you to repeat the lie that MDs currently supervise APRNs. They're required to "review" 10% of the APRN charts and that's it. So as far as Im concerned you're done pretending that the current structure is anything other than a government mandated kickback program for doctors. frick off.
I review 100% of my NP's notes and am readily available for all questions and issues. So you frick off.
Sonic in Hot Springs. Now. Better check my knuckles baw.
Posted on 4/9/16 at 9:05 pm to Hopeful Doc
quote:
. It could easily be said that this is just a move by NP's to attempt to make more money.
Who cares? Is that supposed to bother non NPs? That's meaningless to me. I don't get more money either way, so which way increases access to medical care? That's the criteria.
Posted on 4/9/16 at 9:09 pm to uway
quote:
so which way increases access to medical care?
The proposed bill doesn't increase access at all. NPs can already see patients in LA under a licensed physician who reviews, as stated above, a minimum of 10% of the chart (the vast majority do significantly more than that).
Posted on 4/9/16 at 9:12 pm to uway
quote:
Who cares? Is that supposed to bother non NPs? That's meaningless to me. I don't get more money either way, so which way increases access to medical care? That's the criteria.
So how does it increase your access to care?
Posted on 4/9/16 at 9:14 pm to SmackoverHawg
Is the 10% review requirement not a restriction on NPs providing care? Is that your contention?
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