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

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You should tell all of your patients about GoodRx. Are you familiar with it?

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We hand out cards in the office, and I literally teach patients with smart phones how to use it.

It's a fantastic piece of software. I used it for myself for the first time on Friday. Worked pretty much just as expected.

We get nothing from it. I think it's basically a slickdeals for rx drugs thing. Maybe pharmacies pay something to be listed or manufacturers pay as some sort of advertising platform. I have no idea who runs it or how it's profitable, but I go over it with patients on a frequent basis.

Go back and watch the testimony again. The NPs have been vigorously preventing the improvements that doctors have tried to make to the CPA, which would make it more than a "piece of paper". Many CPAs are also established with little or no fee, depending on the cost to the physician (malpractice rates, time away from office, etc.) CPAs specifically outline under what circumstances a mid-level provider (NP or PA) must contact the collaborating physician.
They want to establish a completely separate practice of medicine under the nursing board with no physician involvement. The "wagons are being circled" because corporate money wants to remove physicians from healthcare, or at least make them less influential. That is a Bad Thing.

Certain complaints go to MDs and some complaints go to NPs.

If someone has allergy issues, or thinks he had a cold or the flu... Then you have to be able to triage these cases.

Is this just so different than how doctors get trained that they see no reason to change? Kind of goes to the protectionism point raised earlier.

Didn't this same type of law just get passed so that physical therapist can see patients without them first going to MDs?

There are obviously alot of people in here who think doctors are greedy, protectionist, etc.

But I will slowly break the issue down for you again

No one in the thread is saying that NPs shouldn't be able to do what MDs can do. We are simply saying make them go through the same amount of clinical training before sending them off on their own. And we say this because we know how valuable the training was to us and you don't realize what you can miss or mismanage until you see the right way to do things through proper training. Most NPs you have had experience with are good, but guess what, they have had alot of on the job training with a MD overseeing them. That's great. What we are worried about is the fresh out of NP school big shot who was an inpatient nurse for a few years going to open up their own shop.

Just get the proper training is all we are saying.

Does that make sense?

Can you put aside your preconceived notions about doctors for one second and see that this is the argument.

Why don't they include the requirement for more training for NPs in this bill? How would that effect the outcome in anyway? It wouldn't, but they just want to get what they want through legislation not qualification.

When a patient comes to you, there has to be a way you can grade the risk their symptoms and the NPs get the low risk patients.

If you keep raising the standards to be a NP then you are going to have a shortage of NPs. It basically inches them closer to just being a MD under a different title and pay scale.

Do you fight like hell because of your own profit motive? Or do you fight because you know there are half-trained people out there causing harm, and causing more mess for you to clean up?

CPAs are protectionist for both reasons. They want to limit the number of people with the certification and they want to limit the number of dumbasses providing trusted advice.

Adding a tenure requirement seems reasonable. They could report to MDs for 5-7 years before having more autonomy.