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

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I get carried away and I admit that I can be a pompous, self important, egotistical dickhead at times. I would probably help my arguments on here at ton if I stayed more rational and even keeled but that's not my personality.

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dude, you may be changing my perception of you... i'd love to be your e-bro here, i really would, but you can understand my skepticism...

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Bro hug

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i respect your intellect, you just have to, like you said, remain even keel, because your responses sound much more informed and educated...

You clearly have a little man complex; I wish you the best in overcoming that.

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Smack, we good? i'm hopeful for our e-friendship going forward... don't frick it up for me, bro

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We're good.

F off.

Wife is a NP and runs circles around many of the idiot doctors just writing pain scripts. Doctors allow themselves 2-3 minutes top to evaluate a patient whereas NP's actually spend more time and look for a more natural solution rather than just scripts. You fricking moron.

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Doctors allow themselves 2-3 minutes top to evaluate a patient whereas NP's actually spend more time and look for a more natural solution rather than just scripts.

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This rhetoric is such BS.

I surely see pros and cons here. I wouldn't want a NP for a serious or complex issue. However MDs now feel competition- something they have been buffered from. Healthcare per capita in the US costs significantly more than other major countries. Segmenting the patient population may be better for MD's. If you are in a risk model you may be able to take better care of your patients in the long run if acute issues (i.e. Colds and minor ailments) were effectively outsourced to lower levels of care.

FWIW I am a healthcare consultant and there are plenty of sides to this argument.

And one more thing

You realize that the MD is taking care of every patient that comes in. He doesn't get to triage the tough patients to someone else. So he is trying to allocate his time and spend more time with the difficult patients. So when he pops in and checks a few things for your sinus infection and then is gone, he might be spending 20-30 minutes with something very complex next.

You wife may think she is crushing it all day and is just the model of a perfect physician when she is being triaged all of the URIs and gets to spend 15 minutes holding their hand

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I surely see pros and cons here. I wouldn't want a NP for a serious or complex issue. However MDs now feel competition- something they have been buffered from. Healthcare per capita in the US costs significantly more than other major countries. Segmenting the patient population may be better for MD's. If you are in a risk model you may be able to take better care of your patients in the long run if acute issues (i.e. Colds and minor ailments) were effectively outsourced to lower levels of care.

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I agree with the competition part. We have to separate us from mid-levels. Many doc's are not delivering the care they are trained for. Competition is never bad. The only thing I ask is that all things be equal. There should be some licensing exam administered by the board of medicine if you are going to practice medicine. The strawman here is pitting the elite mid-levels with years of supervised experience against the laziest, worst doctors. Does this legislation prevent shitty mid-levels from practicing solo? And healthcare cost? Seriously? Adding more primary care will only push providers to generate more visits. How will it decrease costs? I've never seen a clinic add midlevels and the costs to patients go down. I see more visits generated on the same pt's to a large degree. Want to cut healthcare cost? Cut administrative costs and other overhead for doctors, then we can talk. Cut drug costs. Cut hospital expense, imaging, and other ridiculously priced services. The problem in healthcare is that the people making the big money are not doctors and other healthcare providers. It's hospital execs and admins, insurance execs, pharmaceutical execs, medical supply company owners....basically the people providing all the peripheral things we need to provide care. Meanwhile, the ones actually providing the care get stuck with ever increasing overhead and ever decreasing reimbursement.

Make no mistake. I'm doing fine and have no complaints about my income. I'm just stating that you are WAAAAAAAAAAAy off base if you think increasing the number of midlevels and giving them autonomy will decrease cost and increase access to care. If it was going to, why hasn't it already? It seems to me that it has done nothing but drive up cost, send more doctors into specialties and decreased access to care.

You can become a Nurse Practitioner through ONLINE classes with Southeastern. That's all I need to know.