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

I'm an optometrist, fella. My wife is a family practice NP and has been with the same group 10 yrs. She finds this whole thing comical. When I asked her how often her docs review her charts or how often her docs spend 30 min in a room, she laughed. She has absolutely no desire to open her own practice. She enjoys having the ability to collaborate with her docs, if need be. She does a lot more than just treat sinusitis.

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I'm an optometrist, fella.

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Thought so. Another one that wants to expand their scope of practice not through education and training but through legislation under the veil of access to care. I'm all for this stuff if it can fix some of our healthcare problems, but none of these bills ever specify that the providers will need to meet the same minimum standards that doctors need to meet to care for patients as well. You need more training, that's the only thing I'm saying. Period.

First off, ODs scope was already expanded last year, so that ship has already sailed. Same arguments were used against ODs when they wanted to treat conjunctivitis years ago. You also are allowed to practice b/c legislation deemed you qualified, through your training.

It is if you are just diagnosing a head cold, sinus infection or the flu. No need to have to sit through an appointment that a doctor is late for just to get that taken care of.

I hope this passes.

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One of the primary reasons a doctor has an NP is because he can't take care of every patient. Cheaper to hire NP's than to bring another doctor into the clinic.

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I don't think any of us are really anti-NP. The argument is over required supervision. Is it provided as it should be in many situations? No. Is lessening the standard the way to fix it? Of course not.

Here's what I see happening. The vast majority of NP's will continue business as usual. The don't want the hassle or liability of being in command. The ones that will take advantage of it will be the ones least needing to. I've seen it here even under the current restrictions, which I guess really are a farce. There's one NP that has been through about 35 physicians. After reviewing her charts and practice habits, no one except the shadiest neediest docs will sign off on her. Adipex for elderly women, pain pills for any and all complaints...the candy store stays open. Of course, she is seeing pt's that no one else wants and there are some doc's out there that will do the same. So, I guess she has increased access to care. I just think it's a slippery slope. Almost every pill mill I've ever seen or heard of in Texas were NP's with some old arse doctor signing off. The can't draw in legit business because most pt's with good insurance or enough money want to see the doctor. I think by allowing more autonomy and flooding the market with mid-levels, we are just asking for problems. Just my opinion.

I never said she can run circles around her collaborating physicians. I said, after 10 yrs of being in a group with 4 other family practice docs, they don't review her charts and none of them spend 30 minutes in a room with a patient. I also said that she is perfectly happy with the way things are regarding the way she practices. She has stated that making her docs see 5-7 more patients a day, to make the same amt of income, does not improve the standard of care. She sees a max of 20 patients a day. The 4 others in her group see anywhere from 30-40/day.

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FNP checking in... I am not a doctor and I don't deserve to be called a doctor even with a Doctorate degree in nursing. I do not believe that NPs were created to practice with complete independence. I do believe that online schooling for this degree should be phased out. My program was 75% classroom/skills lab and 15% online. It was a 2.5 year program. I graduated from LSU HSC. This is not the "norm" for NP programs, but should be. We also had to complete more clinical hours when compared to other programs, which is why I went to LSU. I also feel that more clinical hours would be beneficial. Unfortunately, there are idiots in every field of work that somehow managed to make it through schooling, but should not be in practice and these are the people who frighten me the most if this bill passes. NPs like myself, will never want complete autonomy. If we did, we would have went to medical school to begin with. With that said, I do believe that NPs should be able to practice to the full extend of their Scope of Practice as defined by the LSBN.

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Would like to re-post this reply from an NP earlier.

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you mean about 1100 clinical hours, so a little less than half a medical students first clinical year (year 3). And with online classes comes online tests that can be done with an open book. Doesn't sound very challenging.

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While my mother is probably the exception the rule, I can assure you, she has more hours logged in her particular area than any med student would in all combined years of med school due to her experience prior to being in NP school.