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

Yeah, the guy just can't stop spouting off about general practitioners when it's wholly irrelevant to the topic at hand, it's like he's having a conversation with himself that we're interrupting. Seems like a pretty typical anti social behavior I see in a lot of docs.

Anti social disorder is when you like damage society

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Anti social disorder is when you like damage society

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Astute thoughts doc

Sure, I like that plan even better.

I'm saying the way u used it is medically inaccurate. Google antisocial disorder. It's in all the med school psychiatry classes and on the board exams in questions

Is this melt all about a desire for recognition?

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gp is something a person says about their PCP when they don't understand how much training he/she endured

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I feel like I'm getting trolled.

Mid level trolled or autonomously trolled?

FWIW, I've always appreciated your perspective on medicine and physician practice.

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took my x-ray, looked at it, showed me the crack, and then also made a cast for me. He had instructions for care that mirrored the industry standard in the US. The whole ordeal cost $150, no insurance, no bullshite

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There are plenty of cash-only practices in the US. One guy I work with said his buddy is running an office somewhere in SELA that is strictly $25/visit, but I believe he just writes orders for labs/X-rays which the patients are responsible for on their own. He's even doing minor procedures for that price.

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Every time I go I show up on time, if not 5 or 10 minutes early yet I have to wait in the examination room for 15-30 minutes. The doctor NEVER says "sorry I was late with another patient" and the doctor is NEVER on time.

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There's no excuse for not acknowledging that you're behind when someone is upset about it. But here's the thing about being a doctor- your time is absolutely valuable. When I'm with you, it's even more valuable than the next person I'm going to see. Because these 5, 10, 15 minutes face to face are the only time I can look at you and talk with you face to face for often months at a time. Sometimes this causes the day to get backed up. Sometimes the guy/gal right before you hit me up with an "Oh, by the way..." As I was walking out the door.
See, the doctor-patient interview for a simple problem is, by design, supposed to last about 15 minutes. That includes documentation. And I know doctors who document after hours so they can spend more time with their patients. But the encounter is designed like this- Subjective- (what's wrong, since when, how bad, what makes that better/worse? First time feeling like this? What worked last time? Who else have you seen about this?), objective (physical exam) then processing the last 5m to say "alright, here's what we're going to do..."
To do a good job, when a problem is brought up as I'm leaving the room, I still need to go through all that again.
That said, there's an alternative to the doctors who value you're time when they're in the room with you- there's the doctors that let you talk about one thing per visit. You're on a timer. If you go beyond time, you'll have to come back. If you have two problems to talk about, you'll have to schedule another appointment.
Neither one is right or wrong objectively. But you need to choose which you want, because unfortunately we are limited to those two options. Run on time all the time vs give patients the time they need and be within a reasonable time of scheduled appointments.

That said, if you express your frustration with having to wait to be seen, there is zero excuse for not receiving an apology and/or explanation.

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Also, doctors make mistakes yet rarely admit to it. I've caught a mistake a doctor made with my mom that I was able to figure out simply by googling it. It would have harmed her greatly had the procedure been needlessly performed. He never apologized although the other doctor was "troubled" by the recommendation.

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Too generic to say whether he was wrong or right in his thinking. Patient presentations are highly variable and can change quickly. If he thought something one night and someone thought something different the next morning, while its possible that he was flat-out wrong, it's more likely that there was an atypical presentation that was different the next time someone laid eyes on it.
Heck, you wouldn't believe the number of times a patient answers the exact same question differently when asked by two different people- to the tune of it totally changing their work up, diagnosis and plan.
Again, not saying the guy wasn't wrong. We're all human and we all make mistakes. We should readily admit to them if and when they're made.

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They claim that you need an MD to ensure that nothing will go wrong or be missed and yet when they make a mistake they claim that law suits need to be restricted.

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It's not that MDs won't miss anything. It's that they're exposed to exponentially more than midlevels, thus making the distinction. People really just don't appreciate the difference between the two styles of training. Neither is better than the other. it's different roles.

Now, mistakes and malpractice are very different things. Mistakes can and will happen in medicine. And carpentry. And engineering. And law. They do happen. What's not OK is the sue-happy culture we live in where people think they were wronged so tie up a physician's time and money in a lawsuit that isn't malpractice. The fear of the culture we live in leads to more "bad medicine" that I described earlier, where things that aren't necessary get ordered for patient satisfaction and for fear of being sued, losing time, money, and reputation over something that's not actually even bordering on malpractice. some of us think it's a little silly that if we stood in a room when a child was born and signed our name in the chart that we can be sued 17 years later for literally anything the mother thinks happened 17 years before.