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

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that include pharmacists?

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Yes. Dammit I knew I was forgetting important people. Sorry.

Part of the problem we have conveying our message about the necessity of a thorough medical education is that people in government do not understand the subtleties and intangible differences btw a mid level and an MD.

Similar to examples posted above, I have first hand witnessed PAs hesitation and mismanagement of Acute A fib. Sometimes when these pts are hypotensive, rate/rhythm control is all that is needed to increase pressure. Yet, reflexively, some PAs assume that's a pressure of 90/60 is to low to start a CCB, and start pounding them with IVF, when in fact getting the heart to beat in a coordinated manner restores normal pressure.

This knowledge gap is flat out dangerous. And is something that is not appreciated by the lay public unless you have served in a roll as an MD working with PAs/NPs etc.

On a completely different note, I think it's flat out ricoulous that anyone but doctors wear long white coats in a patient care setting. I see house keeping staff these days in white lab coats. This only creates confusion for patients who don't know better.

When you run out of nice things to say, I guess the next thing to try is impugne someone's character. I love how y'all spend this thread not explaining why someone should not assume a role they are traditionally not trained for but instead just trash the thread author. Stick to the argument. I haven't said anything off limits the whole time

I support you and your efforts in this thread.

On the Internet, when people passionately protect what is rightly theirs, the onlookers tend to veiw this person negatively, and commence to name calling.

Props to you too, Smackover. You are on my short list of who Id have a beer with.

And then this too. How can you be upset with the content of this thread from my posts? Even if you're an NP reading this, nobody is trying to keep you from doing whatever you thought you would do when you made the decision about what school to go to. I love theses debates where it's as if the traditional side is some how oppressive and unfair. You signed up for school to do what is currently legally permissible for you to do in Louisiana. There was no fine print that said hey come be an NP and then we'll move the law and the line in the sand on scope of practice and eventually you'll be a primary care doctor a few years after you graduate NP school. The person who advocates changing the law is the one on whom it is incumbent to prove his point of view and defend that. Defending the status quo or arguing against complete independence of an NP (which has never existed legally in the state of Louisiana) is not being a douche, it is defending standards for the purpose of safety. Prove your point and explain how they are qualified without the schooling if you want to win us over. Just calling names is what you do when you've run out of intelligent things to add

And then where does it stop? Are we gonna have NPs scoping people, banding esophageal varices? Are they gonna do ECT on psych pts? Are the NPs gonna administer chemo, are they gonna become outpatient imagers and read scans? Are they gonna do in vitro fertilization? Where does this all end?

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Even if you're an NP reading this, nobody is trying to keep you from doing whatever you thought you would do when you made the decision about what school to go to.

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This. And it's not an anti-NP thread. Although it has devolved to that at times. They play a role in patient care. But that role should involve physician oversight just as it always has and always was intended to. The ones pushing this the most are people that stand to benefit financially. So how are we the assholes?

And I have ZERO fear of losing income. I have no fear of my NP's leaving. And ultimately, I don't give a shite if this law passes or not. I'm in Arkansas. But even the NP's that have posted in this thread have agreed that physician oversight is needed. Is it always to the degree it should be? No. If anything needs to be addressed it is this. Mid-levels need MORE oversight, not less. This can lead to cheaper and more efficient healthcare.

And what many of you dumbasses don't realize is that prices WILL NOT COME DOWN. You think the big hospital groups pushing this in hopes of replacing docs with cheaper providers to feed their specialist are gonna turn around and lobby for lower pay for NP's? Hell no. People really do not understand how the system works. We don't set prices, insurance does. It even affects our cash prices because the overhead costs of filing/dealing with insurance and all the paperwork raises our breakeven costs. You think NP's are gonna lobby for lower insurance reimbursement? I don't think so.

The idea of some of the dumbshit girls from my high school who became nurses giving primary care is utterly terrifying.

Specialists are gonna hate this shite when NP's are flooding them with bullshite problems that haven't been worked up properly.

And I'm not defending shitty doctors either. But the existence of inept, half-arse doctors does not make this legislation a good idea. A better idea would be to improve primary care training and financial incentives for GOOD primary care doctors.