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Started By
Message
re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187
Posted on 5/19/16 at 7:36 pm to PygmalionEffect
Posted on 5/19/16 at 7:36 pm to PygmalionEffect
quote:
but generally, we need to try to break the monopoly that doctors and hospitals have on medical care. There is too much anti-competition and restrictions to care. We have the internet now, we can do more to treat ourselves.
You think medical care is a monopoly run by physicians and hospitals? If that were true they would set the prices. Yeah they can "charge" whatever they want for sure then the insurance can say "that's a funny joke bc we only pay X for that service."
You think the Internet is a good source of performing your own medical care? People are so damn clueless about the fact that the first thing that has similar symptoms isn't necessarily what's going on with them.
More options to become a provider without 8 years of school? If you are so against traditional medicine go see a "spirit healer" or some other useless shite.
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Posted on 5/19/16 at 9:15 pm to PygmalionEffect
quote:
but generally, we need to try to break the monopoly that doctors and hospitals have on medical care
Doctors and hospitals don't set prices. Insurance companies and the government do. Also doctors and hospitals wouldn't constitute a monopoly unless they all worked for the same company. With your logic I could say that physical therapists have a monopoly on physical therapy (as they should).
quote:
The medical field does a lot to restrict the flow of people into the field
Those are called admissions standards, and they prevent morons from being physicians. Even so, medical schools could lower standards but that would just mean there would be more medical graduates who can't practice medicine because there wouldn't be more residency positions. Residency positions are funded by whom? The government (more specifically, Medicaid/Medicare).
quote:
which allows them to charge the enormous fees they charge
Doctors can charge whatever they want but they are paid only what the insurance companies decide to pay. Blame the costs of healthcare on insurance companies and administrators/government.
quote:
and all live millionaire lifestyles.
Lol. The richest people in healthcare aren't the doctors; they're the administrators. Most doctors are paying off tons of debt and catching up on income they lost out on while in medical school/residency/fellowship while their friends had already been working normal jobs for 7-12 years.
quote:
From an education standpoint, it's gotten so expensive that only doctors can afford to send their kids to med school.
I graduated from medical school today. No one else in my family is a doctor.
quote:
The medical industry is the only industry that performs services, sometimes without your permission,
Only in an emergency in which you are unable to provide consent and your life is in imminent danger. Otherwise your informed consent is required for any procedure. Your consent for routine labs and other diagnostic tests is implied when you voluntarily check into a hospital.
quote:
They rarely disclose the cost of a procedure or test.
Blame the insurance companies for not disclosing those, not the doctors.
quote:
More drugs need to be designated OTC.
So that people can unsafely take drugs with interactions that they don't understand? That would only serve to increase medical costs.
quote:
More people need to be allowed access to practice medicine without 8 years of college
Should we also allow people to design bridges without degrees in architecture or engineering?
quote:
$150,000 in tuition or whatever it is.
I agree that tuition is obscenely expensive.
Your post displays a massive misunderstanding of just about every aspect about which you spoke, and that is frightening as well as frustrating.
This post was edited on 5/19/16 at 9:22 pm
Posted on 5/19/16 at 9:17 pm to Patron Saint
Can a nurse write me a script that's all I give a shite about because I'm tired of having to pay $350 dollars just to get a antibiotic from a doctor where I have to wait six weeks to get an appointment.
The doctors brought this shite on themselves.
The doctors brought this shite on themselves.
Posted on 5/19/16 at 9:24 pm to ihometiger
It's the doctor's fault that he/she doesn't have available appointments? You would have the exact same problem even if this bill went through once all of the NP's appointments were booked.
ETA: I'm not trying to pretend to know all the ins and outs of everything in the healthcare system. No one could possibly know everything. In my previous post I was just responding point by point to the other poster's claims.
ETA: I'm not trying to pretend to know all the ins and outs of everything in the healthcare system. No one could possibly know everything. In my previous post I was just responding point by point to the other poster's claims.
This post was edited on 5/19/16 at 9:44 pm
Posted on 5/19/16 at 9:34 pm to ihometiger
quote:
Can a nurse write me a script
No. Nurses are not prescribers. Nurse practitioners can write you a script today. They do so under the oversight of a ohayciian which reviews at least 20% of their work and signs off on it.
quote:
I'm tired of having to pay $350 dollars just to get a antibiotic from a doctor where I have to wait six weeks to get an appointment.
A simple, straightforward problem-focused visit with a primary care physician will usually run you $60 cash. And if you're established and non Medicaid (which if you're getting a bill, you aren't), wait times are consistently same day - 48 hours for primary care. Specialists have a back log like you mention, but I don't know why you'd want a nurse to write a script that you'd require a specialist for offhand. What script and what kind of doctor are you waiting 6 weeks and paying $350 for?
quote:
The doctors brought this shite on themselves.
What exactly did we bring upon ourselves? Dissatisfaction with medical care? We're sick of PQRS, Meaningful Use, CPOE, and ICD 9/10 and the amount of bloat in the system leading to increased cost, too.
Most of us just happen to believe the answer isn't letting people who were never intended to deliver patient care unsupervised do so without oversight from the state medical board. I'd actually like to see the LSBME, PT, Optometry, nursing, PA, and dentistry (I'm sure I'm forgetting someone. Forgive me) merge into a common board which made decisions like this. Too many people who do not understand (the legislators) are currently defining/redefining the delivery of care, and it's less efficient than a smaller group of knowledgeable people.
ETA- cost savings from using midlevels is passed onto the insurance company at a rate of 85% that of the physician. Patients will pay the same for the visit and antibiotics which everyone seems to think they need.
99% of what's behind this bill is big chain pharmacies wanting to open minute clinics to drive up their own sales. The NP lobby has spent like $500,000-700,000 mostly given by major players like Walgreens, CVS and the like. As it stands today, they didn't have the votes to pass it. The physician lobby, as of yesterday, had spent a grand total of $5,000 to "hold their ground" on the issue.
Your dissatisfaction is 100% valid. I can't say I agree with your perception of what's going to fix it.
This post was edited on 5/19/16 at 9:52 pm
Posted on 5/19/16 at 10:27 pm to Hopeful Doc
quote:
Hopeful Doc
Where you wanting to practice at eventually? I like your style.
Posted on 5/19/16 at 10:50 pm to SmackoverHawg
I'll almost definitely wind up in (redacted). I'm actually going look at a practice down that way tomorrow.
Private ~60 bed hospital, almost entirely primary care driven. There's a solo practice that's inviting me to potentially step in. FP guys still see newborns and are the NICU team, a few of them still scope, won't be doing any OB.
I don't think I could ever enjoy being employed by a hospital or live in an area where direct access to subspecialists exists.
Private ~60 bed hospital, almost entirely primary care driven. There's a solo practice that's inviting me to potentially step in. FP guys still see newborns and are the NICU team, a few of them still scope, won't be doing any OB.
I don't think I could ever enjoy being employed by a hospital or live in an area where direct access to subspecialists exists.
This post was edited on 5/20/16 at 12:42 am
Posted on 5/19/16 at 10:57 pm to Hopeful Doc
quote:
99% of what's behind this bill is big chain pharmacies wanting to open minute clinics to drive up their own sales. The NP lobby has spent like $500,000-700,000 mostly given by major players like Walgreens, CVS and the like. As it stands today, they didn't have the votes to pass it. The physician lobby, as of yesterday, had spent a grand total of $5,000 to "hold their ground" on the issue
I wish things like this were common knowledge. Sadly it will go unnoticed and the public will go on thinking doctors are the bad guys, even though we get screwed more and more each day. Masterful job by big pharma, insurance, and the companies you listed. They are laughing all the way to the bank. It really is amazing how easy these issues can go unnoticed if you aren't actively researching the facts. I'm sure it happens in every industry.
The real root of the problem is lobbyist and campaign finance. Man would it be nice to put an end to that bullshite
Posted on 5/19/16 at 11:02 pm to Hopeful Doc
quote:
I'll almost definitely wind up in rural South Louisiana. I'm actually going look at a practice down that way tomorrow. Private ~60 bed hospital, almost entirely primary care driven. There's a solo practice that's inviting me to potentially step in. FP guys still see newborns and are the NICU team, a few of them still scope, won't be doing any OB. I don't think I could ever enjoy being employed by a hospital or live in an area where direct access to subspecialists exists.
So, you're gonna be a REAL doctor.
Posted on 5/19/16 at 11:04 pm to greenhead11
The Board of Examiners really dropped the ball on this legislation. I've watched LANP grow in strength over the past 3 years and become organized. Still, LANP is a mess as for as controlling the number and quality of NPs coming out of school. Some of these people are dangerous and don't have the background to be an ICU nurse!!!
If my Rep votes for this bill then he's going to lose reelection.
If my Rep votes for this bill then he's going to lose reelection.
Posted on 5/19/16 at 11:06 pm to SmackoverHawg
Im all for NPs having access to the procedure codes that are being discussed. Just like the Ophalmologists didn't want ODs near their procedure codes, PCPs don't want NPs with theirs unless they get their cut. It's a money game and has very little to do with patient outcomes.
Posted on 5/19/16 at 11:09 pm to SmackoverHawg
quote:
So, you're gonna be a REAL doctor.
that's the plan. Though I'll admit, I feel like a suck at clinic (as a soon to be PGY 2) and sometimes half consider going the hospitalist route. We train pretty heavy on the inpatient side. But then I realize that would make me 80% of what's wrong with medicine.
Posted on 5/19/16 at 11:10 pm to WaWaWeeWa
Just wanted to add to your statement about appearing to address the issue by saying that independent nurse practitioners would not be able to accept Medicare patients. Under the current Medicare system, a nurse practitioner's services will only be accepted for payment if he or she is under a collaborative service agreement.
Also another add that I am noticing people do not have an understanding of is that the independent nurse practitioners WILL be required to work in "medically underserved areas." They will still have to be in a CSA to practice in urban areas.
Combining the above two statements, I don't see how this bill will help medically underserved areas adequately if NP's will not be able to see Medicare patients.
Also another add that I am noticing people do not have an understanding of is that the independent nurse practitioners WILL be required to work in "medically underserved areas." They will still have to be in a CSA to practice in urban areas.
Combining the above two statements, I don't see how this bill will help medically underserved areas adequately if NP's will not be able to see Medicare patients.
Posted on 5/19/16 at 11:11 pm to LSUfan4444
There may be some unintended consequences on the medical malpractice side for these NP's.
Posted on 5/19/16 at 11:12 pm to L S Usetheforce
Ha cool. Sorry I stepped away for awhile and haven't read any of this business discussion going on so take what I said with a grain of salt
Posted on 5/19/16 at 11:12 pm to Hopeful Doc
quote:
But then I realize that would make me 80% of what's wrong with medicine.
And clinic is where the money is at. No matter what they say.
Posted on 5/19/16 at 11:13 pm to LSUfan4444
quote:
Just like the Ophalmologists didn't want ODs near their procedure codes, PCPs don't want NPs with theirs unless they get their cut.
Uhhhh not even close my friend. Optometrists wanted to do surgery with no surgical training. You should see the crap they send us as it is, and you want them to be able to cut on people with no training? They wear long white coats and call themselves eye doctors, most people will be fooled into thinking they had surgical training if they are offering to do a procedure. How many times have you asked your doctor how much training he or she has had in a given area?
Posted on 5/19/16 at 11:14 pm to EmperorPenguin
quote:
EmperorPenguin
1 post
Nicely done
Posted on 5/19/16 at 11:16 pm to EmperorPenguin
quote:
independent nurse practitioners WILL be required to work in "medically underserved areas." They will still have to be in a CSA to practice in urban areas.
Can you point me to the language in the bill that supports this claim?
Posted on 5/19/16 at 11:17 pm to PygmalionEffect
I'm think you have a confused view of physician salaries
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