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

you don't have to see an OD for anything medical, but why do you care if I do?

Except of course for your fellow MDs who don't want those office visits going elsewhere?

You can still see an Ophalmologist for every visit you chose.

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Womski

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You have proven more then once that you are a complete clown, and everytime you post I can't help but think you are just trolling. GTFO

A primary eye doctor is a general ophthalmologist who did not do extra fellowship training after residency. This is not a hard concept.

A primary mental health doctor is a general psychiatrist

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If the majority of systems allowed PCPs to practic genral medicine the way it should be practiced this shite wouldn't be so desired.

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I'm confused by what you mean by this.

My understanding: folks like me (and from what I know of them, Smackoverhawg and Bleeding Purple) are weird. Practicing primary care in rural areas isn't desirable because people like living in cities. Cities don't have primary care shortages with the exception of very poor uninsured, non-Medicaid folks. So if this really were about patient care, it would absolutely tie them into those two demographics. But when we talk about quality of care, they want fewer restrictions. One of the arguments that was made by their side was that collaborative agreements were sometimes unreasonably expensive (namely when the physician was taking a big risk on a so-so to low-quality NO, but that's another story in and of itself). The LAFP lobby actually approached the NP lobby and offered to change policy to where the physician could not charge for the collaborative service agreement at all. The NP lobby refused it flat out. That tells me all I need to know about which group has patient care first on its mind.

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The patient (from a provider side) has taken a back seat to profit.

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As a provider, I'll have to disagree. One reason I refuse to be someone else's employee is that medicine is a crappy business. I don't want a boss who's a non-physician dictating the number of patients I need to see or the services I need to offer, because on the human level, it's inappropriate. When medicine is run as a business, you get what you describe. That's something that a lot of folks are turning to, but in rural areas (where they want to "help,") I'd wager the majority of folks are still self employed, taking care of people, and letting the dollars that roll in be enough rather than concerning them self about the dollars rolling in at the cost of good care.

I know of multiple guys who are working in underserved populations who refuse to comply with Medicare standards costing them ~2% of their Medicare reimbursement. That makes them sound like bad guys, until you realize that what Medicare wants us to do is, after we've done complete documentation of everything, buy an EMR that includes check boxes for the patient's BMI, whether you documented a plan for their BMI, if they're smoking, what their meds are, etc. Again, these things are already documented elsewhere, but they want it documented in a second, specific section. This takes time. Over the volume of patients rolling through in a day, it was costing some guys as many as 2-3 patient encounters. So they quit doing it, because it adds nothing to their patients' care, cost them some of their reimbursement from Medicare, but they're able to see an additional 2-3 patients because of it.
Where I'm at now is a hospital-run clinic.
I think you'd be pleasantly surprised if you saw some rural privately-owned offices and groups in practice and see the amount of money "thrown away" from things that would optimize them from a business standpoint but hurt patient care.

There is no arguing with an MD (or one who aspires to be), the only option is outlasting them. No matter what you say, in the end and in their mind they are above you, they are right and you are wrong.

I will support patient options because MDs are the most self serving group of professionals I have ever dealt with in my entire life. if they won't come out on top, it's wrong.

You left the th out of the word.

More power to you if u wanna have them manage your cavernous sinus fistula. Whatever floats your boat

Right, u didn't build that

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As you know, mid level reimbursement is lower than physician reimbursement.

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The amount of money they receive from the patient is identical.

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Oh wow. Look, like it or not Optometrists ARE primary care eye doctors. Do you think they do nothing but refractions in school? First semester is the left eye? Second semester is the right eye?

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I'll tell you what I KNOW they don't do

Take call
See emergency patients
See hospital inpatients
Learn basic surgical technique
See complex cases (because they are all referred to an Ophthalmologist)
Interact with other physician specialties

But I guess none of that is important

Potentially his life