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re: Defeat the Nurse Practitioner scope of practice expansion - Louisiana SB 187
Posted on 5/20/16 at 4:17 pm to lsujro
Posted on 5/20/16 at 4:17 pm to lsujro
quote:
also, lawyers won't be "chomping at the bit" because the limits aren't any higher for a np than for a md.
And you don't think that will change with mid levels having complete autonomy?
I wish I could live in utopia along with you.
2
Posted on 5/20/16 at 4:18 pm to Hopeful Doc
quote:
Hopeful Doc
just admit you're only interested in protecting your own income
Posted on 5/20/16 at 4:19 pm to Dale Murphy
quote:
And you don't think that will change with mid levels having complete autonomy?
the state is going to increase the maximum recovery for med mal suits? i haven't seen that on the table. so no, i don't think that will change.
Posted on 5/20/16 at 4:20 pm to LATigerdoc
Cannot find the article but I am pretty sure I read somewhere recently that a larger proportion of primary care doctors work in rural underserved areas than the proportion of NPs doing that.
Anybody have data on this?
Anybody have data on this?
Posted on 5/20/16 at 4:21 pm to lsujro
quote:
so no, i don't think that will change.
cool. again, I wish I could have the same optimism. But allowing someone with much less training to suddenly be put in a position with absolutely no oversight is almost guaranteed to cause legal issues. it's just a matter of time. sorry you don't feel the same way.
Posted on 5/20/16 at 4:21 pm to Hopeful Doc
quote:
are there NPs and absolutely no physicians within miles?
Along 10 between Oakdale and Fort Polk.
Posted on 5/20/16 at 4:23 pm to chadg
(no message)
This post was edited on 5/21/16 at 4:45 pm
Posted on 5/20/16 at 4:25 pm to lsujro
quote:
but it's cool if someone who did attend medical school does it, amirite?
the "fallout" will be the same. np's have med mal insurance just like docs. these doomsday scenarios just aren't realistic.
In the event of a malpractice suit, the defendant's actions are compared to the standard of care. For physicians, the standard of care is set by the state medical board (I believe). However, NPs are not governed under the Louisiana State Board of Medical Examiners. They are governed by a separate nursing board, so in a malpractice suit there would be a question as to whether they are held to the standard of care as set by the LSBME or the nursing board. So there could be a huge difference in the level of legal responsibility for the two groups, which is completely unfair.
Posted on 5/20/16 at 4:25 pm to lsujro
At least the medical doctor took the tests
Posted on 5/20/16 at 4:26 pm to lsujro
quote:
just admit you're only interested in protecting your own income
Want me to post the link for the third time where it shows that physicians salaries increase at a faster (albeit insignificant rate) when NPs can see patients without oversight? The trend would be toward me making more money if it passed.
And again, they can't do what I can do. The hospital isn't going to grant them privileges, they won't have learned most of the procedural skills I have, and they definitely won't be able to do colonoscopies, EGDs, place central lines.
I'm not worried a bit for my income. The only NPs that can't find a collaborater now are the ones who are terrible.
Posted on 5/20/16 at 4:28 pm to lsujro
It medicine was all about income, all primary care would shut down regular clinics and just shoot Botox. Believe it or not physicians take a great deal of effort in like to guard their patients from harm. This is not a money deal
Posted on 5/20/16 at 4:29 pm to Dale Murphy
Well legal issues as well as HARM
Posted on 5/20/16 at 4:31 pm to LATigerdoc
quote:
Well legal issues as well as HARM
Yeah, but in the minds of these guys, all we primary care docs do is dish out amoxicillin all day. So unless someone has a penicillin allergy, the NPs should be safe.
Posted on 5/20/16 at 4:32 pm to Hopeful Doc
quote:
The only NPs that can't find a collaborater now are the ones who are terrible.
and what exactly are these NP's going to do? get six figure business loans and open their own practice, despite not having any admitting privileges and not being able to do all the things you said?
how realistic is it that any of these NP's could actually operate without any oversight?
Posted on 5/20/16 at 4:34 pm to Hopeful Doc
quote:
The bare minimum is a cell phone and access to the EHR with recommended chart review.
which, in my opinion is vague and worthless, I feel we should either make the supervision requirements actually mean something or get rid of them all together
From what I hear this bill is going to have trouble passing the house, so if it fails...maybe the med board (since they can not regulate NP's) make some regulations for the physicians that supervise them
Posted on 5/20/16 at 4:35 pm to Dale Murphy
quote:
Yeah, but in the minds of these guys, all we primary care docs do is dish out amoxicillin all day. So unless someone has a penicillin allergy, the NPs should be safe.
i don't think anyone is arguing that. if someone in this thread is, well that's not entirely surprising - the OT is absolutely overflowing with stupid.
the point is a NP can dish out amox and, despite your contention, read a medical chart. i know several np's and it is unimaginable to me that one wouldn't consult with a md in a situation where there was some question as to the nature of the ailment or appropriate course of treatment. the vast majority of what they are doing is exactly what you seem to not want to do
Posted on 5/20/16 at 4:38 pm to Dale Murphy
I don't think y'all get it what we are saying - we have serious legitimate concern that patients will preventably die of missed cancers and diseases due to lack of training and lack of understanding of some diseases without ANY supervision.
It's a set up for bad problems
It's a set up for bad problems
Posted on 5/20/16 at 4:42 pm to LATigerdoc
quote:
I don't think y'all get it what we are saying - we have serious legitimate concern that patients will preventably die of missed cancers and diseases due to lack of training and lack of understanding of some diseases without ANY supervision
Oh I get it completely. I was just being facetious. Just this week, I sent a patient from the clinic to get a CT scan. Ended up with a subarachnoid hemorrhage. Not a big deal in the long run but something that was missed by other medical professionals previously. Granted, a CT scan in his situation was likely something that should have been common sense to most in the medical field, but it just proves that those with less experience and training are prone to make more mistakes, even in the primary care setting.
Posted on 5/20/16 at 4:45 pm to lsujro
quote:
how realistic is it that any of these NP's could actually operate without any oversight?
With the passage of this bill, they most certainty could find an urgent care or pharmacy (the big national pharmacies are donating lots of money to this campaign) to have someone writing scripts in their pharmacy to be filled at the next counter. I posit that they wouldn't function well without any amount of oversight, and this paves the way to allow them to do so.
Flip side- what's the benefit of this bill for them? The LSBME/LAFP lobby countered with making the agreements literally cost $0. Nursing board refused, pressed on.
Posted on 5/20/16 at 4:47 pm to Tigerpaw123
quote:
which, in my opinion is vague and worthless, I feel we should either make the supervision requirements actually mean something or get rid of them all together
I totally agree- the rule needs to be reworded for more stringent oversight. Again, id love to see a "mega board" of all the distinct groups come together and keep these decisions out of the legislators' hands. There's a bit too much to this to trust folks who aren't really involved in the field to make decisions like this.
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