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

Off topic I do think docs need to step up. Ive worked in the laboratory for years and I can tell you the Medical Directors of our lab ( of any lab) should take note of the np power grab. It could happen in the lab. The Pathologist to me is indespensible but the current crop of them seem to not want anything to do with what is going on in their own lab...until something goes wrong. They are paid generously to sign off on our regulatory due diligence. And seem bothered to do so.

In the past 5 pages of this thread, I've seen you type:
I'm
Not
In
Primary
Care

A minimum of 5 times. It's not cute. It's not funny. And I think we've all received the memo at this point. Stop acting like a douche, express an informed opinion, and maybe people will take you a bit more seriously.

To be fair, people keep calling him out for "looking out for his pocketbook" despite repeatedly saying that

Either they don't understand or they just aren't paying attention

I was answering your questions about whether there were financial implications tied to the bill

Have a down vote. Leave nurse practitioners alone you jealous arse.

quote:

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Against my wife's better advice (to see a dermatologist) I went to the np at work for a some red bumps on my scalp. Like most np's she prescribed oral and topical steroid. I shoulda effin known better. She only glanced at my bald head and said it was a contact dermatitis. Well, it wasnt. I took the meds as prescribed and symptoms cleared. When I got off the regimen ooh lawd. shite came back with a vengeance. My whole scalp was like a giant pustule. That's when I went to the derm. He took a skin scraping, went to the scope, came back with a camera to document the utter fricking stupidity of a np handling a derm case. It was a demodex reaction and I had a herd of em. Never will I see a np.

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It's hard to criticize this one just at face value. I can't say any primary care doc wouldn't have done the same thing initially. But, there would be far less of a chance of it and I doubt the NP you saw was promoting herself as a Dermatologist. I do a lot of derm and have had a lot of derm training, but I'd never dare promote myself as a derm clinic. That is my concern with all this. The NP's are not held to the same standard of "false advertising". And I know they are currently do it under the umbrella of a supervising physician. But what's gonna stop them from opening cardiac clinic, endo clinics, derm clinics? It's been done already in LA rampantly. And I'll guarantee there is very little oversight. Or at least I hope that's the case due to the gross mismanagement of pts and inadequacy of care. However, the pt's see these people as "specialist". These are people that have far less training and expertise in there area than any doc I know. And I cannot speak for all, just the ones I've had the misfortune to have to fix their shite bombs. This is 100% as much the fault of the overseeing physician as it is the NP, and that is the problem with the system. MORE oversight and instruction is needed, not less.

One of my current NP's would've qualified under LA law had this passed. She had at least 3000 hours "supervised". After a few weeks working with me, she admitted that she had no clue how much she didn't know and would never consider practicing without adequate physician oversight. And she's good or I wouldn't have sought her out to hire. But there are limits to their knowledge and it's my job to supplement and add to that knowledge. Now in a few years, she may feel different after appropriate oversight and instruction. I tell mine that their first 3 years will essentially be a residency. But not all NP's get this level of instruction during their first few years. In my opinion, there should be testing and certification under the medical boards of the states to allow an NP to practice medicine unsupervised prior to them being allowed to. There is NO uniformity in their training or supervision. At the least, they should have to undergo some sort of certification process dictated by the state's medical board.

Yeah, but for a lot of things, a doctor isnt necessary. Your average ear infection at the doc in the box, an infected cut, etc. Nurse practitioner would be fine for that.

He should have gone to a derm np

That's so scary.. Autonomous Derm np is very frightening. Some serious stuff could get out of control with that