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re: How do you feel about Nurse Practitioners?
Posted on 3/20/24 at 2:13 pm to tgrbaitn08
Posted on 3/20/24 at 2:13 pm to tgrbaitn08
quote:
the hospital is run by doctors
uh no
quick google search of the BR Generals leadership team page is almost entirely made up of doctors LINK
eta: about 2/3 doctors
This post was edited on 3/20/24 at 2:30 pm
2
Posted on 3/20/24 at 2:36 pm to LSUA 75
quote:
Hate,to break it to you but that is pretty much all Drs.do this day(not specialists)
It’s called protocols.So many Drs work for hospitals or other health care entities and they have to follow protocols.
True, there are protocols for different medical conditions. However, there are conditions with differential diagnoses that a doctor with 7 years of training might be familiar with, but a 2-year trained NP might not pick up on.
For example: kid brought to clinic for sudden onset wheezing, the NP by protocol administered nebulized albuterol. The kid felt better and was sent home. This scenario was repeated for 6 months.
Finally, the parents took their kid to another clinic and saw an MD. On exam, MD noticed slight decrease breath sounds over right lower lung field. When inquired about the kid's history, parents stated that kid was healthy and wheezing started 6 months ago and would have periodic flare-ups and would receive breathing treatments and oral steroids at the previous clinic, but never had a chest x-ray.
Chest x-ray was ordered and found the outline of a tooth cap lodged in the kid's right bronchus. When the result of the x-ray was relied to his parents. They remembered that 6 months ago, the kids had dental work done.
Yes, the NP could have easily ordered the CXR, but was trained to give breathing treatments and oral steroids for wheezing episodes.
The MD noticed:
1. Sudden onset of wheezing that started 6 months ago
2. Kids was healthy with no history of previous airway issues
3. Decreased breath sounds in right lung fields, may indicated a foreign body because the majority of foreign body aspirations would go to the right main bronchus.
It's the finer details that makes the difference between MD's and Np's.
This post was edited on 3/20/24 at 2:38 pm
Posted on 3/20/24 at 2:36 pm to SaintlyTiger88
Primary care and things like follow ups for specialty services is fine. The only time i wouldn’t would be if i were seeing a specialist (cardiologist, dermatologist, etc.) for something that goes beyond the scope of primary care. Those specialist MDs went to school for years extra to focus on that one specialty.
Posted on 3/20/24 at 2:38 pm to SaintlyTiger88
My son got his NP last year but he had 15 years experience as RN in the ER to draw on. Assigned to ICU currently- says it is different but has adjusted to the change.
One difference as I understand it is NP can write Rx but PA can’t, but the training is pretty comprehensive and you decide on a specialty after graduation to concentrate on a particular field
One difference as I understand it is NP can write Rx but PA can’t, but the training is pretty comprehensive and you decide on a specialty after graduation to concentrate on a particular field
Posted on 3/20/24 at 2:43 pm to ArkBengal
quote:
One difference as I understand it is NP can write Rx but PA can’t, but the training is pretty comprehensive and you decide on a specialty after graduation to concentrate on a particular field
I'm fairly certain that everything in that paragraph is wrong
Posted on 3/20/24 at 2:47 pm to SaintlyTiger88
All primary care should be NPs and PAs. MD should just be specialists. This could help with Dr shortage and medical costs.
Posted on 3/20/24 at 2:48 pm to ArkBengal
quote:
One difference as I understand it is NP can write Rx but PA can’t, but the training is pretty comprehensive and you decide on a specialty after graduation to concentrate on a particular field
Both can write scripts, the difference is NP study under the nursing model and PA's under the medical model. There are advantages to both models.
Depending on the state, a NP can be an independent practitioner like a physician, a PA has to have a supervising physician.
Posted on 3/20/24 at 2:51 pm to ArkBengal
quote:
One difference as I understand it is NP can write Rx but PA can’t,
Wrong
Posted on 3/20/24 at 2:58 pm to MRTigerFan
quote:Overly bloated government.
Why am I paying for indigent patients?
quote:Again, the doctor isn't charging you 15k. The hospital, run ny MBAs and Accointants is. Why do they create large bills but accept 10-20%, I don't know.
Why would a doctor charge me $15k for a procedure but only charge BCBS $1500 for the same procedure
Posted on 3/20/24 at 3:00 pm to MRTigerFan
quote:
quick google search of the BR Generals leadership team page is almost entirely made up of doctors LINK eta: about 2/3 doctors
Hospital board of directors still don’t run things financially, corporation bean counters do.
Posted on 3/20/24 at 3:01 pm to SaintlyTiger88
I wouldn’t let it bother me.
Most likely you aren’t gonna get the doctor in so there is no point in getting bothered by it especially if you problem is minor anyway
Most likely you aren’t gonna get the doctor in so there is no point in getting bothered by it especially if you problem is minor anyway
Posted on 3/20/24 at 3:01 pm to SaintlyTiger88
Personally, I think doctors, or the offices themselves use the NP's too much. I believe they have their use. Quick appointments, checkups, etc.. But they are getting put in appointments where there are issues that are far beyond their training. Figuring out ailments, figuring out conditions that require expertise and research that only doctors are qualified and trained for.
For example, my wife has been having gastro issues for the last couple years, and keeps asking to see the Dr on her case, but instead they keep sending her to the NP.
For example, my wife has been having gastro issues for the last couple years, and keeps asking to see the Dr on her case, but instead they keep sending her to the NP.
Posted on 3/20/24 at 3:04 pm to Kracka
quote:
For example, my wife has been having gastro issues for the last couple years, and keeps asking to see the Dr on her case, but instead they keep sending her to the NP.
Any decent office has them rotate in the MD every other visit. Also need
understand the physican is signing off on everything the NP does/prescribs and can change orders at will
Posted on 3/20/24 at 3:08 pm to Jake88
quote:
Why do they create large bills but accept 10-20%, I don't know.
Maybe so they can write off larger amounts of unpaid bills? I have no idea
Posted on 3/20/24 at 3:09 pm to MRTigerFan
quote:
quick google search of the BR Generals leadership team page is almost entirely made up of doctors
The CEO and admin are almost non-physicians though.
Are the medical directors part of the leadership? Yes. Do they make decisions on the finances? No.
Counting them into the same group is like saying professors run the university since the department heads are professors who currently also teach
Posted on 3/20/24 at 3:17 pm to SaintlyTiger88
quote:
How do you personally feel about seeing a nurse practitioner for medical treatment and care vs seeing a medical doctor?
I've only ever had to see one, my physician will see me for my regularly scheduled wellness visits. The one time that I saw an NP was when I needed a same day visit because I had the flu, and I have no problem seeing an NP for something like that. I wouldn't go to a physician that pawned me off on his NPs for regularly scheduled visits though.
Posted on 3/20/24 at 3:18 pm to MRTigerFan
quote:
I always thought the board rooms of hospitals and medical groups were made up of doctors
No. The people sitting in board rooms have MBA's. Pretty much is the main issue with healthcare in general. Every aspect of it is run by non medical personnel.
Why does it take 2 hours to fill a prescription at a big chain pharmacy? Because you have business people determining staffing levels.
Same thing with hospitals and how budget is allocated
Posted on 3/20/24 at 3:18 pm to SaintlyTiger88
I have no problem with NPs; they are very good for generalized core and basic care. My mother was a doctor and my aunt was an NP before they retired. When it came to generalized stuff, both were knowledgable, with my aunt knowing a good deal more than my mother as far as current common sicknesses and what best to treat them with.
Now, my mother was an oncologist, so if you had cancer, you'd have been much better off seeing her than my aunt.
There is one big caveat with NPs. The effectiveness and level of care you can get from an NP will vary greatly from state to state. Each state has different rules and regulations around what they allow NPs to do. Some states restrict their ability to prescribe drugs or designate a treatment schedule. At one point my aunt was considering taking a job in a different state until she realized that in that particular state, what she was able to do was extremely limited and she would have wasted the additional education and time in practice.
Now, my mother was an oncologist, so if you had cancer, you'd have been much better off seeing her than my aunt.
There is one big caveat with NPs. The effectiveness and level of care you can get from an NP will vary greatly from state to state. Each state has different rules and regulations around what they allow NPs to do. Some states restrict their ability to prescribe drugs or designate a treatment schedule. At one point my aunt was considering taking a job in a different state until she realized that in that particular state, what she was able to do was extremely limited and she would have wasted the additional education and time in practice.
Posted on 3/20/24 at 3:19 pm to bigpetedatiga
quote:
Secondly, a big part of medicine is experience. A NP with 20 years under their belt actual practice is going to be more qualified than an MD with let's say 5 years or less of experience. In medicine experience is king.
I would take an MD with 10 years of experience over one with 30 years of experience any day of the week, and I work in healthcare
Posted on 3/20/24 at 3:21 pm to SaintlyTiger88
It’s fine for a walk in clinic when I just need some amoxicillin for something basic.
But having to see an NP or even a PCP in order to get into see a specialist is maddening at times.
But having to see an NP or even a PCP in order to get into see a specialist is maddening at times.
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