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re: SB 435 would allow advanced practice nurses to not work under a physician
Posted on 4/4/18 at 5:32 pm to LSUintheNW
Posted on 4/4/18 at 5:32 pm to LSUintheNW
quote:and you know my email
Well, she had a reduction.
Eta...and a lift. They look awfully good.
0
Posted on 4/4/18 at 5:32 pm to toosleaux
The dumbing down of medicine continues.
I notice paralegals are never allowed to practice law.
I notice paralegals are never allowed to practice law.
This post was edited on 4/4/18 at 5:36 pm
Posted on 4/4/18 at 5:34 pm to NoHoTiger
quote:
I would think it would depend on the scope of their practice. If they are working at an Urgent Care seeing routine sore throat/cold type things or a Minute Clinic for the same types of issues, probably not as a big a deal as say diagnosing and treating complex cardiovascular issues.
Is there a way to ensure that NPs only see “easy” cases? Do you just hang a sign that says “Sore Throats Only”?
Posted on 4/4/18 at 5:39 pm to Golfer
quote:
I wonder why?
I have a three month waiting list to get into my outpatient practice.
Try again nimrod.
I don’t want patients to get substandard care. There are enough low quality MD’s out there. We don’t need even lower quality care.
Posted on 4/4/18 at 5:47 pm to EFHogman
quote:
Study after study has been done that show np's provide just as competent primary care as a physician. This is about money and pt's are the ones that suffer by limiting NP's ability to practice within their full scope.
Can you link a study?
Posted on 4/4/18 at 5:49 pm to WaWaWeeWa
quote:
Is there a way to ensure that NPs only see “easy” cases? Do you just hang a sign that says “Sore Throats Only”?
That's the problem. Something that can be deemed "easy" can turn into something complex. I had a patient in the ER the other day that complained of a "sore throat," and was sent to our FastTrack, where I was working at the time. Turns out the "sore throat" was actually a pneumothorax. Same scenario, "sore throat" ended up being retro-pharyngeal abscess. I was able to tell something wasn't right on both exams, and thankfully my physician was there to help guide me along in the management of these patients. I knew what needed to be done in both cases, but they were there to assure me and help further diagnose, treat, and monitor the patient with me.
Posted on 4/4/18 at 5:50 pm to WaWaWeeWa
quote:
Study after study has been done that show np's provide just as competent primary care as a physician.
Competent and quality are 2 completely different things.
Posted on 4/4/18 at 6:01 pm to Scooby
Exactly. I would just like to evaluate the study to make sure they are comparing apples to apples. Not a situation where the MD is being sent all the chest pain cases and the NP is being sent runny noses. And how is the study measuring competency?
I would be shocked if it’s a legitimate study because I think this is a very complex issue that statistical post hoc analysis can’t sort out.
I would be shocked if it’s a legitimate study because I think this is a very complex issue that statistical post hoc analysis can’t sort out.
Posted on 4/4/18 at 6:09 pm to AlceeFortier
quote:
Alas, there is a primary health care provider shortage in La. (and likely in all rural areas across the country) and this may be the best fix until it is financially palatable to run a PCP clinic in the rural areas
That isn't what this bill addresses, and I saw a graphic recently that doesn't really support that they gravitate towards cities > rural areas.
Posted on 4/4/18 at 6:12 pm to toosleaux
In Texas CRNAs, who put you under for surgery, have been able to practice without doctor supervision. And they make a lot more than those in Louisiana while helping keep the overall costs under control.
Posted on 4/4/18 at 6:13 pm to Hopeful Doc
One time I went to get my add medicine refilled and only the nurse practitioner was there and she made me piss in a cup for a drug test
So I say make nurse practitioners illegal
So I say make nurse practitioners illegal
Posted on 4/4/18 at 6:21 pm to cajuncarguy
quote:
In Texas CRNAs, who put you under for surgery, have been able to practice without doctor supervision. And they make a lot more than those in Louisiana while helping keep the overall costs under control.
They also do significantly more training. As well as a very rigorous admissions standards (by nursing standards). There aren’t any online CRNA schools as far as I know.
Posted on 4/4/18 at 6:25 pm to cajuncarguy
Also, is cost your main concern? Or access to care?
Having a ton of NPs is not going to reduce costs. It’s already ridiculous how people in this country expect to be seen for every ache, pain, or cough IMMEDIATELY and they want their antibiotics and steroids
The tough pill that America will have to swallow if it wants to solve this healthcare problem is rationing of care. A bunch of NPs aren’t going to solve the healthcare crisis and the thought that they can practice “preventative medicine” is a joke. They will practice exactly like MDs are now, and they will still be profit driven. The only person with the power to practice preventative medicine is the patient, and in this country it’s a different animal, you can’t compare us to the European countries.
Having a ton of NPs is not going to reduce costs. It’s already ridiculous how people in this country expect to be seen for every ache, pain, or cough IMMEDIATELY and they want their antibiotics and steroids
The tough pill that America will have to swallow if it wants to solve this healthcare problem is rationing of care. A bunch of NPs aren’t going to solve the healthcare crisis and the thought that they can practice “preventative medicine” is a joke. They will practice exactly like MDs are now, and they will still be profit driven. The only person with the power to practice preventative medicine is the patient, and in this country it’s a different animal, you can’t compare us to the European countries.
Posted on 4/4/18 at 6:42 pm to WaWaWeeWa
quote:
I would be shocked if it’s a legitimate study because I think this is a very complex issue that statistical post hoc analysis can’t sort out.
I've never seen one that actually linked any sort of meaningful outcome long term. There are studies that show that patients are just as satisfied, that NPs typically spend something like 1 minute longer in the room, and are more likely to order tests and refer than MDs. They also had comparable systolic blood pressures. NPs actually had something like a 1-2mmHg lower SBP.
None of this is particularly important, groundbreaking, or useful information. It does not prove quality, consistency, or show that either field has more outliers or malpractice/mismanagement cases. It is often quoted in their defense, though, and unfortunately, people who don't critically read or understand what the information published may draw a line that does not exist/cannot be determined.
Posted on 4/4/18 at 6:45 pm to WaWaWeeWa
quote:
you can’t compare us to the European countries
I completely agree. Everyone in America has to have a diagnosis right now, right this minute, and they need to feel better before they go on their cruise at the end of the week. LOL. It's ridiculous.
I actually took care of a couple from Canada who were traveling with the husband for work. The wife said before she left Canada, she had a completely free (she understood that nothing is free) full work-up. EKG, labs, stress test, colonoscopy, PAP...literally full work-up. The only problem, like she said, is that if something was found on her work-up that needed further investigation, it would take 4 months or more to get in with a specialist. That is the thing that American's don't realize. If we need people to get in with a specialist, we can pretty much make it happen in a timely manner (a majority of the time). It won't be tomorrow, and it may not be next week, but it will happen in a time frame that the condition dictates.
Edit: And not to mention we are a much more heterogeneous group than a majority of the European countries we are compared to.
This post was edited on 4/4/18 at 6:49 pm
Posted on 4/4/18 at 6:49 pm to Hopeful Doc
quote:
None of this is particularly important, groundbreaking, or useful information. It does not prove quality, consistency, or show that either field has more outliers or malpractice/mismanagement cases. It is often quoted in their defense, though, and unfortunately, people who don't critically read or understand what the information published may draw a line that does not exist/cannot be determined.
Exactly. I compare the situation to a common situation seen on the Rant... the backup QB
When the starting QB (in this case the healthcare system/MDs) isn’t performing well everyone thinks the backup QB will always solve the problem. The backup QB is assigned all sorts of extraordinary qualities. No one wants to accept that the problem is more systemic and not easily solved. There is a reason why the backup QB (in this case NPs) are on the bench.
But this bill will eventually pass because of the money and persistence of the NP lobby to expand their scope of practice through legislation
This post was edited on 4/4/18 at 7:09 pm
Posted on 4/4/18 at 6:55 pm to Scooby
quote:
I completely agree. Everyone in America has to have a diagnosis right now, right this minute, and they need to feel better before they go on their cruise at the end of the week. LOL. It's ridiculous.
x100
quote:
If we need people to get in with a specialist, we can pretty much make it happen in a timely manner (a majority of the time). It won't be tomorrow, and it may not be next week, but it will happen in a time frame that the condition dictates.
The studies claiming the US isn’t the global leader in healthcare are a joke. I have read them cover to cover. They cherry pick stats and don’t compare apples to apples. Americans are very naive and in some sense spoiled
This post was edited on 4/4/18 at 6:56 pm
Posted on 4/4/18 at 6:58 pm to tgrbaitn08
quote:You would be surprised.
Some of those NP's probably know more than you..
That includes the ones who have been doing it for years.
Seriously, you would be amazed.
How much training do you think NPs have?
This post was edited on 4/4/18 at 7:01 pm
Posted on 4/4/18 at 7:06 pm to Scruffy
I just find it mind boggling that the public would fight so hard to have a doctor NOT be checking up on their NP. Fight to NOT have a MD available to answer questions or help out if something seems strange.
It just goes to show you how little the public understands about healthcare.
The cost of:
A. Solo NP
Vs
B. NP + MD oversight
Is trivial. It actually might be zero, just less money in the NPs pocket. Why would you not want that oversight?
This bill being passed has no bearing on wether or not you can see your NP. You will still have the same copay. It’s not going to lower yours or anyone else’s healthcare costs.
It just goes to show you how little the public understands about healthcare.
The cost of:
A. Solo NP
Vs
B. NP + MD oversight
Is trivial. It actually might be zero, just less money in the NPs pocket. Why would you not want that oversight?
This bill being passed has no bearing on wether or not you can see your NP. You will still have the same copay. It’s not going to lower yours or anyone else’s healthcare costs.
This post was edited on 4/4/18 at 7:09 pm
Posted on 4/4/18 at 7:10 pm to Golfer
quote:
And if I want to solicit financial advise from a bank teller, I'm free to do so.
But the bank teller isn't allowed to give you advice, particularly if you're paying for it.
You can ask an NP for free advice, but if he or she can't be compensated for that advice, why would he or she take on the liability?
Sometimes a little regulation is necessary for the good of the public.
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