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Message
re: SB 435 would allow advanced practice nurses to not work under a physician
Posted on 4/4/18 at 7:11 pm to WaWaWeeWa
Posted on 4/4/18 at 7:11 pm to WaWaWeeWa
quote:
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.
Exactly. NPs will still charge for the same reimbursement as MDs.
ETA - and I'd imagine their liability insurance would be more costly than an MDs.
This post was edited on 4/4/18 at 7:13 pm
2
Posted on 4/4/18 at 7:18 pm to slackster
quote:
Exactly. NPs will still charge for the same reimbursement as MDs.
I didn't think about this aspect of this whole situation. Right now we can bill "incident-to," if the MD is in the building and get full reimbursement at the MD rate. But if we are seen as "independent" (if the bill passes), I'm sure MCARE will be adamant about only reimbursing at 85% the MD rate because we won't need "supervision." That's a very interesting situation I haven't considered to this point. BTW, it should be only 85% the MD rate if this bill passes, because we aren't physicians.
Posted on 4/4/18 at 7:18 pm to slackster
quote:
ETA - and I'd imagine their liability insurance would be more costly than an MDs.
Why would you imagine that? I don’t believe their scope of work is being expanded (procedures/surgeries), just the oversight by a physician is being removed.
Posted on 4/4/18 at 7:23 pm to toosleaux
Not really going to matter. The Med Staffs of most hospitals will not go along with it, due to liability issues.
Posted on 4/4/18 at 7:25 pm to Epic Cajun
quote:
Why would you imagine that? I don’t believe their scope of work is being expanded (procedures/surgeries), just the oversight by a physician is being removed.
I'm just speculating - sort of like losing a co-signer on a loan.
Posted on 4/4/18 at 7:26 pm to Scooby
quote:
That's a very interesting situation I haven't considered to this point. BTW, it should be only 85% the MD rate if this bill passes, because we aren't physicians.
Thanks for the information. Didn't realize the reimbursement could be lower.
Posted on 4/4/18 at 7:27 pm to Scooby
quote:
Scooby
Out of curiosity, how do you think a NPs pay would increase if they didn’t have oversight of a MD? Does the MD take a cut of collections? I don’t know how these arrangements work
Posted on 4/4/18 at 7:32 pm to slackster
Reimbursement is definitely lower for NPs (85% of MD), but the diagnostic tests that they order are still the same price. I would say 15% the cost of an office visit is a drop in the bucket to overall healthcare costs.
What happens if you factor in more referrals to specialists, more tests, more visits, more prescriptions?
What happens if you factor in more referrals to specialists, more tests, more visits, more prescriptions?
Posted on 4/4/18 at 7:36 pm to WaWaWeeWa
quote:
Out of curiosity, how do you think a NPs pay would increase
In a hospital setting, no I don't think it would increase. Not sure about nursing home setting as I don't have any experience there. If this does pass, I think you would see hospitals and med staffs still requiring CPAs to practice.
I think the only real way salary would increase would be for rural health clinics if the CPA was ever removed for a clinic setting. There are several RHCs paying a "supervising physician" a couple grand a month to remote into the EMR and sign X% of charts for medicaid and reimbursement requirements.
Posted on 4/4/18 at 7:56 pm to Epic Cajun
Who is gonna pay for their frick ups when there isn’t a doc.
Posted on 4/4/18 at 7:57 pm to LZ83
quote:
Who is gonna pay for their frick ups when there isn’t a doc.
The same malpractice insurance companies that do it now.
Posted on 4/4/18 at 7:59 pm to LZ83
And you don’t think the insurance will go up for a less qualified NP rather than MD
Posted on 4/4/18 at 8:02 pm to LZ83
quote:
And you don’t think the insurance will go up for a less qualified NP rather than MD
I think it would depend on what "specialty" is listed. It may go up some, but not exponentially. An internal med physician's malpractice is much lower than a general surgeon's. I think the same will be true with NPs.
Posted on 4/4/18 at 8:04 pm to Golfer
quote:
Let the consumer decide for themselves what is reasonable and prudent for their situation.
This isn’t buying a tv. Some of the scariest medical professionals I’ve been around are nurses that think they are physicians.
Posted on 4/4/18 at 8:18 pm to Hoops
quote:
This isn’t buying a tv. Some of the scariest medical professionals I’ve been around are nurses that think they are physicians.
The Dunning-Kruger effect. The less you know the more you think you know. It’s real, look it up.
I don’t know many MDs that are hard pressed to find patients, I think most fight a bill like this because of how much medicine has humbled them over the years. Not that MDs are humble, but the vast amount of knowledge that needs to be mastered and experience required is astonishing. Not to mention it is a field that is constantly evolving so you have to be able to teach yourself and use critical thinking to adapt to future medical progress.
This post was edited on 4/4/18 at 8:19 pm
Posted on 4/4/18 at 8:29 pm to WaWaWeeWa
quote:
I don’t know many MDs that are hard pressed to find patients, I think most fight a bill like this because of how much medicine has humbled them over the years.
Exactly.
When someone jumps on MD’s as “scared of competition” it shows just how little they know about medicine.
I do not know of a single collegue of mine who is not completely swamped with patients. We are all overworked and we need more providers. I am personally excited about the idea of expanding the number of physician extenders but only under in house supervision.
But we don’t need substandard care.
Posted on 4/4/18 at 8:39 pm to Hoops
quote:
I’ve been around are nurses that think they are physicians
Absolutely. The DNP programs are full of them, and some of the professors are the worst culprits. And some of our "advocates" don't see the need for supervising physicians, because they've correctly diagnosed a patient that another physician "misdiagnosed."
Don't get me started on DNPs trying to announce themselves as Dr. (Name), NP. I understand they worked extremely hard, but that is not the correct title in that arena.
Posted on 4/4/18 at 8:42 pm to Scooby
Yea why do they wear long white coats and call themselves doctor? Why not wear baby blue coats and call themselves nurse practitioners?
I think the deception and trying to portray yourself as something you aren’t bothers some
I think the deception and trying to portray yourself as something you aren’t bothers some
Posted on 4/4/18 at 8:44 pm to toosleaux
Doctors have all become overpaid government workers - no better than lower paid government workers.
Bring on the NPs...
Bring on the NPs...
Posted on 4/4/18 at 8:49 pm to SECdragonmaster
quote:
I am personally excited about the idea of expanding the number of physician extenders but only under in house supervision.
I am excited to see the ways that we can be of service to ER physicians (my "specialty") in the future. I hope to be able, some day after further training, to be able to place central lined and intubate patients so that the ER physician has more time to focus on the other aspects of the patients care (electrolyte correction, antibiotic delivery, consults, and admission.) I think that I can be of service in those areas, as well as starting work-ups on less complex patients while physicians are dealing with CVA, STEMI, and trauma patients. On my shift now, it is my goal that the physician doesn't have to do a Lac or I&D during their shift (if they dont want to). They check the lac before I start, and I call them if I find any tendon involvement/other complications. This keeps them moving other patients, instead of getting bogged down with procedures.
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