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1
Posted on 4/5/18 at 4:55 am to cwil177
I’m a physician (specialist). We used to have mid levels in our practice but patients complained too much about not seeing us so we stopped. But I’m in a specialty that could use the help so we may reconsider in the future.
I agree with MD tiger and plead the 5th: this is a horrible idea.
I agree with MD tiger and plead the 5th: this is a horrible idea.
Posted on 4/5/18 at 6:45 am to Hoops
quote:
Some of the scariest medical professionals I’ve been around are nurses that think they are physicians.
Some of the scariest medical professionals I've been around are physicians that think they are god
Posted on 4/5/18 at 7:42 am to Magicmikeforlsu
quote:
The same can be said for physicians. I've worked in healthcare for 23 years, I've had numerous interactions with all types of physicians. Trust me, there are some great physicians out there, and there are some that should never have been given a license. That's a fact!!!
You are exactly right.
So why would we want another group of providers with significantly less training taken from a pool of people who weren’t smart enough to get into medical school to have complete autonomy?
What do you think the bottom of their barrel looks like if you already think the bottom of the medical school barrel is horrendous?
Use some common sense people
Posted on 4/5/18 at 7:48 am to Epic Cajun
quote:
Some of the scariest medical professionals I've been around are physician
It’s amazing how some people don’t see this glaringly obvious point
Your statement is true. And that is after one of the most difficult application processes and highly selective admissions requirements in a medical school.
Now you want to open the door to people who can get to the same level of autonomy by going through an online school. Please tell me how that won’t lead to even scarier results?
I’m almost positive no one has a good answer to this
Posted on 4/5/18 at 8:02 am to pleading the fifth
quote:
NPs also can “specialize” and change fields (from general surgery to dermatology to neurology to primary care, etc) without any further training.
See this is one thing that aggravates me too. I know a couple of NPs that have hopped around a few specialties and think they're "experts" in their new worriedly specialty after a year. I've been in the ER for 5 years, and I'm just now feeling confident with me knowledge base and skill level. I couldn't imagine switching to another specialty after I've invested this much time and effort into emergency medicine. And, ER is just the best specialty anyways.
Posted on 4/5/18 at 8:03 am to WaWaWeeWa
quote:
Now you want to open the door to people who can get to the same level of autonomy by going through an online school. Please tell me how that won’t lead to even scarier results?
I pondered this thread some more and an Engineering equivalent would be someone allowing a team to build a new roadway system and no one on the team has a stamp (PE). People can die from being wrong. Moreso in the medical field.
Posted on 4/5/18 at 8:14 am to 50_Tiger
Yea that’s close. I would say it’s more like...
The public isn’t happy with the state of bridges and roads in the country. They say obviously we just don’t have good engineers that can build quality, long lasting structures or keep up with demand. The next logical step would be to train more and better engineers, right? Instead the public is saying... let’s just have construction managers build the roads and bridges without any oversight of an engineer. Doesn’t seem right to me. It’s probably the same difference in schooling as well
The public isn’t happy with the state of bridges and roads in the country. They say obviously we just don’t have good engineers that can build quality, long lasting structures or keep up with demand. The next logical step would be to train more and better engineers, right? Instead the public is saying... let’s just have construction managers build the roads and bridges without any oversight of an engineer. Doesn’t seem right to me. It’s probably the same difference in schooling as well
Posted on 4/5/18 at 8:15 am to WaWaWeeWa
quote:
The public isn’t happy with the state of bridges and roads in the country. They say obviously we just don’t have good engineers that can build quality, long lasting structures or keep up with demand. The next logical step would be to train more and better engineers, right? Instead the public is saying... let’s just have construction managers build the roads and bridges without any oversight of an engineer. Doesn’t seem right to me. It’s probably the same difference in schooling as well
BINGO Telecom has been trying to take a cheaper route with contractors and routinely we have to go in behind them and fix the mess.
Posted on 4/5/18 at 8:30 am to Kentucker
Look at the map from the first page. Looks like Louisiana will continue to lose doctors to Texas. First oil now medicine
Posted on 4/5/18 at 8:36 am to Adam Banks
Would be interesting to see how much lower the standard of care is in the 20 or so states where NPs have full autonomy vs states where they are restricted by the collaborating physician agreement. Are patients getting that much better treatment in Utah (because the NP is under a physician) as opposed to Arizona, Colorado, or Nevada, where the NP is able to practice without the physician oversight?
This post was edited on 4/5/18 at 8:44 am
Posted on 4/5/18 at 8:45 am to Adam Banks
quote:
Looks like Louisiana will continue to lose doctors to Texas.
Part of that might be malpractice laws in Texas. I hear it is more difficult to get sued over there.
Posted on 4/5/18 at 8:46 am to MDTiger 13
Why would it be ok to work independently in some settings and not others? Are those patients less valuable?
Either you have the training or you dont, you see everyone everywhere or you cant.
If they are deemed competent by lawmakers, they should practice independently everywhere.
No MD would employ one and NPs and MDs could compete head up for patients and revenue.
Either you have the training or you dont, you see everyone everywhere or you cant.
If they are deemed competent by lawmakers, they should practice independently everywhere.
No MD would employ one and NPs and MDs could compete head up for patients and revenue.
Posted on 4/5/18 at 9:05 am to tigerfoot
That’s right. Make them an independent separate entitiy. If the Nursing board/lobby is so confident that they can deliver better or equivalent care independently then separate yourself. Wear something other than a long white coat and actually call yourself a nurse practitioner. I don’t see many nurse practitioners advertising their credentials. They just want to wear a white coat and call themselves doctors.
Posted on 4/5/18 at 9:15 am to guttata
quote:
Would be interesting to see how much lower the standard of care is in the 20 or so states where NPs have full autonomy vs states where they are restricted by the collaborating physician agreement. Are patients getting that much better treatment in Utah (because the NP is under a physician) as opposed to Arizona, Colorado, or Nevada, where the NP is able to practice without the physician oversight
Do you have a reliable way the test this? I think the burden of proof should be on the NPs to prove they are competent.
If so much less training is required to be competent why don’t we just create an excellerated track through medical school if you want to do primary care?
I think physician oversight is more about catching mistakes and bad practice patterns over time. Also having a MD to ask questions if you need them or send difficult cases. It’s a stop gap for the looney tunes NPs that would get through, just like there are looney tunes MDs. I don’t see why that is a bad thing. You would have to show me that there would be tremendous cost savings with independent NPs to justify that. And it’s just not true.
Posted on 4/5/18 at 9:16 am to WaWaWeeWa
You obviously don’t work with many NPs. My wife is a NP and she has worn a white coat for as long as she has been a NP...as a matter of fact, when she was in NP school at LSUHC, they actually required all of them to wear the white coat.
Posted on 4/5/18 at 9:24 am to WaWaWeeWa
quote:I have never seen this. I am pro NP.
They just want to wear a white coat and call themselves doctors.
But you see this in many fields, including allied health.
They want direct access to the patients and if they are truthful about it, it is because they think they can get more of the pie. So they lobby and try to carve out certain things for themselves.
Posted on 4/5/18 at 9:26 am to guttata
What is your point?
I’m aware that they have always tried to portray themselves as doctors, and I think that’s fine as long as there is some physician oversight. But if you think you are capable of practicing independently and are confident in your abilities then clearly distinguish yourself, don’t blur the lines.
I’m aware that they have always tried to portray themselves as doctors, and I think that’s fine as long as there is some physician oversight. But if you think you are capable of practicing independently and are confident in your abilities then clearly distinguish yourself, don’t blur the lines.
Posted on 4/5/18 at 9:32 am to WaWaWeeWa
Maybe the MDs should wear a bright pink coat to distinguish themselves as being a MD. There are too many other allied health professions to require all of them to change from the traditional white coat.
Posted on 4/5/18 at 9:35 am to WaWaWeeWa
quote:
If so much less training is required to be competent why don’t we just create an excellerated track through medical school if you want to do primary care?
I believe this is what the Rural Scholars program is at LSUMC. 3rd and 4th year is more focused on IM or Family Practice instead or the normal rotations. I think a scholarship covers part of the tuition as well.
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