Called an NP a midlevel...

[Beezlebub]

It is like md/do threads or urm threads. New crop of people come on here, and we have to do it all over. These threads almost always end up being rant threads, with no real substance to them.

even though when you start a thread, the search engine automatically brings up related topics and keywords. People still insist upon starting a new thread instead of bumping an existing one. #SDNDRAMA

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[auferstehen92]

Threads like these are why I think every pre-med student should be required to work an entry level position at a hospital. Your "premed" sense of entitlement gets a serious reality check.

 

[Beezlebub]

Threads like these are why I think every pre-med student should be required to work an entry level position at a hospital. You're "premed" sense of entitlement gets a serious reality check.

Did you even read what the OP wrote? He/she (assuming she b/c jiggypuff based on probability) had no intention of using it as a derogatory or offensive term. There's no sense of entitlement, just a misunderstanding. Unfortunately, the situation was blown out of proportion.

 

[750335]

Threads like these are why I think every pre-med student should be required to work an entry level position at a hospital. Your "premed" sense of entitlement gets a serious reality check.

I actually blame SDN for this one. We hear our superiors here talk a lot about this and how they feel about nurses, and well they know more, so we start to imbibe many of their ideas. What we forget is while attendings can get away with this mentality, we have a long way to go to get there, and at one stage or the other we will need them, and they can truly make our lives hell. While I agree with nurses understanding their role, and realizing they are not doctors, even though I think most are actually aware of this, these threads just create more of a problem than they solve.

 

[Funny_Current]

I really wanted to understand what it's like to take care of patients and, only being a premed at the time, I decided to get a job as a CNA. It's nothing short of hard work - if you really care about your job and the patients. CNA's and nurses spend the most time with patients, and I think this helps reinforce patients care by giving informed information to the physicians. Nurses really are on the front line and I think their job is just as essential to patient care as a physician. Many of the "teams" that would do their rounds in the morning consisted of NPs, pharmacists, Med students, residents, and the attendings. From my experience, the NPs were highly involved in the overall well being of the patients; they would come back once or twice during the day to check on the patients and spend more time on average with them than the doctors. I think this reflects the training they receive in NP School and I could see the positive impact it had on patients.

My point is that each member involved in taking care of a patient serves a vital role and although the amount of education each receives may be different, it doesn't mean their part in a patients care is any less significant. That said, I don't see anything wrong with classifying the type of treatments each person can provide using hierarchical terms like mid level. In fact, they even use such terms for billing purposes. I appreciate anyone who wants to be involved in healthcare, but I think you devalue the altruistic aspect of caring for others if you act like those kinds of terms are objective. Although they share essentially the same goal, there are differences in healthcare providers.


Sent from my iPhone using SDN mobile

 

[cbrons]

NPs/PAs know more than any of us pre-meds..
I think as pre-meds we can learn from them, and as people who may end up in med school they would be your colleagues in the future.

So?
I'm also not a pre-med.

 

[cbrons]

Several posters had commented they had never heard of this being considered offensive, hence providing the information. I also pointed that the CMS designation of midlevels is being considered for rule change by NP, PA, and RN groups with no formal opposition being proposed by AMA that I can find. So this designation may be changed adminstratively within medicare within the next few years

Right, and my question was - who cares?

RNs do not care about NPs being midlevels.
Vast majority of PAs do not care about being midlevels.
A small minority of NPs who are super insecure and want to pretend they are something they are not are the only ones who care.

 

[cbrons]

You don't think this whole thread is indicative of exactly the kind of sentiment that they're trying to fight against? The vitriol spouted by all of these people is so toxic, it's hard to believe.

Ohhh yeah it's so TOXIC. Lol... get a grip.

 

[auferstehen92]

Did you even read what the OP wrote? He/she (assuming she b/c jiggypuff based on probability) had no intention of using it as a derogatory or offensive term. There's no sense of entitlement, just a misunderstanding. Unfortunately, the situation was blown out of proportion.

I wasn't so much referring to OP as I was to the commenters who swarm these threads to protect their future (and as yet unproven) status as physician. I agree that referring to an NP as a midlevel is not offensive in any way, but confrontation is not the best way to deal with this issue. My advice for premeds: keep your nose down, do your job, and rest assured that residents and attendings don't need you to come to their defense every time someone slights a physician.

 

[Podstar]

Grab a detention slip, she will see you after class.

 

[Beezlebub]

I actually blame SDN for this one. We hear our superiors here talk a lot about this and how they feel about nurses, and well they know more, so we start to imbibe many of their ideas. What we forget is while attendings can get away with this mentality, we have a long way to go to get there, and at one stage or the other we will need them, and they can truly make our lives hell. While I agree with nurses understanding their role, and realizing they are not doctors, even though I think most are actually aware of this, these threads just create more of a problem than they solve.

What in the world are you talking about?

 

[sliceofbread136]

There a plenty of angry silly people in the hospital, you just learn to ignore them

 

[787593]

I dare everyone to watch the entire video linked below without facepalming.

As someone who has been admitted in the hospital I spent more time with the doctor
The nurse would come in to check vitals, the doctor would visit more often and actually update me on my care.
So I don't really get what she is saying....

Didn't even make it 20 seconds. As soon as she said "I graduated high school with 40 college credits" I closed the tab.

I got to 27 seconds and quit

Edit: Kinda cute though

 

[787593]

What she says in this video is completely reasonable. She says nursing is less of a commitment in terms of years of training, more conducive to raising a family, and although being a NP isn't the same as being a family doc that more medicine-related route is available. She even went out of her way to say that even though she was a strong student in high school the pre-med path has the uncertainty of not getting in. What's so ridiculous about this to you? That a nurse dared to think that medicine was an option available to her? Do you honestly think that every single nurse is just someone who couldn't handle the path to medicine?

There are a lot of obnoxious little sh**s in this thread, especially ones who haven't even gotten accepted to med school and already think they're better than nurses. Pretty disturbing

 

[787593]

I get distracted easily
So I won't know if I will get it lol
It requires dedication to get a really good MCAT score
From what I read those who get high scores pretty much dedicate their life to the mcat for months.
I get a 514 I am good
I could be competitive for my state school

You can do it.

 

[787593]

You have failed us. Time to commit sudoku.

Wut? Methinks you have the wrong word...

 

[787593]

NPs/PAs know more than any of us pre-meds..
I think as pre-meds we can learn from them, and as people who may end up in med school they would be your colleagues in the future.

"But.... like.... I can do organic chemistry things"

 

[Dr.Sticks]

I actually blame SDN for this one. We hear our superiors here talk a lot about this and how they feel about nurses, and well they know more, so we start to imbibe many of their ideas. What we forget is while attendings can get away with this mentality, we have a long way to go to get there, and at one stage or the other we will need them, and they can truly make our lives hell. While I agree with nurses understanding their role, and realizing they are not doctors, even though I think most are actually aware of this, these threads just create more of a problem than they solve.

Nurses are your superiors
(Not sure if this applies to med students, it does to any pre-med who volunteers in a hospital or is a low level of sorts)

 

[JeSuisUnDoc]

.

 

[Ashleigh99MD]

even though when you start a thread, the search engine automatically brings up related topics and keywords. People still insist upon starting a new thread instead of bumping an existing one. #SDNDRAMA

Sorry, I didn't think I was supposed to bump old/dead threads.

Did you even read what the OP wrote? He/she (assuming she b/c jiggypuff based on probability) had no intention of using it as a derogatory or offensive term. There's no sense of entitlement, just a misunderstanding. Unfortunately, the situation was blown out of proportion.

This is correct. I didn't even know it could be used as a derogatory term because I have heard it used by several PA's I work with. I wasn't gossiping or talking down about the NPs or PAs. I try to be respectful with everyone, so I will avoid using the term in the future.

Honest question, what term should I use when referring to a group of NP's/PA's. The term provider isn't always appropriate if I want to specify the non-physician providers. Non-physician provider is also listed as offensive in that article. What term can I use to be clear and still be respectful to everyone?

 

[libertyyne]

Sorry, I didn't think I was supposed to bump old/dead threads.



This is correct. I didn't even know it could be used as a derogatory term because I have heard it used by several PA's I work with. I wasn't gossiping or talking down about the NPs or PAs. I try to be respectful with everyone, so I will avoid using the term in the future.

Honest question, what term should I use when referring to a group of NP's/PA's. The term provider isn't always appropriate if I want to specify the non-physician providers. Non-physician provider is also listed as offensive in that article. What term can I use to be clear and still be respectful to everyone?

They like the term "Advanced Practice Provider" or "APP" for short. Which is kinda funny considering one of the criticisms Doctors make is that they blindly follow Algorithms like an actual App, and secondly it introduced the same naming convention issue where if they are "Advanced" is someone else a basic practice provider or a backwards practice provider?

 

[Beezlebub]

Sorry, I didn't think I was supposed to bump old/dead threads.



This is correct. I didn't even know it could be used as a derogatory term because I have heard it used by several PA's I work with. I wasn't gossiping or talking down about the NPs or PAs. I try to be respectful with everyone, so I will avoid using the term in the future.

Honest question, what term should I use when referring to a group of NP's/PA's. The term provider isn't always appropriate if I want to specify the non-physician providers. Non-physician provider is also listed as offensive in that article. What term can I use to be clear and still be respectful to everyone?

Morning Jigglypuff, I am not aware of a specific term other than midlevel provider. To keep it simple just refer to them as a group of "nurses/PA/x" or ancillary staff

 

[Mad Jack]

https://www.aanp.org/images/documents/publications/useofterms.pdf


The term is formally opposed by both NP and PA associations. There is significant dislike of the term across NP, PA, and RNs across the country. I would suggest that by the time most of you are in practice it will be considered a term of derision. They are promoting changes in CMS to remove the term via regulatory processes. At the moment is remains the legal classification for purposes of billing

I get it. It's like how I cringe every time someone calls a DO an osteopath.

 

[libertyyne]

I get it. It's like how I cringe every time someone calls a DO an osteopath.

Are DO's offended by that term?

 

[Beezlebub]

I get it. It's like how I cringe every time someone calls a DO an osteopath.

link also states:
"When it is necessary to group providers for policymaking or other purposes, more appropriate terms may instead be: primary care providers; health care providers; health care professionals; advanced practice providers; clinicians; and/or prescribers."

So basically describing an MD. I can't imagine any confusion at all!

Also,
"The term “mid-level provider” implies an inaccurate hierarchy within clinical practice. Nurse practitioners practice at the highest level of professional nursing practice. It is well established that patient outcomes for NPs are comparable or better than that of physicians.2 NPs provide high-quality and cost-e ective care."

So the AANP explicitly states that NPs > MD. Intuitively, this imples that fewer yrs of training at a far more advanced level and training will result in better outcome. We may as well make med school 6 months instead of 4yrs so I can save some loan money and go to Disney World.

 

[balston82]

I am so stealing this...

 

[tarheelpenner]

They don't call them residents for nothin'

Wow. So after months of hanging out on the same threads as you (and even talking back and forth a little bit), I have JUST NOW REALIZED that your profile thing is an MRI of a banana (right?), and not a worm like I had previously thought. lol. (C. elegans anyone?) Maybe I shouldn't go to med school.....haha jk. I just suck at common sense.

 

[Mad Jack]

Are DO's offended by that term?

Osteopath implies a non-physician practitioner of osteopathy- basically a glorified chiropractor. It's a term of derision when used toward DOs.

 

[libertyyne]

Osteopath implies a non-physician practitioner of osteopathy- basically a glorified chiropractor. It's a term of derision when used toward DOs.

Man, everyone's jimmies get ruffled all the time.

 

[810390]

Sorry, I didn't think I was supposed to bump old/dead threads.



This is correct. I didn't even know it could be used as a derogatory term because I have heard it used by several PA's I work with. I wasn't gossiping or talking down about the NPs or PAs. I try to be respectful with everyone, so I will avoid using the term in the future.

Honest question, what term should I use when referring to a group of NP's/PA's. The term provider isn't always appropriate if I want to specify the non-physician providers. Non-physician provider is also listed as offensive in that article. What term can I use to be clear and still be respectful to everyone?

I can see how calling someone a midlevel would give them an inferiority complex, and cause them to redirect that in anger. The term labels them as healthcare providers at the intermediate level, but it could be misinterpreted as a remark that they're providing healthcare, generally, at a subpar level to physicians. But the thing is, what they do and the assistance they provide is critical to any practice setting.
Using "midlevels" could make them feel as if their work is less important than physicians; physicians can do everything that they can; and that they're a secondary existence in practice.
The OP didn't intend any of this. But we should address them as midlevels only when they're not around. You can't fight human nature head-on here unless modules are in place that clearly addresses NP's and PA's from the beginning of their training that they are mid-level healthcare providers. Even if some really can't, they do want to be the best at what they do...
Off paperwork, you should address NP's and PA's as nurses, NPs, PAs, or NPs and PAs.

 

[Mad Jack]

Man, everyone's jimmies get ruffled all the time.

There's actually a big difference though- osteopaths are those educated outside of the United States in colleges of osteopathy. They do not prescribe or administer medication, and are not trained in modern or mainstream medicine. It's actually illegal for a DO to call themselves an osteopath in Australia for this reason- it's an entirely separate profession, more akin to chiropractic than American osteopathic medicine.

 

[Lucca]

Just a reminder that sockpuppeting (using two accounts to comment on the same boards) is against TOS.

Also good job keeping this thread..uhh...stable.

 

[810390]

Just a reminder that sockpuppeting (using two accounts to comment on the same boards) is against TOS.

Also good job keeping this thread..uhh...stable.

HI DAD

 

[Dr.Sticks]

Man, everyone's jimmies get ruffled all the time.

Why I try to keep my mouth shut 90% of the time on social media and 99.9% of the time in real life..

 

[787593]

I am also good at reading...

Everything can be learned

Why am I a fast reader? Because as a kid I always had my nose in a book..
I was made to read 10 books a week in elementary school growing up.
That would make anyone a skilled reader...

If I was made to do 20 math problems every night before I went to sleep maybe I wouldn't suck at math that much.. I haven't even taken calc 1 yet and I'm a sophomore
Most take it as freshman..

 

[787593]

Dude. The whole point of this discussion is that not everything can be learned- sometimes things are just skills you're born with. Take the MCAT and let us know.

I was born with an innate understanding of the electron transport chain, nbd

 

[mwsapphire]

I was born with an innate understanding of the electron transport chain, nbd

Well that's not what I meant. I mean, not everybody can learn the ETC that easily and apply the knowledge on the tricky questions that are on the MCAT.
Some people can bang and bang their head against the wall, and really understand the ETC and other tough topics, but are just S**t at standardized tests. That's juts the way it its. And don't smoke. You'll get cancer and die.

 

[mwsapphire]

Why I try to keep my mouth shut 90% of the time on social media and 99.9% of the time in real life..

I don't think your mouth has ever been shut in these threads ( as in, you always have something to say. That's not bad, it's just I feel what you just said isn't true.

 

[787593]

Again: I didn't say it was easy
I said with dedication I don't see why someone can't score high
That dedication is extreme though
The dedication to getting straight A grades is 30 to 40 hours a week
From my research the high achievers usually dedicate 30-40 hours a week to mcat prep as well

I then followed up saying I am not sure if I can dedicate myself like that.

Is dedicated 30+ hours to a test for months easy? Nope

That is why the average is not every high, that is why not every gets an A grade.

I refuse to accept that someone is too stupid to get an A or do well on the MCAT.

Anyways enough off topic posts please..
PM if you want to discuss this further, and maybe I will start a thread on the appropriate forum and tag all of you.
I don't mind citing peer reviewed sources and writing a full length paper on why intelligence isn't something one is born with.

Stupid is as stupid does.

 

[Dr.Sticks]

I don't think your mouth has ever been shut in these threads ( as in, you always have something to say. That's not bad, it's just I feel what you just said isn't true.

Anonymous internet forum..
Why not?
I'm not going out of my way to offend anyone though, nor do I post to offend anyone.
I will say I am a lot more careful about what I say on social media and in real life though...

 

[Dr. Stalker]

Wooooow, some of what you guys are saying is super condescending. Maybe it's because my mom's a nurse and my grandmother was a nurse, but I really don't get the disdain for nurses that some of you guys have.

I've never heard of "midlevel" being considered an offensive term, but to be fair, the NP and PA that I work with are both referred to as providers. (Before you guys start freaking out, there's not really any harm in this. When you have a bunch of people coming in with a sinus infection or thrush, it doesn't really matter if it's a NP or PA or MD or DO treating you.)

I feel you mate. It's not a matter of disrespect. I was raised to respect the janitor and a CEO as the same. And tbh, nurses work way harder than doctors. The terminology (in my opinion) is due to levels of education. MD/DO. 4 years undergrad + 4 brutal years of medical school + at least 3 years of an intense residency = doctor.

An NP and PA do undergo higher education and advanced training, but its nothing like the hell doctors have to go through.

 

[piii]

The latter part I agree with;I would say she is wrong about the fact that doctors don't spend much time with patients.
Wouldn't you?
I would say it is a myth that nurses spend more time with patients than docs..
Tell me a nurse spends more time than a doc who probably will see 15+ patients in a day..
At least that is what I have learned through volunteering and shadowing
I see that the doctors are much more involved with patient care not nurses.
Not to say nurses aren't involved.

I wouldn't know; My only experience with inpatient care is being a patient myself.
I saw the residents a lot, the attending not that much. Probably saw the resident more than the nurse.
I have shadowed private practice and based on that experience I find her opening statement to be not completely accurate.

You seem to have a quite a lot of opinions for a premed who only has the tiniest amount of experience.

 

[787593]

I get it. It's like how I cringe every time someone calls a DO an osteopath.

Wut... I've used that term

 

[787593]

Wow. So after months of hanging out on the same threads as you (and even talking back and forth a little bit), I have JUST NOW REALIZED that your profile thing is an MRI of a banana (right?), and not a worm like I had previously thought. lol. (C. elegans anyone?) Maybe I shouldn't go to med school.....haha jk. I just suck at common sense.

Omg

I thought it was a worm. I feel so ashamed.

 

[787593]

Well that's not what I meant. I mean, not everybody can learn the ETC that easily and apply the knowledge on the tricky questions that are on the MCAT.
Some people can bang and bang their head against the wall, and really understand the ETC and other tough topics, but are just S**t at standardized tests. That's juts the way it its. And don't smoke. You'll get cancer and die.

Smoking is cool though.

 

[787593]

Anonymous internet forum..
Why not?
I'm not going out of my way to offend anyone though, nor do I post to offend anyone.
I will say I am a lot more careful about what I say on social media and in real life though...

Not to brag, but I just read your reply in like 0.0000001 seconds.

 

[mwsapphire]

Wut... I've used that term

Well then CLEARLY , CLEARLY, you're an DINGUS. OBVIOUSLY.

 

[787593]

I feel you mate. It's not a matter of disrespect. I was raised to respect the janitor and a CEO as the same. And tbh, nurses work way harder than doctors. The terminology (in my opinion) is due to levels of education. MD/DO. 4 years undergrad + 4 brutal years of medical school + at least 3 years of an intense residency = doctor.

An NP and PA do undergo higher education and advanced training, but its nothing like the hell doctors have to go through.

Bruh...

 

[mwsapphire]

Not to brag, but I just read your reply in like 0.0000001 seconds.

WELL then how come you don't have a 545 MCAT???

 

[787593]

Well then CLEARLY , CLEARLY, you're an A**Hole. OBVIOUSLY.

Clearly! I didn't even know!