JAMA article: "Rates of Psychiatrists’ Participation in Health Insurance Networks"

[vistaril]

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Yeah, basically no FP is going to want to manage extra psych patients. If the pay isn't there for psychiatrists to do it, why the hell would PCPs want to take over? "Yay, another service that hardly covers my time and expenses, with patients I really don't want to work with! Wonderful!"

This PhD totally doesn't get it.

Well I think the idea is that they generally aren't extra psych pts to manage.....they are patients with the usual chronic medical issues who are going there anyways, and oh by the way they are a little depressed.

 

[Mad Jack]

Well I think the idea is that they generally aren't extra psych pts to manage.....they are patients with the usual chronic medical issues who are going there anyways, and oh by the way they are a little depressed.

It's still extra time and a medication management skill set that most PCPs both don't have and aren't comfortable with. They also probably wouldn't be down with bringing specialized psych NP and social worker staff on board just to manage patients that are what amounts to a money sink.

 

[vistaril]

It's still extra time and a medication management skill set that most PCPs both don't have and aren't comfortable with. They also probably wouldn't be down with bringing specialized psych NP and social worker staff on board just to manage patients that are what amounts to a money sink.

Yeah I don't disagree with that in general....I think it's very likely that psych nps are going to in the future be the one siphoning this revenue stream off independently.

 

[Baller MD]

Yeah I don't disagree with that in general....I think it's very likely that psych nps are going to in the future be the one siphoning this revenue stream off independently.

Once they get their DNPs, they are going to advertise themselves as doctors of psychiatry.

 

[PikminOC]

I did have an interim CoS who was a Dentist ask me if I were willing to take on a week of 'night float' for the IM hospitalist service because I was attached to Medicine.

"I don't think that's a good idea. I hadn't treated a lot of these conditions in quite a while."
"That's ok, we have algorithms for everything you'll be treating. You just need to follow them...."

This is whats coming down the pike. Mid level providers love cookbooks.
There is NO EVIDENCE showing they are worse than physicians, right?

 

[PikminOC]

you're confusing yourself here- splik didn't say there WAS EVIDENCE that there is no difference between the qualities(your placebo example). He said there was NO EVIDENCE that there is any difference. There is an important distinction there.

If there is truly NO EVIDENCE, there is nothing he can possibly cite....since it doesn't exist.

So then why wouldn't this apply to anything?
There is NO EVIDENCE that my dog can't treat bipolar disorder as well as a psychiatrist.

All that really matters is when there's a lawsuit..
http://blogs.findlaw.com/eighth_cir...revives-cymbalta-failure-to-warn-lawsuit.html

 

[Mad Jack]

Yeah I don't disagree with that in general....I think it's very likely that psych nps are going to in the future be the one siphoning this revenue stream off independently.

Yet if NPs fight for both independent practice and "equal pay for 'equal' work," how are they saving the system any money? They're just providing an inferior product for the same price...

 

[NontradCA]

Yet if NPs fight for both independent practice and "equal pay for 'equal' work," how are they saving the system any money? They're just providing an inferior product for the same price...

I sat in and watched the licensing board in my state pass legislation to take away PAs right to prescribe Cardiac drugs in emergency settings two days ago. Pas were arguing they were equivalent to NP, but the physicians unanimously blocked the PAs. I bet the NP lobby is strong here, and money is being exchanged.

Bunch of old physicians by the way. They don't give a **** about us.