NPs and PAs Fight For Your Rights Now!!

[guetzow]

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[jwk]

You need to actually READ the bill.

The problem is that some non-physicians, especially those with doctorate degrees, seem to think that it is acceptable to be referred to as DR. in a healthcare setting, and in fact DO mislead patients into thinking they are a physician when they are not. This happens NOW, and includes doctorate-prepared CRNA's, PT's, PharmD's and others. When patients hear the word "doctor", they assume physician. They don't assume therapist, nurse, pharmacist, etc.

Although the wording of the bill might not be perfect, the intent of the bill is perfectly legitimate and reasonable.

 

[deleted92121]

Sorry, but I agree with the bill. If you want to prescribe and perform complex procedures, go to med school.

Why do you think PA's and NP's should not be allowed to prescribe? Complex procedures is a misleading statement because what one person considers complex, another may not.

With all due respect, med school is not for everyone interested in medicine.

dxu

 

[FoughtFyr]

You need to actually READ the bill.

The problem is that some non-physicians, especially those with doctorate degrees, seem to think that it is acceptable to be referred to as DR. in a healthcare setting, and in fact DO mislead patients into thinking they are a physician when they are not. This happens NOW, and includes doctorate-prepared CRNA's, PT's, PharmD's and others. When patients hear the word "doctor", they assume physician. They don't assume therapist, nurse, pharmacist, etc.

Although the wording of the bill might not be perfect, the intent of the bill is perfectly legitimate and reasonable.

Ditto

- H

 

[prairiedog]

You need to actually READ the bill.

The problem is that some non-physicians, especially those with doctorate degrees, seem to think that it is acceptable to be referred to as DR. in a healthcare setting, and in fact DO mislead patients into thinking they are a physician when they are not. This happens NOW, and includes doctorate-prepared CRNA's, PT's, PharmD's and others. When patients hear the word "doctor", they assume physician. They don't assume therapist, nurse, pharmacist, etc.

Although the wording of the bill might not be perfect, the intent of the bill is perfectly legitimate and reasonable.

Do also consider optometrists, chiropractors, podiatrists, psychologists making patients thinking they are doctors when they are not? Would you also expect MDs to not use the title DR. in a non-medical setting, like a university setting?

 

[FoughtFyr]

Do also consider optometrists, chiropractors, podiatrists, psychologists making patients thinking they are doctors when they are not? Would you also expect MDs to not use the title DR. in a non-medical setting, like a university setting?

Actually, that is a bit different. Each of those professionals is in a limited outpatient setting where their care is specifically sought. This is different than the patient in the hospital being led to believe that the nurse with a PhD in nursing theory is a physician.

And the MD is, like it or not, an academic title. Even if one never gets their license, they are still referred to as "Dr.".

- H

 

[FoughtFyr]

With all due respect, med school is not for everyone interested in medicine.

dxu

Nope, but it is for those who "want to prescribe and perform complex procedures" without some direct physician oversight (or it should be...)

- H

 

[prairiedog]

Actually, that is a bit different. Each of those professionals is in a limited outpatient setting where their care is specifically sought. This is different than the patient in the hospital being led to believe that the nurse with a PhD in nursing theory is a physician.

And the MD is, like it or not, an academic title. Even if one never gets their license, they are still referred to as "Dr.".

- H

Thus, those "professionals" in "limited" outpatient settings are not being preceived as physicians? Only the PhD nurse? How many PhD nurses have you encountered leading patients in the hospital to believe they are MDs? Please remember the same about the JD, another academic title.

 

[prairiedog]

Because NPs and PAs don't have enough training and didactic background to prescribe across the board. Even allowing NPs and PAs to begin prescribing antibiotics and such leads to issues of what can/can't they prescribe and the boundary lines wear thin, and eventually someone will get hurt by a well-meaning NP or PA.
.

Have you reviewed the studies? Do you think no one ever is harmed by "well- meaning" MDs? Scope of practice defines what PAs can prescribe.

 

[DogFaceMedic]

I had a quick look at the bill and understand part of its objective.

So, one question and one comment; then fire away:
Has anyone seen any study or other evidence that there really is a problem of PhDs, DNPs, etc. misleading patients that they are more clinically/medically knowledgeble than they really are?

I have seen many info-mercials by snake-oil salesmen calling themselves Dr and recommending everyone buy their special brand of vitamins, anti-oxidants, extracts of rattle snake saliva that cures obesity, arthritis, hemorrhoids, gout, diabetes, hangovers, and then you can still eat and drink.
So, is this bill targeted at the frauds selling crap at your local GNC or on TV?

 

[guetzow]

Please re-read my original post regarding this (Addendums recently added). I am in TOTAL agreement ragarding the innapropriate use of "Doctor" by NPs/PTs.

-Former HM2

 

[Febrifuge]

How is this bill an attack on midlevels? There is absolutely nothing in the text of HR 5688 that is a threat to the practice or prescribing privileges of PAs. Have you read the text?

The bill purports, in a quick summary, that NPs and PAs are not
qualified to prescribe medications or perform "complex" medical procedures or
surgery (though no further examples given) and that there are ample instances of NPs and PAs holding themselves out to by medical doctors to the public.

No, it doesn't. And no, it doesn't.

I'm going to be a PA, and I think this bill represents a good idea. It might curtail non-medical people giving themselves medical titles. I don't see how this hurts PAs in any way shape or form.

 

[megsMS]

With no respect intended, med school should be required for everyone who practices medicine.

With all due respect, med school is not for everyone interested in medicine.

dxu

 

[brightness]

I agree with everything except being able to prescribe medications. I think that the training IS adequate to prescribe certain classes of medication. Everything else seems reasonable.

 

[rn29306]

With no respect intended, med school should be required for everyone who practices medicine.

Unfortunately for your frail ego that you incessantly flaunt around this forum, a court case in 1936 secured my spot as an anesthesia provider.

No respect intended either.

 

[FoughtFyr]

Thus, those "professionals" in "limited" outpatient settings are not being preceived as physicians? Only the PhD nurse? How many PhD nurses have you encountered leading patients in the hospital to believe they are MDs? Please remember the same about the JD, another academic title.

Actually, I've seen a med almost pushed because a PharmD on an intensive care unit was regularly referred to as "Doctor". A new nurse took the PharmD's suggestion to the team during rounds to be an order. The suggestion had been discussed later and rejected by the team. I also know of at least two occasions where a local FNP (with a PhD in Nursing theory, not a DNP) has told her patients to "have the ER doctors call her and discuss any treatment before treating her patients". Yeah, I'm going to call and discuss this with your "doctor", who, in my experience practices more alternative medicine than anything else...

- H

 

[PublicHealth]

Elitist tactics.

http://www.patientsrightscoalition.org/

 

[FoughtFyr]

Elitist tactics.

http://www.patientsrightscoalition.org/

Or genuine patient safety concern!

- H

 

[PublicHealth]

Or genuine patient safety concern!

- H

Show me the data, oh empirical one. MDs/DOs have been playing the safety card all too often. And it has not been serving them well! Just look at how many nonphysician providers are filling in the gaps that medicine leaves behind, especially in primary care. If the concern is really patient safety, then MDs/DOs should sponsor a bill that evaluates the safety and efficacy of nonphysician healthcare providers, not one that protects usage of the term "doctor." It's all political, pal, you know it.

WAAAH! Others professionals will be called 'doctors,' WAAAH! Give me a break.

 

[DogFaceMedic]

Is there any empirical data on mistakes made by Drs that are not MD/DOs?
Or, more probable, any surveys of patients if they are confused by job titles?
(I can do a comprehensive literature review myself, but I'm waiting for some spare time to show up.)

 

[FoughtFyr]

Is there any empirical data on mistakes made by Drs that are not MD/DOs?
Or, more probable, any surveys of patients if they are confused by job titles?
(I can do a comprehensive literature review myself, but I'm waiting for some spare time to show up.)

Don't worry about "publichealth", in his world, if you are planning to do a study, it is the same as having completed it. Actual data are wasted on his, as is breath.

- H

 

[PublicHealth]

Don't worry about "publichealth", in his world, if you are planning to do a study, it is the same as having completed it. Actual data are wasted on his, as is breath.

- H

Cop out.

 

[prairiedog]

Actually, I've seen a med almost pushed because a PharmD on an intensive care unit was regularly referred to as "Doctor". A new nurse took the PharmD's suggestion to the team during rounds to be an order. The suggestion had been discussed later and rejected by the team. I also know of at least two occasions where a local FNP (with a PhD in Nursing theory, not a DNP) has told her patients to "have the ER doctors call her and discuss any treatment before treating her patients". Yeah, I'm going to call and discuss this with your "doctor", who, in my experience practices more alternative medicine than anything else...

- H

You may want both sides of the story with the FNP. I also know of several instances where the FNP said she wanted to be called before treating her patients. The reason was simple, she wanted her patient to receive appropriate care. Have you never requested to be called about "your" patient before treatment? You trust every healthcare provider "your" patient encounters. In reality there are numerous poor providers (PA,NP,MD), maybe these "two" occasions were a result of the ER doctors previous care? My last question, did she refer to her self as a Dr. ? I see the Pharm D did, I thought your previous tenet was a nurse calling herself a Dr. in the hospital.

 

[Dr_Feelgood]

I too think that this bill is garbage. I come from a different background, specifically podiatry. DPMs are also excluded from this bill. Using some posters logic, they should be included. We attend 4 years of medical school and 3 years of residency. According to this bill we should not be able to advertise as doctors and cannot claim we have equivalent training. According to the Journal of Bone and Joint Surgery, a Foot and Ankle Orthopod has about 1.5 years of training in the area of the foot and ankle; compare that to 5-6 years of training in podiatry. Now I'm not saying pods are better but they certainly can claim in the area of the foot and ankle only, they are equally qualified.

If this bill was about patient welfare, then why are DDS included in the listing of "doctors"? What makes them more qualified than a DPM??? A vast majority of DDS do not undergo post-grad residencies. DDS have as limited scope as NPs, PAs, and DPMs. So why are they included??? Power and money! They are able to control and limit any expansion into dental care.

I feel we have laws in place already to cover these areas. Let's enforce them and bring the offenders in front of the medical licensing board not Congress.

 

[jwk]

I'm with you on this bill being BS. I don't want to debate where pods are "physicians" but the fact is we do go to 4 years of med school and 3 years of residency. According to this bill, I am not a doctor but a DDS is. This bill is very exclusive and has more to do with money and control than informed patients. If it was about the patients than why would a DDS be included???

You're a little paranoid. The bill wording will end up being changed, but the INTENT is to keep nurses (especially nurses, and especially NP's and DNP nurses), PT's, pharmacists, and others not TRADITIONALLY thought of as DOCTORS in a healthcare setting from using the term DOCTOR when dealing with patients within that setting. This bill would not have come about, but for the FACT that some of these providers are already calling themselves DOCTOR. Several examples in this thread indicate the NEED for such a bill.

 

[Dr_Feelgood]

Where does the law limit its scope??? The law is enforced by the letter not by the intent.

 

[FoughtFyr]

You may want both sides of the story with the FNP. I also know of several instances where the FNP said she wanted to be called before treating her patients. The reason was simple, she wanted her patient to receive appropriate care. Have you never requested to be called about "your" patient before treatment? You trust every healthcare provider "your" patient encounters. In reality there are numerous poor providers (PA,NP,MD), maybe these "two" occasions were a result of the ER doctors previous care? My last question, did she refer to her self as a Dr. ? I see the Pharm D did, I thought your previous tenet was a nurse calling herself a Dr. in the hospital.

Actually, she did. And I am an emergency physician. I was the one she attempted to educate on her unique brand of supplement therapy. The best was when she asked me to use some fish oil supplement (that she would "run right over" to the ED) instead of the standard ACS treatment. BTW - all of this concerned her patient greatly as both she and I "went to medical school" (the patient's words) so why didn't we agree? Why does her patient believe she went to medical school?

- H

 

[jwk]

Where does the law limit its scope??? The law is enforced by the letter not by the intent.

It's not a law - it's a bill, a proposal. It can be changed, amended, revised - hell it might not even pass. Don't podiatrists have a lobbyist around somewhere asking questions about this?

Understand the intent - it goes a long way. Even the OP doesn't get it - it's NOT a scope of practice bill.

 

[Dr_Feelgood]

1) I understand "how a bill becomes a law" my point is as it is written this bill is crap.

2) Yes we have PPAC and they are actively fighting this bill.

3) The best intent is skewed in the legal system and will be used against those "outside" the bill. Do you think that the 2nd amendments was intended to cover tanks or rockets??? It says we can bear arms and intent can be skewed.

 

[prairiedog]

Actually, she did. And I am an emergency physician. I was the one she attempted to educate on her unique brand of supplement therapy. The best was when she asked me to use some fish oil supplement (that she would "run right over" to the ED) instead of the standard ACS treatment. BTW - all of this concerned her patient greatly as both she and I "went to medical school" (the patient's words) so why didn't we agree? Why does her patient believe she went to medical school?

- H

In your case I would have the patient call me if she was seeing this specific NP. My point is there are good providers and bad providers regardless of title. The FNP who introduces herself as Dr. in the clinic is wrong, I think she is the exception. I do know PAs and NPs that I would see before some MDs. I am betting you would do the same. Patients get confused when seeing providers, they think they are all doctors. PAs can explain over and over that they are not doctors, the patient will refer to the PA as Dr.

 

[Ross434]

Yeah if you're an NP or PA ,and you're really self important and trying to deceive the public, you should probably be upset about this bill.

It's not changing anything except making it illegal to intentionally confuse patients and misrepresent yourself.

Most NPs and PAs can keep on prescribing and acting in their scope of practice (which, for nurses, which i guess this bill is target at, is pretty much completely wide open) without worry.

The fact that there's language in the bill that says "midlevel providers dont have the same training" and "people can be assumed to want doctors for their health care" doesnt really mean anything in the long run and in the impact of the bill. This language is probably there to assuage the egos of doctors who belonged to the sponsoring/lobbying group, which knew that they really couldnt do anything like restrict scope of practice or rights, given the excellent safety and satisfaction record of mid-levels.

Bottom line is this: Mid-levels will keep on providing great care, and many people will still choose to see them instead of a doctor.

 

[Gentle_Touch]

I believe mid-level practitioners should able to prescribe certain classes of drugs..leave the rest to suitable physicians. ie) level 1 or 2 drugs.

Anyways tell some of your mid-level practitioner fellows to introduce themselves as PA/NP when servicing patients. I encounter several occassion where mid-levels would not informing patients that they are not Doctors, but PA/NP. This is confusing patients and leading to wannabe doctors, this is bad for those whose in the field to keep it nice and clear. Especially those mid-levels work in rural or free public community clinics/offices.

 

[Dr_Feelgood]

It's not changing anything except making it illegal to intentionally confuse patients and misrepresent yourself. .

I'm not going to get into this argument but if this is true than why are DDS included in this bill.

 

[FoughtFyr]

I'm not going to get into this argument but if this is true than why are DDS included in this bill.

Believe it or not there are some alternative providers who practice "dentistry"... The bill is not only aimed at NP/PAs but to alternative health providers who hold out their "educations" as "equal to" that of MD/DO/DDS.

- H

 

[lawguil]

“Health care providers are regulated by state boards of nursing and medicine, and all 50 states have legislation on the books already making it illegal to hold one's self out to the public as a physician.”

This bill appears to be very similar to legislation that already exists. However, there might be a slightly different angle…..holding one’s self out to be a physician and calling one’s self DR in the clinical setting because you have a PhD or some type of inflated clinical doctorate may not be clearly legislated in the already existing state bills.

Let’s say if I were a DPT or DNP and called myself Dr. in a clinical/hospital setting, would I be breaking the law that currently exists in all 50 states? Perhaps not, because I’m technically not holding myself out to be a physician, but would have a “clinical doctorate” degree and this may result in confusion by patients.

I don’t have a firm opinion about this, but I wonder if a dentist or podiatrist should refer to themselves as Dr. in the hospital setting. It does present a possibility for confusion to patients, nurses and other staff.

DDS have as limited scope as NPs, PAs, and DPMs. “dr-feelgood”

If this is true, shouldn’t DPM’s and DDS’s introduce themselves as dentist and podiatrist as opposed to Dr.?

“Consumers believe that complex medical issues, procedures, surgeries and prescribing medications should be performed by medical doctors”

I don’t know what to think about this statement. Why say it in this bill and why a consumer’s opinion would mean that much since they can’t figure out the difference between practitioners anyway. I think asking the ill-informed this type of question in some type of survey and including it in a bill is a bit weak!

 

[dqbanrn]

I believe mid-level practitioners should able to prescribe certain classes of drugs..leave the rest to suitable physicians. ie) level 1 or 2 drugs.

Anyways tell some of your mid-level practitioner fellows to introduce themselves as PA/NP when servicing patients. I encounter several occassion where mid-levels would not informing patients that they are not Doctors, but PA/NP. This is confusing patients and leading to wannabe doctors, this is bad for those whose in the field to keep it nice and clear. Especially those mid-levels work in rural or free public community clinics/offices.

By definition, schedule 1 drugs are those with no accepted medical use in the united states and prescriptions may not be written for them. They are not considered safe for clinical use and are considered highly addictive. Marijuana is considered a schedule 1, cocaine is schedule 2 becuase it is used in practice. i believe some opthamologist may use it as an anesthetic and am sure there are other uses. So, no one should be writing prescriptions for schedule 1, MD or NP/PA.

 

[jwk]

I believe mid-level practitioners should able to prescribe certain classes of drugs..leave the rest to suitable physicians. ie) level 1 or 2 drugs.

See post above this one - and who should and should not be prescribing?

Kinda makes you wonder when you don't even know the difference between Schedule I and Schedule II drugs.

 

[Dr_Feelgood]

DDS have as limited scope as NPs, PAs, and DPMs. "dr-feelgood"

If this is true, shouldn't DPM's and DDS's introduce themselves as dentist and podiatrist as opposed to Dr.?

I'm fine with that as long as that hold true for everyone who holds a doctorate. I'm Biochemist Johnson and I'm Allopathic Bill.

My point was at most hospitals you get privileges is you have completed 3 years of residency like a maxillofacial surgeon i.e a DDS who does a surgical rotation. So I'm pretty sure if most of the hospitals call us doctor or physician so should the House of Reps.

Don't get me wrong I believe that everyone should have there credentials listed. But that is true of all specialties. I think that Family practice should say Blah blah, MD/DO Family Practice or Orthopods should say Blah blah, MD/DO Orthopedics or Foot and Ankle Orthopedics. Because it is bull sh#t if an orthopod gives you advice for ED. Scope of practice is crap b/c MD/DOs have unlimited scope but limited experience and knowledge. Therefore, this bill should make everyone list what the hell you do not who you are. That is just my opinion.

 

[lawguil]

DDS have as limited scope as NPs, PAs, and DPMs. “dr-feelgood”

If this is true, shouldn’t DPM’s and DDS’s introduce themselves as dentist and podiatrist as opposed to Dr.?

I'm fine with that as long as that hold true for everyone who holds a doctorate. I'm Biochemist Johnson and I'm Allopathic Bill.

My point was at most hospitals you get privileges is you have completed 3 years of residency like a maxillofacial surgeon i.e a DDS who does a surgical rotation. So I'm pretty sure if most of the hospitals call us doctor or physician so should the House of Reps.

Don't get me wrong I believe that everyone should have there credentials listed. But that is true of all specialties. I think that Family practice should say Blah blah, MD/DO Family Practice or Orthopods should say Blah blah, MD/DO Orthopedics or Foot and Ankle Orthopedics. Because it is bull sh#t if an orthopod gives you advice for ED. Scope of practice is crap b/c MD/DOs have unlimited scope but limited experience and knowledge. Therefore, this bill should make everyone list what the hell you do not who you are. That is just my opinion.

I think I agree with much of what you are saying. However, I think most people think of a physician when the term doctor is used. Physicains (and PA's) have a generalist training both academically and clinically before they specialize. This is the difference in the hospital setting. DPM's and DMD/DDS don't have the same education or experiences or they would be used interchangably with these providers. If you're a type of non-physician specialist, I think you should refer to yourself as dentist or podiatrist.
In an hospital emergency when somebody is asking for a doctor, they are probably not looking for a dentist! A nurse with ACLS training would probably be more appropriate!

 

[Gentle_Touch]

See post above this one - and who should and should not be prescribing?

Kinda makes you wonder when you don't even know the difference between Schedule I and Schedule II drugs.

Are you kidding me..? I just dont want to be specific, ppl already know there are variation in drugs classificiation. Some cities in CA passing a law able to write Schedule 1 like marijuana for medicinal usage (But it's all about politics between feds/state/local). Basically, Schedule 1 is STRONGEST than any drugs and goes down to 5 etc.. like OTC, Tylenol, Motrin etc.. It has been this way long before you were borned--son. Remember those old days where doctors have to write in triplicate carbon copies. One goes to State/DEA drug controller, one goes to pt, and the other stays in the physician's binder. These are really strong medications, addictive, with vast side-effects. Most doctors these days prescrbing much lesser like 2 or 3 Vicodin, Tylenol w/Codine, Demoral etc.. (these mid-levels shouldn't touch). I once worked with ophthalmologist, ortho, they totally not renewing for certain schedules stronger drug than 3. Again, I believe the suitable physicians to prescribe all schedules ex) Pain Management Physicians, IMs with extensive fellowship, orthos, or surgeons after post-op but, for long-term Tx the pt should refer to a specialist to do further evalution work-up. BTW, in CA now all Physicians requires to complete a 12unit CME on Pain Mgmt excludes Radiologists and Pathologists.

 

[Jengirl18]

Speaking about the misuse of antibiotics by "PAs"....in Miami, my Internal Med preceptor is seeing outbreaks of CA-MRSA, and he told me some of the PHYSICIANS in the ED aren't recognizing it, aren't culturing it, and prescribing antibiotics blindly. You would think that it would have been a no-brainer. So, just b/c one is a physician, does not mean that they use abx intelligently. By the way, my (physician) preceptor has already compared me to having more medical knowledge (when asked on the spot) than some 4th year med students he's taught in the past...and im only in my 2nd year/1st rotation of PA school...Not to toot my own horn, but, just thought ide put in a good word for the PAs out there

 

[Dr_Feelgood]

I think I agree with much of what you are saying. However, I think most people think of a physician when the term doctor is used. Physicains (and PA's) have a generalist training both academically and clinically before they specialize. This is the difference in the hospital setting. DPM's and DMD/DDS don't have the same education or experiences or they would be used interchangably with these providers. If you're a type of non-physician specialist, I think you should refer to yourself as dentist or podiatrist.
In an hospital emergency when somebody is asking for a doctor, they are probably not looking for a dentist! A nurse with ACLS training would probably be more appropriate!

I think you are little confused when comparing DDS to DPM. DPMs are not as specialized as you think. DPMs work in the hospital and are trained in general med. While they are specialized to the foot and ankle, they are required to rotate in all areas of medicine except OB-GYN and opthalmology. DPM schools are required to have an affliation w/ a DO or MD program. At some of the schools, the DPMs take the same classes as the DOs and MDs. There are quite a few podiatrists that are chiefs at various hospitals. You don't find DC, DDS (minus a maxillofacial surgeon) or OD in a hospital setting, but you'll find a ton of DPMs. And DPMs are required to have ACLS training also.

But if I went to a hospital for an emergency I wouldn't care if a monkey saved my life letters mean nothing if you lose your head or let your head get too big.

 

[lawguil]

I think you are little confused when comparing DDS to DPM. DPMs are not as specialized as you think. DPMs work in the hospital and are trained in general med. While they are specialized to the foot and ankle, they are required to rotate in all areas of medicine except OB-GYN and opthalmology. DPM schools are required to have an affliation w/ a DO or MD program. At some of the schools, the DPMs take the same classes as the DOs and MDs. There are quite a few podiatrists that are chiefs at various hospitals. You don't find DC, DDS (minus a maxillofacial surgeon) or OD in a hospital setting, but you'll find a ton of DPMs. And DPMs are required to have ACLS training also.

But if I went to a hospital for an emergency I wouldn't care if a monkey saved my life letters mean nothing if you lose your head or let your head get too big.

If this is the case with the DPM, I agree! Thanks for the better understanding of the DPM degree. I really should know more about it before I speak! Thanks, L.

 

[Dr_Feelgood]

If this is the case with the DPM, I agree! Thanks for the better understanding of the DPM degree. I really should know more about it before I speak! Thanks, L.

I'm not offended. Many people aren't aware of anyone's training and this is why open disclosure of training is important. I feel a bill like this assumes that only DOs and MDs have certain training. A full disclosure of all training should be mandated. That includes MD/DO specialist. (Disclaimer: I do not think that DPMs are better than Foot and Ankle Orthopods) F&A orthopods are the expert in the foot and ankle in the eyes of the AMA, insurance companies, and the general public but they receive at most (according the the article I quoted above) 1.5 years of training in the foot and ankle. That means they spend less than 20% of there residency training on the foot and ankle. Non-F&A orthopods another surgeon who is allowed to operate on the foot and ankle, on average spend 3-6 months on the foot and ankle. Knowing that do you, does this bill really increase the publics knowledge on the training of health professionals.

 

[NufinButTheToof]

DPMs are also excluded from this bill. Using some posters logic, they should be included. We attend 4 years of medical school and 3 years of residency.

If this bill was about patient welfare, then why are DDS included in the listing of "doctors"? What makes them more qualified than a DPM??? A vast majority of DDS do not undergo post-grad residencies.

I don't disagree with you when you say that DPMs are qualified to work on foot and ankle.. But, you say that the vast majority of dentists do not attend any post graduate residency training. But you say.. "we (or DPMs) attend 4 years of medical school and 3 years of residency".

I wasn't aware that residency was required for DPMs.. I was also under the impression that most DPMs do not undergo any post grad training. ?

I am aware that there are a small few residencys out there, but I didn't think this was the norm for Pod training.

 

[Dr_Feelgood]

It is required by all 50 states that pods undergo at least 2 years of post grad training to receive a license. If you only undergo a 24 month program you are only board certified in forefoot surgery; those who undergo a 36 month program are certified in forefoot and rearfoot surgery.

As for the number of residencies there are quite a few. In the 90s, there were a lot more pods than residencies. Those pods who were allowed to practice w/o post-grad training are why pods have fought to require post-grad training (pods giving podiatry a bad name)

 

[NufinButTheToof]

It is required by all 50 states that pods undergo at least 2 years of post grad training to receive a license. If you only undergo a 24 month program you are only board certified in forefoot surgery; those who undergo a 36 month program are certified in forefoot and rearfoot surgery.

As for the number of residencies there are quite a few. In the 90s, there were a lot more pods than residencies. Those pods who were allowed to practice w/o post-grad training are why pods have fought to require post-grad training (pods giving podiatry a bad name)

Thanks for that info.. so this is a very recent requirement then. I wasn't aware. When did this become law?

 

[jwk]

I think you are little confused when comparing DDS to DPM. DPMs are not as specialized as you think. DPMs work in the hospital and are trained in general med. While they are specialized to the foot and ankle, they are required to rotate in all areas of medicine except OB-GYN and opthalmology. DPM schools are required to have an affliation w/ a DO or MD program. At some of the schools, the DPMs take the same classes as the DOs and MDs. There are quite a few podiatrists that are chiefs at various hospitals. You don't find DC, DDS (minus a maxillofacial surgeon) or OD in a hospital setting, but you'll find a ton of DPMs. And DPMs are required to have ACLS training also.

But if I went to a hospital for an emergency I wouldn't care if a monkey saved my life letters mean nothing if you lose your head or let your head get too big.

DPM's work on foot and ankle - period. If that's not specialized, I don't know what is.

DPM's do NOT do general medicine. They don't treat hypertension, diabetes, do pelvics, vaccinations, etc. They may get exposure to those areas during school, but they don't do it in practice after graduation. They are not primary care physicians of any sort.

Sure there are pods on hospital staffs. I know lots of them. DC's and OD's aren't nor is there any reason for them to be. However, I doubt seriously you'll find a DPM as chief of anything at any hospital, unless that hospital does a majority of their work in podiatry, and those hospitals are few, far between, and small. On the other hand, dentists have been on hospital staffs for years - that's general dentists, not just oral surgeons - I don't know where you came up with that one. And having DPM's on general hospital staffs, as opposed to just majority podiatry facilities, is a relatively new thing in many areas, particularly in larger hospitals. Most of them really don't need hospital facilities anyway, since most of their procedures are outpatient. Even in hospitals that they're on staff, they often can't admit patients without an MD/DO signing on with them for medical management.

DPM's don't staff ER's either. And absent a hospital requirement for all members of their medical staff to be ACLS certified, there is no requirement for pods to have it. It's certainly not a bad idea, especially if they're doing office surgery, but it's not required.

The original discussion of the thread was about a bill intended to prohibit those not traditionally referred to as "doctor" from misleading patients into thinking that they're something they're not. I have no problem referring to DPM's, DC's, OD's, and DDS's as "doctor". I know quite a few podiatrists, including some that are personal friends, and some that I refer patients to when asked if I know a good one or if someone has a podiatry-related problem. However, when you start talking about DPM's being required to have ACLS (they don't) and doing general medical care (they don't) and giving the implication that they're "not specialized" and doing so much more than foot and ankle, one has to wonder who is being misleading.

 

[Dr_Feelgood]

DPM's work on foot and ankle - period. If that's not specialized, I don't know what is.

DPM's do NOT do general medicine. They don't treat hypertension, diabetes, do pelvics, vaccinations, etc. They may get exposure to those areas during school, but they don't do it in practice after graduation. They are not primary care physicians of any sort.

Sure there are pods on hospital staffs. I know lots of them. DC's and OD's aren't nor is there any reason for them to be. However, I doubt seriously you'll find a DPM as chief of anything at any hospital, unless that hospital does a majority of their work in podiatry, and those hospitals are few, far between, and small. On the other hand, dentists have been on hospital staffs for years - that's general dentists, not just oral surgeons - I don't know where you came up with that one. And having DPM's on general hospital staffs, as opposed to just majority podiatry facilities, is a relatively new thing in many areas, particularly in larger hospitals. Most of them really don't need hospital facilities anyway, since most of their procedures are outpatient. Even in hospitals that they're on staff, they often can't admit patients without an MD/DO signing on with them for medical management.

DPM's don't staff ER's either. And absent a hospital requirement for all members of their medical staff to be ACLS certified, there is no requirement for pods to have it. It's certainly not a bad idea, especially if they're doing office surgery, but it's not required.

The original discussion of the thread was about a bill intended to prohibit those not traditionally referred to as "doctor" from misleading patients into thinking that they're something they're not. I have no problem referring to DPM's, DC's, OD's, and DDS's as "doctor". I know quite a few podiatrists, including some that are personal friends, and some that I refer patients to when asked if I know a good one or if someone has a podiatry-related problem. However, when you start talking about DPM's being required to have ACLS (they don't) and doing general medical care (they don't) and giving the implication that they're "not specialized" and doing so much more than foot and ankle, one has to wonder who is being misleading.

I'm not going to aruge w/ you about your ignorance. If you want info on the truth, PM me. But I'd love to see were you got your information. What amazes me is you are an anestologia assistant but you know more than I do in my own field.

I'll clear up a few of your ignorant statements and then I'm done on the topic of podiatric training. Like I said if you are truly interested PM me and I will be happy to discuss the topic.

-DPMs do work in the ER
-DPM students are required to get their ACLS (we rotate through the ER, IM, ect)
-We don't do pelvic exams except when training; I wonder how often orthopods or neurologist or other specialist do pelvic exams??? Probably only in training
-We never treat systemic diseases, neuropathy those nerves don't go to the brain, DVTs never move out of the calf, shower emboli come from outer space not the heart; Just is case you can't catch it, that is sarcasm.
-I'll give you two examples Dr. Vincent Mandracchia is the Chief of Physicians at Broadlawn's Medical Center in Des Moines, Dr. Robert Mendincino is the Chief of Foot and Ankle Surgeons at a place called Western Pennsylvania Hospital, Dr. Jordan Grossman at a small hospital called St Vincent Charity in Cleveland teaches the foot and ankle to the orthopedic residents
-Finally, dentist on staff do much less than the pods

 

[Dr_Feelgood]

Thanks for that info.. so this is a very recent requirement then. I wasn't aware. When did this become law?

It is different state to state and that this one of the major problems in podiatry. Every state has different scopes, licensing requirements, ect. Personally, I'm not into big government, but this is one thing I would like to be universal. I am not an advocate for unlimited scope as some pods; I feel that the tibial tuberosity is the limit w/ the ability to collect grafts from the hip and buttocks.

There are two reasons I (in my opinion) this "not an issue." One pods can't agree on a scope, and two orthopods don't want a universal scope b/c then the "equal pay for equal work" issue would be bought back up.