NPs can now train in EM MD Fellowships

[workhardoverall]

The precedent has been set. Can’t get warm bodies to fill EM physician residency positions let alone a fellowship spot. EM is an absolute joke of a speciality. So what is the plan to combat this?

Dr. John Barrett, DNP Faculty, First Nurse Practitioner to Join One-year Certificate Training Program in Advanced Emergency Ultrasonography

Penn Medicine’s Division of Emergency Ultrasound is at the forefront of promoting the use of bedside ultrasound. On July 1st, Dr. John Barrett, senior l...

www.nursing.upenn.edu

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Members don't see this ad.

 

[norski]

Is this a real fellowship?

 

[bravotwozero]

Beginning of the end for EM. Thank you ACEP, ABEM, state medical board of Pennsylvania.

PS, eff off.

 

[GonnaBeADoc2222]

Useless fellowship for useless PLP.

Tracks right.

Not worried. These ivy type places are midlevel simp houses.

 

[RustedFox]

Useless fellowship for useless PLP.

Tracks right.

Not worried. These ivy type places are midlevel simp houses.

My thoughts exactly. "Oh, look - hyperacademia just thows themselves all over pointless stuff in the name of inclusivity and to carry favor with the muggles."

 

[Lexdiamondz]

Not surprised at UPenn. These are the same people that put out that paper suggesting that radiology techs were better at interpreting studies than radiology residents and nearly got censured by the American College of Radiology.

UPenn's EM department is average at best, and foolishness like this knocks them down many rungs. It's telling when the majority of their med students applying to EM would rather go to Temple down the street than their own home program.

 

[thegenius]

The precedent has been set. Can’t get warm bodies to fill EM physician residency positions let alone a fellowship spot. EM is an absolute joke of a speciality. So what is the plan to combat this?

Dr. John Barrett, DNP Faculty, First Nurse Practitioner to Join One-year Certificate Training Program in Advanced Emergency Ultrasonography

Penn Medicine’s Division of Emergency Ultrasound is at the forefront of promoting the use of bedside ultrasound. On July 1st, Dr. John Barrett, senior l...

www.nursing.upenn.edu

What is he a doctor of?

 

[cyanide12345678]

What is he a doctor of?

Doctorate of nurse practitioner.

That’s how NPs call themselves doctors.

 

[JacobMcCandles]

These things will eventually take care of themselves, I think.

 

[southerndoc]

Beginning of the end for EM. Thank you ACEP, ABEM, state medical board of Pennsylvania.

PS, eff off.

I'm assuming you're a member of AAEM and you've contacted your legislators regarding issues?

Sorry, I see a lot of people complaining on here but doing absolutely nothing to try to stop the advancement of APPs.

 

[bravotwozero]

I'm assuming you're a member of AAEM and you've contacted your legislators regarding issues?

Sorry, I see a lot of people complaining on here but doing absolutely nothing to try to stop the advancement of APPs.

Yes to both

 

[EctopicFetus]

Join PPP and donate $$$.

I have some unpoppular opinions so here is another one.

Other than critical care,ems and maybe sports all the other em fellowships are for idiots who are afraid of being an actual doctor. You don’t need a fellowship to do ultrasound. Spend extra time during residency. Stop letting these craptastic Ed groups and programs abuse you.

 

[RustedFox]

Join PPP and donate $$$.

I have some unpoppular opinions so here is another one.

Other than critical care,ems and maybe sports all the other em fellowships are for idiots who are afraid of being an actual doctor. You don’t need a fellowship to do ultrasound. Spend extra time during residency. Stop letting these craptastic Ed groups and programs abuse you.

Hurr durr durr ultrasound durrr.

 

[thegenius]

The precedent has been set. Can’t get warm bodies to fill EM physician residency positions let alone a fellowship spot. EM is an absolute joke of a speciality. So what is the plan to combat this?

Dr. John Barrett, DNP Faculty, First Nurse Practitioner to Join One-year Certificate Training Program in Advanced Emergency Ultrasonography

Penn Medicine’s Division of Emergency Ultrasound is at the forefront of promoting the use of bedside ultrasound. On July 1st, Dr. John Barrett, senior l...

www.nursing.upenn.edu

Does this guy call himself a doctor? In front of other patients?

 

[RustedFox]

Does this guy call himself a doctor? In front of other patients?

Guaranteed.
They all do that nonsense.

Meanwhile, we're un-fcuking-up their patients in the real ERs.

I am regularly on the telephone with community NPs with my OtherJob, telling them "you know that thing that you tell your patients to do? Yeah, you're dead wrong. Stop that. Also, stop THIS, and the OTHER thing."

 

[Birdstrike]

Am I correct that ultrasound is still a non-accredited fellowship?

If so, then…

 

[Birdstrike]

Other than critical care,ems and maybe sports all the other em fellowships are for idiots who are afraid of being an actual doctor.

Proud-idiot, not-real doctor right here.

 

[EctopicFetus]

Proud-idiot, not-real doctor right here.

I’ll say i forgot about that. Much like critical care you stop being an EM doc. Much like I wouldnt tell someone to be an IM doc being a GI or cards is a different world.

 

[RustedFox]

Proud-idiot, not-real doctor right here.

That's not what he meant.

 

[Brigade4Radiant]

Proud-idiot, not-real doctor right here.

Lets not try to act like Pain is an EM fellowship it is a multspecialty fellowship like pallative. However Pain departments are run by anesthesia you don't have a Pain department that is run by EM felllows

 

[ScepticSkeksis]

Proud-idiot, not-real doctor right here.

He's just jealous because he's still in the meat-grinder. You've shown us the way to salvation. Find something you like that's NOT EM that will make money and do that.

 

[Siggy]

Lets not try to act like Pain is an EM fellowship it is a multspecialty fellowship like pallative. However Pain departments are run by anesthesia you don't have a Pain department that is run by EM felllows

To be fair, the same is true about critical care. Which CC fellowship is under EM and not IM, anesthesiology, or surgery?

 

[Siggy]

Join PPP and donate $$$.

I have some unpoppular opinions so here is another one.

Other than critical care,ems and maybe sports all the other em fellowships are for idiots who are afraid of being an actual doctor. You don’t need a fellowship to do ultrasound. Spend extra time during residency. Stop letting these craptastic Ed groups and programs abuse you.

But if I do a wilderness med fellowship then I’ll get paid to go hiking. (Let’s ignore the opportunity cost that would pay for lots of hiking).

 

[southerndoc]

Does this guy call himself a doctor? In front of other patients?

In a few states, this will get you fined if you call yourself a doctor in a healthcare settings without holding an MD, DO, DMD, DDS, or OD. In Georgia, you can say "I'm Doctor so-and-so" if you're a nurse practitioner, but you must say "I'm Doctor so-and-so, I'm a nurse practitioner and not a licensed physician." I've heard rumors that secret shoppers are going to be used to identify violations.

New Georgia Law Reins in NP, PA Use of 'Doctor' in Clinical Settings

NPs, PAs with doctoral degrees must state they're not physicians during patient interactions

www.medpagetoday.com

 

[Apollyon]

if you're a nurse practitioner, but you must say "I'm Doctor so-and-so, I'm a nurse practitioner and not a licensed physician."

That's a step above a guy I worked with 10 years ago. He was an NP with a PhD (before the advent of the not academically rigorous - at all - DNP), and he would say "I'm Dr Smith, the nurse practitioner".

 

[southerndoc]

That's a step above a guy I worked with 10 years ago. He was an NP with a PhD (before the advent of the not academically rigorous - at all - DNP), and he would say "I'm Dr Smith, the nurse practitioner".

I wonder how many will get busted because they won't want to say "I'm not a licensed medical doctor" or "I'm not a licensed physician"?

 

[Apollyon]

I wonder how many will get busted because they won't want to say "I'm not a licensed medical doctor" or "I'm not a licensed physician"?

However many sure deserve it, though!

 

[EctopicFetus]

But if I do a wilderness med fellowship then I’ll get paid to go hiking. (Let’s ignore the opportunity cost that would pay for lots of hiking).

Umm.. yes you will get paid very little to do this once in a blue moon..

 

[Lee Ik-jun MD]

I just had a geriatric patient who I'm trying to wean off Opiates after a hip surgery 2 months ago. Got a call from her daughter who introduced herself to our staff as "Doctor last name" . She started by " my professional recommendation is to increase the frequency of Norco to 4 times a day and give her 90 day supply "... long story short.. she's DNP And No soup for you!

 

[Brigade4Radiant]

To be fair, the same is true about critical care. Which CC fellowship is under EM and not IM, anesthesiology, or surgery?

That’s true and that’s why those fellowships actually give you options

 

[ProReduction]

I just had a geriatric patient who I'm trying to wean off Opiates after a hip surgery 2 months ago. Got a call from her daughter who introduced herself to our staff as "Doctor last name" . She started by " my professional recommendation is to increase the frequency of Norco to 4 times a day and give her 90 day supply "... long story short.. she's DNP And No soup for you!

I really do not want this to be true because if it is then medicine is done. Stick a fork in it. Yet I am certain it is true. A nurse maintaining her elderly mother's opiate addiction all while calling herself a "doctor".

Medicine is such a dumb job.

 

[wholeheartedly]

I just had a geriatric patient who I'm trying to wean off Opiates after a hip surgery 2 months ago. Got a call from her daughter who introduced herself to our staff as "Doctor last name" . She started by " my professional recommendation is to increase the frequency of Norco to 4 times a day and give her 90 day supply "... long story short.. she's DNP And No soup for you!

Was she trying to steal some for herself?

 

[wholeheartedly]

We had an NP, who was from the contract company that staffed our urgent care and ED, that apparently was Rxing adderall to multiple ppl in the bar when she was in town.

CEO told whoever found out about it not to report it. I was like screw that, not his place to prohibit ppl making a board complaint about a legit concern.

 

[namethatsmell]

I just had a geriatric patient who I'm trying to wean off Opiates after a hip surgery 2 months ago. Got a call from her daughter who introduced herself to our staff as "Doctor last name" . She started by " my professional recommendation is to increase the frequency of Norco to 4 times a day and give her 90 day supply "... long story short.. she's DNP And No soup for you!

Then advise her that she's welcome to write for them as a "professional."

Every time I hear stories like this, I'm reminded how spectacularly few midlevels and physicians embrace (or understand) the reality that there are no good studies supporting the use of ongoing opioids for MSK pain. And some of the best data available suggests those on opioids tend to have worse pain.

Let that sink in...while some patients/family love to jump to choreographed conclusions on why some of us almost never recommend opioids for chronic pain ie "you're just afraid of the gobberment and the DEA" or "so you think I'm an addict?!!"...the pre-text to all that is flawed by the faulty assumption that there's actually good evidence that we can rely on opioids to really improve long-term MSK pain. But there isn't any evidence. So the remainder of the decision tree on weather or not to prescribe is moot.

 

[Kissmyabjj]

I just had a geriatric patient who I'm trying to wean off Opiates after a hip surgery 2 months ago. Got a call from her daughter who introduced herself to our staff as "Doctor last name" . She started by " my professional recommendation is to increase the frequency of Norco to 4 times a day and give her 90 day supply "... long story short.. she's DNP And No soup for you!

GTFO

 

[watermanMD]

Then advise her that she's welcome to write for them as a "professional."

Every time I hear stories like this, I'm reminded how spectacularly few midlevels and physicians embrace (or understand) the reality that there are no good studies supporting the use of ongoing opioids for MSK pain. And some of the best data available suggests those on opioids tend to have worse pain.

Let that sink in...while some patients/family love to jump to choreographed conclusions on why some of us almost never recommend opioids for chronic pain ie "you're just afraid of the gobberment and the DEA" or "so you think I'm an addict?!!"...the pre-text to all that is flawed by the faulty assumption that there's actually good evidence that we can rely on opioids to really improve long-term MSK pain. But there isn't any evidence. So the remainder of the decision tree on weather or not to prescribe is moot.

Lolol as IF…the unfortunate reality is: majority of patients could give two ****s about evidence. I mean, I just straight up don’t write for this. But when I sit down and explain the evidence in layman’s terms—zero ****s. “I wan’t *insert medical stuff here* and I want it now”. They’re like children. Actually, they’re worse. And, unfortunately, my partners will dole this stuff out. I expect that to increase, as now Press Ganey/ our own version of patient satisfaction nonsense is now 10% of bonus.

 

[namethatsmell]

Lolol as IF…the unfortunate reality is: majority of patients could give two ****s about evidence. I mean, I just straight up don’t write for this. But when I sit down and explain the evidence in layman’s terms—zero ****s. “I wan’t *insert medical stuff here* and I want it now”. They’re like children. Actually, they’re worse. And, unfortunately, my partners will dole this stuff out. I expect that to increase, as now Press Ganey/ our own version of patient satisfaction nonsense is now 10% of bonus.

Who said that patients are always logical or are able to adult lol? Especially in the ED.
In the pain clinic patients tend to be much more collected and the most dysfunctional/inappropriate never make it here.

When I discuss why I'm not prescribing, it's either a 30 second conversation if the patient is bordering on rude/argumentative or several minutes if they're reasonable. Of course patients don't always agree, but coming at it from the perspective that the evidence says they don't work has borne out a suprising amount of fruit. I have a growing collection of patients who stay with me rather than going to other clinics where they'd absolutely get opioids. And when patients don't like my rationale, usually the worst is that we agree to disagree and they quietly leave the clinic and try their luck elsewhere. A few have actually asked to see the evidence and I happily give it to them.

Don't get me wrong, I'm not saying you should take time away from sick patients in the ED to have this discussion.
In the pain clinic though I view this education as part of my job. My spiel on this is very direct and delivered as early as is relevant during their visit to lay out clear expectation for patients and not waste their/my time if that's all they want (I've had a few walk out in the first few minutes of our visit, much smoother that way than keeping them in suspense for 15-20 minutes). And the place I happen to work give me the support to do this.

 

[Splenda88]

These things will eventually take care of themselves, I think.

I would not bet on that.

 

[southerndoc]

Statement on Preserving Educational and Career Opportunities for Physicians in Emergency Medicine

Recently, the decision by the University of Pennsylvania (UPenn) Emergency Ultrasound Fellowship to accept a nurse practitioner into its Emergency Ultrasound Fellowship Advisory Council Accredited (EUFAC) program has sparked controversy within the medical community.

www.aaem.org