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2000 First Aid = 401 pages
Amazon product ASIN 0071358498
you can get a used copy for $0.01
15 years later...
2015 First Aid = 768 pages
Amazon product ASIN 0071840060
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Nurse propaganda
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2000 First Aid = 401 pages
Amazon product ASIN 0071358498
you can get a used copy for $0.01
15 years later...
2015 First Aid = 768 pages
Amazon product ASIN 0071840060
700 hours of on the job training? that's what interns get in only 2.5 months!!
Well I heard they spend more time w/ pts so they must be better, training be damned.
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The real problem wasn't when NPs were employed by physician owned practices or partnered up with physicians in practice for supervision. The problem started when they leveraged these positions to market themselves to hospitals as replacements for physicians rather than physician extenders (which was really the whole point of them in the first place). In the hospital system, you're not the employer, the hospital is. If it's cheaper to hire 2 NPs at 100K/yr to "collaborate" with the existing physicians in the department rather than hire another physician at 250K/yr, well you can see where it's heading. Even if the physicians in the department would rather have another one of them on board, they don't make the ultimate hiring decision if their practice is owned by the hospital.
We actually do need more specialists overall, which is part of the reason certain specialties' salaries are relatively inflated. There's actually really large (albeit self-created) shortages of specialties like derm, ortho, neurosurg and (to a lesser extent) ENT. Take a look at the recruiter postings for derm and ortho positions..there's a crapload.
I like the way they admit PAs have 2.8X more hours of training than they do (which is still less than during residency of any sort but whatever) but then go on to say PAs can't handle asthma and diabetes. lol wut? Also, what NPs is "interpreting" a biopsy? Haven't seen many NP pathologists out there. Always love the studies that show that "NPs spend more time asking questions and offering advice than doctors do" never mind if the advice was actually correct or the health outcomes actually the same (not saying it was or wasn't...but those might be new important outcomes someone might want to measure). It just really torques me the wrong way when they throw these crap studies out there to try to make them look more "caring" or "thoughtful" than physicians.
Unfortunately, this is what our culture celebrates now. "Only 2.5 months worth of intern hours and they can do exactly what a real doctor does?? Wow how awesome!!" The sad part is that lots of the PAs and NPs I've met have really great relationships with the physicians they work with. Too bad the NP lobbying organizations are turning it into an "us vs them" situation.
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What doctors should do is refuse to work with NPs and let them demonstrate just how capable they are on their own and completely on their own.
No, it's because you can do a spinal surgery that has marginal evidence at best and still grab 1.5k despite little improvement in symptoms.
Hey not arguing against that either. However these artificially created shortages (which are still shortages) do nothing but keep salaries artificially inflated (and if we're being honest that's why they maintain these limited numbers of residency positions).
Thanks for that **** study from NZ bro.
ouch. you got me!
Mean registered nurse experience 28.2 years (95% CI: 25.58–30.82)
Mean registered nurse experience in specialty area 17.03 years (95% CI: 14.11–19.96)
Mean number of years house officer experience 2.88 (95% CI: 2.18–3.57).
Mean number of years experience in current specialist training programme 3.42 (95% CI: 2.06–4.78)
Four doctors had previously worked as a doctor in another specialty training programme prior to commencing their current specialty training.
The small number of nurse practitioners in NZ and the need for participant anonymity prevents the numbers from each specialty area being shared.
Title and model used in study :
Presentation to an acute tertiary hospital
Number of acute care specialists if you wanna call the first two that:
Cardiology 3 (18.75%)
Respiratory 1 (6.00%)
Emergency care 2 (13.00%)
n=16
Kill yourself.
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Thank you for your input. I am no longer in school, and no longer have access to full length publications. Was merely re-posting I read before work on Medscape.
Now, on to a lighter note. Watch your language. Internet law related to anonymity is not as favorable as it used to be 🙂
Doesn't sound like a lighter note to me. Sounds like weaponizing your emotional feeling of being offended that I called you out. Why are you in these forums posting garbage you can't back up anyway?
For exactly what you provided? So that others with more access/knowledge can provide their input?
You deserve an A+
Wut.
Dude, I haven't even taken Intro. Stats and I can tell you that your "study" is pure applesauce. Come on back to the pre-med forums now....
I appreciate your efforts.
The study is published in International Journal of Nursing Studies? Bias must be non-excistent
You went from being a meaningless poster to a pure **** poster in 5 quick posts. Congratulations.
It is quite amusing that I posted a link and got everyone so riled up.
Posting about nurses in here attracts the same amount of vitriol as posting BlackLivesMatter on Fox News.
I hate this defense mechanism that gets pulled so often around here. You didn't "rile" anyone up like you're some experienced heckler. Most of us are responding with "you're a ****ing idiot" from work/commute/taking a ****. It's your last ditch attempt to make it seem like you're some cool guy that got all the neurotic posters on SDN all fired up!!! I would bet money every poster that responded to you was literally sitting there stoned face, emotionless, while we went about our lives.
I thought we were all trying to have some fun here...
I expected a complex article with some deep analysis and was pleasantly surprised how elegantly that cartoon depicted typical troll behavior. Actually laughed.
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You are right on target. With the explosion of medical knowledge, there's absolutely no way that primary care physicians can know it all and do everything like the general docs of 50 years ago, much like general surgeons don't operate on nearly every organ system in the body like they did 50 years ago; maybe unless primary care residency programs want to lengthen the duration of residency. I'm in a surgical subspecialty in which there are talks of extending the residency to 6 years (rather than 5) because the amount of information keeps growing so rapidly, and with duty hours restrictions there's less time to see and do everything.
From my experience in multiple academic and private clinic settings, this is the direction that healthcare is going: the PCP's will generally try treating diseases like sinusitis, sleep apnea, otitis media, etc. with the first line treatments, and if they aren't seeing results then they'll refer them to us. Reading the NP notes, they generally have a laundry list of problems in the note because they spent an hour listening to the patient's every complaint, then each complaint gets referred out to a specialist instead of actually trying to be treated. Got sinus problems? ENT consult. Aching back? Neurosurgery consult. Headaches? Neurology consult. Trouble urinating? Off to urology. Etc. etc. As a result of this, patients are now going to primary care docs and pretty much demanding to be referred to subspecialists for problems that don't need subspecialty care, because that's what they expect. The end results is that a lot of specialty clinics (including mine) are being overrun with patients who absolutely do not need to be seen by a specialist and can easily be managed by a well-trained primary care doc. Not only is that driving up the cost of healthcare, but it is also taking time away from patients in clinic who have legitimate surgically manageable diseases. This is what scares me the most about the rise of mid-level providers seeing patients unsupervised, because while our clinics are being flooded with unnecessary patients, I cannot tell you the number of delayed cancer diagnoses I have made (often in the ED) that have been completely missed by NP's, who are treating all sore throats and lymphadenopathy with antibiotics. Is that being published? No, because I don't have the time to try to bash NP care in the public forum; I have better things to do in my time.
NP's should be embarrassed if they actually want to "replace" physicians. Or, do they literally not know that they don't have even a fraction of the education and training that docs do? I wonder if they are that naive and clueless. I can see a nurse doing the trivial, basic cases that PCP's don't have time for, but if they want to do any more than that( as in, have more autonomy) , they should be laughed at by everyone. But then again, this is America... Nurses are great because they spend more time with patients and therefore must care more than the physician does. The physician doesn't give a rats ass and just wants the paycheck. You know, so they can fuel their Porsche buying, lavish lifestyles!
Face it, the general public doessnt give a **** how long and hard it took, how many years and hundreds of thousands of dollars it took to study/train to become a physician... Unless they have a choice by whom they'd like to be treated- I'm guessing they would usually rather be treated by a physician
Face it, the general public doessnt give a **** how long and hard it took, how many years and hundreds of thousands of dollars it took to study/train to become a physician... Unless they have a choice by whom they'd like to be treated- I'm guessing they would usually rather be treated by a physician
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Let NPs go independent and carry third own malpractice risks...
These are good thoughts, but to the bolded: Do you really? I mean if it was happening that often, I feel like you'd be compelled to take action to prevent it.
This is flawed logic; just because most nurses are women doesn't mean most women want to be nurses, which was his assertion.
So what words should we use to describe someone who is actually being sexist or homophobic, oh wise one? Tell us so that we may be "grown-ups" like you. [emoji57]
you attack their argument, not their character. and I've still never seen an example of actually being homophobic, because being afraid of gay people isn't a common view. disagreeing with gay marriage =!= being afraid of gay people (this is coming from someone who supports gay marriage)
But calling an argument sexist IS attacking their argument.
And regarding your second point: don't pretend like you think "homophobia" refers only to a literal phobia. Come on.
In any case, I have no idea what you would call beliefs like "gay marriage/adoption will degrade the family, the basic unit of society" if not a phobia—a strong and irrational fear.
It's not a fear, it's an opinion. You might disagree, but that doesn't make it homophobic.
You call them opinions. That way you don't pass your judgement on others beliefs.
No, it may be an opinion, but it's also a fear. That's just a fact. No one who says that gay marriage will ruin society is looking forward to it. They fear it, supposedly.
Or are you just objecting to the suffix of "phobia"? Because, again, I think we can all agree that the standard definition of homophobia does not entail a literal psychiatric phobia (though there are similarities...)
Saying "the gays" are going to "ruin America" is something I would consider both a phobia and a ridiculous opinion. Saying you're against "the gays" because you're worried a guy/girl is going to sexually assault you in the bathroom is equally ridiculous and phobic.
Saying that individual families may suffer as a result of homosexual relationships? Well, I don't know. A limited search on Google Scholar netted very few articles that have explored the topic, though most seem to indicate that there isn't much of a difference with respect to a variety of outcome measures. But I wouldn't consider that a phobia. There's not an overt "fear" that the downfall of society is going to result from "the gays" or something similarly grandiose. It's an opinion - perhaps ill-formed, but at least based on something (e.g., the perception that a "natural" family is composed of a heterosexual couple and their children and thus preferable to a homosexual couple + children for whatever reason). Thinking "the gays" are going to ruin America or assault you in a bathroom is based on absolutely nothing, thus more phobic.
Regardless, labeling everything as "homophobic" that doesn't comply with your or others' conception of gay rights, equality, whatever does little but stifle conversation. It's an argumentation tactic and does nothing to advance anything.
This is getting off topic.
I'd be interested to see if there's any studies about malpractice lawsuits (or just the number of malpractice cases) that have occurred and the outcomes from independently practicing NPs. I'm guessing it's too early for any major studies to be out as all I could find was this:
https://www.rmf.harvard.edu/Clinici...es-After-Offhours-Call-to-NP-for-Flu-Symptoms
I'd be interested to see if anyone else has better luck, as everything I saw was related to NP's who were under physician supervision or just about buying malpractice insurance.
If it's homophobic or sexist, I'm going to have to call it that. I won't do it if it's not, but I'm going to if it is, because I don't like those things!
And yet again, we need to accept that "homophobia" isn't a literal phobia. The meaning of that word is widely understood to refer to anti-gay discrimination, in the same way that "hate crime" refers to a crime motivated by racism, not just the one literal emotion of hate.
I think the problem here is that comments like that do nothing but stifle conversation. There is a strong negative psycholinguistic association with terms like "racist", "sexist" and "homophobic". The reason for this is that most people (white power advocates and the like being exceptions) take great exception to being called these things, and in many cases people's careers have been ruined due to casual remarks like that. Still not as bad as McCarthy Era society where you could be blacklisted for being called a "pinko" (a communist sympathizer, so you are just a little red), but the concern there is real.
So addressing points that you want to view as "homophobic" or "sexist", I would suggest rather than just immediately paint the opponent as a deviant (a logical fallacy called Ad Hominem), you should state "Your statement X is wrong because of the following inconsistencies, contrary facts, statistics, etc.". The key to a well established debate or dialectic is to address points made, and the logical premises and conclusion of said points. This leads to (hopefully) a broader understanding of the matter by both parties involved, and often helps uncover truth when it sometimes can be blurry around the edges.
Unless all you care about is winning in the public eye, in which case I would encourage to keep arguing like modern politicians and forget that example below used to be the common form of pundit debate...
Edit: Vidal did spend a little too much time calling Buckley a "crypto-nazi" during that debate, but otherwise an incredible exchange of ideas.
Stahp
Except sometimes the position is so fallacious that there is no need for argumentation.
No one argues with the Flat Earth Society, or with radical feminists who believe that all men should be exterminated.
I would put people who argue that women should stay in the kitchen or that homosexuals endanger our children and the such in the same category, and feel free to call them sexists and homophobes and stopping the argument there, because there cannot be logical conclusions to the discussion.
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That's the whole point though. As several posters pointed out, believing homosexuals endanger children and believing that homosexuality might be a threat to the traditional family unit which is an important part of society are different view points. Calling the latter homophobic is really just attacking the person not the argument. Same can be said about the "sanctity of marriage" argument.
Not it's not. You're confusing the social acceptance and the fundamental value of the argument.
Most nowadays accept that women are equal to men, but it wasn't the case before mostly because of religious influence (women being submissive to men in the Christian religion, not being able to become priests etc). Of course you could find some arguments which seemed, in appearance, at least somewhat motivated by "logic", e.g. "women aren't interested in politics" or "women aren't educated enough to vote" but it was only a strawman, really. Not being able to vote was one of the main reasons women couldn't get educated in the first place. The main influence was by far moralistic, based on purely subjective feelings.
The exact same can be said about marriage. It's acceptable still, in 2015, in the USA, to claim that homosexual marriage threatens the "sanctity of marriage" (whatever that means), but it's no less moralistic and rooted in non-sense than claiming that women are inferior to men (notice the attempt to rationalize the belief too: "it's bad for the kids" or "it's unnatural, gay animals don't care for kids"... boy my brain).
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I'm not confusing anything but I see this is futile.
lol I watched thank you for smoking the other day and thought of you
AAMC has been sending me alarming emails about projected physician shortage--90k in 2025. Maybe it might be a good idea to flood the market with primary care physicians so we can put NP out of business. I understand that will depress wages🙁, but it might be a small price to pay after all...
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