PAs/NPs attempting to "cancel culture" the AMA

Burrell College of Osteopathic Medicine
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cookiegrub said:
Nope not one bit do I regret getting anxious abt these matters. A resident that works 80+hrs and getting half the pay of someone who went to school for 2 years. On top of that, hospitals and rule makers are not doctors and they have absolute control over management. The system is so broken and it is all due to our professions indifference. An assistant should stay an assistant and nothing more. If you want to be a doctor go through medical school. Heck ppl arent crazy to go to the Caribbean to be one. Also if you were already working you'd know that money drives unqualified ppl to seek for spots they dont deserve. Once government rules are swayed in the mid levels favor, you just wait and watch how crazy their leadership will get.
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regardin admin: if you can’t beat, join em...

...then boot them to the street
 
I mean....the analogy should be fairly straight forward. Do you want an airline pilot flying your summer plane to Paris, or do you want the flight attendant who has peaked into the cabin once or twice when nobody was looking to do it?
 
Umm... I fail to understand why so many people on here antagonize NPs and PAs. Most physicians I have met who work with/ know NPs and PAs understand they are valuable members of the team. It is of course important that patient safety comes first and people don’t perform procedures and order medications they do not have the training to understand, but most PAs and NPs are not doing this. There is a reason the amount of NPs and PAs is growing so quickly: demand for medical care is growing quickly and the supply of physicians just can’t keep up (for many reasons, i.e. doctors take a while to train, Congress not increasing residency spots— idk if I would even advocate for this). We need NPs and PAs in order to fulfill the healthcare needs of the public. Yes a physician should be a short call/ walk away in case something outside their scope comes up. They should be trained to notice what is outside their scope. But we also shouldn’t constantly antagonize them on here or through our advocacy organizations because we need their help if we’re going to adequately care for an aging population.
 
detritus said:
Umm... I fail to understand why so many people on here antagonize NPs and PAs. Most physicians I have met who work with/ know NPs and PAs understand they are valuable members of the team. It is of course important that patient safety comes first and people don’t perform procedures and order medications they do not have the training to understand, but most PAs and NPs are not doing this. There is a reason the amount of NPs and PAs is growing so quickly: demand for medical care is growing quickly and the supply of physicians just can’t keep up (for many reasons, i.e. doctors take a while to train, Congress not increasing residency spots— idk if I would even advocate for this). We need NPs and PAs in order to fulfill the healthcare needs of the public. Yes a physician should be a short call/ walk away in case something outside their scope comes up. They should be trained to notice what is outside their scope. But we also shouldn’t constantly antagonize them on here or through our advocacy organizations because we need their help if we’re going to adequately care for an aging population.
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have you been to canada? have you had the chance to wait the length of time to get specialist care?
Do you want to be like the lawyers who have degrees but are unemployed?
In the city, if I want to see a doctor, I see a doctor in the same week..stop this BS where you feed on the "shortage of doctors"
In the rural areas, even the NPs and PAs are not going, so why do you think doctors will go. I agree residency #s are not increasing but the shortage isn't necessarily because of that.
Firstly, what do you mean by shortage (where is this)?
Secondly, do you think those places where there is a shortage, we'd have willing doctors working there if we just incr residency training? (Lemme guess...no, because they're going to settle in the city where prices are jacked up and salary will go down)
Thirdly, You are espousing NPs and PAs work independently in a rural setting, where ppl are even more vulnerable to uneducated advice without fact checks until it's too late.
Fourthly, there are many satellite DO programs getting opened and some schools are clearly abusing the system. They have no interest in student "specialty" success and have zilch resources beyond primary care. The only thing that will keep their pants tight is if residency placement remains competitive. If the flood gates are opened I suspect it will just give them incentive to further go unchecked. What will you have on your hands as a graduate? a pat in the back and no good job prospects

Here's something everyone needs to know: becoming a physician is a long and arduous journey. It has its tears and sweat, and that's why it is a prestigious degree. We are not being handed candy out of the store and provided online degrees because "ppl need our help and we just need to graduate to help them". Respect yourself for the length of time you train. I know it's frustrating but the only thing saving healthcare is this proper process which has been ripped by midlevels who claim we are "going too slow to meet the demands". It's not their place to be saying this because they say it so to give reason for why they are going rogue.
 
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detritus said:
We need NPs and PAs in order to fulfill the healthcare needs of the public. Yes a physician should be a short call/ walk away in case something outside their scope comes up. They should be trained to notice what is outside their scope. But we also shouldn’t constantly antagonize them on here or through our advocacy organizations because we need their help if we’re going to adequately care for an aging population.
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It's just not true. We do not, and will not ever need PAs/NPs. It used to just be physicians and nurses, and then people got stupidly greedy. What we do need is significantly increased incentive for physicians to go to undesirable areas. No care is better than substandard care, which is what these independent PAs/NPs provide.
 
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slowthai said:
It's just not true. We do not, and will never need PAs/NPs. It used to just be physicians and nurses, and then people got stupidly greedy. What we do need is significantly increased incentive for physicians to go to undesirable areas. No care is better than substandard care, which these independent PAs/NPs provide.
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Literally there are tons of countries around the world that don’t have midlevels and function just fine. Our entire country has been brainwashed into thinking midlevels are necessary to solve some shortage rather than actually incentivize actual doctors to go to the areas where they’re needed, since we don’t actually have a shortage for most of the shortage specialties.
 
Matthew9Thirtyfive said:
Literally there are tons of countries around the world that don’t have midlevels and function just fine. Our entire country has been brainwashed into thinking midlevels are necessary to solve some shortage rather than actually incentivize actual doctors to go to the areas where they’re needed, since we don’t actually have a shortage for most of the shortage specialties.
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The U.S. consumes way more healthcare resources than these countries. Physicians also aren’t paid very much in those countries, probably because of increased supply relative to health care utilization. If NPs and PAs are unnecessary why do they exist? Wouldn’t there be longer wait times without them?
 
Also I never said there is a shortage of physicians. I am saying demand for medical care is increasing. The amount of physicians is adequate to take care of this demand clearly, as people can see a doctor/ specialist relatively quickly compared to other countries (how these folks pay for this care is another issue I won’t even get into). Without NPs and PAs though, are you certain that physicians can still care for the same amount of people? If so just explain how.
 
detritus said:
The U.S. consumes way more healthcare resources than these countries. Physicians also aren’t paid very much in those countries, probably because of increased supply relative to health care utilization. If NPs and PAs are unnecessary why do they exist? Wouldn’t there be longer wait times without them?
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Really? You can't $ee any po$$ible rea$on for the ri$e of midlevel$?
 
cookiegrub said:
have you been to canada? have you had the chance to wait the length of time to get specialist care?
Do you want to be like the lawyers who have degrees but are unemployed?
In the city, if I want to see a doctor, I see a doctor in the same week..stop this BS where you feed on the "shortage of doctors"
In the rural areas, even the NPs and PAs are not going, so why do you think doctors will go. I agree residency #s are not increasing but the shortage isn't necessarily because of that.
Firstly, what do you mean by shortage (where is this)?
Secondly, do you think those places where there is a shortage, we'd have willing doctors working there if we just incr residency training? (Lemme guess...no, because they're going to settle in the city where prices are jacked up and salary will go down)
Thirdly, You are espousing NPs and PAs work independently in a rural setting, where ppl are even more vulnerable to uneducated advice without fact checks until it's too late.
Fourthly, there are many satellite DO programs getting opened and some schools are clearly abusing the system. They have no interest in student "specialty" success and have zilch resources beyond primary care. The only thing that will keep their pants tight is if residency placement remains competitive. If the flood gates are opened I suspect it will just give them incentive to further go unchecked. What will you have on your hands as a graduate? a pat in the back and no good job prospects

Here's something everyone needs to know: becoming a physician is a long and arduous journey. It has its tears and sweat, and that's why it is a prestigious degree. We are not being handed candy out of the store and provided online degrees because "ppl need our help and we just need to graduate to help them". Respect yourself for the length of time you train. I know it's frustrating but the only thing saving healthcare is this proper process which has been ripped by midlevels who claim we are "going too slow to meet the demands". It's not their place to be saying this because they say it so to give reason for why they are going rogue.
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I think physicians should be the leaders of the healthcare team. I’m in medical school, I’m aware of all of the difficulties of medical training. I don’t think we should increase the number of residency spots by much. What I am arguing is not even independent practice of NPs and PAs. I am only arguing that our professional organizations should not publicly post inflammatory content antagonizing these professionals, if the AMA wants to lobby against independent practice laws that’s fine. Just don’t post this stuff on Facebook. It makes it look like physicians are being hostile to many of the people that work with us in clinics and hospitals.
 
Matthew9Thirtyfive said:
Really? You can't $ee any po$$ible rea$on for the ri$e of midlevel$?
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I understand they are very profitable to hospital systems, but primary care specialty salaries are rising too. I’m just saying it’s not a zero sum game, they can help us increase our productivity, making everyone more money provided demand continues to increase. If demand falls I don’t think it’s physicians that will be laid off while NPs and PAs are running everything. It will just make less financial sense to hire NPs and PAs when a physician alone can do all of the work without the liability exposure of someone with less training caring for huge numbers of undifferentiated patients in primary care clinics.
 
detritus said:
I think physicians should be the leaders of the healthcare team. I’m in medical school, I’m aware of all of the difficulties of medical training. I don’t think we should increase the number of residency spots by much. What I am arguing is not even independent practice of NPs and PAs. I am only arguing that our professional organizations should not publicly post inflammatory content antagonizing these professionals, if the AMA wants to lobby against independent practice laws that’s fine. Just don’t post this stuff on Facebook. It makes it look like physicians are being hostile to many of the people that work with us in clinics and hospitals.
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How do you propose the combat the propaganda of the AANP and CRNA group?

Edit: Public support is what they have because they have been running smear campaigns claiming they’re equal for years. Saying that our training isn’t inflammatory (or shouldn’t be), it’s quite literally fact.
 
detritus said:
I understand they are very profitable to hospital systems, but primary care specialty salaries are rising too. I’m just saying it’s not a zero sum game, they can help us increase our productivity, making everyone more money provided demand continues to increase. If demand falls I don’t think it’s physicians that will be laid off while NPs and PAs are running everything. It will just make less financial sense to hire NPs and PAs when a physician alone can do all of the work without the liability exposure of someone with less training caring for huge numbers of undifferentiated patients in primary care clinics.
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As far as I understand it, medicare dollars are fixed every year. Therefore, if they need to reimburse midlevels more for their work, that money has to come out of physician reimbursement, right? So in that sense, I think it is a zero sum game.
 
detritus said:
I understand they are very profitable to hospital systems, but primary care specialty salaries are rising too. I’m just saying it’s not a zero sum game, they can help us increase our productivity, making everyone more money provided demand continues to increase. If demand falls I don’t think it’s physicians that will be laid off while NPs and PAs are running everything. It will just make less financial sense to hire NPs and PAs when a physician alone can do all of the work without the liability exposure of someone with less training caring for huge numbers of undifferentiated patients in primary care clinics.
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This mindset is what has led to the situation we are in now.
 
detritus said:
I think physicians should be the leaders of the healthcare team. I’m in medical school, I’m aware of all of the difficulties of medical training. I don’t think we should increase the number of residency spots by much. What I am arguing is not even independent practice of NPs and PAs. I am only arguing that our professional organizations should not publicly post inflammatory content antagonizing these professionals, if the AMA wants to lobby against independent practice laws that’s fine. Just don’t post this stuff on Facebook. It makes it look like physicians are being hostile to many of the people that work with us in clinics and hospitals.
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their professional organizations constantly post inflammatory content against physicians in public all the time.
 
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detritus said:
I think physicians should be the leaders of the healthcare team. I’m in medical school, I’m aware of all of the difficulties of medical training. I don’t think we should increase the number of residency spots by much. What I am arguing is not even independent practice of NPs and PAs. I am only arguing that our professional organizations should not publicly post inflammatory content antagonizing these professionals, if the AMA wants to lobby against independent practice laws that’s fine. Just don’t post this stuff on Facebook. It makes it look like physicians are being hostile to many of the people that work with us in clinics and hospitals.
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Dude the midlevels are openly insulting physicians on social media and idiotically called physician interest groups as hate groups
 
detritus said:
I think physicians should be the leaders of the healthcare team. I’m in medical school, I’m aware of all of the difficulties of medical training. I don’t think we should increase the number of residency spots by much. What I am arguing is not even independent practice of NPs and PAs. I am only arguing that our professional organizations should not publicly post inflammatory content antagonizing these professionals, if the AMA wants to lobby against independent practice laws that’s fine. Just don’t post this stuff on Facebook. It makes it look like physicians are being hostile to many of the people that work with us in clinics and hospitals.
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Yeah, do you realize that the president of the AAPA called PPP a legit hate group? Those are her exact words. Their (and the AANA and AANP) entire campaign is centered around inflammatory and defamatory statements against physicians. That’s not even to mention the propaganda that their education is just as long and in depth as ours, and their awful, AWFUL “studies” that they use to show equivalence.
 
Matthew9Thirtyfive said:
Yeah, do you realize that the president of the AAPA called PPP a legit hate group? Those are her exact words. Their (and the AANA and AANP) entire campaign is centered around inflammatory and defamatory statements against physicians. That’s not even to mention the propaganda that their education is just as long and in depth as ours, and their awful, AWFUL “studies” that they use to show equivalence.
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Was not aware that people were calling any advocacy organizations hate groups. That’s absurd and they should apologize. Also it’s ridiculous to claim their education is equivalent.
 
sunshinefl said:
their professional organizations constantly post inflammatory content against physicians in public all the time.
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I’m against that too. I support what the AMA is advocating for. I just don’t want people to see our organizations as bitter and old gate keepers. Y’all are going in on the dislikes so clearly I haven’t made my point in the best way. I was just expressing the prevailing sentiment in medicine that every member of the team is valuable.
 
detritus said:
I’m against that too. I support what the AMA is advocating for. I just don’t want people to see our organizations as bitter and old gate keepers. Y’all are going in on the dislikes so clearly I haven’t made my point in the best way. I was just expressing the prevailing sentiment in medicine that every member of the team is valuable.
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But we are, by definition, the gatekeepers. Doctors are the standard, end of story. It's not some stupid social club where we keep people out because we're so full of ourselves. These are professional and clinical/medical standards.

There's no time for kumbaya here, lives are at stake! I don't even think bitterness is the word. It's anger and frustration. These people are actively harming patients, and it's going to continue to get worse. That alone is enough to cause most to blow a gasket.
 
Tbh, I’m cool w mid levels as long as they do all the scut work so I don’t have to do it and they leave me to real medicine and don’t take my $
 
slowthai said:
But we are, by definition, the gatekeepers. Doctors are the standard, end of story. It's not some stupid social club where we keep people out because we're so full of ourselves. These are professional and clinical/medical standards.

There's no time for kumbaya here, lives are at stake! I don't even think bitterness is the word. It's anger and frustration. These people are actively harming patients, and it's going to continue to get worse. That alone is enough to cause most to blow a gasket.
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Exactly. The midlevel lobbies want to paint this as some sort of gatekeeper situation where we're punching down at midlevels. It's about patient safety. If a doctor needs 6000 clinical hours to graduate med school and 16,000 clinical hours to become an attending, plus 4 licensing exams in order to safely take care of patients independently, in what world is it okay for someone with an online degree and 500 hours of clinical experience that may be mostly shadowing to just go out and do the same thing?

They are harming patients physically and financially.
 
detritus said:
I think physicians should be the leaders of the healthcare team. I’m in medical school, I’m aware of all of the difficulties of medical training. I don’t think we should increase the number of residency spots by much. What I am arguing is not even independent practice of NPs and PAs. I am only arguing that our professional organizations should not publicly post inflammatory content antagonizing these professionals, if the AMA wants to lobby against independent practice laws that’s fine. Just don’t post this stuff on Facebook. It makes it look like physicians are being hostile to many of the people that work with us in clinics and hospitals.
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Hmm let's see here..doctors cant form unions yet nurses can. While these crazies are going out there taking over healthcare, we cant even post out what is right on a social media platform?
 
Matthew9Thirtyfive said:
I literally read multiple accounts of it on r/residency that were just posted today of midlevels disrespecting residents in front of patients with zero repercussions. Hope it doesn’t happen to you ever, but it definitely seems to happen.

****, when I was just an OR tech talking about going to med school, an NP told me I would never go to med school and in a decade I’d still be just an OR tech.
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I sincerely hope you encounter that NP when you’re a physician! When I was applying to med school, also after well over a decade in the OR, the surgeons, anesthesiologists, and midlevels were super supportive, above and beyond. It was a select few RNs, especially my manager (who had been rejected from med school, including mine), who tried to undermine my confidence. As crappy as it was at the time, I shrugged my shoulders and kept my mouth shut. It was so gratifying giving notice, and even better when they were congratulating me on social media when I graduated.
 
njtrimed said:
I sincerely hope you encounter that NP when you’re a physician! When I was applying to med school, also after well over a decade in the OR, the surgeons, anesthesiologists, and midlevels were super supportive, above and beyond. It was a select few RNs, especially my manager (who had been rejected from med school, including mine), who tried to undermine my confidence. As crappy as it was at the time, I shrugged my shoulders and kept my mouth shut. It was so gratifying giving notice, and even better when they were congratulating me on social media when I graduated.
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Lol I’ll probably never see her again. I haven’t seen her in a decade and she worked at a civilian hospital in a state with no Navy bases lol.
 
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Absolutely hilarious. I laughed my head off when I saw this. Imagine your inferiority complex being so massive that you actually do this stupidity.

Not sure if this is breaking the rules, but here's the reddit post where I got it from just in case they take it down.

You know what I hate? The way they use language to garner sympathy towards themselves, as if they're part of an oppressed and marginalized group. It makes me want to vomit. That's why I can't stand when people say "pROviDeR iSn'T a BiG dEaL, gEt OvEr It" It's 100% a big deal. Language is precisely how these non-physicians deceive patients.
 
slowthai said:
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Absolutely hilarious. I laughed my head off when I saw this. Imagine your inferiority complex being so massive that you actually do this stupidity.

Not sure if this is breaking the rules, but here's the reddit post where I got it from just in case they take it down.

You know what I hate? The way they use language to garner sympathy towards themselves, as if they're part of an oppressed and marginalized group. It makes me want to vomit. That's why I can't stand when people say "pROviDeR iSn'T a BiG dEaL, gEt OvEr It" It's 100% a big deal. Language is precisely how these non-physicians deceive patients.
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Utah should be slammed for allowing this to happen at med admissions level
 
The sad thing is that physicians often perpetuate this stuff too, whether to virtue signal or out of a real sense of being an "advocate" for their mid-level colleagues. The AMA will post something like this about everyone doing their job (not saying midlevels suck or some such inflammatory content, but just that docs should lead the team), and docs join in the AMA-hating. You can't speak out around other docs for fear of being stigmatized for hating on midlevels or being greedy. BY OTHER DOCS. It's the same BS that keeps us from lobbying for stable pay or reasonable hours - other docs will berate you openly for being greedy or having no work ethic, and they're viewed as being in the right. We need to stop hating on each other and support each other. And try to come together, because if we don't, no one else is going to lobby for us. (Like, if you don't like where the AMA is going, why not try to change it instead of standing off to the side and bashing it?) Okay, rant over...
 
slowthai said:
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Absolutely hilarious. I laughed my head off when I saw this. Imagine your inferiority complex being so massive that you actually do this stupidity.

Not sure if this is breaking the rules, but here's the reddit post where I got it from just in case they take it down.

You know what I hate? The way they use language to garner sympathy towards themselves, as if they're part of an oppressed and marginalized group. It makes me want to vomit. That's why I can't stand when people say "pROviDeR iSn'T a BiG dEaL, gEt OvEr It" It's 100% a big deal. Language is precisely how these non-physicians deceive patients.
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Yeah that’s absurd. What an inferiority complex.
 
detritus said:
I’m against that too. I support what the AMA is advocating for. I just don’t want people to see our organizations as bitter and old gate keepers. Y’all are going in on the dislikes so clearly I haven’t made my point in the best way. I was just expressing the prevailing sentiment in medicine that every member of the team is valuable.
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you haven't seen the real world have you son? the moment you are nice, people assume you are a pushover. Physicians have been nice for too long now..this is the reason we are in this puddle. We aren't being mean old gatekeepers though, now we are just pointing out the plain dang truth. We realize physicians of our own community have been perpetuating these midlevel entitlement thoughts and these are the people we need to target first. Like you, many of these physicians are thinking that by defending midlevels you break the old guard. That's great but guess what? The old guard had a point. This is patient safety we are talking about.
 
detritus said:
I’m against that too. I support what the AMA is advocating for. I just don’t want people to see our organizations as bitter and old gate keepers. Y’all are going in on the dislikes so clearly I haven’t made my point in the best way. I was just expressing the prevailing sentiment in medicine that every member of the team is valuable.
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Gatekeeping would be denying a DO to take a job because "you didn't go to an MD school."

This is about advocating for patient safety.
 
Even most NP's hate NP diploma mills because they're lowering their salaries lmao and they get paid less than they would as an experienced RN. Location dependent, obviously. Just wait, they're going to implode by their own self, and "independent practice" will not save them, because there are already examples of them getting burned in lawsuits because of their crap care in independent practice. Plus nobody actually respects them, they can try all they want with "heart of a yadi yada", the public thinks nursing is a menial task and something they could do if they wanted, but they don't view physicians that way.
 
cookiegrub said:
I also find it ridiculous during morning meets, there's a sea of NPs and PAs wearing white coats that are just as long as the attending. At the end all it serves is an ego boost without having done the work to attain the medical degree.
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Come PGY-2, I'm going to emblazon "PHYSICIAN" on my coat in as large a font as I can get away with.

scoopdaboop said:
Can we all just agree that we are overreacting a tad bit.
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Definitely not. Mid-levels want more respect and money (which is fine) at the price of patient safety (not fine). And they're trying to accomplish it by tearing down physicians.
 
scoopdaboop said:
Even most NP's hate NP diploma mills because they're lowering their salaries lmao and they get paid less than they would as an experienced RN. Location dependent, obviously. Just wait, they're going to implode by their own self, and "independent practice" will not save them, because there are already examples of them getting burned in lawsuits because of their crap care in independent practice. Plus nobody actually respects them, they can try all they want with "heart of a yadi yada", the public thinks nursing is a menial task and something they could do if they wanted, but they don't view physicians that way.
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Guess again. My own sister sees an NP and continues to do so despite substandard care.
 
underthesun said:
Nurses and NPs are the most petty, insecure people that you’ll encounter in the hospital. Was discouraged by several when trying to get into med school. Will be putting as many as possible in their place if they forget what it is.
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Just don’t fall into availability bias. Just because you’ve encountered crappy nurses doesn’t mean the nurse in front of you is crappy. Coming at them assuming they are is a good way to have friction.
 
Matthew9Thirtyfive said:
Just don’t fall into availability bias. Just because you’ve encountered crappy nurses doesn’t mean the nurse in front of you is crappy. Coming at them assuming they are is a good way to have friction.
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Welp, guess we should all just quit medical school and get online doctorates in NP. I'm cool with that, screw the 500k debt I will have at the end of training. With your argument, even some doctors give substandard care but just because one does it, it doesnt reflect all. Ok..but that's not our argument. Our argument is that this was never the role of NP and PA to become independent. They are breaching the line and they shamelessly know it. Many even feel the burden when they lose a pt and feel like they are inadequately trained. Hospitals are notorious for saving them because they get to pay these midlevel less. Dont be surprised if your job as a doctor esp in some fields become less respected or powerful. I've seen one senior doctor whose office was run by a rude NP, he just kept mum the whole time.
 
cookiegrub said:
Welp, guess we should all just quit medical school and get online doctorates in NP. I'm cool with that, screw the 500k debt I will have at the end of training. With your argument, even some doctors give substandard care but just because one does it, it doesnt reflect all. Ok..but that's not our argument. Our argument is that this was never the role of NP and PA to become independent. They are breaching the line and they shamelessly know it. Many even feel the burden when they lose a pt and feel like they are inadequately trained. Hospitals are notorious for saving them because they get to pay these midlevel less. Dont be surprised if your job as a doctor esp in some fields become less respected or powerful. I've seen one senior doctor whose office was run by a rude NP, he just kept mum the whole time.
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There are so many logical fallacies in here I don’t even know where to start.
 
Why does everyone sensationalize and freak out about everything literally 24/7? Between **** like this, COVID, Trump, and election nonsense, it’s literally everywhereZ It’s exhausting guys. Midlevels have been expanding and docs salaries continue to go up, and there are plenty of jobs. They will continue to advocate for independent practice, saturate themselves out of a market, and get sued so much that they won’t be touched with a 10 foot pole.
Cmon now.

Definitely something to monitor but saying we should all drop out and be NPs is such a ridiculous SDN take
 
Chibucks15 said:
Why does everyone sensationalize and freak out about everything literally 24/7? Between **** like this, COVID, Trump, and election nonsense, it’s literally everywhereZ It’s exhausting guys. Midlevels have been expanding and docs salaries continue to go up, and there are plenty of jobs. They will continue to advocate for independent practice, saturate themselves out of a market, and get sued so much that they won’t be touched with a 10 foot pole.
Cmon now.

Definitely something to monitor but saying we should all drop out and be NPs is such a ridiculous SDN take
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Again. Some of us are concerned with patient safety.
 
Primary care mid-levels should be able to practice independently in areas of the country that suffer from physician shortages. People living in these areas deserve to have the option to see a local mid-level on short notice instead of waiting a month to see a physician in a city several hours away.

With that being said, autonomous mid-level should not misrepresent themselves as physicians or describe their education/training as being equal to that of a physician.
 
Chibucks15 said:
Why does everyone sensationalize and freak out about everything literally 24/7? Between **** like this, COVID, Trump, and election nonsense, it’s literally everywhereZ It’s exhausting guys. Midlevels have been expanding and docs salaries continue to go up, and there are plenty of jobs. They will continue to advocate for independent practice, saturate themselves out of a market, and get sued so much that they won’t be touched with a 10 foot pole.
Cmon now.

Definitely something to monitor but saying we should all drop out and be NPs is such a ridiculous SDN take
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Oh it's definitely a bigger problem than salaries and job prospects. Physicians are being sued by patients that they've never even seen. What's worse? Physicians may not take these patients being treated by the NP for fear of malpractice litigation. In short, you could see NP's getting all of the glory and fun of independent practice without most, if not all, of the liability that comes with it. This will only drive up healthcare costs since:
  1. APP's are associated with ordering more imaging studies, compared to Primary Care Physicians taking on similar cases.
  2. APP's were more likely to prescribe antibiotics to patients than PCP's seeing similar patients requiring the same level of care.
  3. Physicians had a higher quality of referrals for patients, compared to NP's and PA's.
  4. 96% of NPs had regular contact with pharmaceutical representatives. 48% stated that they were more likely to prescribe a drug that was highlighted during a lunch or dinner event.
  5. Only 25% of all NPs in Oregon, an independent practice state, practiced in primary care settings.
  6. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits
The fact is, the evidence we have indicates major deficits in many areas that threaten quality, safety, and cost-saving measures in healthcare. But you may ask "well, they need to expand access to those in rural areas where doctors don't want to go!!" Well, there is one good reason for that! Under the current guidelines from the CMS, if you want to receive Medicare and Medicaid funding, you must have a midlevel on staff at least 50% of the time the clinic operates. The way I see this, this prevents more physicians to be allocated to the rural area to work in the private practice. And if you think rural people are easy to treat with bread and butter cases, think again. According to the CDC, 15% of Americans live in what is designated as a "rural area" and suffer from complex maladies, such as heart disease, stroke, cancer, and chronic lower respiratory illnesses. I would not trust an NP to manage long-term care of complex patients without any input or oversight from a physician.

In short, the answer isn't to fund more jobs for midlevels; we need to fund more residency positions. I'm sorry, but the compounding fact that NP's have a severe lack of training compared to physicians and the aforementioned data shown above, this will only hurt patients as a whole in the long run. It's that mindset you posted as a main reason why there are discussions in the first place. And why we need to waste money on studies to prove something that's kind of obvious.
 
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Matthew9Thirtyfive said:
My wife is a nurse. She pretty much gets it now, but I had to explain it to her as well. Most people have no idea, including people in healthcare.
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"So how many more years do you have left?" Every staff member to me at every stage of training no matter how many times I'd told them before
 
FutureSurgical said:
You know what I hate that hasn't been discussed ITT? When CRNAs use "Physician Anesthesiologist" and "Nurse Anesthesiologist." Same thing with "MDA." It's just "Anesthesiologist." It may be semantics, but CRNAs co-opting the title reserved for a physician are purposefully blurring the lines.

You're not a "nurse anesthesiologist," your a "nurse anesthetist." Once again, this may be semantics, but no one in my family would know the difference unless it was spelled out to them. And people who THINK they're getting care from a physician are actually getting care from a CRNA. CRNA's are capable people, but IMO, in a physician-led role.
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This is where state laws need to be passed for title protection. Next thing you know they're going to start saying that NP means Nurse Physician
 
Mad Jack said:
This is where state laws need to be passed for title protection. Next thing you know they're going to start saying that NP means Nurse Physician
Click to expand...

I’m tempted to delete this so they don’t see it and get any ideas.
 
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