No, I'll comment if I want. You no longer own the internet.
You're the one who gave that example and you see that same thing over and over again. That's the first thing people jump to when they feel threatened.
It was a suggestion to improve the way you come across. Not to protect my delicate space. Commenting all this doom and gloom constantly to other doctors, many of whom are negatively affected by these trends and then saying “but its fine, I couldn't care less, because it doesn't affect me at this point.” You might as well be giving a big f you to all your colleagues. But hey you wanna come across as a douche? Go ahead! Internets yours!
1. From the little I've seen of your posts I don't think you're in any position to give advice on how someone should come across.
Please point out this great advice you’re giving…
Oh I employ 2 PA’s and my practice employs 7 in total. Like I said Im not as worried about midlevel encroachment as I am about the reimbursing bodies that be constantly giving us the squeeze. They aren't just giving us the squeeze. They squeeze the midlevels one and the same.
Wow. Insert slow clap here. Some advice. I now know not to take a single thing you say seriously.
I use my midlevels for follow-ups. Thats it. It certainly as death and taxes, is not using them to do your procedures. Not in any clinic I’ll ever work in.
So don't. I'm not in a position to worry about that at this point. I know the issues that I had to deal with when I started up and I knew what I wanted. Despite the naysayers, I made it work and got everything out of my practice that I wanted. There will always be issues that need to be dealt with. I have no doubt that if I were starting up today I would figure it out. Those who are capable will figure out a way to succeed. Those who aren't will just complain about it.
The future??? I bet that's a business plan for many people today. I bet the future will be the mid-levels remaining in the procedure suite all day and competing directly with physicians.
That sounds like CRNA model for anesthesia.
Ive never worked in a clinic or hospital where your midlevels do your blocks or other major procedures.
Mics are for dropping. How could she not know?
There is a large PE practice in my state that incentivizes this:
I have no problem with this model. In fact this is essentially my practice model. I do have a problem with them actually performing procedures. I see all new patients though.
Mhmm, this model incentivizes mid-levels to push procedures, even if not indicated, or borderline etc...
I always confirm exam findings and indications before I do any procedure.
Indeed, but it's inevitable if you want to survive.
You’re sippin some serious retirement cool-aid man. Dementia much?
Exactly. Its disgusting.
I think you're taking this the wrong way. There are my beliefs on the capabilities of people and then there's the reality of the US healthcare environment. Education to me is important but the vast majority of what's learned is learned on the job for the most part and anyone can learn anything by working at it enough. An established group with a vested interest in any particular field has the typical superiority complex and doesn't like to hear this and I see the same theme repeated in every business I'm involved in.
witty
as an old school doc, i would have concerns with this model too.
my problem with this is that we are seeing very poorly educated NPs pretend to practice medicine and harming patients. there is no recourse for the patients because the NP either can't be sued or they aren't held to the same standards of a physician or the supervising physician is the one who takes the hit in a lawsuit.
I agree. Well put. Now if only we could find a way to keep the government from giving us the big squeeze.
Who gets to draw the red line for which the practice of NPs cannot be crossed? Why is it okay now for them to see pts, prescribe meds, and manage the visits that reimburse less so they can then feed procedures to the doctor, which reimburses more? It's okay because the practice that is set up like that is generating revenue with that system. This type of practice, unsurprisingly, is not argued against in this post because it financially benefits the practice. You can clearly see this in this thread.my problem with this is that we are seeing very poorly educated NPs pretend to practice medicine and harming patients. there is no recourse for the patients because the NP either can't be sued or they aren't held to the same standards of a physician or the supervising physician is the one who takes the hit in a lawsuit.
they're being legislated into the practice of medicine instead of being educated. just look at their paltry education and almost complete lack of clinical training. nursing isn't medicine. years of clinical nursing do not equate to understanding how to formulate differentials and diagnose disease.
if you aren't familiar with the group Physicians for Patient Protection take a look at their website and consider their book Patient's at Risk. it's pretty eye opening.
I personally think these people need to be supervised and function like residents, not be given carte blanche to practice medicine because they lobby for "full practice authority". there is room for them to extend the services of a physician. they aren't meant (nor educated) to replace us or function independently.
I try not to see anyone of course but I prefer, at least initially, a physician. Better educated and they worked a lot harder to get to where they are. There is something to be said in and of itself for surviving the intensity of med school training. That's just my initial bias but once I get to know and trust someone I probably wouldn't care too much.
Hey man, Im not even gonna hurl an insult back at you. Your posts do a pretty good job of making you look bad. My outcomes are, so far, immaculate (knocking on wood). I put patient safety first every single day. Its sad that you and Dr. Lobel love to look down on all your fellow physicians as inferior. We're all committing malpractice, putting patients at risk, blah blah blah. Just seeing what you post here, I wouldnt trust your judgement with 2 sheep drawn on a piece of paper, much less any medical care of mine.
Why you coming after me?
Well, because you constantly make comments questioning the quality of everyone else's care. Actually, I like your posts most of the time. Unlike pains.
See Mitch's post above. Daily, I get to see things that aren't real, true, accurate, or remotely correct. CRPS patient came in today complaining of how her fat was exposed on her nerve as the sheath was stripped away. Chiro office saw it on MRI. Gave her stem cells and visco in her knee. Normal MRI report.
