starbuckscoffee

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http://news.yahoo.com/s/ap/20100414/ap_on_he_me/us_med_dr_nurse

Any thoughts on this article?

Summary for those who don't feel like reading:

-28 states are considering expanding the authority of NPs due to primary care shortage
-What NPs are asking for: right to be called Dr (if have doctorate), right to practice independent of physicians, right to prescribe narcotics
-AMA does not support these requests
-NPs are reimbursed by Medicare at 85% of the physician rate. New Obama health care bill gives nurse midwives the same Medicare reimbursement as doctors. NPs want all NPs to get 100% of physician Medicare rate.
 
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SilverSpyderGT

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Wandered over here from the vet forums... wow, this article rubs me the wrong way, and I'm not even a human doc. Here are some gems:

"Chicago nurse practitioner Amanda Cockrell, 32, who tells patients she's just like a doctor 'except for the pay.'" - Yeah, and the extra four years of medical school.

"The health care overhaul law gave nurse midwives, a type of advanced practice nurse, a Medicare raise to 100 percent of what obstetrician-gynecologists make." - Not that you could pay me enough to mess around in a human's nether regions, but... really? Residency and board certification don't mean ANYTHING to Medicare?

"Nurse practitioners say patients aren't confused by veterinarians calling themselves 'Dr.' Or chiropractors. Or dentists. So why, they ask, would patients be confused by a nurse using the title?" - Probably because I don't walk into an exam room and say, "Hi, Mrs. Smith, I'm Dr. SilverSpyderGT. How is your knee feeling today?"

Stuff like this devalues genuine medical education. It's sickening. Why pay $150,000 for medical school when nursing school is clearly sufficient? We're fortunate enough in the small field of vet med that we have a clear divide between veterinarian and technician responsibilities, but I paid just as much for veterinary school as many doctors do for med school, and I'd be pretty angry if someone was stepping on my turf like this.
 

mig26x

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this one is insulting and scary: "Chicago nurse practitioner Amanda Cockrell, 32, who tells patients she's just like a doctor 'except for the pay.
 

smq123

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Moving to Topics in Healthcare.
 

JaggerPlate

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Welcome to 21st century America ...

Everybody wants something without doing the work. Want to be famous but have no talent? Be a slut on a reality TV show. Want to be a pop-star, but can't sing??? Welcome to autotune. Want to be called a Dr and get to walk around in a cool white coat, but don't want to waste all that time and money undergoing appropriate training ...

you get where I'm going with this. It's an epidemic, and it lowers the quality of EVERYTHING for EVERYONE.

My guess is that because nurses honestly have way more lobbying power than docs, they will get everything they want. They will get to be called Dr Fakey, DNP in all 50 states, get reimbursed 100% Medicare, Medicaid, PPOs, etc.

The interesting part with be the mal-practice and how quickly people sue. My guess is that things may slow down a bit at that point.

OH, also ... don't expect this to stop at primary care. Soon, they will start DNP 'residencies,' using the platform of how easily they took over primary care to jump into other lucrative fields (i.e. derm).
 

Instatewaiter

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The DNPs don't deserve the title doctor because their education really isn't a doctorate. It is still just masters level course work. The difference between a masters NP and a doctral NP are 6 credits of clincally useful courses and no increased hours of clinicals. The math can be found here: http://forums.studentdoctor.net/showpost.php?p=9538605&postcount=97

Now the difference between a DNP and a FPs training is embarassing.
Going from a bacchelors to a DNP is 72-80 credits. Half of those credits are non-clinical coureses like nursing leadership, ethics, nursing activism, nursing history, and research design. Furthermore, the 72-80 credits includes the meager 1000 hours of clinicals. So 40 hours is a doctorate now?

The MD is roughly 115 credits (104 are clincally related) not including the 4200 hours of medical school clinicals or the roughly 10,000 hours for residency.

MD is 104 credits of clinical courses. The DNP is 40 credits which includes their clinical hours.

Just by clinical hours: An FP goes through 14,000 hours+ vs the DNP's 1000 hours of clinicals.
http://forums.studentdoctor.net/showpost.php?p=9538627&postcount=98
 

Sneezing

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Well then, let them have medicaid and medicare. All physicians should then drop these low paying insurance companies. Reinforce that money equals quality. Otherwise, accepting these low payors that equate you to an NP means you agree with it. Set out on your own and charge what you are worth. Bring back quality. Bring back working for your patient.
 

medsurg2010

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MODS:

Any way we can combine this thread and the other two in "Topics in Healthcare" about the same topic?

Sorry but no real different question exists in this thread than the others.

Thanks
 

JaggerPlate

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Well then, let them have medicaid and medicare. All physicians should then drop these low paying insurance companies. Reinforce that money equals quality. Otherwise, accepting these low payors that equate you to an NP means you agree with it. Set out on your own and charge what you are worth. Bring back quality. Bring back working for your patient.
What makes you think they would only get the medicaid and medicare patients?
 

sideways

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Why is this legal?

The AMA is pathetic.

Hopefully the current crop of med students and residents can muster something resembling a spine and combine that with a level of common-sense and self-preservation and ultimately get some **** done in the name of PHYSICIANS in this country. The last thing our profession needs is some alphabet soup with jelly stains on a white coat that's so long she needs bridesmaids to carry the tail introducing herself as a doctor to unsuspecting patients.

 
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IDBasco

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So I just remembered that in the beginning of 1st year a NP came to my school and gave one lecture on stress and illness. Long story short, my roommate went to see her because she wasn't feeling good for a while and thought she might get some help. So she went in and was given all these saliva tests and I don't remember what all but it was like $800 all told. She came home with supplements or vitamins and I think protein, but the kicker was one thing they told her to do that she didn't do at the time because she was in a hurry. Luckily she didn't do it as its a total scam. She brought a brochure home for this service, which is supposed to "detox" your body through your feet- can I get an industrial size rolleyes smilie?

https://www.aquadetoxusa.com/

I immediately raised an eyebrow when I saw the pamphlet. Supposedly this NP goes all over the country to lecture docs, midlevels, etc. What a joke. Here is a little more about it.

http://en.wikipedia.org/wiki/Aqua_Detox

One of two things are possible to explain how the NP could offer this service. 1- she has no understanding of how it works (or rather, doesn't) or 2- she knows it doesn't work and continues charging people for the "treatment" ergo she is bilking patients. Now, this person is just a little more schooling away from being a "doctor"? Get real.
 

JaggerPlate

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Why is this legal?

The AMA is pathetic.

Hopefully the current crop of med students and residents can muster something resembling a spine and combine that with a level of common-sense and self-preservation and ultimately get some **** done in the name of PHYSICIANS in this country. The last thing our profession needs is some alphabet soup with jelly stains on a white coat that's so long she needs bridesmaids to carry the tail introducing herself as a doctor to unsuspecting patients.

It's clear that action needs to be taken. I just don't know from who and what? Us (I'm down)? A bigger society? Schools? Specialty organizations?? Etc.

Open to suggestions ... because this problem isn't going away.
 

Slack3r

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Well then, let them have medicaid and medicare. All physicians should then drop these low paying insurance companies. Reinforce that money equals quality. Otherwise, accepting these low payors that equate you to an NP means you agree with it. Set out on your own and charge what you are worth. Bring back quality. Bring back working for your patient.
Until they make not accepting govt insurance illegal, like they're already doing in MA.

My favorite part is that doctors are greedy *******s who spend all day on the golf course and cruising around in the benz while the nurse sees patients and actually cares. But when they lobby for more money, they're underpaid and overworked and "greed" never enters the discussion.
 

Neuro Surg

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If they want to be called "doctors", do the same treatments, all without not going through medical school and residency, then they should have to cover their own ass with malpractice. How many DNP mega malpractice lawsuits do you think it'll take before the public gets buyers remorse on this one?
 

Dr Oops

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If they want to be called "doctors", do the same treatments, all without not going through medical school and residency, then they should have to cover their own ass with malpractice. How many DNP mega malpractice lawsuits do you think it'll take before the public gets buyers remorse on this one?
They will most likely refer out the cases that are lawsuit prone. Also someone else brought this up, but they wont necessarily be held to the same standard of care for medicine, since they are "practicing nursing".