NYT: Nurses aren't doctors

[HOLA]

I used to have a thing for Japanese nurse porn.

 

[Jukai]

Edit: I thought this thread was on page one. Question answered a longggg time ago.

 

[JuliaB4GSP]

Wait 'til you guys get a Doctor of Osteopathic Medicine as your pcp...

 

[PainIsLIfe]

The training is in no way remotely comparable, sorry. If you want to be a doctor, you should go to medical school. I can't understand how you can rationalize equality when you have like 1/10 the training and don't take the same exams. If you want to practice like a primary care doctor, you should be held to the same standards. Go pass the USMLE 1,2, & 3, and then we'll talk.

Let me give you the story of a quack I went to see once - actually twice.

I was congested and feeling run down all the time and went to the new doctor that took over my former dr's practice. He prescribes an anti-biotic and zyrtec. I'm fine for a couple of weeks and it starts again.

I go back and he tells me move zyrtec and as for feeling tired, he can prescribe zoloft. I said doc, I'm not depressed - just tired. His reply was that some people get a "boost" from anti depressants and "you're already taking a pill every day, it would just be one more".

Needless to say I had my records transferred to another primary. Turns out that I had large turbines and all my sinus cavities where clogged. Surgery to clean the cavities, drill a couple more drains and shrink my turbines was the answer. Of course the "good" doctor wanted to give me an anti-depressant.

 

[dza76wutang]

Wait 'til you guys get a Doctor of Osteopathic Medicine as your pcp...

But my bones are fine...

 

[AznTrojan]

Wait 'til you guys get a Doctor of Osteopathic Medicine as your pcp...

only the lay people give a shit where someone goes to medical school.. people in the medical profession care where you do your training (residency and fellowship) which are predominantly allopathic

nevertheless.. i like to give my brother shit for being a DO and calling him a bone doctor..

 

[GermanBJJ]

No one is saying that NPs are as intelligent or experienced as MDs. They aren't. So the MDs here can put their dicks back in their pants - the measuring contest is over.

But that's not the point - the issue is that lots of people are basically getting (a) either zero medical care or (b) crappy medical care under the current system because physicians think they should be allowed to spend 3 min with a patient, write an Rx and then bill for a $400 visit.

Patients and providers realize that you don't need a 7-figure a year rubber stamp for the vast majority of common ailments so they are seeking alternatives.

Medical schools could cure this problem with the stroke of a pen: just graduate more physicians. But then they wouldn't have (a) bragging rights of only accepting the top 3% of applicants (because God knows that 4% person could NEVER practice medicine) and (b) they couldn't cry for more money like the writer of this NYT article.

The author's solution to a lack of adequate healthcare care is literally pure comedy: pay us more and don't seek alternatives. Can you imagine a member of any other industry other than medicine saying something so infinitely stupid in a public forum?

 

[Josh]

No one is saying that NPs are as intelligent or experienced as MDs. They aren't. So the MDs here can put their dicks back in their pants - the measuring contest is over.

But that's not the point - the issue is that lots of people are basically getting (a) either zero medical care or (b) crappy medical care under the current system because physicians think they should be allowed to spend 3 min with a patient, write an Rx and then bill for a $400 visit.

Patients and providers realize that you don't need a 7-figure a year rubber stamp for the vast majority of common ailments so they are seeking alternatives.

Medical schools could cure this problem with the stroke of a pen: just graduate more physicians. But then they wouldn't have (a) bragging rights of only accepting the top 3% of applicants (because God knows that 4% person could NEVER practice medicine) and (b) they couldn't cry for more money like the writer of this NYT article.

The author's solution to a lack of adequate healthcare care is literally pure comedy: pay us more and don't seek alternatives. Can you imagine a member of any other industry other than medicine saying something so infinitely stupid in a public forum?

I got a good chuckle out of the synopsis at the end. Well stated.

 

[New User 122121]

Wait 'til you guys get a Doctor of Osteopathic Medicine as your pcp...

I've only had a couple patients ever ask about my medical school or residency. In the real world, patients come to you by referrals from friends or other physicians. The only people who care about what medical school you went to are pre-meds and narcissists who think attending a big named school matters. And for those patients, they can go to those doctors. They need each other.

 

[New User 122121]

Medical schools could cure this problem with the stroke of a pen: just graduate more physicians. But then they wouldn't have (a) bragging rights of only accepting the top 3% of applicants (because God knows that 4% person could NEVER practice medicine) and (b) they couldn't cry for more money like the writer of this NYT article.

The author's solution to a lack of adequate healthcare care is literally pure comedy: pay us more and don't seek alternatives. Can you imagine a member of any other industry other than medicine saying something so infinitely stupid in a public forum?

Adding more physicians isn't going to help. There are already plenty of doctors, and schools are churning them out at rates in excess of the population growth. The problem is that medical students aren't interested in primary care. Only around 30% of doctors now are working in primary care, and the numbers are steadily shrinking. One study showed something like only 2% of students interested in pursuing internal medicine. NPs were suppose to help fill these gaps, but they have no interest in doing primary care either. High debt, less prestige, low pay, working your ass off to meet overhead, and still only making a fraction of what a lot of specialists make? Why would anyone want to do primary care? The solution is to make primary care more appealing.

 

[2014Classic**]

Never met a doctor that could diagnose for shit.

 

[Prefect]

a level that is rarely required

Do you want someone to work on you who's reach doesn't extend beyond their reach? An odd reaction to a drug or some other emergency their isn't time to carry out a dozen test to figure out the problem and you are in real trouble. The training is not remotely similar. Hospitals probably love them because they are cheaper than doctors and they order more test, which means they make more money.

 

[Poatan Power]

Do you want someone to work on you who's reach doesn't extend beyond their reach? An odd reaction to a drug or some other emergency their isn't time to carry out a dozen test to figure out the problem and you are in real trouble. The training is not remotely similar. Hospitals probably love them because they are cheaper than doctors and they order more test, which means they make more money.

That's not how it works in hospitals.

How dare this topic be posted during nurses week, too.

 

[Dogstarman]

A physician writes an article to protect his field and money scheme? No kidding. FYI, the article is complete garbage asserting causative relationships to correlational information. Not to mention he completely negates to mention the training NPs go through, including a three year "residency" under supervision of an MD including 1,000 clinical hours doing nurse practitioner school. That's in addition to the hours they spend in their primary employment as an RN, and in addition to the 900+ clinical hours they spend in their initial RN training programs.

That IOM report that the article cited (which I've read exhaustively, unfortunately for me), also cited that 55% of cases handled by physicians in the community are low-complexity. PA's and NP's were 56% and 57%, IIRC. In other words, there are 55% of cases that physicians handle that a PA/NP could also do, but the problem is then a physician wouldn't be able to gouge your insurance company for his over-priced time.

FYI, a nurse practitioner is not just a nurse. A nurse could be someone who has a 1 year junior college education (LVN/LPN), a 2 year associate program (ADN-RN), a four year program (BSN-RN), a four year program with an additional two years of education (MSN-RN) and also doctorate programs to go along with the additional training it takes to become a nurse practitioner.

So a nurse practitioner is someone with at least 6 years of education in addition to their years of experience in the acute care setting. This half-wit ass clown is trying to write that only people with an M.D. can do what a primary care physician in an office does. What a load of horse shit.

This attitude is all rooted in MD's shitting themselves because their cash cow (the ACA guaranteeing insured patients) slice of the pie getting smaller. They won't be able to bill your Blue Cross $750 for looking in your ear and giving you a refill on your life-long monthly prescriptions.

I'm off my soap box.

(Guess what I do for a living, by the way?)

Well said. But most of these fools will never understand. They will continue with the but your not a dr theme.

 

[Prefect]

That's not how it works in hospitals.

How dare this topic be posted during nurses week, too.

Are you you saying that hospitals bill people on treatment and not on procedures?

 

[chud]

"And to attract more of the best and brightest in our medical schools, let

 

[SeefourDC]

As a critical care RN with a 4 year BSN and years of experience and time spent in a teaching hospital I'll say my part here. I have still yet to have an experience with a resident wherein I felt they could hold a candle to a Nurse Practitioner. The reality of the MD programs is that you can't actually throw every single piece of knowledge about the body at a human being and expect that they will really applicationally be able to apply any of it without actually applying it (which MD's don't while in school). The amount of times I've had to listen to an attending have a basic anatomy and physiology conversation with a resident is innumerable at this point because even after passing all of those exams that people in this thread are touting that NP's can't pass that MD's take MD residents have incredibly limited skill sets and applicational knowledge.

Let me further establish this point to you. The critical care nurses (4 year bsn nurses with a great deal of expertise) are expected... no REQUIRED to protect patients from the Residents because Residents so regularly order and do things that can and will harm our patients (see: kill them).

I'm not saying all these things to denigrate Residents. The way they teach doctors is very cumbersome and through most of doctoral programs the reality is doctors apply absolutely nothing to what is really going on. The outcome is that doctors know a lot of useless information until it's honed after school. The nurse path is different because nurses actually have to touch patients and practice before going back for advanced degrees. Generally speaking every nurse practitioner before they get their advanced practice degree has spent time at the bedside dealing with advanced practice decision making on a daily/weekly basis and has developed a great deal of practical and book knowledge.

It is not possible to directly compare the years of school or clinical hours MD's and nurse practitioners go through because it's just not the same thing. The reality is most GP (MD's) are no more prepared than any nurse practitioner to find rare conditions as GP's don't go through anywhere near as rigorous of training as say... a surgeon for example, who will go through a significantly longer training process.

MD's post graduation are scary for a long time... and the reality is a Resident isn't actually required to meet any training parameters to "graduate" from their residency. They just have to serve out a number of years. I have listened to some very good fellows at my facility lament about how they hardly got to practice certain procedures... and yet they became fellows anyway. (Our fellows are amazing... but I am lucky to work at one of the best facilities in the world so this isn't always the case. I know... I've worked elsewhere and seen attending's that would need to be watched like residents at my current facility)

I think that's enough for now.

 

[Poatan Power]

Are you you saying that hospitals bill people on treatment and not on procedures?

No, I'm referring to the general way in which NP's are used in hospitals. Long story, don't want to delve into it atm lol

 

[Poatan Power]

As a critical care RN with a 4 year BSN and years of experience and time spent in a teaching hospital I'll say my part here. I have still yet to have an experience with a resident wherein I felt they could hold a candle to a Nurse Practitioner. The reality of the MD programs is that you can't actually throw every single piece of knowledge about the body at a human being and expect that they will really applicationally be able to apply any of it without actually applying it (which MD's don't while in school). The amount of times I've had to listen to an attending have a basic anatomy and physiology conversation with a resident is innumerable at this point because even after passing all of those exams that people in this thread are touting that NP's can't pass that MD's take MD residents have incredibly limited skill sets and applicational knowledge.

Let me further establish this point to you. The critical care nurses (4 year bsn nurses with a great deal of expertise) are expected... no REQUIRED to protect patients from the Residents because Residents so regularly order and do things that can and will harm our patients (see: kill them).

I'm not saying all these things to denigrate Residents. The way they teach doctors is very cumbersome and through most of doctoral programs the reality is doctors apply absolutely nothing to what is really going on. The outcome is that doctors know a lot of useless information until it's honed after school. The nurse path is different because nurses actually have to touch patients and practice before going back for advanced degrees. Generally speaking every nurse practitioner before they get their advanced practice degree has spent time at the bedside dealing with advanced practice decision making on a daily/weekly basis and has developed a great deal of practical and book knowledge.

It is not possible to directly compare the years of school or clinical hours MD's and nurse practitioners go through because it's just not the same thing. The reality is most GP (MD's) are no more prepared than any nurse practitioner to find rare conditions as GP's don't go through anywhere near as rigorous of training as say... a surgeon for example, who will go through a significantly longer training process.

MD's post graduation are scary for a long time... and the reality is a Resident isn't actually required to meet any training parameters to "graduate" from their residency. They just have to serve out a number of years. I have listened to some very good fellows at my facility lament about how they hardly got to practice certain procedures... and yet they became fellows anyway. (Our fellows are amazing... but I am lucky to work at one of the best facilities in the world so this isn't always the case. I know... I've worked elsewhere and seen attending's that would need to be watched like residents at my current facility)

I think that's enough for now.

Great post. I don't want you to divulge too much information, but whereabouts did you go to school?

 

[SeefourDC]

Great post. I don't want you to divulge too much information, but whereabouts did you go to school?

I got my bachelor's from UT Houston (the school attached to MD Anderson). I have worked with adults in a trauma/surgical ICU with Medical overflow patients and I currently work in critical care in a top pediatric facility.