NYT: Nurses aren't doctors

[UpaLoompa]

The main thing is too not mix medicines you shouldn't, and really any nurse can google that. Do you really think the Dr doesn't do the same thing? Its not like he stops at med school and knows all

These days even pharmacists don't do much of that and a lot of it is database driven.

 

[Seriously-Dead]

If your girlfriend was a doctor you should know there are no 2 years residence programs.

Family medicine in Canada is only a two year residency. You can extend it by doing +1 sub-specialities (like Emergency medicine for a rural community), but for your generic PCP it's only a two year residency.

http://www.cfpc.ca/ProjectAssets/Templates/Resource.aspx?id=4350

 

[Blackened]

While obviously you're going to want a doctor for a lot of things I think you're confusing ideal situations with reality. The 5-10 minutes you spend with your primary care doctor aren't going to lead them to prevent or catch much of anything. Glad the doctor got to me an hour late for that.

Also, the ability of most medical doctors to assess scientific information is on par with the ability of a warm turd to do the same.

This may be true in most cases, but I suspect it to change with less and less foreign schools being allotted a residency. Most MD programs recommend research. However I'm thinking I'll end up DO so I hope not to fall into that category. If I don't get accepted this cycle I'll be able to squeeze in a little research and maybe go MD (hell maybe MD/PhD) next cycle

 

[UpaLoompa]

This may be true in most cases, but I suspect it to change with less and less foreign schools being allotted a residency. Most MD programs recommend research. However I'm thinking I'll end up DO so I hope not to fall into that category. If I don't get accepted this cycle I'll be able to squeeze in a little research and maybe go MD (hell maybe MD/PhD) next cycle

I've seen nothing to indicate it has anything to do with foreign schools as opposed to a general ignorance of statistics, experimental design, and critical thinking. I had a Chief of Staff of a major metropolitan hospital once tell me "I just look to see if p is less than 0.05 and that's all that matters".

I'm also of the opinion that letters of recommendation from university faculty regarding med school should shift solely to: Would you ever let this person near you with a scalpel.

 

[dza76wutang]

I've seen nothing to indicate it has anything to do with foreign schools as opposed to a general ignorance of statistics, experimental design, and critical thinking. I had a Chief of Staff of a major metropolitan hospital once tell me "I just look to see if p is less than 0.05 and that's all that matters".

I'm also of the opinion that letters of recommendation from university faculty regarding med school should shift solely to: Would you ever let this person near you with a scalpel.

Numerical illiteracy is painful, and in healthcare, this can be literal.

 

[LucasWithLidOff]

I've seen nothing to indicate it has anything to do with foreign schools as opposed to a general ignorance of statistics, experimental design, and critical thinking. I had a Chief of Staff of a major metropolitan hospital once tell me "I just look to see if p is less than 0.05 and that's all that matters".

I'm also of the opinion that letters of recommendation from university faculty regarding med school should shift solely to: Would you ever let this person near you with a scalpel.

Well to be fair, if a study doesn't have significant results, I ain't reading the methods. But that doctor does sound pretty ignorant for a person in his position.

 

[UpaLoompa]

Well to be fair, if a study doesn't have significant results, I ain't reading the methods. But that doctor does sound pretty ignorant for a person in his position.

The use of critical thresholds, like 0.05 (as opposed to 0.06 ), is problematic for researchers, let alone for people that have to consider and implement the results. It shouldn't be though.

What sort of statistical and experimental training do MD's typically get if they don't have a research focus?

 

[LucasWithLidOff]

The use of critical thresholds, like 0.05 (as opposed to 0.06 ), is problematic for researchers, let alone for people that have to consider and implement the results. It shouldn't be though. Multivariable calculus isn't required to get into med school and they certainly aren't teaching it to you in med school.

What sort of statistical and experimental training do MD's typically get if they don't have a research focus?

Not enough. Classes on mathematical statistics are not required (even baby statistics isn't). I actually took a mathematical statistics class for a math minor, but never got into that deeply ever again. Multivariable calculus isn't required to enter med school and they certainly aren't teaching it to you there. But if you do go into research, biostatistics is becoming hot and they actually do teach it.

Significance is a relative term that depends on the degree of precision desired by whoever cares. The .05 thing just makes me think the guy only saw statistics as part of a scientific writing class, which is where most strict bio majors get their statistics training.

And on a side note, I think statistics is a huge hole in most undergraduate science programs. They expect you to use statistics but they don't actually require you to learn it.

 

[Magooglie]

What about a really experienced nurse?

 

[UpaLoompa]

Significance is a relative term that depends on the degree of precision desired by whoever cares. The .05 thing just makes me think the guy only saw statistics as part of a scientific writing class, which is where most strict bio majors get their statistics training.

And on a side note, I think statistics is a huge hole in most undergraduate science programs. They expect you to use statistics but they don't actually require you to learn it.

Agreed. The issue is that stats classes are notoriously awful. I've run a couple of stats workshops at other universities and institutes and they've sucked too. You really have to teach yourself the methods and their mathematical background. In other words, you actually have to care.

Aside: I had a paper accepted (pending minor revisions) earlier this week where we estimated variance parameters using MCMC/Bayesian approaches. I wrote something like "the Bayesian probability/wc that the thingees differ was ~91%". Roughly that would compare to a p of 0.09 (at least based on how people typically mis-interpret p's). We actually caveated the conclusions a fair bit as I'd consider that pretty provisional but ultimately we found some support for one of multiple hypotheses. There probably isn't enough data in the world to estimate those parameters with sufficient precision to satisfy "significance".

 

[Blackened]

I've seen nothing to indicate it has anything to do with foreign schools as opposed to a general ignorance of statistics, experimental design, and critical thinking. I had a Chief of Staff of a major metropolitan hospital once tell me "I just look to see if p is less than 0.05 and that's all that matters".

I'm also of the opinion that letters of recommendation from university faculty regarding med school should shift solely to: Would you ever let this person near you with a scalpel.

I'm with you. I think GRE should be required as well.

You're probably thrilled to hear this "The MCAT exam will be changing in 2015, to learn more about these changes visit the MCAT2015 for students. The first applicants to sit for MCAT2015 will be those who apply to medical school for entry in the fall of 2016.

One of the skills assessed on the new test is "Data-based and Statistical Reasoning;

 

[UpaLoompa]

Frankly I'm not necessarily sure I really care about the statistical abilities of doctors, was mainly addressing the comment about doctors reading the scientific literature while NP's don't. I've no idea if that's a real difference but if it is I'm not sure it matters given the turd comparison.

 

[LucasWithLidOff]

I would hope someone who diagnoses and triages for a living would at least keep current on the latest studies relevant to his or her field even he or she isn't a good critical consumer of data.

 

[Seriously-Dead]

Agreed. The issue is that stats classes are notoriously awful. I've run a couple of stats workshops at other universities and institutes and they've sucked too. You really have to teach yourself the methods and their mathematical background. In other words, you actually have to care.

I can definitely back this. I've taken stats at the graduate level and these courses are absolutely awful. They teach you more about how to become a stat drone for publishing and nothing about how to think critically about research, or how to critically assess your own research. I'm having to take matters into my own hands to get the education I'm looking for. I was lucky enough to be reading papers from people like Ioannidis prior to my biostat courses, otherwise I would have just been another sucker.

 

[UpaLoompa]

I would hope someone who diagnoses and triages for a living would at least keep current on the latest studies relevant to his or her field even he or she isn't a good critical consumer of data.

That gets back to the central point of this thread though, what are most doctors doing? The answer to that is probably: Viagra, Lipitor, and Vicodin.

 

[SeefourDC]

Nurses are overpaid, and do not realize how good they have it just for going into that particular field. I like nurses, but they have the woman disease as a whole. They want to faction form and make life difficult for the Doctors, because they have the numbers, and simply because they have the ability to do so. FOCUS ON YOUR JOBS. I actually heard a nurse complaining about Doctors and their decision to have a diagnostic performed on me before a couple other people while they were taking me to the test. It was DISGUSTING. Bitchiness and its "power' is really hurting morale in America.

I'm sorry you had to go through this but I do want you to know this has nothing to do with nursing and everything to do with unprofessionalism. What you don't realize is that we, as nurses, are responsible for advocating for you because you don't know enough about the healthcare field to adequately do so. Doctors do amazing things, but nurses with their knowledge and skills are intended to be there to insure that you don't get both unnecessary procedures done OR miss getting something done that needs to be done.

I can't tell you the amount of times where a doctor has ordered a procedure or lab test that has already been done in the last 48 hours and I have to call them to let them know that it's already been done. Unfortunately many doctors are seeing 50+ patients. Your comments are just unkowledgeable and untrue. Nurses do absolutely important things that save patients money and protect patients from harm EVERY DAY. I also work my ass off and deal with people who are miserable and take it out on us every day. Most people don't know this but nurses are one of if not the most assaulted people as far as jobs go and we just have to take it. Imagine a patient punching you and you have to turn around and argue with a MD right afterwards about something that's best for that person no matter how frustrated you are by being assaulted?

Again, just unprofessional on their part, but reality is you should HOPE they are willing to go against the docs on things.

 

[Amerikuracana]

I'm sorry you had to go through this but I do want you to know this has nothing to do with nursing and everything to do with unprofessionalism. What you don't realize is that we, as nurses, are responsible for advocating for you because you don't know enough about the healthcare field to adequately do so. Doctors do amazing things, but nurses with their knowledge and skills are intended to be there to insure that you don't get both unnecessary procedures done OR miss getting something done that needs to be done.

I can't tell you the amount of times where a doctor has ordered a procedure or lab test that has already been done in the last 48 hours and I have to call them to let them know that it's already been done. Unfortunately many doctors are seeing 50+ patients. Your comments are just unkowledgeable and untrue. Nurses do absolutely important things that save patients money and protect patients from harm EVERY DAY. I also work my ass off and deal with people who are miserable and take it out on us every day. Most people don't know this but nurses are one of if not the most assaulted people as far as jobs go and we just have to take it. Imagine a patient punching you and you have to turn around and argue with a MD right afterwards about something that's best for that person no matter how frustrated you are by being assaulted?

Again, just unprofessional on their part, but reality is you should HOPE they are willing to go against the docs on things.

Yeah, my post was a bit of hyperbole and maybe over the top. But I have 300 clinical hours in with nurses, so your assessment of my lack of knowledge is incorrect. I was lucky to do those hours in some busy places at some busy times for the most part. That is when Nurses and Doctors shine together. I saw wayyy to much of nurses calling Doctors a*sholes behind their back for basically nothing but acting like a Doctor should, and I actually saw a bit of the Union "we deserve more for this" attitude as well. It's a tough job, but so are a lot of jobs. Nurses and Police officers should not and can not be the high paying jobs of choice for everybody, because they do not create wealth. Anyways, I worked at U of M Trauma burn, an OB unit (I was always there holding feet and helping more than the student docs that would stand 10 feet away, because I have so much experience with my own kids) and an emergency room. I like nurses, overall. BUt I alos saw the ol' modern American unprofessionalism, the one where as long as the woman was "cool" she could get away with it, and I saw the modern divide and conquer techniques I have seen with (I'm sorry) women too often in the last 15 years. With women, and with Nurses, I saw a power struggle with the Doctors which should NOT have existed. Nurses are there to help patients, and help doctors, and perform more advanced procedures at times than people would think they would, like lavages and vacuum dressings. But Nurses need to STFU and let Doctors be Doctors, even though they are wrong sometimes like everybody else. Nurses get paid really well for their education level.

 

[Bob Charlie]

Typical nurses want to do everyone's job but their own (admittedly administration of care is a fucking horrible job) but they constantly fuck up and kill people by not following simple instructions of physicians or pharmacists or they do something "they've been doing for years" because it "makes sense to them" but they were never formally taught it and somebody dies. Its because they're really not that smart in comparison to other medical professionals (their programs are much easier to get into). CNP is a backdoor for people who weren't smart enough to get into medical school to equate themselves with physicians. The truth of the matter is PAs do the same thing as them with much less training and its because a chimp could tell you that what you have is a sinus infection.

 

[loyalyolayal]

statistically speaking, there would be more posters here who are related to or are friends with nurses than doctors. the butthurt is understandable.


is normal.

 

[Crono7]

Doctor is just appealing to his own authority because he's threatened by the nurses. No different from a chef talking down to a cook. One has the title, the other has the actual skills.

Actual skills? wtf