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nonesuchgirl
I have to agree with this. I know some lovely people who are NPs, but I'll be d@mned if I have to go through hell to go in to g surg only to find out in 2 years surgical NP now equals surgeon.
NMBE sells out the medical profession to the nurses
- Thread starter Taurus
- Start date
I have to agree with this. I know some lovely people who are NPs, but I'll be d@mned if I have to go through hell to go in to g surg only to find out in 2 years surgical NP now equals surgeon.
In the end I think it's too late to change things now. The face of medicine is changing and cost-cutting is the name of the game. If DrNP's perform near physician levels for less pay they'll replace physicians in primary care. The only thing we really have going for us is there is a growing portion of the population who are dissatisfied with seeing NP's and such and I think that might in the end be what saves us.
The AMA needs to abandon this team-oriented fluff and start putting out ads like, "Tell your insurance company you want to see a medical doctor."
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What a great idea. We should take a cue from the drug companies and start aggressively advertising toward patients.
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nonesuchgirl
A year of grad school bio =/= preclin. Especially on kids who came from CCs or StateU with their RNs.
Oh, wow! You know people in med school. Me too!
It is what it is? Doesn't mean it has to stay that way. And you are paraprofessionals, sweetie. You aren't recognising that MD/DO are unmatched, you are encroaching on the territory specifically reserved for those holding MD/DO because of their training. To allow further expansion of the NP/DNP role is to lower standards of care.
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Physicians do respect other healthcare providers. They just don't get nor do they deserve the same respect that physicians do. You get what you earn. If it takes you 2 years to earn your degree, then you get that much respect. If it takes you 4 years to earn your degree, the respect level goes up. If it takes you 4 years of graduate eduction in addition to 3-8 years of residency training to get your education, you get the respect that you earned. It is annoying to people who spend 10+ years of the best times in their lives studying away and spending hundreds of thousands of dollars for a career that will only be eaten away by someone who didn't work as hard nor is as qualified. Could you imagine if law clerks began to represent some clients and then said that you had to call them a lawyer/attorney. The differences in the level of education between PAs, DrNPs and MD/DO vs law clerk and JD is quite similar. I am pretty sure you wouldn't go to a law clerk to represent you in a criminal trial would you?
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A law clerk does not require graduate education, whereas a lawyer does.
An NP and PA require graduation education. So no the differences in level of education is not equivalent.
Just as I wouldn't go to a law clerk instead of a lawyer, I would not go to an NP or PA in a life or death situation. I would go to a doctor - a doctor with many years under his/her belt. I would however, go to an NP or PA when I have the flu or an ear infection when I can get an appointment the next day instead of waiting weeks or months for an appointment with a doctor.
As for physicians respecting their healthcare professionals, you NCF, I have no doubt do. However, there are people on this forum who not showing respect for other professionals (or paraprofessionals if you'd like nonesuchgirl).
Like I said before, everyone in the health care field has the same goal - help patients. If you, an overworked primary care physician can assure quality care that you oversee by a PA or NP, why not do it? At least in my state, you are still the one making the final decision and overseeing all Rx. It is still your knowledge and expertise that makes the decision, others are just there to help more people get better.
With that, I am leaving this discussion. I have made my point and tried to clarify our goals. Just remember what goes around comes around - if you dont respect other people - they won't respect you. If you show respect for your nurses, I promise, life in the hospital will be better.
An NP and PA require graduation education. So no the differences in level of education is not equivalent.
Just as I wouldn't go to a law clerk instead of a lawyer, I would not go to an NP or PA in a life or death situation. I would go to a doctor - a doctor with many years under his/her belt. I would however, go to an NP or PA when I have the flu or an ear infection when I can get an appointment the next day instead of waiting weeks or months for an appointment with a doctor.
As for physicians respecting their healthcare professionals, you NCF, I have no doubt do. However, there are people on this forum who not showing respect for other professionals (or paraprofessionals if you'd like nonesuchgirl).
Like I said before, everyone in the health care field has the same goal - help patients. If you, an overworked primary care physician can assure quality care that you oversee by a PA or NP, why not do it? At least in my state, you are still the one making the final decision and overseeing all Rx. It is still your knowledge and expertise that makes the decision, others are just there to help more people get better.
With that, I am leaving this discussion. I have made my point and tried to clarify our goals. Just remember what goes around comes around - if you dont respect other people - they won't respect you. If you show respect for your nurses, I promise, life in the hospital will be better.
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The common trend for Primary Care in non-rural areas is group practice anyhow. In the future, you'll have more of these groups consisting of an MD director working with DNP/NP's. Although DNPs can practice independently, in most non-rural areas it will almost definitely be to their best interest to work in a group with an MD head.
Most doctor's offices I know place their degree after their name in signs and advertisements. The American public is educated enough to tell the difference between DNP and MD.
In response to another post above, I totally agree that DNPs go through quite a bit of training as well. In terms of time, they're pretty on par with an MD family physician. While they shouldn't be held to as much responsibility or get paid as much as MDs, it's not unreasonable to address them as Dr. I called most of my professors Dr. anyway.
Most doctor's offices I know place their degree after their name in signs and advertisements. The American public is educated enough to tell the difference between DNP and MD.
In response to another post above, I totally agree that DNPs go through quite a bit of training as well. In terms of time, they're pretty on par with an MD family physician. While they shouldn't be held to as much responsibility or get paid as much as MDs, it's not unreasonable to address them as Dr. I called most of my professors Dr. anyway.
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I don't think anyone, at least I don't, have a problem with calling DNPs Dr. They have a doctorate degree and deserve that title just as much as MDs, DOs, and PhDs. The problem is not them working in shortage areas, the problem is the NBME making an exam like the one above. It is setting up a slippery slope that could easily lead to more encroachment in areas where it is not needed.
Holy **** I almost pee and crap my pants from laughing so hard when I read this. To all the DNPs (aka MD wannabes) since you want to play doctor why not take steps 1-3. Are you afraid of flunking them? How would you like a DNP doing a CABG on you, or removing a tumor, or managing your heart failure, reading your imaging studies, or putting a stent in your coronaries? If you want to play doctor assume the responsibilities, and the malpractice insurance. HAHAHA becoming a "doctor" online. Good one.
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Folks,
She is one of the nicer ones, and still look at the agenda.
Make a sticky. We need to FLOOD the AMA, ASA, AAFP with phone calls of support, and DEMAND we fight this.
Email the address at the bottom of the WSJ article.
Georgia, you are very kind to post, but you are a mid-level practioner, and not a physician. Your colleagues and leaders have a goal in mind, which is to take over medicine through a back door of cutting corners and chips on shoulders. The actions of your colleagues are making ALOT of us think twice about EVER hiring an NP, and going the PA route instead. The hospital already has too many long white coats, we really don't need anymore.
She is one of the nicer ones, and still look at the agenda.
Make a sticky. We need to FLOOD the AMA, ASA, AAFP with phone calls of support, and DEMAND we fight this.
Email the address at the bottom of the WSJ article.
Georgia, you are very kind to post, but you are a mid-level practioner, and not a physician. Your colleagues and leaders have a goal in mind, which is to take over medicine through a back door of cutting corners and chips on shoulders. The actions of your colleagues are making ALOT of us think twice about EVER hiring an NP, and going the PA route instead. The hospital already has too many long white coats, we really don't need anymore.
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That's in an academic environment. In a hospital it should be clear who and who isn't a doctor.
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I made a vow to myself.
1) I will never agree to hiring an NP or DNP. If I am in group practice, I will do my best to block their hiring in preference of PA's. If NP's or DNP's are currently working in my practice, I will do my best to replace them with PA's. If I can't get rid of NP's or DNP's in my practice, then they will be nothing more than glorified secretaries when they work with me and they can whine til the cows come home about how they're not developing professionally.
2) I will never agree to mentor or precept an NP or DNP student. I will only teach medical or PA students.
3) I will jump at the chance to give my expert opinion if I am asked to testify at the malpractice trial of an NP or DNP. I hope that the jury returns a $200 million judgment and the insurance companies take notice and jack up NP malpractice premiums.
4) I will pressure every doctor I know, the AMA, and every damn meaningful medical organization to not sell out our profession to the nurses.
Anyone else want to make this vow?
1) I will never agree to hiring an NP or DNP. If I am in group practice, I will do my best to block their hiring in preference of PA's. If NP's or DNP's are currently working in my practice, I will do my best to replace them with PA's. If I can't get rid of NP's or DNP's in my practice, then they will be nothing more than glorified secretaries when they work with me and they can whine til the cows come home about how they're not developing professionally.
2) I will never agree to mentor or precept an NP or DNP student. I will only teach medical or PA students.
3) I will jump at the chance to give my expert opinion if I am asked to testify at the malpractice trial of an NP or DNP. I hope that the jury returns a $200 million judgment and the insurance companies take notice and jack up NP malpractice premiums.
4) I will pressure every doctor I know, the AMA, and every damn meaningful medical organization to not sell out our profession to the nurses.
Anyone else want to make this vow?
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Why such a preference for PA's? They want more scope just like the nurses.
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The midlevel genie is out of the bottle. If you have to hire a midlevel, hire a PA because they fall under the board of medicine. It's an issue of picking your poison and between the two the PA is the better choice.
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Then why won't the DNPs simply be taking the USMLE Step 1? My guess is that they would not be even close to prepared for that test.
It's not an issue of respect, it's an issue of me thinking that a DNP is not going to be qualified for the area that they are seeking to serve. Of course we don't just think that the nurse passes meds and gives baths, but that doesn't mean a nurse is anywhere near equivalent to the level of education a physician has.
Then don't take it personally when you are rebuffed from trying to make a move on their turf.
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http://forums.studentdoctor.net/showthread.php?p=6467553#post6467553
Above is a thread in General Residency issues which has contact information for the AMA, ASA, AAFP. Links to the WSJ article, and a USNEWS article asking for reader comments regarding people's opinions. I encourage everyone to go post a comment! Make the calls, guys..
Above is a thread in General Residency issues which has contact information for the AMA, ASA, AAFP. Links to the WSJ article, and a USNEWS article asking for reader comments regarding people's opinions. I encourage everyone to go post a comment! Make the calls, guys..
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nonesuchgirl
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NP's decided to create the DNP's because their education was lacking compared to MD's or even PA's. An NP gets 500 clinical hours before graduation. A PA gets 2400 hours. Med students get 5000 hours.
Even after the DNP, the student gets only 1000 hours.
Stop drinking the kool-aid that the ANA gives to you.
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Just wanted to post a prediction that I made quite a while back.
It's hard to fight the effects of the almighty dollar.
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If we lose primary care, then we should lose it to the PA's, not the NP's. At least with the PA's, they fall under the board of medicine so we have a degree of control over them.
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It isn't cheaper to see a mid level than it is a real Dr. For instance all these minute clinics charge about $59 CASH for a ten minute visit. If a single mid level sees about 4 patients an hour, 7 hours a day, 5 days a week for a year thats 396K CASH that is brought in. Of course the mid level sees a fraction of that and the rest goes to corperations that own the clinics. I can't think of any PCP who works in a similar low overhead practice who wouldn't be willing to take that. Take out taxes and expenses and thats still over 200K a year working 35 hours in clinic a week. With no call.
Hell thats Derm hours and pay right there. If something like that took off I could see a lot of residency personal statements changing from "From a young age I've always been fascinated with skin" to "I've always dreamed of working in a Walmart or K -Mart helping the common man with his medical issues."
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No offense, but that's part of the issue. The ceiling is not the same height for everyone.
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Uh...actually it is. You can't compare a cash pay business to one dominated by insurance and medicare/medicaid. Third party payers typically reimburse midlevels at a lower level than MD/DO (85% for most unless they are billed incident to which is pretty shaky in most situations). But I was also referring to the lower level of take home pay that midlevels receive vs docs.
My wife is an NP who works in a FP clinic and sees more than the patient load you talked about but not all colds and headaches like a minute clinic (last month diagnosed SIADH stemming from lung cancer, CHF, as well as treating your run of the mill chronic problems). The doctors love her because she is a cash cow for the clinic. She is paid about 40% less than an MD would demand and last month saw more patients than two of the doctors combined. Let's see...40% less salary with double the patients reimbursed at 85% = truckloads of money in profit for the clinic, plus the third party payers paid less than for the same treatment from an MD.
Like I said, it's hard to fight against the almighty dollar.
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You're giving the american public way to much credit. Most people don't know the difference and many aren't paying that much attention. Im in PM&R. Several times I've had patients tell me they spoke to their doctor, when in reality they were talking to a DPT wearing a long white coat. Happens all the time when non-physicians introduce themselves as doctor. How many random people on the street really know the difference between an optometrist and an ophto. Generally, most people only know that we went through 8 years of schooling. Some people that I have spoken to look at medicine and nursing as part of the same continuum. Take a nurse and put them through a few extra courses and, voila, you got yourself a physician. And apparently this doesn't exclude many of our lawmakers.
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I was talking mainly about the patients and their costs. Their rates are the same regardless of who they see. But I see your point with insurance companies and medicare looking at the bottom line.
Although with the impending collapse of medicare I see them going after high paying specialties before they try and scrape off whats left of primary care.
Although with the impending collapse of medicare I see them going after high paying specialties before they try and scrape off whats left of primary care.
Yeah to most of the world
Male/Female with a white coat = doctor
You may laugh but doctors really need to start advertising their utility and capabilities especially compared to DNP's/NP's. Don't expect the public or lawmakers to know the difference.
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Respect is earned, not awarded. As medical students we have earned the respect and the right to look skeptically towards those who say "My school is just as hard to get in to/just as hard once you're in" or "we are as competent as you." The fact of the matter is that no it's not, and no you're not.
We are dealing with it. Unfortunately for you, that attitude will result in a split between medicine and ancillary care providers. If you lose your hospital privileges you have no practice. Harsh, but you're playing with fire.
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I hate to say this, but this a good question..
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I may sound like a jerk when I say this, but I hope I don't offend.
1st) medical schools across the country seek the brightest and best. It is very very difficult to get into medical school. It is hard to get through medical school, then it is hard to get into the residency of your choice. It takes a great deal of intelligence, commitment and perseverance to go through all of this. Therefore,
2nd) The practice of medicine, being a doctor (md/do) and the authority, salaries, knowledge, respect and rights that go along with it are earned. It is given to people have have the above mentioned characteristics and a desire to help people. Not that other healthcare professionals don't have these characteristics, but doctors have to put in a ton of work that not many individuals are ready to put in.
3rd) Lets face it. This country is built upon rewarding those who work their behinds off, or have a special talent. I think that doctors (MD/DO) are in that group. They work their butts off and they have special talents, talents that in many cases no one else can perform.
4th) I am not saying that NP's or DPT's or PA's or anyone else is not as intelligent as a physician. What I am saying is if you have the talent to become a physician then become a physician. If you have the talent to go to the NBA then go to the NBA. Don't go to the CBA (Canadian Basketball Association) and expect NBA respect, NBA rights, NBA salaries and so on. If you have the talent earn the right to be called an NBA basketball player.
As I said I don't mean to be a jerk, but there has to be mid levels and high levels. Everyone can't be a high level, that causes too much confusion. Finally, In the words of Stone Cold Steve Austin: "KNOW YOUR ROLE."
I guess I don't want to see medicine become a field where there is a name brand, and a generic, i.e. the generic has most of the same ingredients but it isn't quite as good as the name brand. In medicine this could be a matter of life or death when it comes to decision making. Patients should always have access to the name brand in this case, and that is a qualified Medical Doctor or Doctor of Osteopathic Medicine (I say this knowing and understanding that Mid and upper level nurses are fully qualified to do SOME of the things physicians do, BUT NOT ALL).
1st) medical schools across the country seek the brightest and best. It is very very difficult to get into medical school. It is hard to get through medical school, then it is hard to get into the residency of your choice. It takes a great deal of intelligence, commitment and perseverance to go through all of this. Therefore,
2nd) The practice of medicine, being a doctor (md/do) and the authority, salaries, knowledge, respect and rights that go along with it are earned. It is given to people have have the above mentioned characteristics and a desire to help people. Not that other healthcare professionals don't have these characteristics, but doctors have to put in a ton of work that not many individuals are ready to put in.
3rd) Lets face it. This country is built upon rewarding those who work their behinds off, or have a special talent. I think that doctors (MD/DO) are in that group. They work their butts off and they have special talents, talents that in many cases no one else can perform.
4th) I am not saying that NP's or DPT's or PA's or anyone else is not as intelligent as a physician. What I am saying is if you have the talent to become a physician then become a physician. If you have the talent to go to the NBA then go to the NBA. Don't go to the CBA (Canadian Basketball Association) and expect NBA respect, NBA rights, NBA salaries and so on. If you have the talent earn the right to be called an NBA basketball player.
As I said I don't mean to be a jerk, but there has to be mid levels and high levels. Everyone can't be a high level, that causes too much confusion. Finally, In the words of Stone Cold Steve Austin: "KNOW YOUR ROLE."
I guess I don't want to see medicine become a field where there is a name brand, and a generic, i.e. the generic has most of the same ingredients but it isn't quite as good as the name brand. In medicine this could be a matter of life or death when it comes to decision making. Patients should always have access to the name brand in this case, and that is a qualified Medical Doctor or Doctor of Osteopathic Medicine (I say this knowing and understanding that Mid and upper level nurses are fully qualified to do SOME of the things physicians do, BUT NOT ALL).
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I'll double crap ya on that one Beagle. I've seen mid-levels try to read EKG's and film... it usually aint pretty. Take Step I,II,III? Hell let's see em try to do a 3-5 year 80 hr/week residency. I promise you won't see em lining up to do that!
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NoMind, where is your avatar from? That is absolutely hilarious.
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It doesn't take years after college to become an RN. Most people take the licensing exams directly after they graduate and do not have to return to school in order to become an RN. Even for those who got degrees in another field, it's only 18 months to get a BSN. You seem to be making the timeline to DNP a lot longer than it actually is.
If you are counting the 4 years to get a BA, then you need to count the four years pre-med students spent in school - bring your average FP up to 11 years and leaving your DNP
No one is being disrespectful. On the contrary, I'd say this conversation has remained very civil.
You'll have to understand that we are somewhat skeptical about the amount of pathophysiology and pharmacology being taught, when the curricula posted look like this. There's just no path, pharm, micro, or even much hard SCIENCE on there. I'm not trying to pick on you, I just disagree from what I read.
If I had a dime for each person who told me "I thought about going to medical school" or "I could have gone to medical school if I'd wanted to" then I pretty much wouldn't have any student debt. Getting into medical school is a crapshoot at best, with 50% being rejected in any given year (at least when I applied). Only an admissions committee can make the final decision, so to claim that you "could have gone" to medical school is a bit disingenuous.
It's possible that you are getting your DNP in order to go into primary care and relieve the overburdened system. However, I can promise you that a significant number of midlevels go into non-primary care specialties - even though the justification for their existence was to improve primary care.
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I just read the whole thing and this is just fcuking ridiculous
First every Tom, Dick, and Harry in the hospital wants to wear a white coat (this includes the janitor and the patient escort) and now this. I'm gonna do my part in all this and be sh1tty to every nurse, dnp, pa, np, fu whatever if they have a sense of entitlement and try to act like they are just as knowledgeable as I am.
I've met PAs that claim they know more than the doctor they are working for, nurses that roll their eyes every time a resident gets something wrong, phds who pretend they are medical doctors, and now Dnps who are taking "philosophy of science" as a course pretending they are md equals after passing what is essentially a diluted mcat most likely.
hey as$holes, if you are so in love with our profession then just apply to medical school. oh wait, you have personal reasons for not going to med
school? you had the grades and the gpa and the mcat score? really? ohh, but you wanted to do less work, enjoy your 20s, spend less money, but still wanted to walk/talk/act/get paid like a physician. Yeah, that makes sense.
First every Tom, Dick, and Harry in the hospital wants to wear a white coat (this includes the janitor and the patient escort) and now this. I'm gonna do my part in all this and be sh1tty to every nurse, dnp, pa, np, fu whatever if they have a sense of entitlement and try to act like they are just as knowledgeable as I am.
I've met PAs that claim they know more than the doctor they are working for, nurses that roll their eyes every time a resident gets something wrong, phds who pretend they are medical doctors, and now Dnps who are taking "philosophy of science" as a course pretending they are md equals after passing what is essentially a diluted mcat most likely.
hey as$holes, if you are so in love with our profession then just apply to medical school. oh wait, you have personal reasons for not going to med
school? you had the grades and the gpa and the mcat score? really? ohh, but you wanted to do less work, enjoy your 20s, spend less money, but still wanted to walk/talk/act/get paid like a physician. Yeah, that makes sense.
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That's the whole problem. Unless you make people put their money where their mouth is, human nature dictates that they won't. Just like anything else, most people are programmed to take the path of least resistance, i.e. what is the least amount of work/time/money I can spend to get X amount of respect/pay/position/etc. And, as long as you can convince the cliente that you are a duck (by delivering the product that they pay for), then, to them, you will be a duck, with all associated rights and privileges. That is, until the actual ducks get wise to your charade.
Physicians need to get territorial. Nobody is protecting our little corner of the world - we need to do it ourselves. What our clientele (our patients) needs to understand is that to cut corners is to produce an inferior product. We need to take the initiative and provide that information. Nobody else is going to do it. If we are talking about the future of medical care, the prospect of an inferior product is a pretty frightening concept. I've said it before, and I'll say it again - if you want to be a doctor, go to medical school. There are no shortcuts. We need to make sure that this is realized.
Taurus said:
This is the best argument I've heard yet. Talk all you want about the DNP courseload and how "Philosophy of Science" will make you a better clinician. The proof of the pudding is in the eating.
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yeah, true, but someone has to be the captain of the ship, and that's gotta be MD
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Just wondering where you got your numbers from.
My wife's FNP program was about 850 clinical hours. I couldn't find what my school's PA program declares for clinical hours, but we only have 3500 clock hours for 3rd and 4th year.
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CuriousGeorgia said:
BS. The "collaborative care" delivery method confuses and angers the hell out of patients and practitioners alike. Nobody in our hospital wants to be micro-managed by 20 different "health care professionals" who are all clamoring for the #1 spot. This is exactly the model that we need to move away from in this country.
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Not sure exactly what you meant by this, but you might want to check out this paper:
Mundinger MO, Kane RL, Lenz ER et al. Primary care outcomes in patients treated by nurse practitioners or physicians. JAMA. 2000; 283:59-68
The NPs (even without the DNP) have shown that their treatment outcomes are on par with MDs for primary care. Hell, it was published in one of OUR medical journals. The onus is now on the MDs to put up or shut up. Saying: "You haven't been through the same training as me," isn't a valid argument if the treatment outcomes are the same.
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Which then begs the question: Why didn't they become MD's?
Also more likely that an NP will see less severe cases, shuffling all the more difficult ones to an MD.
And I'm sorry, but where I worked for a year, an NP at the practice constantly had to interrupt the MD's while they were seeing patients in order for the MD to also "have a look at the patient". Would their diagnosis always be on par with an MD without the help of an MD who has seen a lot more and done a lot more? Not likely.
Conclusion: That assertion (even if published in a journal) is bogus.
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That's amazing. My school has an 80-week requirement for 3rd and 4th year combined. Even if we only clocked 40 clinical hours per week (feasible on only a couple of clerkships, and thus a gross underestimate), that would already be 3200 hours. We also have required hours during years 1 and 2.
I don't know where Taurus's numbers came from, but, given my own schedule, it doesn't seem too far off the mark.
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If you took the time to go and actually read the article instead of spouting off you would see that part of the study was that the NPs didn't consult with physicians.
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That's just our published numbers. Mine is 86 wks long and the actual numbers are probably higher for pre-rounding, etc. I was trying to go off the published numbers and wasn't counting any for first and second year since the midlevel training also has clinical contact during their basic science too.
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You might want to check out another JAMA issue from 2000, where every aspect of that study is torn to shreds by 7 separate letters to the editor.
[FONT=verdana,arial,helvetica,sans-serif]Health Outcomes Among Patients Treated by Nurse Practitioners or Physicians.
[FONT=verdana,arial,helvetica,sans-serif] Bruce Bagley; Kirk M. Chan-Tack; Paul Hicks; Keith Rayburn; Laeth Nasir; James P. Willems; Catherine Kim; Caroline M. Poplin; Mary O. Mundinger; Robert L. Kane; Harold C. Sox
JAMA. 2000;283:2521-2524..
There were numerous flaws with design of the study. A few that were pointed out in the letters:
1. Patient outcomes were measured only for pre-diagnosed conditions. No comparison was made of the abilities of NP's and MD's to actually diagnose. In other words, even if there weren't methodological problems with the study, it would not prove that care in general is equivalent, rather that management of pre-diagnosed conditions is equivalent.
2. The patients were followed for only 6 months, too short a time to access quality of care for chronic illnesses.
3. The sample was not representative of an average primary care practice (77% women, 90% Hispanic).
4. The study was improperly controlled, since no baseline measurements of the quality of care indicators (HbA1C, peak flow) were taken. There was no control for severity of disease at the start of the study.
The study was junk.
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Just like with most things in life, there is probably a lot more to it than meets the eye. And just because something was published in a prestigious journal, doesn't mean it's the absolute truth. Just look at the lung cancer research fiasco at Cornell that was paid for by BIG TOBACCO and GE, the maker of CT scans that the study was promoting
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Yeah, after taking our Evidenced Based Medicine class in med school, I tend to trust all published papers much less.
