NPs vs. MD's.

[Psai]

What's bad is they actually teach this **** in nursing school. We would spend a month on "socio-cultural" projects concerning people's social backgrounds and how it affect care. But when they would teach us that ACE inhibitors may cause a cough in some patients and we asked why, no one had a clue and it wasn't important to know why. This type of teaching style continues from bachelors-masters-doctorate. Sadly, growing up in a rural area many people choose to go to "Ms. Jodi" BSN-APRN-FNP-DNP-associate of arts in general studies, etc. because she is "nicer" than the mean MD who is just out for money. It's becomin a big issue in society as people don't know any better. I know this is true, especially in rural areas. Scary.

Pretty sure you meant Dr. Jodi BSN RN MSN APRN CFNP-BC ANP-BC DNP FAAN, Doctor of Nurse Practitioning

---

Members don't see this ad.

 

[dwgrubbs1s]

Pretty sure you meant Dr. Jodi BSN RN MSN APRN CFNP-BC ANP-BC DNP FAAN, Doctor of Nurse Practitioning

You are correct. I had the order wrong. I think they should start including any high school accomplishments behjnd their name as well to let us know how important they are. "VPJC" Vice President of Junior Class.

 

[Mjolner]

Pretty sure you meant Dr. Jodi BSN RN MSN APRN CFNP-BC ANP-BC DNP FAAN, Doctor of Nurse Practitioning

You forgot all the merit badges they earned in middle school.

 

[Mad Jack]

Pretty sure you meant Dr. Jodi BSN RN MSN APRN CFNP-BC ANP-BC DNP FAAN, Doctor of Nurse Practitioning

I think they hope patients will just get bored before they finish reading all the acronyms and realizing that they're not a doctor.

 

[MedBreak]

NPs can probably do some of what MDs can do but they can not advance their clinical acumen because they dont have a foundation to build anything on; anybody can figure out to prescribe drug A for disease X and if drug A doesnt work to move on to drug B ... and how about if someone presents with an atypical presentation??

 

[Instatewaiter]

I have done telepsych from the comfort of my home, to nursing homes in small town, rural eastern Ohio. Lots of dementia, Alzheimer's type stuff. Great job. A 25 minute follow up paid $69.28 from Medicare. NPs get 85% of that. After you write your notes, you probably spend 35 minutes per patient. The money is decent on nursing standards (most NPs earn about $110K per year), but low on MD standards.

And as for the sample test you guys all "did so well on as M1's"... no way you would pass this test. This sample is easy, and not reflective of the real thing. An M3, after general medicine clerkship, no problem, but not an M1.... the test has too many side effect scenarios, med interaction stuff that only somebody w/ real clinical experience is ready for. The test is just as hard as the MCAT, and I took both.

And finally, somebody above asked me if I thought I could pass the MD Psych Cert. Boards. I took a 100 question sample test, and scored a 62% w/o studying one second. Yes, w/ a good "Kaplan Course Review", and w/ my 30 years experience, I think I could pass, although the liver enzyme "metabolism stuff" has always given me problems, and it seemed to have a lot of that on there.

Cheers

Having seen what comes from Rural, eastern ohio (Ashtabula and the like) I can confidently say that nothing that could be construed as medical care happens there.

 

[Psai]

Having seen what comes from Rural, eastern ohio (Ashtabula and the like) I can confidently say that nothing that could be construed as medical care happens there.

No, no they have their excellent nursing telecare, didn't you read the post?

 

[Carbocation1]

Why are we in medical school?

 

[oncology2020]

Why are we in medical school?

The propaganda is ridiculous but as we all know repeat something enough times and it becomes the truth for the public...their marketing seems ridiculous to us but it's very effective for the average person

 

[Mad Jack]

Why are we in medical school?

What the actual ****. Should've put a trigger warning in that post, because I just got triggered to the max.

 

[Carbocation1]

The propaganda is not only being shoved down the throats of the public masses, but it is being disseminated in nursing schools as well. Just talk to any nursing student and they will be quick to state how doctors have no bedside manners.

 

[witzelsucht]

The propaganda is not only being shoved down the throats of the public masses, but it is being disseminated in nursing schools as well. Just talk to any nursing student and they will be quick to state how doctors have no bedside manners.

I've known my fiancee and her family for like 10 years. She has a cousin, who I've known forever and always gotten along with, who started nursing school as nontrad last year when I was a 3rd year. She (at the time) had never had a single clinical rotation or anything. And at christmas she gave me a lecture about being nice to nurses. Me, who always starts an ED student shift by politely asking all the nurses if I can do foleys or blood draws or IVs for them, just ask, I'd love the experience. Where the **** do people come up with this ****.

 

[deleted407021]

Why are we in medical school?

What the fuq does "heart of a nurse" even mean? I've worked with several nurses, and they don't seem any more, uhh ... heart ... than any other provider.

And listening to NPs and docs talk about the same issue demonstrates clearly that the former def. doesn't have the "brain of a doctor".

 

[Mad Jack]

I've known my fiancee and her family for like 10 years. She has a cousin, who I've known forever and always gotten along with, who started nursing school as nontrad last year when I was a 3rd year. She (at the time) had never had a single clinical rotation or anything. And at christmas she gave me a lecture about being nice to nurses. Me, who always starts an ED student shift by politely asking all the nurses if I can do foleys or blood draws or IVs for them, just ask, I'd love the experience. Where the **** do people come up with this ****.

The thing that really rubs me the wrong way about it more than anything is that I've met plenty of nurses that didn't give a **** about their patients. Being a nurse doesn't make one caring any more than being a doctor makes someone cold and withdrawn. People are people, and choosing a profession doesn't change their underlying personality.

 

[Mad Jack]

What the fuq does "heart of a nurse" even mean? I've worked with several nurses, and they don't seem any more, uhh ... heart ... than any other provider.

And listening to NPs and docs talk about the same issue demonstrates clearly that the former def. doesn't have the "brain of a doctor".

I think they're trying to tell us that NPs are actually Frankenstein's monster type creations that were created using the harvested brains of dead physicians and the hearts of deceased nurses.

 

[deleted407021]

I think they're trying to tell us that NPs are actually Frankenstein's monster type creations that were created using the harvested brains of dead physicians and the hearts of deceased nurses.

Wow. Online courses can do more these days than I thought.

 

[Mad Jack]

Wow. Online courses can do more these days than I thought.

That's why the courses are so useless- they just wait until you go to the exam center, pull out the old brain and heart, throw in a new one, and you're good to go, a fresh NP ready to be unleashed upon the world

 

[WingedOx]

I'm only posting this because sometimes it's fun to pour gasoline on an already raging dumpster fire...

 

[WingedOx]

@Mad Jack To go from a mid 80s to a low 90s in med school, it seems like one has almost to double the amount of study time... Some of the stuff these PhD professors ask are beyond ridiculous...

let's not start that thread again...

 

[Affiche]

Why are we in medical school?

Hahahahaha I literally LOL'ed

 

[W19]

Physicians as a whole probably have higher IQ than NP, but these people are a heck of a lot smarter than us...

 

[Bearcat74]

I wasn't going to get back into the "fray", but that "brain of a doctor poster" really is a good one. That will get any M.D. or med student "going". I don't agree w/ it, but do find it somewhat "entertaining"!

When I see my PCP, he doens't hardly make any eye contact. He is friendly, and extremely knowledgeable after 30 years of practice, but he is so busy writing his EMR on his tablet so the encounter note is finished when he walks out, that a person who is NOT in the medical field would view his behavior as rude. I know that he is just trying to "stay on schedule".

When I did tele-psych w/ the rural SE Ohio nursing homes, before I was involved, their psych was managed by IMG IM docs, who did not know anything about psych. I'd have 90 y/o patients on 1000 mg. of Depakote ER for agitation, and they would wonder why the pt was drowsy all the time. I would lower it to 125 mg, and they would "come back to life" in a matter of a few days.

I think the public's perception regarding NPs is that we spend more time w/ the pt, so "that means we care more". I find that the younger MDs are much more accepting too, of NPs. Face it folks, as Bob Dylan sang, "Times are a changing"!

As I said in the very beginning of this thread, NPs do NOT want MD's jobs. What we want is the opportunity, when properly trained, to do primary care, generally in areas where MDs don't want to be, or where the facility cannot afford to pay them. On-line students have tremendous problems getting preceptors, and many never get their certifications and DEAs as a result.

I work "in the hood" in SW Ohio. If it were not for NPs, 80% of our patients would not have anybody to take care of them.

And finally, aren't you guys going to wish me "Happy NP's week"?

 

[NotWayneBrady]

Nip it in the bud before medicine crumbles like anesthesia is doing now.

Minor derail incoming:

What on earth is happening in anesthesia right now? Does this have to do with increasing #s of CRNAs?

 

[NotWayneBrady]

Why are we in medical school?

What in the actual...?

 

[NotWayneBrady]

Physicians as a whole probably have higher IQ than NP, but these people are a heck of a lot smarter than us...

IQ is entirely ridiculous. Don't encourage people who think it means anything please.

 

[deleted407021]

And finally, aren't you guys going to wish me "Happy NP's week"?

Troll?

 

[wjs010]

Can't be serious! Even a second year med student won't do something stupid like that. What do they freaking teach at these NP schools?

I had to explain to a nursing student the other what a proton pump inhibitor is... She is a nursing student, but... Geez!

B blocker for HTN? Lol. Wtf. Why would that ever be given. Even if you didn't understand the pharmacology of ACEi's, arbs, CCB's... There should be like, a guideline to follow maybe? Especially if a mid level is gonna give a B-blocked for HTN.

 

[W19]

B blocker for HTN? Lol. Wtf. Why would that ever be given. Even if you didn't understand the pharmacology of ACEi's, arbs, CCB's... There should be like, a guideline to follow maybe? Especially if a mid level is gonna give a B-blocked for HTN.

Regardless of what we think, they are still practicing medicine... Our physician leaders have convinced some people that you need 11 year of school to be able to do primary care... They are talking about adding one more year to FM training... Go figure!

 

[Bearcat74]

Troll?

Na, just trying to be funny. I didn't even know it was National NP Week!

 

[Mad Jack]

Minor derail incoming:

What on earth is happening in anesthesia right now? Does this have to do with increasing #s of CRNAs?

Go read the gloom and doom on the anesthesia forums. It's a combination of CRNAs and AMCs.

 

[VA Hopeful Dr]

Regardless what we think, they are still practicing medicine... Our physician leaders have convinced some people that you need 11 year of school to be able to do primary care... They are talking about adding one more year to FM training... Go figure!

The 4 year thing ain't gonna happen.

And to do primary care well, you need the full training.

And let's stop including college in this discussion, its not part of anything remotely medical so just stop it.

 

[W19]

The 4 year thing ain't gonna happen.

And to do primary care well, you need the full training.

And let's stop including college in this discussion, its not part of anything remotely medical so just stop it.

I just would like to know the % of FM docs who practice full adult/peds/Ob...

 

[chipwhitley]

And let's stop including college in this discussion, its not part of anything remotely medical so just stop it.

Can we get rid of it then? Plenty of countries let you go straight to med school without college. Why don't we? It would save a ton of time and money.

 

[W19]

Can we get rid of it then? Plenty of countries let you go straight to med school without college. Why don't we? It would save a ton of time and money.

Hey! That's the way it's always been done... Why change it now? [sarcasm]....

 

[VA Hopeful Dr]

Can we get rid of it then? Plenty of countries let you go straight to med school without college. Why don't we? It would save a ton of time and money.

There are programs that use that model here in the US. I have nothing against that idea, though I think that 24 in many people is too young to be a physician. I know I wouldn't have been ready then.

 

[VA Hopeful Dr]

I just would like to know the % of FM docs who practice full adult/peds/Ob...

Depends what you mean by "full". If you mean taking care of those populations generally, I'm going to say the vast majority of us. Everyone in my residency class, the one above, and the one below sees adults and children. I don't delivery babies, but when pregnant women get sick who else is going to take care of them? OBs aren't very good at non-OB related illness, internists and peds hate pregnant patients generally speaking, and going to the ED for bronchitis seems overkill. That leaves us. As for peds, every family doctor in town has pediatric patients. Admittedly not as many as we used to have, but still a good number. I'd say about 15% of my current practice is pediatrics.

 

[username456789]

As I said in the very beginning of this thread, NPs do NOT want MD's jobs. What we want is the opportunity, when properly trained, to do primary care, generally in areas where MDs don't want to be, or where the facility cannot afford to pay them.

And as I said, you either know this is a lie and are intentionally being misleading and propagating propaganda to be inflammatory, or you really are that stupid. I'm not sure which one is better.

 

[chipwhitley]

There are programs that use that model here in the US. I have nothing against that idea, though I think that 24 in many people is too young to be a physician. I know I wouldn't have been ready then.

I'm assuming you're referring to the accelerated BS/MD programs? They still require 2-3 years of college (the BS part). There aren't any US medical schools that allow directly entry without a college education of some sort.

 

[WingedOx]

There are programs that use that model here in the US. I have nothing against that idea, though I think that 24 in many people is too young to be a physician. I know I wouldn't have been ready then.

I saw a mixed bag from the people who were in that program at my med school. Some were ready, many were not. Maturity tends to come with experience and in a lot of cases they learn to mature fast.

My biggest problem isn't so much having people go out into the world with an MD at 24, it's SELECTING potential med students at 18. No one who shows up at a professional school interview wearing a varsity jacket should be given a green light to being a physician... yet.

 

[Immunophile]

I wasn't going to get back into the "fray", but that "brain of a doctor poster" really is a good one. That will get any M.D. or med student "going". I don't agree w/ it, but do find it somewhat "entertaining"!

When I see my PCP, he doens't hardly make any eye contact. He is friendly, and extremely knowledgeable after 30 years of practice, but he is so busy writing his EMR on his tablet so the encounter note is finished when he walks out, that a person who is NOT in the medical field would view his behavior as rude. I know that he is just trying to "stay on schedule".

When I did tele-psych w/ the rural SE Ohio nursing homes, before I was involved, their psych was managed by IMG IM docs, who did not know anything about psych. I'd have 90 y/o patients on 1000 mg. of Depakote ER for agitation, and they would wonder why the pt was drowsy all the time. I would lower it to 125 mg, and they would "come back to life" in a matter of a few days.

I think the public's perception regarding NPs is that we spend more time w/ the pt, so "that means we care more". I find that the younger MDs are much more accepting too, of NPs. Face it folks, as Bob Dylan sang, "Times are a changing"!

As I said in the very beginning of this thread, NPs do NOT want MD's jobs. What we want is the opportunity, when properly trained, to do primary care, generally in areas where MDs don't want to be, or where the facility cannot afford to pay them. On-line students have tremendous problems getting preceptors, and many never get their certifications and DEAs as a result.

I work "in the hood" in SW Ohio. If it were not for NPs, 80% of our patients would not have anybody to take care of them.

And finally, aren't you guys going to wish me "Happy NP's week"?

I don't know why, but your incorrect over-use of quotation marks in all your posts makes it difficult for me to take you seriously.

 

[Mad Jack]

I don't know why, but your incorrect over-use of quotation marks in all your posts makes it difficult for me to take you seriously.

I don't know why anyone would ever take anything said on SDN seriously.

 

[Carbocation1]

This was just posted in the FM forum.

"So the UC I moonlight at just wrote me to tell me they're canceling all of my future 6-10 pm shifts as they only want PAs to work them. Have you guys seen this?

Honestly, I can't fault them. We charge more than double what a midlevel does and the UC gets equal reimbursement for our work. Doesn't seem like I have any recourse to take here. I guess PAs will displace more and more physicians. What am I missing?"

http://forums.studentdoctor.net/threads/mid-level-uprising.1169443/#post-17098669

 

[W19]

@Carbocation1 This is the fault of our leaders. You don't need 11 years of school to be able to do primary care effectively. I shadowed a PCP last year for 20 hours as mandated by my school and 90%+ of what she was treating was HTN/DM/Hyperlipidemia/hypothyroidism...

I am not too sure about NP, but I think PA are well qualified to do primary care... Today, my pathology professor was talking about that and he said they should have never gotten rid of GP and then come up with FM... The guy seems to hate the system and said our leaders have 'corporatized' (his word) medicine... I was wondering if the guy has been reading these SDN threads...

 

[Bearcat74]

And as I said, you either know this is a lie and are intentionally being misleading and propagating propaganda to be inflammatory, or you really are that stupid. I'm not sure which one is better.

And you, and the rest of the student doctors/residents/attendings have generally been very rude and mean spirited to my honest comments. If I wanted to be inflammatory, I would have told you from the get-go that in five years, all 50 states (21 right now), will have independent practice, and NPs will be putting FP and IM docs out of business. My hospital owned PCP charges $175 for an office visit. NPs I work with in Kentucky, who have independent practice, charge $75. They can handle your HTN, DMII, sinusitis, otitis media, strep, etc.... very well.

I guarantee you could go to a NP Forum, and you would be treated very kindly. Perhaps that is why patients, at least at my community mental center of over 1000 patients, well they voted 2 to 1 via an agency survey, that they would rather see any of the NPs over any of the MDs. Your bedside manners already suck, and that is a fact, Jack!

 

[Bearcat74]

P.S. I am outa here!

 

[ACSurgeon]

I wasn't going to get back into the "fray", but that "brain of a doctor poster" really is a good one. That will get any M.D. or med student "going". I don't agree w/ it, but do find it somewhat "entertaining"!

When I see my PCP, he doens't hardly make any eye contact. He is friendly, and extremely knowledgeable after 30 years of practice, but he is so busy writing his EMR on his tablet so the encounter note is finished when he walks out, that a person who is NOT in the medical field would view his behavior as rude. I know that he is just trying to "stay on schedule".

When I did tele-psych w/ the rural SE Ohio nursing homes, before I was involved, their psych was managed by IMG IM docs, who did not know anything about psych. I'd have 90 y/o patients on 1000 mg. of Depakote ER for agitation, and they would wonder why the pt was drowsy all the time. I would lower it to 125 mg, and they would "come back to life" in a matter of a few days.

I think the public's perception regarding NPs is that we spend more time w/ the pt, so "that means we care more". I find that the younger MDs are much more accepting too, of NPs. Face it folks, as Bob Dylan sang, "Times are a changing"!

As I said in the very beginning of this thread, NPs do NOT want MD's jobs. What we want is the opportunity, when properly trained, to do primary care, generally in areas where MDs don't want to be, or where the facility cannot afford to pay them. On-line students have tremendous problems getting preceptors, and many never get their certifications and DEAs as a result.

I work "in the hood" in SW Ohio. If it were not for NPs, 80% of our patients would not have anybody to take care of them.

And finally, aren't you guys going to wish me "Happy NP's week"?

And here's the biggest lie (in bold). Nurses lobby with that excuse and then try to get jobs in the most desirable areas. I've never seen nurses lobby for special autonomy in rural areas. They lobby for autonomy period.

 

[ACSurgeon]

And- like someone else said, to do primary care well, you need full training. It's a shame that PC is now left for nurses and the bottom percentile of medical students and IMGs.

 

[username456789]

And you, and the rest of the student doctors/residents/attendings have generally been very rude and mean spirited to my honest comments.

So it was the latter, then.

 

[W19]

...

 

[Psai]

Why are we in medical school?

This is actually very incredibly insulting to both doctors and nurses
Are they saying that nurses are dumb? And doctors are heartless?