PAs/NPs attempting to "cancel culture" the AMA

[Matthew9Thirtyfive]

Not sure how helpful sharing this would be anyway

The public as a whole is a lot more sympathetic to nurses and midlevel providers because they don't make as much and aren't ever perceived as elitist. We joke about the gunner ***hole who becomes an ortho or a doc who primarily cares about money, but unfortunately, that minority of physicians does exist and hurts our image. Patients are aware of them, as they've dealt with them.

Makes it harder to communicate the broader issues with an increased scope of PA/NP care

Yes, despite evidence that nurses and nurse practitioners are much less likely to follow EBM and the fact that their unions push for higher salaries with less work (they start out at like 100k in some places), they have gotten the public to think they are these noble, altruistic people not in it for the money. Anyone who has worked with nurses for any amount of time knows that there are plenty of nurses just in it for the money.

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[scoopdaboop]

Can we all just agree that we are overreacting a tad bit. There's already more than half the states with FPA... physicians still in demand, massively, not only because these NPs don't want to work independently because they realize they don't have the knowledge base; I mean why do you think there are statistics like less than 25 percent of NPs actually work to 'fill rural care". Also, physicians are just more valuable to a hospital system. I'm all for being a goof a bit, making fun of these people, but it seems like in almost every specialty where they can't manage to work independently (things like cardio, neurology, surgery) they basically live like a perpetual intern/resident and just do scut work (cleaning wounds, random lame follow ups) etc.

I guess an argument can be made that FPA is a gateway for other things... I mean why even advocate for it if most NPs don't actually work independently, and don't care for it. Is it just the lobby/select few NPs trying to overcome their short comings in life for not being a real doctor? Could be possible. Maybe it's to slowly creep up their salaries. "We do the same thing as doctors in these FPA states, we should get paid the same". Yet, there are a lot of people that would not want that to happen; Medicare/Medicaid, insurance companies, and obviously physicians. If they tried to fight for that, they would get stomped out fairly quickly...

 

[altblue]

Yes, despite evidence that nurses and nurse practitioners are much less likely to follow EBM and the fact that their unions push for higher salaries with less work (they start out at like 100k in some places), they have gotten the public to think they are these noble, altruistic people not in it for the money. Anyone who has worked with nurses for any amount of time knows that there are plenty of nurses just in it for the money.

Yup, I don't disagree with you at all there - I'm just describing public perception. Not super familiar with nurses on a personal basis, but I'm sure there are selfish ones too.

I have a number of classmates who are in medicine for the right reasons and whom I'd trust with my life. There are legitimate grievances against NP/PAs if you care a great deal about patient care.

 

[popopopop]

Can we all just agree that we are overreacting a tad bit. There's already more than half the states with FPA... physicians still in demand, massively, not only because these NPs don't want to work independently because they realize they don't have the knowledge base; I mean why do you think there are statistics like less than 25 percent of NPs actually work to 'fill rural care". Also, physicians are just more valuable to a hospital system. I'm all for being a goof a bit, making fun of these people, but it seems like in almost every specialty where they can't manage to work independently (things like cardio, neurology, surgery) they basically live like a perpetual intern/resident and just do scut work (cleaning wounds, random lame follow ups) etc.

It's not overreacting. It's a slippery slope and we're seriously getting attacked from all fronts. Physicians are valuable to a hospital system, hence you can find articles of whole physician groups being replaced by teams of NPs for obvious cost-saving. They may work like a resident like you said, but a minority of them definitely think they can take your job and their leadership is totally supporting that. Read some of the AMA fb's comments if you want your head to explode on how equivalent/BETTER their care is.

Yes, despite evidence that nurses and nurse practitioners are much less likely to follow EBM and the fact that their unions push for higher salaries with less work (they start out at like 100k in some places), they have gotten the public to think they are these noble, altruistic people not in it for the money. Anyone who has worked with nurses for any amount of time knows that there are plenty of nurses just in it for the money.

Not even just the public. I'm astonished at how many of the comments on the fb post are from np/pa that thinks they are just better than a physician. Money isn't a red flag motivator to me anymore as long as you provide good care.

 

[scoopdaboop]

It's not overreacting. It's a slippery slope and we're seriously getting attacked from all fronts. Physicians are valuable to a hospital system, hence you can find articles of whole physician groups being replaced by teams of NPs for obvious cost-saving. They may work like a resident like you said, but a minority of them definitely think they can take your job and their leadership is totally supporting that. Read some of the AMA fb's comments if you want your head to explode on how equivalent/BETTER their care is.

Well yeah, there's no doubt mid-levels are more of a threat in EM and Primary care than anywhere else... You are referencing the Urgent care who let go of docs to replace with NPs while keeping a few on staff for supervisory roles? That type of stuff happens in a lot of places. Specialists on the other hand are safer for now.

 

[altblue]

Not even just the public. I'm astonished at how many of the comments on the fb post are from np/pa that thinks they are just better than a physician. Money isn't a red flag motivator to me anymore as long as you provide good care.

Nothing wrong with wanting to live comfortably and support a family, but money is just that if it's by far your biggest motivation. You don't even have to be a saint... if you just don't fundamentally don't care about the quality of your work as you do money, it will show and patients will pick up on that. I've known a surgeon like this.

That's beside the point though, since I don't think nurses are better in this regard than physicians.

 

[scoopdaboop]

Nothing wrong with wanting to live comfortably and support a family, but money is just that if it's by far your biggest motivation. You don't even have to be a saint... if you just don't fundamentally don't care about the quality of your work in some fashion, it will show and patients will pick up on it. I've known a surgeon like this.

That's beside the point though, since I don't think nurses are better in this regard than physicians.

Nurses pretending they don't do NP/CRNA for the money are spewing a pile of BS larger than me after I eat taco bell at night + drink coffee the next morning. If they truly didn't do it for the money, they would remain nurses. I mean there's examples of NP students dropping out because they realized their training is garbage, and nurses quitting from facilities because the NPs are so bad lmao. Also, they can get away with it, because let's face it, majority of NPs are women so they automatically "have a good heart". load of garbage.

 

[altblue]

Nurses pretending they don't do NP/CRNA for the money are spewing a pile of BS larger than me after I eat taco bell at night + drink coffee the next morning. If they truly didn't do it for the money, they would remain nurses. I mean there's examples of NP students dropping out because they realized their training is garbage, and nurses quitting from facilities because the NPs are so bad lmao.

Like I said, I'm not saying nurses are better in this regard. Public perception.

 

[RocuROMANium]

I didn’t think we did. We literally always got along great until I started talking about wanting to go to medical school.

Yikes. It sounds like someone is insecure about their life choices...

 

[Matthew9Thirtyfive]

Yikes. It sounds like someone is insecure about their life choices...

Yeah, it’s funny. She never overstepped her role as far as I could see. She was literally exactly what an NP should be. But she had a real chip on her shoulder about that I guess.

We had another NP who was nice as can be, but she would constantly introduce herself as doctor to patients and tell them to ignore their surgeons’ recommendations and stuff.

 

[Matthew9Thirtyfive]

Not even just the public. I'm astonished at how many of the comments on the fb post are from np/pa that thinks they are just better than a physician. Money isn't a red flag motivator to me anymore as long as you provide good care.

Oh yeah, it’s definitely not just the public. There are physicians who responded to the AMA post defending midlevels and saying they are equivalent or better. The brainwashing is very pervasive.

 

[Matthew9Thirtyfive]

Nothing wrong with wanting to live comfortably and support a family, but money is just that if it's by far your biggest motivation. You don't even have to be a saint... if you just don't fundamentally don't care about the quality of your work as you do money, it will show and patients will pick up on that. I've known a surgeon like this.

That's beside the point though, since I don't think nurses are better in this regard than physicians.

I don’t really know if patients do. I have worked with nurses who didn’t give 8 cans of shark **** about patients, but they turned on the charm whenever they were around them.

 

[altblue]

I don’t really know if patients do. I have worked with nurses who didn’t give 8 cans of shark **** about patients, but they turned on the charm whenever they were around them.

Yup!

A good deal of it is also that doctors are seen as the face of the medical team, held to a higher standard, even if patients often interact with the nurse or midlevel provider first. So in the end, the occasional questionable bed-side manner of doctors will be scrutinized far more heavily than that of nurses or midlevels (that "stuck up" doctor versus that "tired and overworked" nurse). In the end, this also ends up affecting the reputation of each in different ways.

It's getting off-topic, so this just brings me back to my point that nurses and NP/PA have a far more effective PR machine than us for a variety of reasons, including clinical perceptions over time

 

[Matthew9Thirtyfive]

Yup!

A good deal of it is also that doctors are seen as the face of the medical team, held to a higher standard, even if patients often interact with the nurse or midlevel provider first. So in the end, the occasional questionable bed-side manner of doctors will be scrutinized far more heavily than that of nurses or midlevels (that "stuck up" doctor versus that "tired and overworked" nurse). In the end, this also ends up affecting the reputation of each in different ways.

It's getting off-topic, so this just brings me back to my point that nurses and NP/PA have a far more effective PR machine than us for a variety of reasons, including clinical perceptions over time

Yep. Also, when you have a small n, you are limited likely to see extreme results. When you only see a doctor a few times, it is much more likely that your experiences will be all good or all bad than when you see a nurse dozens of times, where there will be a regression to the mean.

 

[ewax]

Exactly. I worked in the OR for 8 years. They are fine on easy cases until something happens. Then they are completely useless.

Fixed that for you.

 

[Konigstiger]

I'm actually pretty impressed they put that message back up after taking it down, but good on them. The first step to solving this issue is for physicians to stop shooting themselves in the foot and trying to score points with NP/PA organizations that would stab them in the back the first chance they got.

 

[fldoctorgirl]

My favorite responses are the "is this ReALly?!? what we need to be arguing about right now during a pandemic!!!!"

I can't handle these people lol. Just found this gem: "As a nurse, this infuriated me. NP’s/PA’s are just as capable as providing safe, competent care. In fact, a nurse with 25 years experience is more qualified than a 2nd year resident, or a new attending after 3 years of training. Without nurses, doctors could not do their jobs."

Um. Yes. More qualified at being a nurse. Not at being a doctor lol.

 

[readmypostsMD]

It’s back up! Slightly different wording, but the message is the same.

View attachment 322154

this is beautiful.

 

[Matthew9Thirtyfive]

My favorite responses are the "is this ReALly?!? what we need to be arguing about right now during a pandemic!!!!"

I can't handle these people lol. Just found this gem: "As a nurse, this infuriated me. NP’s/PA’s are just as capable as providing safe, competent care. In fact, a nurse with 25 years experience is more qualified than a 2nd year resident, or a new attending after 3 years of training. Without nurses, doctors could not do their jobs."

Um. Yes. More qualified at being a nurse. Not at being a doctor lol.

They are so delusional. Also the gaslighting is infuriating. They literally used the pandemic as a vehicle to get full practice authority in states. The hypocrisy is astounding.

 

[Lawpy]

How will midlevels respond to SDN if this thread gets posted on social media? I'm hoping several of them will stop by and debate

 

[readmypostsMD]

Kind of want to have a hospital run by mid levels and see how it goes...

Maybe they’ll finally learn

 

[popopopop]

How will midlevels respond to SDN if this thread gets posted on social media? I'm hoping several of them will stop by and debate

That's my dream, a townhall style debate like when Bill Nye battled Ken Ham. Have the president of AMA/PPP vs ANA/AANP or whatever debate each other with a real moderator. I'd love that!

 

[slowthai]

How will midlevels respond to SDN if this thread gets posted on social media? I'm hoping several of them will stop by and debate

We'll all drown in midlevel tears. Welp, at least my debt will be gone

 

[Matthew9Thirtyfive]

That's my dream, a townhall style debate like when Bill Nye battled Ken Ham. Have the president of AMA/PPP vs ANA/AANP or whatever debate each other with a real moderator. I'd love that!

It’ll never happen. They know what they are doing when they move goalposts, gaslight, and such, and they will never willingly go into an arena where they aren’t allowed to do that. They know they don’t actually have a leg to stand on, because if they did, they would simply present the evidence as it is and not resort to all those logical fallacies and manipulative tactics.

 

[Matthew9Thirtyfive]

Can we all just agree that we are overreacting a tad bit. There's already more than half the states with FPA... physicians still in demand, massively, not only because these NPs don't want to work independently because they realize they don't have the knowledge base; I mean why do you think there are statistics like less than 25 percent of NPs actually work to 'fill rural care". Also, physicians are just more valuable to a hospital system. I'm all for being a goof a bit, making fun of these people, but it seems like in almost every specialty where they can't manage to work independently (things like cardio, neurology, surgery) they basically live like a perpetual intern/resident and just do scut work (cleaning wounds, random lame follow ups) etc.

I guess an argument can be made that FPA is a gateway for other things... I mean why even advocate for it if most NPs don't actually work independently, and don't care for it. Is it just the lobby/select few NPs trying to overcome their short comings in life for not being a real doctor? Could be possible. Maybe it's to slowly creep up their salaries. "We do the same thing as doctors in these FPA states, we should get paid the same". Yet, there are a lot of people that would not want that to happen; Medicare/Medicaid, insurance companies, and obviously physicians. If they tried to fight for that, they would get stomped out fairly quickly...

It is absolutely about money and ego for them. The majority of people wanting to fight it are concerned about patient safety, though obviously job security and salary is a part of it too.

 

[Eye-eye]

The sad thing is, it doesn't matter how much evidence we show... The public perception will always be selfless, hard-working nurses vs uncaring docs who just want more money. At least until we really lose this fight and the public/administrators/politicians see all the complications that arise from it.

I mean, come on, the public will largely believe what the media tells them, especially if it's in line with what makes them feel good. Trump gets his care from a DO = DOs must not be real doctors (had to explain that DO=MD to an otherwise extremely well educated friend the other day). Docs and nurses/PAs are fighting over scope of practice = docs are dinguses oppressing poor nurses. It'll never change until real world ramifications are seen en masse, because the only people who understand the differences well enough are the docs and some of the midlevels, whose egos (and obvious self interest) will keep them siding with midlevels.

 

[jambro]

I'll freely admit that as a medical student, it's in my interest to be right on this one. If you're an NP, you want to believe you can treat patients just like physicians can, since you'll feel good about yourself and feel like you can justify demanding a higher salary.

If i was just a patient, i'd think it was insane to see a midlevel for anything even possibly important, but I could just specifically seek out physicians and let my loved ones know what's going on as well. Unfortunately, as future physicians, we have to deal with these dynamics professionally and can't simply ignore them just because it doesn't affect our health personally.

 

[Eye-eye]

I'll freely admit that as a medical student, it's in my interest to be right on this one. If you're an NP, you want to believe you can treat patients just like physicians can, since you'll feel good about yourself and feel like you can justify demanding a higher salary.

If i was just a patient, i'd think it was insane to see a midlevel for anything even possibly important, but I could just specifically seek out physicians and let my loved ones know what's going on as well. Unfortunately, as future physicians, we have to deal with these dynamics professionally and can't simply ignore them just because it doesn't affect our health personally.

The patient sees someone in a long white coat and who may even introduce themself as "doctor." Sadly, many don't know the difference, which is just as unscrupulous midlevels like it. I've had the pleasure of working with great midlevels so far, that have no apparent desire to increase their scope or pretend to be something they aren't. But their lobbying groups sadly are expanding scope of practice for those with the least moral qualms about doing something they aren't trained for / the least insight into their own training and abilities. A scary combination, if you ask me.

 

[jambro]

Completely agree. Have only worked with midlevels in the private practice world, so not sure if its any better in a more established hospital system, but I've seen/heard some ****ed up ****. At my job an NP would introduce herself as "Dr.", and a friend of mine worked with PAs who constantly say they did med school in 2 years, call themselves a dermatologist, and just **** patients up overall doing "surgeries" and removing things even the real dermatologists wouldn't touch.

 

[Ganon]

One of the huge issues is that the only people who truly know the difference between the two professions are NP’s and MD/DO’s. I have worked with RN’s long enough, and am married to an RN as well, to know that they don’t really understand the difference.

Really can't generalize your wife/husband's lack of knowledge to the entire population, though.

I have never met an RN who didn't know the difference.

I have been stopped by multiple MD students and residents who wanted to understand different varieties of nurses, but I wouldn't use that to assume that doctors don't understand nursing education.

 

[RocuROMANium]

Really can't generalize your wife/husband's lack of knowledge to the entire population, though.

I have never met an RN who didn't know the difference.

I have been stopped by multiple MD students and residents who wanted to understand different varieties of nurses, but I wouldn't use that to assume that doctors don't understand nursing education.

That’s why I replied to Lawpy with the comment below

Maybe it's just the hospital that I work at or the particular nurses that I have worked with but a lot of RN's here do not know the significant differences between the two professions.

 

[Ganon]

That’s why I replied to Lawpy with the comment below

Out of curiosity, are you in a rural area, or a major metro?

I'm wondering what the regional differences in opinions are. For example, I live in a state without independent NP practice, so I bet opinions differ than the ~1/2 that do

 

[RocuROMANium]

Out of curiosity, are you in a rural area, or a major metro?

I'm wondering what the regional differences in opinions are. For example, I live in a state without independent NP practice, so I bet opinions differ than the ~1/2 that do

Major metropolitan area in a state without independent NP practice as well

 

[Cornfed101]

In fact, a nurse with 25 years experience is more qualified than a 2nd year resident, or a new attending after 3 years of training. Without nurses, doctors could not do their jobs."

Um. Yes. More qualified at being a nurse. Not at being a doctor lol.

100% this. It’s like @Matthew9Thirtyfive saying his 8 years experience as a tech makes him more qualified than a senior resident.

 

[Matthew9Thirtyfive]

100% this. It’s like @Matthew9Thirtyfive saying his 8 years experience as a tech makes him more qualified than a senior resident.

I mean it does. At being an OR tech.

 

[Medmortise]

Can we all just agree that we are overreacting a tad bit. There's already more than half the states with FPA... physicians still in demand, massively, not only because these NPs don't want to work independently because they realize they don't have the knowledge base

I fully disagree. This is only the beginning. The rates at which these online mills are producing NPs is staggering. There is a reason they are trying to blur the line as much as possible. Why do you think nurse anesthetist are trying to change their name to nurse anesthesiologist? There is literally ZERO reason to do so other than try to deceive the public. If we don't take a stand now there is no telling what the future of medicine will be like.

 

[deleted966164]

I fully disagree. This is only the beginning. The rates at which these online mills are producing NPs is staggering. There is a reason they are trying to blur the line as much as possible. Why do you think nurse anesthetist are trying to change their name to nurse anesthesiologist? There is literally ZERO reason to do so other than try to deceive the public. If we don't take a stand now there is no telling what the future of medicine will be like.

SARCASM One could argue that med school is online too. I haven’t been to class in person for two weeks now... /SARCASM

 

[slowthai]

One could argue that med school is online too. I haven’t been to class in person for two weeks now...

The volume of information that we're required to master doesn't change because we're online.

Whenever "online diploma mill" is used in these discussions, it's just in reference to the fact that there is minimal clinical experience gained and that there is no rigor. It's the university of phoenix equivalent of an "advanced nursing degree". The graduates of these programs are, by definition, unequipped to practice medicine. They never will be unless they go to med school.

 

[jambro]

One could argue that med school is online too. I haven’t been to class in person for two weeks now...

When there's an all-online residency, then we can compare them.

 

[deleted966164]

My goose... I was merely being sarcastic

 

[slowthai]

When there's an all-online residency, then we can compare them.

Lol, we don't even need to bring residency into the conversation. Med school alone overwhelms those HDTV degrees to the billionth power

 

[slowthai]

My goose... I was merely being sarcastic

You should've put /s at the end so that we would know that you weren't being an ignoramus

 

[MLNS]

Really can't generalize your wife/husband's lack of knowledge to the entire population, though.

I have never met an RN who didn't know the difference.

I have been stopped by multiple MD students and residents who wanted to understand different varieties of nurses, but I wouldn't use that to assume that doctors don't understand nursing education.

ive worked with hundreds (possibly thousands?) of nurses by this point and I’d put the over/ under of RNs that know the difference to be roughly 10%.

 

[scoopdaboop]

I fully disagree. This is only the beginning. The rates at which these online mills are producing NPs is staggering. There is a reason they are trying to blur the line as much as possible. Why do you think nurse anesthetist are trying to change their name to nurse anesthesiologist? There is literally ZERO reason to do so other than try to deceive the public. If we don't take a stand now there is no telling what the future of medicine will be like.

Why don’t physician groups just change what we should be called to like “real doctor of anesthesia” or “real doctor of cardiology”. Or something not as facetious like “doctor of medicine in cardiology”, “ medical doctor of anesthesiology”. If these nursing lobbies can basically decide what they can call themselves we can make it more clear that we are trained in med school and thru residency. The anesthesia lobby, Idk their name, should make it required to say that if you are a crna, no matter the title change say nurse when introducing themselves and they can’t use the title given to anesthesiologists if we do something akin to above.

 

[Matthew9Thirtyfive]

When there's an all-online residency, then we can compare them.

Also I am still going in for SP encounters and ****, and in a couple months I will be headed to the wards for 2.5 years. None of that is online lol.

 

[Ganon]

ive worked with hundreds (possibly thousands?) of nurses by this point and I’d put the over/ under of RNs that know the difference to be roughly 10%.

I've been in healthcare since paper charts and my experience has been different XD
I truly wonder if it's regional

 

[cookiegrub]

I have never even remotely close been “bullied”. It’s largely SDN nonsense, if it does happen it’s just cuz that NP is a turd not a generalization about the field.

I hate mid level creep as much as the next guy but it has literally not affected me at all

You're lucky because I've seen a physician get fired over midlevel politics. Beware

 

[cookiegrub]

Can we all just agree that we are overreacting a tad bit. There's already more than half the states with FPA... physicians still in demand, massively, not only because these NPs don't want to work independently because they realize they don't have the knowledge base; I mean why do you think there are statistics like less than 25 percent of NPs actually work to 'fill rural care". Also, physicians are just more valuable to a hospital system. I'm all for being a goof a bit, making fun of these people, but it seems like in almost every specialty where they can't manage to work independently (things like cardio, neurology, surgery) they basically live like a perpetual intern/resident and just do scut work (cleaning wounds, random lame follow ups) etc.

I guess an argument can be made that FPA is a gateway for other things... I mean why even advocate for it if most NPs don't actually work independently, and don't care for it. Is it just the lobby/select few NPs trying to overcome their short comings in life for not being a real doctor? Could be possible. Maybe it's to slowly creep up their salaries. "We do the same thing as doctors in these FPA states, we should get paid the same". Yet, there are a lot of people that would not want that to happen; Medicare/Medicaid, insurance companies, and obviously physicians. If they tried to fight for that, they would get stomped out fairly quickly...

Nope not one bit do I regret getting anxious abt these matters. A resident that works 80+hrs and getting half the pay of someone who went to school for 2 years. On top of that, hospitals and rule makers are not doctors and they have absolute control over management. The system is so broken and it is all due to our professions indifference. An assistant should stay an assistant and nothing more. If you want to be a doctor go through medical school. Heck ppl arent crazy to go to the Caribbean to be one. Also if you were already working you'd know that money drives unqualified ppl to seek for spots they dont deserve. Once government rules are swayed in the mid levels favor, you just wait and watch how crazy their leadership will get.

 

[Matthew9Thirtyfive]

Nope not one bit do I regret getting anxious abt these matters. A resident that works 80+hrs and getting half the pay of someone who went to school for 2 years. On top of that, hospitals and rule makers are not doctors and they have absolute control over management. The system is so broken and it is all due to our professions indifference. An assistant should stay an assistant and nothing more. If you want to be a doctor go through medical school. Heck ppl arent crazy to go to the Caribbean to be one. Also if you were already working you'd know that money drives unqualified ppl to seek for spots they dont deserve. Once government rules are swayed in the mid levels favor, you just wait and watch how crazy their leadership will get.

They’re already crazy. They are literally doing everything they can to back door themselves into being the same as physicians in scope of practice and title. It’s remarkable to me that they can be telling the public that they are the same as someone with 900% more training than them and the public just says oh okay cool.

 

[Cornfed101]

They’re already crazy. They are literally doing everything they can to back door themselves into being the same as physicians in scope of practice and title. It’s remarkable to me that they can be telling the public that they are the same as someone with 900% more training than them and the public just says oh okay cool.

people always have their little anecdotes of some doctor that didn’t find their diagnosis and then an NP found it right away and cured them! What good is all that training?

I want to strangle those people

A lot of anti-vaxers have a similar stupid logic. Something like, my kid had an allergic reaction so vaccines are bad and I’m gonna convince all of my family and friends to stop vaccinating and we’re all gonna have a measles party.

I don’t wanna have an NP party