Well it's my job to be a good steward of my client. They pay me, and it's really the fault of doctors at the end of the day. Greed is what caused this APP situation. Lack of long term thinking got us to where we are today.
yes I remember right after my cardiology unit, we had "how doctors write the law and control all hospital employment decisions"
That's largely because of American capitalism being dysfunctional
How is it the doctors' fault when private equity and nonclinical administrators are running hospitals and practices?
Lol unabashedly scummy, at least you recognize that you're destroying medicine, or maybe that makes it all the worse.
There’s a special place in hell for people like you
I mean, my thoughts on this are that it’s BS. I am not against midlevels existing, but being independent or supervising actually physicians? Completely against that.
Oh. I think we agree (although i'm blaming the existence of midlevels as a US-only thing, because midlevels really aren't common if they even exist in rest of the world)
I don't know if a socialized system would be any better though. If we replaced private system with government systems, there would still be administrators looking to cut costs by reducing the number of physicians and increasing the number of midlevels.
I'm not sure because midlevels aren't a thing in socialized health systems in other countries. But i'll say midlevels are going to rapidly saturate their job market before transition to socialized system happens.
That's a false dichotomy though. The answer is, there should be an experienced attending available for this.
What why? Why not let a senior resident or attending take care of it?
This is what I found with a quick google search "The countries in which NPs exist as a profession were Australia, Canada, Finland, Ireland, the Netherlands, New Zealand, the four nations of the UK and the U.S. The eight countries have in common that extensive task shifting has occurred in the past, leading to considerably advanced clinical nursing practice for NPs."
Hm, i was mistaken since i saw Canada, Australia and Israel having midlevels. I'm not sure if this is because they were inspired by US model or because of cost cutting measures.
Such an awful article. The NPs at my kids’ pediatrician’s office have been wonderful when it comes to routine things like looking at a diaper rash and prescribing the appropriate ointment. But when I brought in my very sick toddler, one of the same NPs thought she was fine and wanted to send her home. At that point I insisted on seeing a physician, and the one who saw her took one look at her and sent us straight to the ED.In the ED I used to work at we called the PAs/NPs midlevels. When I transitioned to working in a private practice, I was in a conversation with a NP referencing midlevels and she corrected me that it was a derogatory word, then sent me this via a text:
Stop calling nurse practitioners mid-level providers
The term "mid-level provider” is primarily aimed at nurse practitioners (NPs). It is insulting to health professionals as well as to the patients they serve.www.kevinmd.com
My wife is surgery resident. I'm not destroying medicine, medicine has already been destroyed doctors who decided they wanted to work 15 hour weeks ruined it for every doctor that came behind them. They are the reason that productivity numbers are crazy that every little thing is tracked. Doctors who didn't understand the value of lobbying against their fellow colleagues to stop the encroachment of midlevels because it allowed them to see more patients but not have to be there are the ones people should be mad at. Greed caused a lot of the issues we see now in healthcare, I'm not saying that this extremely fast shift to midlevel is fair but it's what's going to happen. What's best is for other doctors to see what's happening and make sure they don't take it laying down when their own specialties are encroached on.
"Medicine is already on fire so what's it matter if I pour some gasoline on it"
"Por que no los dos?" gif
I would not burn this guy at the cross fam. At all. This is the person you should all be asking questions to, not attacking. I would want to understand his job in and out - the why, the how, how much he's getting paid, who's paying him, who the stakeholders are in his hospital administrations that he's interfacing with... the works. This right here is a god damn unicorn if he's willing to teach us about that. You cannot even begin to fight back if you do not have a thorough understanding of the why or how or who. Most people upset at midlevels and the job market don't even know who is standing in the room when those decisions are made. It gets labeled "some MBA" or "admin" and stops there.
Just doing his job? That's the excuse you're going with?
I'm not going to call it an excuse, I'm going to call it sound reasoning, but yes. He's not any more or less demonic than any other consultant who is hired to cut costs and make a business more profitable. Healthcare is a business. Burying our heads in the sand and pretending it isn't is how a handful of greedy boomer doctors did exactly what you're all accusing them of doing while everyone else sat back and said life is good. And now here we are.
False dichotomy. Boomer docs and consultants like this can both suck.
For several years I did DPC so no, no one like you was involved whatsoever.
Lol okay and what do you do now?
Thanks for the detailed insight. Really appreciate this even though it made me more jaded than before
Oh major hospital system. I'll openly admit that I'm selling out by doing so.
My friend is surgical critical care, not medical. Those departments don't overlap at all in larger hospital systems with IM and surgery residencies. This is not the case for his department, it is specific to the IM department.
Also private equity bad
I think this problem is fundamentally linked to the selfishness of the individual, which later deteriorated to the arrogant laziness that some residents are displaying.
Depends on who you ask...a client I worked with who is PE backed owns part of an ASC that cuts a 6 figure dividend check per surgeon every year since forever.
Anecdotally, our 2 ortho foot/ankle guys don't use PAs at all while lots of the other orthos do.
Not obligatory and unnecessary to bring nazis into the discussion unless you're talking about WW2 or the holocaust as a general rule of thumb.
