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There was a chart somewhere in SDN about that. There are more in specialties than primary care... It was something like 40%+(primary care) to 50%+ (specialties).
When a nurse is your health-care provider, you’re at risk
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however it is, the equivalency would need to be proved solidly.
whether np/do/md all get access to the same residency training, or separate.
but what i don't want to see is govt subsidized residency for md/do, but then no residency training for np or 'work-studies' that get paid for by the student, etc, downloading the cost of training, in order to get to a proven equivalency.
sure, make more pathways to providing healthcare. but:
the equivalency of care must be proven.
the cost of training must not be downloaded onto individuals
the remuneration of services must be equivalent to prevent undercutting and cheapening
there must not be an erosion (or any more) of professional autonomy towards the shoddy treatment of salaried labour .
i believe that the support from payers/policy makers for creation of more pathways are actually, underneath it all, to undermine all of the above, and not for altruistic purposes of broadening access to healthcare or such
whether np/do/md all get access to the same residency training, or separate.
but what i don't want to see is govt subsidized residency for md/do, but then no residency training for np or 'work-studies' that get paid for by the student, etc, downloading the cost of training, in order to get to a proven equivalency.
sure, make more pathways to providing healthcare. but:
the equivalency of care must be proven.
the cost of training must not be downloaded onto individuals
the remuneration of services must be equivalent to prevent undercutting and cheapening
there must not be an erosion (or any more) of professional autonomy towards the shoddy treatment of salaried labour .
i believe that the support from payers/policy makers for creation of more pathways are actually, underneath it all, to undermine all of the above, and not for altruistic purposes of broadening access to healthcare or such
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i agree, but the horse is out of the barn. ideally, have a 'grandfathering' process that makes mds out of all the nps etc, and have only md moving forward.
equivilancy as an alternative is to undermine the motives that are causing all of this difficulty in the first place (the motives being a kind of 'scab labour' scenario that has deleterious effects on the profession of m.d., deleterious effects on patients, and benefits administrative beurocrats all in the name of profit or cost savings while they eat up all this money to administrate)
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You're making less sense every time you post.
Sarcasm? Life and people aren't that simple. So you are either doing sarcasm OR you refuse to except the concept of people being multi-dimensional beings and needing care from another multi-dimensional being, who gets that.
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The "grandfathering process" is called "going to medical school."
Full equivalence is not the same as practicing, in reality anyway, some degree of medicine. Believe it or not, critical care nurses do this. Some do it better than others.
I think the bulk of the difference ultimately comes down to the rigors of residency training and quality clinical hours with an organized, well-controlled system of evaluation. This is what many NPs programs lack. The others that compensate have a boatload of sound, clinical experience--something not every nurse has seen--b/c in reality, he or she did not practice nursing long enough in the right areas.
What I have seen is a fair amount of schools letting nurses with minimal experience move into Grad NP programs or even CRNA programs. Without the right clinical hours over a strong period of time, you are just not going to get it. The programs should be reserved for those that can prove expertise. In most cases, 5 years or less is not going to get you there. Also, if you think nurses don't study medicine or learn independently through scientific journals and other materials, you are mistaken. Some nurses are innately better at this than others. Some nurses are more interested, so they learn on their own time. Does any of this make them equivalent overall to an MD or DO? Of course not. But don't underestimate the body of knowledge and clinical insight a person may have.
I don't know why there has to be polarization. There are reasons for limiting scope of practice, and except where a physician may block what is in the best interest of the patient--generally not a real issue--I would prefer to practice under the supervision of a strong physician. And I have a lot of fairly strong experience in critical care. But the wisest people are those that don't think they know it all. The dangerous people are the sophomoric kind that actually don't know what they don't know--and have yet to see this for themselves. And that, ladies and gentleman, can go for physicians or nurses--advanced practice or not.
Usually it's beneficial to have other people to bounce things off of or discuss and share different perspectives. Part of the point of rounds is not simply to teach and get things covered or implemented as part of the plan for the patient. The best rounds I have been apart of are those that are multi-disciplinary and have more than one physician sharing various considerations. Heck, in children's hospitals, many times family members are invited to round with the team on their child. It's a more open, less closed approach.
I respect mimelin's position. He is not taking a stand as being happily pro-independent practice for midlevels. He is using non-polarizing, balanced thinking. Damn. I wholeheartedly applaud this. Much respect, mimelin.
I think the bulk of the difference ultimately comes down to the rigors of residency training and quality clinical hours with an organized, well-controlled system of evaluation. This is what many NPs programs lack. The others that compensate have a boatload of sound, clinical experience--something not every nurse has seen--b/c in reality, he or she did not practice nursing long enough in the right areas.
What I have seen is a fair amount of schools letting nurses with minimal experience move into Grad NP programs or even CRNA programs. Without the right clinical hours over a strong period of time, you are just not going to get it. The programs should be reserved for those that can prove expertise. In most cases, 5 years or less is not going to get you there. Also, if you think nurses don't study medicine or learn independently through scientific journals and other materials, you are mistaken. Some nurses are innately better at this than others. Some nurses are more interested, so they learn on their own time. Does any of this make them equivalent overall to an MD or DO? Of course not. But don't underestimate the body of knowledge and clinical insight a person may have.
I don't know why there has to be polarization. There are reasons for limiting scope of practice, and except where a physician may block what is in the best interest of the patient--generally not a real issue--I would prefer to practice under the supervision of a strong physician. And I have a lot of fairly strong experience in critical care. But the wisest people are those that don't think they know it all. The dangerous people are the sophomoric kind that actually don't know what they don't know--and have yet to see this for themselves. And that, ladies and gentleman, can go for physicians or nurses--advanced practice or not.
Usually it's beneficial to have other people to bounce things off of or discuss and share different perspectives. Part of the point of rounds is not simply to teach and get things covered or implemented as part of the plan for the patient. The best rounds I have been apart of are those that are multi-disciplinary and have more than one physician sharing various considerations. Heck, in children's hospitals, many times family members are invited to round with the team on their child. It's a more open, less closed approach.
I respect mimelin's position. He is not taking a stand as being happily pro-independent practice for midlevels. He is using non-polarizing, balanced thinking. Damn. I wholeheartedly applaud this. Much respect, mimelin.
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Full equivalence is not the same as practicing, in reality anyway, some degree of medicine. Believe it or not, critical care nurses do this. Some do it better than others.
I think the bulk of the difference ultimately comes down to the rigors of residency training and quality clinical hours with an organized, well-controlled system of evaluation. This is what many NPs programs lack. The others that compensate have a boatload of sound, clinical experience--something not every nurse has seen--b/c in reality, he or she did not practice nursing long enough in the right areas.
What I have seen is a fair amount of schools letting nurses with minimal experience move into Grad NP programs or even CRNA programs. Without the right clinical hours over a strong period of time, you are just not going to get it. The programs should be reserved for those that can prove expertise. In most cases, 5 years or less is not going to get you there. Also, if you think nurses don't study medicine or learn independently through scientific journals and other materials, you are mistaken. Some nurses are innately better at this than others. Some nurses are more interested, so they learn on their own time. Does any of this make them equivalent overall to an MD or DO? Of course not. But don't underestimate the body of knowledge and clinical insight a person may have.
I don't know why there has to be polarization. There are reasons for limiting scope of practice, and except where a physician may block what is in the best interest of the patient--generally not a real issue--I would prefer to practice under the supervision of a strong physician. And I have a lot of fairly strong experience in critical care. But the wisest people are those that don't think they know it all. The dangerous people are the sophomoric kind that actually don't know what they don't know--and have yet to see this for themselves. And that, ladies and gentleman, can go for physicians or nurses--advanced practice or not.
Usually it's beneficial to have other people to bounce things off of or discuss and share different perspectives. Part of the point of rounds is not simply to teach and get things covered or implemented as part of the plan for the patient. The best rounds I have been apart of are those that are multi-disciplinary and have more than one physician sharing various considerations. Heck, in children's hospitals, many times family members are invited to round with the team on their child. It's a more open, less closed approach.
I respect mimelin's position. He is not taking a stand as being happily pro-independent practice for midlevels. He is using non-polarizing, balanced thinking. Damn. I wholeheartedly applaud this. Much respect, mimelin.
How is "equivalence" not "the same as"?
You're lucky there's not a written portion of the mcat anymore.
If you had practiced long enough, you would know that except for the bogus game of playing with nursing diagnoses, in reality, good nurses, especially in critical care, must have a good idea of what they are looking at. There indeed is some crossover. It does not mean total equivalence.
If you want clarification over what someone has stated, be civil and respectfully seek it out. Remember learning about this? Using insults is not effective communication.
Warning. Don't insult me again. I won't play the pizzing game with you; but just don't do it.
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ha ha. if only it were. which it won't be. so whatchya gonna do about it?
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Have you ever heard the saying "if everyone has a problem with you then maybe the problem is you"?
This is a forum for medical students. There are so many other places on this site that are for not-medical students. Here's a list:
http://forums.studentdoctor.net/categories/sdn-high-school.466/
http://forums.studentdoctor.net/categories/pre-medical-forums.5/ (THIS WOULD BE A GOOD PLACE TO START)
http://forums.studentdoctor.net/categories/dental-forums-dds-dmd.55/
http://forums.studentdoctor.net/categories/optometry-forums-od.128/
http://forums.studentdoctor.net/categories/pharmacy-forums-pharmd.121/
http://forums.studentdoctor.net/categories/physical-therapy-forums-dpt.822/
http://forums.studentdoctor.net/categories/podiatry-forums-dpm.152/
http://forums.studentdoctor.net/categories/psychology-forums.8/
http://forums.studentdoctor.net/categories/veterinary-forums-dvm.163/
http://forums.studentdoctor.net/categories/rehabilitation-sciences.208/
http://forums.studentdoctor.net/categories/interdisciplinary-forums.162/
http://forums.studentdoctor.net/categories/health-care-transitions.112/
http://forums.studentdoctor.net/categories/social-and-support-forums.3/
http://forums.studentdoctor.net/categories/free-classifieds.6/
I have been disrespectful to no one. I refuse to tolerate bullying, and it is against the Terms of Service Agreement here to call others out or insult or get threads off-track. So if you attack in support of another, you are still abusing TOS.
OK then
Other pre-med students respond on various threads. In fact there are number of forums that aren't at issue here with civil, pre-med responses and questions. Thank you for demonstrating one of the purposes for bullying. Back to topic.
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Oh snap!
I never really gave this topic much thought until I experienced something horrific first hand.
I had to undergo a procedure that required anasthesia. I guess I wasn't important enough to have an actual anestesiologist present, so a CRNA ended up overseeing everything. Fifteen minutes into the operation, half of my body was undergoing convulsions and my heart almost stopped. The CRNA didn't put the needle that was injecting the medicine into a vein. The area in my arm around the needle ballooned up to the size of a tennis ball (which is when my body started convulsing). At this point I WOKE UP during the procedure and remember people running in and out of the room. Instead of draining the medicine so it doesn't all go into my bloodstream in one huge wave, said CRNA simply shifted the needle, causing me to bleed profusely, and also causing this humungous balloon worth of medicine to drain into the vein, which is apparently when my heart almost stopped.
I know there are a lot of good nurses out there, and this person does not represent them at all. But I personally will never allow a nurse to oversee any operation or procedure I need to go through. This is my life we are talking about here. Why would I let someone with two years of experience oversee something so critical when I can have someone with 6+ years doing so.
I had to undergo a procedure that required anasthesia. I guess I wasn't important enough to have an actual anestesiologist present, so a CRNA ended up overseeing everything. Fifteen minutes into the operation, half of my body was undergoing convulsions and my heart almost stopped. The CRNA didn't put the needle that was injecting the medicine into a vein. The area in my arm around the needle ballooned up to the size of a tennis ball (which is when my body started convulsing). At this point I WOKE UP during the procedure and remember people running in and out of the room. Instead of draining the medicine so it doesn't all go into my bloodstream in one huge wave, said CRNA simply shifted the needle, causing me to bleed profusely, and also causing this humungous balloon worth of medicine to drain into the vein, which is apparently when my heart almost stopped.
I know there are a lot of good nurses out there, and this person does not represent them at all. But I personally will never allow a nurse to oversee any operation or procedure I need to go through. This is my life we are talking about here. Why would I let someone with two years of experience oversee something so critical when I can have someone with 6+ years doing so.
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We're not talking about RNs and nursing dx, but NPs and their encroachment. A year and a half was long enough to practice nursing to realize it is a crappy field. Maybe if you were a decent premed, you wouldn't be stuck.
I don't piz, I rarely pez, and I'm certainly not wanting a contest (too much sugar).
You broke rules 2,9,10,18.
You can call me out all you want, but you're like four times as guilty as me on breaking the TOS.
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Most importantly, rule 18. They've trampled all over that one...
No I did not break rules 2, 9, 10, and 18.
No a year and half is just about zip--and especially not knowing what area you were working.
LOL, I am not "stuck." I graduated summa cum laude from a very good university. What are you talking about?
I have asked repeatedly for civility and non-bullying behavior. Personal attacks are ridiculous. Please return to topic, and if you want to seek clarification, do so in a respectful and civil manner. You can also use the PM feature--or even the "ignore" feature for all I care.
It's enough already. I know exactly the topic of discussion, and my points were germane.
Back to topic.
This is horrible. A new graduate RN should be able to identify such an infiltration. Also, you would know not only by looking but by resistance. I am speaking of after you first put the line in and you have gotten a blood return. There are reasons after this point where the catheter can move out and infiltrate. That's why you have to keep a close eye on the lines. They are often part of the patients' life-lines. I am sorry you went through that. Even when ologists are around for supervision, if they get busy with another case, this could still happen. It shows you can't take anything for granted even for a second.
Just wait till you start residency. I lost a great deal of sanity this year... or it's Stockholm Syndrome... or ::meep:: both?
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Reminder to all: Please keep threads on topic and civil. All are welcome to contribute, and if you find a particular user's contributions objectionable, please refrain from responding and use the report button and/or the ignore button; flame wars fizzle without fuel.
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There is literally no way you are an attending physician. No one who has gone through medical school and residency would even entertain the idea that NPs should be awarded the same degree, never mind entertain the suggestion of equivalence
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I don't see what's so difficult to understand, I mean it doesn't get any more obvious than that
the other thing that makes it apparent that he isn't an attending is that he uses internet speak and sucks at spelling
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watch out. everyone is report and bright blue happy around here. not getting on your case at all. Just sayin
What makes you so sure he/she is not an attending physician?
He's talking about using NPs as "scab fillers." I think he/she is looking at patient safety standards. But I would allow oldanddone to speak for himself/herself.
He's talking about using NPs as "scab fillers." I think he/she is looking at patient safety standards. But I would allow oldanddone to speak for himself/herself.
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Well said, jl lin. I find your positivity refreshing. Too many people in the MD crowd think that if they pound their chest and deride others louder, that ensures they are accomplished and wise. Others who unfortunately share that sentiment will always join them.
This is especially disheartening because these people are supposed to be those exceptional at caring for others. Then they tell you 'We DO treat the whole of a person!! What could we be missing??'
Well said, jl lin. I find your positivity refreshing. Too many people in the MD crowd think that if they pound their chest and deride others louder, that ensures they are accomplished and wise. Others who unfortunately share that sentiment will always join them.
This is especially disheartening because these people are supposed to be those exceptional at caring for others. Then they tell you 'We DO treat the whole of a person!! What could we be missing??'
Appreciated. Hating is ugly.
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So is ignorance and preaching from a soapbox on things one has no bizness preaching about.
My PCP is a family friend, the last time I went, her nurse tried to see me and I got sad :/ mostly bc I wanted to see my friend. Apparently my mom had a fit about it though, figures. Drama queen
My PCP is a family friend, the last time I went, her nurse tried to see me and I got sad :/ mostly bc I wanted to see my friend. Apparently my mom had a fit about it though, figures. Drama queen
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Reported for brattiness
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Hey now, it's a well known fact that only DOs DO treat the whole person
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Reported for brattiness
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I sense that A.T. Still is smiling down upon you tonight.Hey now, it's a well known fact that only DOs DO treat the whole person
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Well said, jl lin. I find your positivity refreshing. Too many people in the MD crowd think that if they pound their chest and deride others louder, that ensures they are accomplished and wise. Others who unfortunately share that sentiment will always join them.
This is especially disheartening because these people are supposed to be those exceptional at caring for others. Then they tell you 'We DO treat the whole of a person!! What could we be missing??'
I agree - I dont see anything harmful about jl lin's attitude in this thread.
The issue on the content still stands, though.
The problem here, is that aside from the usual platitudes along the lines of "well there are great MDs and bad MDs, just as there are great DNPs and bad DNPs!!!", there is the issue of a paradoxical philosophy that proponents of practicing DNPs advocate - and this philosophy is a direct assault on the standard of the practice of medicine in this country.
You see, the practice of medicine is based on a certain licensing standard - a standard that the MD and DO ACGME/LCME/AOA/ uphold and comply with. The thing with DNP is that they are exempt from these standards, and licensed even though they do not meet the standard. Anybody who supports this either must think the current standard is too high, think that it's OK to flood the healthcare system with substandard medical practitioners, or is engaging in cognitive dissonance. Allowing DNPs to practice like PCPs is basically making a mockery of medical licensing system and taxpayer money that goes towards funding residencies. Doctors are not just pounding their chests in hubris - they actually ARE more accomplished and wise [knowledgeable] as per the entire medical-legal system which is why they are licensed!
Let's be real, though - we all know that the practice of medicine is the practice of medicine no matter what you call yourself or what letters you have behind your name. If DNP's want to enter this arena, i say let them - let them in without the competitive advantage of being able to get licensed without meeting the standards. This country is built on fair competition, so I dont see what the problem is if they are subjugated to the same standards, requirements, laws, malpractice, insurance policies as MDs and DOs. There are two things that can happen - they will succeed or they will be exposed and weeded out.
If they succeed it will because they reform their profession to meet the standards. Look what happened to osteopathic medicine - you never hear the term "osteopath" anymore, the AOA is getting obliterated by the ACGME, and curriculums are virtually identical - but DOs are the professional equals to MDs now despite this not have always been the case.
This could theoretically happen with nurses, too - but "nurse physician" designation will likely go the route of "osteopath", and DNP training will became virtually identical to MD and DO training and we'll see everyone clamoring to just be called "medical school" and merge
Basically, this "same but different" thing is a sham - evidence based medicine is evidence-based medicine. Either you practice it while meeting the standards or you dont. The distinct physician and nurse roles exist for a reason
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I choose choice c. cognitive dissonance. LOL
Choice b. is the reality, and I state that while admitting there are some excellent NPs. But sticking with the standards and definition, yes. I would have to say, b., the system is being flooded w/ substandard medical practitioners, and of course the "bottom line" mentality is what is allowing it.
Now what they would say to you is this: "If we define our own practice while implementing EBP, and practice within those parameters, who are you to say it is substandard?" So, then we come again upon the same issue. What is medicine? Who/what determines what it should be or how it should be defined? EBP? Well nurses and APNs employ EBP.
Of course, EBP has limitations in the real world of individuals. Much of it may stay, for God knows how long, suspended in a state of incomplete understanding--as indeed, often it does. Extrapolations are often incomplete and may vary. But that is a whole other discussion.
Regarding the definition of medicine in the bigger scheme of things, I think this is where some of the harshness may be coming from--a point of frustration. We can spin round and round on the issue of what medicine is and who determines what it should be or how it should be defined. Definitions change over time. It's nice when everything is a tidy black or white. When it's not, people can spin around frustrated and irate; b/c things are not as clear and complete as they feel they should be.
So, yea. Come to think of it, the answer may well be both b. and c. --or at least the processes here involve "c." I think the profession of medicine needs to pay careful attention to how the dissonance is resolved.
In the end, perhaps the evolving mechanisms for decreasing the dissonance may become, as you hinted, some amalgamation. It seems idiotic, but the evolutionary processes that are moving things in this direction have been at work since the early 1950's and 60's. If I interpreted oldanddone correctly, yes, the medical science standards would have to be incorporated into the ed. process of becoming a DNP in order for it to be included in this new amalgamation. Of course I am just theorizing. For me, it has always been difficult to see how the two professions, medically speaking, could be "separate but equal." If you "desegregate" then how can anyone logically justify this w/o mandating they meet all the same standards?
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You know that cognitive dissonance = wrong in any debate right lol
The "bottom line" mentality is basically saying that medical credentialing (for MDs and DOs ) is valueless nonsense.
What they dont understand is that the current system in-place does not exist merely for the hell of it. It provides a host of functions, one important one being quality control. If they want to say that there is no rule as to who can and cannot do what in practicing medicine, eliminate all licensing (by this I mean what licensing represents - quality control), and let private institutions credential their own workers, I'm OK with that. What I'm not OK with is the DNP route being a backdoor path that gives a select, lesser trained group a competitive advantage - and anybody who cares about healthcare should not be OK with this either, as it would probably destroy healthcare system. Again, I am OK with this if it means DNP being held to the same level of medical-legal criticism (aka fair competition w/ no competitive advantage)
To be honest, I never even heard of EBP before it was mentioned in this topic subject.
The profession of medicine would not care one bit if DNP underwent the same training as MDs and DOs.
I dont think there is any problem with the definition of (evidence-based) medicine either. The practice changes based on continual advancement based on research, but that's about it.
I dont think it would just be "some" amalgamation, but complete amalgamation (at least in terms of curriculum of education and training).
BTW the "separate but equal " thing also refers to the comments DNP/you make about nurses being better listeners, looking at the whole patients, etc. It seems to me that some of them think that they bring to the table an aspect that the other field doesnt to do the same job.
Yes, it has become for me, so much crap, so little time. The bottom line is what is ruling.
I wonder that various powers don't care if it renders down to substandard care. This is all part of the dissonance.
It's becoming just another layer of confusion for everyone. It's bad enough a lot of non-medical people are calling the shots.
But it doesn't look like it will change. The levee has been breaking for a while now.
[The old business models of American health care are in trouble.
Fee-for-service medicine, where insurers and patients paid a fee for each bit of care and the financial incentive was to do more, was an impregnable fortress fiercely defended by American physicians for a century.
Now it’s crumbling....Another major business practice — cost-shifting — is also crumbling. Since the mid-1980s, hospitals and physicians have billed commercially insured patients extra to cover their losses on Medicare, Medicaid and uninsured patients. This cost-shifting adds more than $1,800 a year to the cost of a family policy, says the Texas Hospital Association.
“The fundamental system of subsidies is completely breaking down,” said Chas Roades of the Advisory Board Co. “Hospitals get about half their revenue from public payers [Medicare and Medicaid] today, but that’s moving to 75 percent or more in eight to 10 years. The commercial share is just getting smaller and smaller.”
....As these changes take place, government insurers are paying less, rather than more. And employers who provide workers with health insurance are losing patience with cost-shifting. They’re turning to specialists who can direct their employees to lower-priced hospitals, which squeezes the traditional model even more.
Some of the pressures on these older ways of doing business come from the 2010 Affordable Care Act. Most of that law focused on transforming health insurance. But the law also pushed out pilot programs to get doctors and hospitals away from fee-for-service medicine.]
http://www.dallasnews.com/business/...h-care-industrys-old-models-are-crumbling.ece
Where do think APNs and such will fit in with lower priced care?
In terms of helping to delineate the differences in education and training, I say, get some more experienced RN and APNs, who have then gone through medical education/training, and let them publically weight in on it. They are not likely to say it is less detailed, less rigorous, or even less comprehensive.
This, however, won't change the power of the bottom line. Bottom line mentality is banking on the percentages of bad outcomes for substandard care (by the set definition) being low.
Also, see:
http://www.dallasnews.com/business/...h-care-prices-markets-dont-work-very-well.ece
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Well, this is all talking about the economics and politics of health care service. Lowering the standards does make things cheaper.
The last several pages we were all talking about this situation with regards to the practice of medicine and quality of the practice of medicine , though.
Point is, it doesn't matter b/c it's will continue to move due to the economics. People can make any claims they want to make pro or con DNP, using more midlevels, etc. At the end of the day, it will be what it will be primarily b/c of the need to lower costs. Moving to 75% public payers is the bigger impetus behind all of this. They are going to cost-control and roll the dice with the risk of substandard effects for patients.
[“The fundamental system of subsidies is completely breaking down,” said Chas Roades of the Advisory Board Co. “Hospitals get about half their revenue from public payers [Medicare and Medicaid] today, but that’s moving to 75 percent or more in eight to 10 years. The commercial share is just getting smaller and smaller.”]
Really, this is one of the bigger reasons why those that are primarily motivated to do medicine for financial reasons shouldn't. And Lord knows if you will still make out by doing fee-for-service--not taking insurance, etc.
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Do you have some way to categorize them, e.g. by designer, color, style? I can't imagine how you can remember what you have!
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Style and color
my uggs/sneakers/spin shoes just sort of get thrown into the bottom of the closet but everything else is pretty organized!...I like my monies right where I can see it all. in my closet.
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- Joined
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People arent complex. They aren't special unique snowflakes. The term holistic is a bunk term used by quacks to make people believe they are something special. It gives value to a valueless professional.
A proper doctor takes all the history and incorporates everything that is required for proper medical care. Otherwise it isn't proper medical care. Holistic is a term is used by people who just cant provide adequate care and need to latch onto something that gives them more value. This is why you don't hear master clinicians use this ridiculous term and you hear mediocre NPs and chiropractors and snake oil salesmen use it all the time.
Honestly, this is an issue of finances. Hospitals make more money if they have salaried mid-levels. So all the "studies" are going to "prove" that mid-levels are fantastic, hospitals make more money and the nursing lobby raises its status.
From a consumer perspective, how are you supposed to fight this? I obviously didn't only want to see a mid-level during a hospital visit but that's all they gave me for my ER visit. What was I supposed to do?
They were nice enough to bill me the full amount though. I feel like the only way this is going to change is if people demand to see a physician. Especially since they are not saving money by seeing a less qualified provider.
I think its easier in an outpatient setting, where you can make a choice. I'm sure the majority of patients would feel more comfortable seeing a physician, but they don't know how to advocate for that. I definitely didn't, I felt weird demanding to see a "real doctor".
From a consumer perspective, how are you supposed to fight this? I obviously didn't only want to see a mid-level during a hospital visit but that's all they gave me for my ER visit. What was I supposed to do?
They were nice enough to bill me the full amount though. I feel like the only way this is going to change is if people demand to see a physician. Especially since they are not saving money by seeing a less qualified provider.
I think its easier in an outpatient setting, where you can make a choice. I'm sure the majority of patients would feel more comfortable seeing a physician, but they don't know how to advocate for that. I definitely didn't, I felt weird demanding to see a "real doctor".
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Interesting read (the article and this thread).
Something that I don't get: Isn't the point of licensing exams for physicians that unless you pass, you aren't qualified to medically treat people?
So then, why do NP's get to bypass this whilst undergoing a much less rigorous training schedule? Something does not compute.
Something that I don't get: Isn't the point of licensing exams for physicians that unless you pass, you aren't qualified to medically treat people?
So then, why do NP's get to bypass this whilst undergoing a much less rigorous training schedule? Something does not compute.
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They get to bypass it bc they are licensed under the nursing board, not the medical board.
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