What nps think of us

[NicMouse64]

Lol I love how no one has yet to propose any realistic solutions to the questions I posted. An incoming M1, if you care that much you can look up my activities on on here or would you like for me to send you my acceptance letters

I'm not worried about it. Why go to medical school then? If what you say is true, you have your RN/BSN, you can do everything a doctor can in 1/3 the time!

---

Members don't see this ad.

 

[Splenda88]

Do NPs really think they are as good as physicians?

 

[HisLovePerfects]

How did they measure mortality? This study and the 6 they quote have atrocious methods for evaluating mortality. Did you know that if a patient didn't call back they were "excluded" from the study in 2 of the studies? What if they were dead? How did they follow the patient's health? This is a poorly put together literature review being used for political purposes.

Loss to follow-up is a potential problem with any clinical trial. Some patients would have been lost to follow-up, but this would only change the results if nurses' patients were more likely to be lost to follow-up - usually, the number lost is similar between nurse and physician arms and, according to the reviewers, most trials had follow-up >80%.

Does the review have limitations? Yes, most notably with the short duration of follow-up. But I glad that policymakers are using this rather than some anecdotes about NPs harming patients or wasting resources.

 

[Nurse2MD2018]

I'm not worried about it. Why go to medical school then? If what you say is true, you have your RN/BSN, you can do everything a doctor can in 1/3 the time!

Medicine invites diversity in thought, pushes you intellectually, encourages you to look systematically at issues while training you to be keen to minute details. I love the subject matter, I love learning, I love caring for patients, and drumroll the OR fascinates me like no other!

Not sure why this became a personal Q&A.

What have I said about midlevels that illustrates any interest in going into the field? I've simply pointed out counter-arguments to the popular anti-midlevel opinion on SDN.

 

[NicMouse64]

Loss to follow-up is a potential problem with any clinical trial. Some patients would have been lost to follow-up, but this would only change the results if nurses' patients were more likely to be lost to follow-up - usually, the number lost is similar between nurse and physician arms and, according to the reviewers, most trials had follow-up >80%.

Does the review have limitations? Yes, most notably with the short duration of follow-up. But I glad that policymakers are using this rather than some anecdotes about NPs harming patients or wasting resources.

Yes I understand this is a pro NP account now. Thank you for informing me!

 

[NicMouse64]

Medicine invites diversity in thought, pushes you intellectually, encourages you to look systematically at issues while training you to be keen to minute details. I love the subject matter, I love learning, I love caring for patients, and drumroll the OR fascinates me like no other!

Not sure why this became a personal Q&A.

What have I said about midlevels that illustrates any interest in going into the field? I've simply pointed out counter-arguments to the popular opinion on SDN.

Just is interesting. Talking to many NPs/PAs there is an echo chamber of rehashed arguments. You are using the same arguments. I understand if you didn't like the OR you would probably go to NP school then? So basically all non-operative medicine is now in the realm of NP/PA SOP. Got it.

 

[Nurse2MD2018]

Just is interesting. Talking to many NPs/PAs there is an echo chamber of rehashed arguments. You are using the same arguments. I understand if you didn't like the OR you would probably go to NP school then? So basically all non-operative medicine is now in the realm of NP/PA SOP. Got it.

Comprehension is key, never explicitly said I wanted to be a surgeon. You are jumping from one extreme to the next. I don't feel the need to reiterate my entire PS on a forum to some random stranger. If you've heard these arguments in the past, then you should have better rebuttals.
I personally had no interest in being a midlevel, I do not want to spend the rest of my life doing their duties. Also getting into +150k debt just to make the same amount of income I make now is also not appealing at all. I respect those who do the job because I witness firsthand the need for them. Both examples I provided you in previous posts directly talked about NP/PAs use in surgical fields...

 

[Instatewaiter]

Does the review have limitations? Yes, most notably with the short duration of follow-up. But I glad that policymakers are using this rather than some anecdotes about NPs harming patients or wasting resources.

Bad data is worse than no data.

This is true for clinical practice and research as well.

 

[deleted480308]

Lol I love how no one has yet to propose any realistic solutions to the questions I posted. An incoming M1, if you care that much you can look up my activities on on here or would you like for me to send you my acceptance letters

It is realistic to train more doctors if we need more doctors. New schools opening all the time and we can open more residencies

Loss to follow-up is a potential problem with any clinical trial. Some patients would have been lost to follow-up, but this would only change the results if nurses' patients were more likely to be lost to follow-up - usually, the number lost is similar between nurse and physician arms and, according to the reviewers, most trials had follow-up >80%.

Does the review have limitations? Yes, most notably with the short duration of follow-up. But I glad that policymakers are using this rather than some anecdotes about NPs harming patients or wasting resources.

If wakefield taught us anything it’s that politically motivated bad data should not be used for anything

 

[jhamaican]

as a medical specialty fellow:

It is painfully obvious when an NP calls over the phone for a consult:

They never know what they are talking about

"blah blah blah, my attending wanted me to tell you to see the patient".

it is like we are playing a game of phone tag.

They can never answer any of the questions I ask about their consult. It has gotten to the point where I just say OK and hang up.

 

[jhamaican]

Also work extensively with CRNA.

both NP and CRNA think they know more than they do.

Want equal pay and autonomy,

but the moment something goes wrong or unexpected.

where is the doctor? I am only an NP!



It is true NP and CRNA can handle the vast majority of basic cases.
But as soon as there is the slightest wrinkle out of normal comes, they flounder hard...

 

[GoSpursGo]

Like the many other recent threads about APPs, I'm moving this to TIH as it's not really relevant to current medical students.

 

[Nurse2MD2018]

It is realistic to train more doctors if we need more doctors. New schools opening all the time and we can open more residencies

Open new schools great, could be easily done. You are charging tuition to cover the cost of operations.
Open new residencies and fellowships, how do you propose these programs get funding? Lack of federal funding already provides barriers to program extensions for current programs. I would love to hear a great solution to this.

 

[NicMouse64]

Open new schools great, could be easily done. You are charging tuition to cover the cost of operations.
Open new residencies and fellowships, how do you propose these programs get funding? Lack of federal funding already provides barriers to program extensions for current programs. I would love to hear a great solution to this.

Stop having the AANP and AARP block residency funding expansion.

 

[VA Hopeful Dr]

Open new schools great, could be easily done. You are charging tuition to cover the cost of operations.
Open new residencies and fellowships, how do you propose these programs get funding? Lack of federal funding already provides barriers to program extensions for current programs. I would love to hear a great solution to this.

Then why are new programs/spots opening every year?

 

[Nurse2MD2018]

Then why are new programs/spots opening every year?

By no means am I an expert in this subject matter. To my knowledge a lot of new programs are internally/grant funded. A huge deficit in funding still persists especially for smaller community programs and academic hospital heavily reliant on Medicare/Medicaid.

 

[RNthenDoc]

Your status as a medical student becomes suspicious with this comment. You could've used my/our, but used "your". Physicians go rural more than NPs. Train more physicians. There is your answer.

More physicians=saturation in each specialty= advocacy groups will curb the numbers of residency/fellowship slots. It is reactionary and protectionist... and historically what has been done.

 

[deleted480308]

Open new schools great, could be easily done. You are charging tuition to cover the cost of operations.
Open new residencies and fellowships, how do you propose these programs get funding? Lack of federal funding already provides barriers to program extensions for current programs. I would love to hear a great solution to this.

If the goal is more appropriately trained staff the answer is to make more appropriately trained staff. Pretending unqualified people are not unqualified for such important skillsets is not appropriate

And yeah that means somewhere in healthcare someone has to cough up dollars whether the hospital systems or the govt if the pitch is the govt has to provide these skillsets

 

[Little Green Mensch]

And yeah that means somewhere in healthcare someone has to cough up dollars whether the hospital systems or the govt if the pitch is the govt has to provide these skillsets

There are many hospitals in the U.S. that are way over their Medicare cap for residents. Being able to pay someone ~$50-60k when they generate substantially more than that in billing is, quelle surprise, profitable. In addition to fixing the geographic distribution of Medicare funding for residency, which overfunds older teaching hospitals in the Northeast, hospitals should probably start picking up a bigger portion of the price of funding residents.

The (rather long) report on GME financing reform notes that most programs have no idea what their actual financial impact on the hospital is: 5 Recommendations for the Reform of GME Financing and Governance | Graduate Medical Education That Meets the Nation's Health Needs | The National Academies Press

Interestingly, according to the same report, sub-specialist training spots expanded 40% from 2003-2013, and there is no compelling evidence for a physician shortage because of "more effective organization, new technology, and deployment of health personnel other than physicians." I would not be surprised if the government and hospitals both balk at increasing GME funding, and find it easier to fill the gap with mid-levels; to an extent, this is what is already happening.

 

[Goro]

If wakefield taught us anything it’s that politically motivated bad data should not be used for anything

Actually, if anything, Wakefield's bad data was motivated by greed, as he was looking to market an alternative measles vaccine (something he didn't feel that the editors of Lancet needed to know).

The anti-vaxxers seized upon the bad data not out of politics, but because it reinforces their belief systems.

Back you you, sb!

 

[deleted480308]

Actually, if anything, Wakefield's bad data was motivated by greed, as he was looking to market an alternative measles vaccine (something he didn't feel that the editors of Lancet needed to know).

The anti-vaxxers seized upon the bad data not out of politics, but because it reinforces their belief systems.

Back you you, sb!

We’ll add greed....fair point

 

[AnatomyGrey12]

Does the review have limitations? Yes, most notably with the short duration of follow-up. But I glad that policymakers are using this rather than some anecdotes about NPs harming patients or wasting resources.

Lol by "limitations" you must mean "significant methodological flaws that make it worth less than a roll of toilet paper."