Expanded role of nurse practitioners

[lordlister]

What do you guys think?

 

[Salukis63]

I would visit a Nurse Practitioner for basic needs IE: sprains, Cold and Flu...but for the big stuff I gotta go with the Physician who's been through more education and intern time... but now the real question is...who will the govt LET us see...lol

 

[Kid Montana]

Not to shit in your breakfast cereal but this is not a topic that a lay poll will illuminate. This topic requires real experts to weigh in on and what a cross section of America thinks is completely immaterial because most people don't understand all the implications. Hell, I don't even understand all the implications.

 

[Gavin]

All I know is that my wife went to multiple doctors for physicals, and none of them caught what a Nurse Practitioner did. Now, my wife has lost half of her thyroid, but is cancer free. I'm grateful that somebody spent the time with her to catch what could have been much much worse.

 

[Mr Peat]

I have no choice. I'm stuck with the wonderful health care the Veteran's receive. I'm at the mercy of the government test victim program.
No insurance company would give me coverage due to all my pre-existing problems. If by some miracle I did, the premium would be
so high I'd have to sell all my vital organs to make the monthly payment.

Between the 11 trips to the Operating Room, Esophageal Cancer, tumor the size of a golf ball that was on the surface of my skull where I
lost 3-4 months of my life, spinal disease, cigar smoking or the other problems connected to the injuries sustained in the Army. I would
get denied flat out. LOL!!!

But if I could chose, I'd want a Doctor that listened to my complaints and looked into finding out what is wrong. I've maybe gotten sick a
total of 3 times since 2002. Due to a sewer leak into the city water, I got sick where it took over 6 months to shake it. City didn't detect the
leak for some time and that is how most of the town got really sick. Its a miracle I survived that incident. Then I got a nasty sinus infection
while in Russia and finally I had a sore throat this year for 3 days. Then snapped out of it while others missed work for over a week
in town. I always joke about the sewer water managed to boost the immune system after that incident. Thus I seldom would see any
health care practitioner. Whether its a Triage Nurse, PA, Nurse Practitioner or a Doctor. I just don't need one unless it deals strictly
with my injuries in the Army.

 

[Rodrigo de Jerez]

What do you guys think?

I don't even know why you are asking this question. It is to easy to make this into a political argument. I also don't think the average medical consumer necessarily has the insight into what role a nurse practitioner should or should not have.

So what spurs you to start such a thread? I think it is a squarely bad idea that will likely lead to little substantive discussion beyond, "This one time when I had Doctor X or Practitioner Y..."

Kid Montana obviously understands.

-Mark

 

[sigar_zealot]

He started the thread because 28 states within the US are considering adopting this as a policy. Currently a nurse practitioner can provide medical care as long as they are supervised by a MD.

 

[Devil Doc]

I'm not even getting involved in this one.

Doc.

 

[grateful1]

He started the thread because 28 states within the US are considering adopting this as a policy. Currently a nurse practitioner can provide medical care as long as they are supervised by a MD.

Exactly.

Unless more training is involved for them, I'd say they should still have the oversight of an MD(although in practice I know w few NP's who are smarter than the Doc's...go figure).
I think a change will be coming and it might be in the form of a more strict/focused 'triage' scenario.

If triage is done properly, most folks turn out to not need an MD.

The medical field is in for quite a time.

Be careful this doesn't fade into a political thread, as policy is what is stirring this movement, not the field.

 

[Rodrigo de Jerez]

He started the thread because 28 states within the US are considering adopting this as a policy. Currently a nurse practitioner can provide medical care as long as they are supervised by a MD.

Don't worry, I'm an avid consumer of American news media.

-Mark

edited to add. *news

 

[grateful1]

I'm not even getting involved in the one.

Doc.

Too late!

Not to shit in your breakfast cereal but this is not a topic that a lay poll will illuminate. This topic requires real experts to weigh in on and what a cross section of America thinks is completely immaterial because most people don't understand all the implications. Hell, I don't even understand all the implications.

This is why we discuss it, to learn about it and educate ourselves.

With out it we fly blind.

The 'lay poll' (odd phrase!) will show what the 'lay person' thinks. These types lay polls usually help those in power know what buttons to push!

 

[Jonesy]

More and more practices are going with Nurse Practitioners and Physician's Assistants. With the way small practices are being bought out by hospitals (as is the case down here) hospitals like going the cheap route and hiring PA's and NP's instead of MD's. My wife has been working in these type of practices for almost 20 years now and the trend of replacing MD's has become common practice these days. The office she works in has 5 "Providers" as they like to call them now. One MD, one D.O., two PA's, and a NP. They all see all the patients, write prescriptions, and the PA's can admit patients to the hospital. It's all about saving money these days.

As far as the argument goes, who knows.

 

[lordlister]

What do you guys think?

I don't even know why you are asking this question. It is to easy to make this into a political argument. I also don't think the average medical consumer necessarily has the insight into what role a nurse practitioner should or should not have.

So what spurs you to start such a thread? I think it is a squarely bad idea that will likely lead to little substantive discussion beyond, "This one time when I had Doctor X or Practitioner Y..."

Kid Montana obviously understands.

-Mark

I was curious what you guys thought. I read an online article regarding proposed policy changes in this regard in several states. It seemed as if all of the comments on the article were made by people with a political agenda ("doctors stink, nurses rule...etc"). I was wondering what you guys thought (I thought I'd get a less biased response from you guys).

And as for Kid Montana, stop pooping in my cereal!

 

[jfields]

It's kind of like the military.

The NCO's being the backbone of the service getting the job done.

I wouldn't say the doctor's stink and the nurses rule, but......... You'd be surprised how many times the on call doctor gets the call on a patient and can't seem to make a decision with the nurse in the end saying I think we need to do x, y, and z. The doctor then saying "Yeah, umm, that sounds good.

My wife has been in school diligently for 6 1/2 years now. The joke I tell all of the time is "Hell! You might as well be an MD by the time you get your degree!" I'm amazed at the things she's had to learn.
They don't screw around either! She started with something like 130 people in her class and it's now down to about 75.

She'd have to do three or four more years to get to NP after that which tells me they've pretty well done it all.

The curriculum that they make them learn has to be waaay harder than it was ten or twenty years ago, so maybe that's the reason for the push as well as to save money/making it more profitable.

My wife has a friend that went and got her NP. She moved up to Maryland where it's already legal and hung out her sign.

For family practice, etc. I don't see a problem with it. Little different for specialty fields like Neurology, Orthopedics, etc.

Either way you go about it, you can have bad doctors and bad nurses.

 

[Humidor Minister]

My wife is a Nurse. The Nurses do most of the work. The Doctors give them provide diagnosis and direction. For the most part, your care is in the hands of a nurse. In the end, they both, of course, are needed for proper care and diagnosis. When it comes down to it though, most care is given by the nurses.

 

[Yesi]

This topic is of great interest to me since I'm a nursing student.

NPs definitely do fulfill a gap in our healthcare system. My primary is a nurse. My OB/GYN is also a nurse. They both do a damn fine job at treating their patients. Although I'm happy with the care I receive, I don't really have much of a choice. As an uninsured American, this is what I can afford. My check-ups are pretty routine since I'm a relatively healthy person with no serious medical conditions. What if, God forbid, I was stricken with some kind of serious illness in the future? I think I would want to see an MD.

Obviously, the the level of education NPs and MDs receive are very different. To be an NP you are required to have, at the very least, a Master's degree with additional clinical training (anywhere from 600 to 1,000 hours, I believe). Now compare that to the education doctors receive. 4 years obtaining their bachelor's degree, 4 years of medical school, and 3 to 5 years of residency training (sometimes longer, depending on the specialty).

"A shortage of one type of professional is not a reason to change the standards of medical care." - AMA president-elect Dr. Cecil Wilson

The bottom line is, doctors are trained to be doctors. Nurse practitioners are trained to be nurse practitioners. Their roles in the medical field are different. If I wanted to be a doctor I would have gone to medical school, not nursing school. Replacing MDs with NPs is going to set a dangerous precedent for this country.

The issue is not so much a shortage of doctors, but a shortage of doctors that want to go into the primary care field. After all, specialities are where the money is at. Instead of diluting the role of the primary care provider, shouldnt we be focusing on drawing more graduates into the primary care field?

 

[thechenman]

Yesi...I couldn't agree with you more. I have many friends and family members who are doctors. Among this small group there are about 16 doctors. Only one if is family practice. It seems that most people will go where the money is, and there is nothing wrong with that. I believe insurance companies with some help from regualtors and legislators could easily find a solution to this shortage of GPs...if they truly wanted to. It's not difficult.

 

[Salukis63]

What do you guys think?

I don't even know why you are asking this question. It is to easy to make this into a political argument. I also don't think the average medical consumer necessarily has the insight into what role a nurse practitioner should or should not have.

So what spurs you to start such a thread? I think it is a squarely bad idea that will likely lead to little substantive discussion beyond, "This one time when I had Doctor X or Practitioner Y..."

Kid Montana obviously understands.

-Mark

I was curious what you guys thought. I read an online article regarding proposed policy changes in this regard in several states. It seemed as if all of the comments on the article were made by people with a political agenda ("doctors stink, nurses rule...etc"). I was wondering what you guys thought (I thought I'd get a less biased response from you guys).

And as for Kid Montana, stop pooping in my cereal!

Wait? You mean those AREN'T Cocoa Puffs?????? :sign:

 

[Smokyballs]

Not trying to be a prick (too late, I know) but...

General discussion about anything other than cigars. Please refrain from discussing politics and other "touchy" subjects, as they tend to cause flame wars.

IMHO,might want to drop this before it turns into something it shouldn't be.

 

[gahdzila]

The bottom line is, doctors are trained to be doctors. Nurse practitioners are trained to be nurse practitioners. Their roles in the medical field are different. If I wanted to be a doctor I would have gone to medical school, not nursing school. Replacing MDs with NPs is going to set a dangerous precedent for this country.

[font="arial][size="3"]Couldn't have said it better myself (I'm a critical care nurse, BTW).[/size][/font]
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[font="arial][size="3"]Physicians are physicians. Nurses are nurses...not "doctor's cute little assistants," not "mini-doctors," not "almost doctors." Nurses and physicians are trained differently, and have different roles in the healthcare system.[/size][/font]
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[font="arial][size="3"]An ideal situation (IMO) would be to be cared for by an NP working closely in conjunction with a physician. You'd get the best of both worlds - the more holistic care of an NP, and the more focused diagnosis-driven care of a physician. [/size][/font]
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[/size][/font]
[font="arial][size="3"]

Not trying to be a prick (too late, I know) but...

General discussion about anything other than cigars. Please refrain from discussing politics and other "touchy" subjects, as they tend to cause flame wars.

IMHO,might want to drop this before it turns into something it shouldn't be.

[/size][/font]
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[/size][/font]
[font="arial][size="3"]I am new around here, so I'm a bit hesitant to throw my two cents in...I do see your point, but there's pretty much *always* the potential for any discussion on an open forum to turn into a flame war. everybody seems to be being civil on this topic so far, don't you think?[/size][/font]